Parent_Caregiver S Parent_Caregiver Survey

National Longitudinal Survey of Youth 2027 Pre-Test

F.4_Parent_Caregiver Survey (English and Spanish)

National Longitudinal Survey of Youth 2027 Pre-Test

OMB:

Document [pdf]
Download: pdf | pdf
Contents
1. Information
2. Family Background
3. Parent Calendar
4. Parent Health
5. BRIEF2A Placeholder
6. Income
7. Child Calendar
8. Child Health
9. Child Expectations
10. Child Family Background
11. Parent/Caregiver Debrief
12. Parent/Caregiver Restart Interview
13. Parent/Caregiver Breakoﬀ
14. Parent/Caregiver Incentive

NLSY27 Specifications Formatting
Parent Information (PINF)
PRELOADS:
MODE: CAPI for administered via project laptop, CAWI for web administration
HHROSTER: A roster/array variable listing each household (HH) member who lives in the
household. 
o HH_UID: Unique ID for each member of the household
o HH_NAME: Name of the household member (Confirmed/updated in Parent Information)
o HH_AGE: Age of the household member (Confirmed/updated in Parent Information)
o HH_SEX: Sex (male/female) of the household member (Confirmed/updated in Parent
Information)
o HH_RACE: Race/ethnicity of the household member f
o HH_EMPLOY: Current employment status of household member aged 15+
o HH_EDUC: Highest education level of household member (non-eligible youth) aged 18+
o HH_MART: Marital status of household member
o HH_ELIGIBLEYOUTH: Flag if the household member is an eligible youth
o HH_PLG: Flag if the household member is a parent or legal guardian of an eligible youth
o HH_CG: Flag if the household member is a caregiver of an eligible youth
o HH_PLGID1: If ELIGIBLEYOUTH = 1, the ID number of their 1st parent or guardian
o HH_PLGNAME1: If ELIGIBLEYOUTH = 1, the name of their 1st parent or guardian
o HH_PLGID2: If ELIGIBLEYOUTH = 1, the ID number of their 2nd parent or guardian
o HH_PLGNAME2: If ELIGIBLEYOUTH = 1, the name of their 2nd parent or guardian
1. HH_CGID: If ELIGIBLEYOUTH = 1, the ID number of their caregiver
o HH_CGNAME: If ELIGIBLEYOUTH = 1, the name of their caregiver
o HH_YOUTHPLG_#: Indicator for relationship of adult household member to eligible youth
(_#), where 1= bio parent, 2= step-parent, 3= adoptive parent, 4= foster parent, 5=legal
guardian, 6=mother figure, 7=father figure, 8=other relative, 9=other non-relative
RESSELECT: Indicator variable for whether HHS respondent was the parent/caregiver selected
for an interview.
HHSINFORMANT_UID: HH_UID of HHS respondent
YOUTHROSTER: Roster of eligible youth in the household created in ES019_LOOP_END
YOUTH_UID_#: Household ID number of the eligible youth.
YOUTH_NAME_#: Name of the eligible youth.
YOUTH_AGE_#: Youth current age
YOUTH_DOB_#: Youth date of birth
YOUTH_DOBYEAR_#: Youth year of birth
YOUTHROSTERNUM: Total number of eligible youth in the household, created in ES019_LOOP_END,
updated in HHS
SPCUID: HHID of primary P/C selected for interview
SPCNAME: Name of parent/guardian selected for parent/caregiver interview
SPCSEX: Parent’s sex
SPCAGE: Parent’s age
SPCMART: Parent’s marital status
0.   Never-married

1.   Married
2.   Separated
3.   Divorced
4.   Widowed
SPCPART: Indicator for residential partner of selected parent/caregiver:
0. None
1. Married and living with spouse
2. Married, no spouse in household
3. Cohabiting with partner
SPCEDUC: Parent’s highest level of education
SPCPARTNER: Name of parent/caregiver’s partner
SPCSPOUSE: Name of parent/caregiver’s spouse
HHID of Selected P/C’s spouse
SPCSPOUSEID:
SPCPARTNERID: HHID of Selected P/C’s partner
SPCPHONE: Phone number of selected P/C from HHS
SPCEMAIL: Email address of selected P/C from HHS
ALTPCUID: HHID of alternate P/C selected for interview
ALTPCNAME: Name of alternate parent/guardian selected for parent/caregiver interview
ALTPCSEX: alternate parent’s sex
ALTPCAGE: alternate parent’s age
ALTPCMART: alternate parent’s marital status
0.   Never-married
1.   Married
2.   Separated
3.   Divorced
4.   Widowed
ALTPCPART: Indicator for residential partner of alternate parent/caregiver:
0. None
1. Married and living with spouse
2. Married, no spouse in household
3. Cohabiting with partner
ALTPCEDUC: Alternate parent’s highest level of education
ALTPCPARTNER: Name of alternate parent/caregiver’s partner
ALTPCSPOUSE: Name of alternate parent/caregiver’s spouse
ALTSPOUSEID: HHID of Selected P/C’s spouse
ALTPARTNERID: HHID of Selected P/C’s partner
ALTCPHONE: Phone number of alternate P/C from HHS
ALTCEMAIL: Email address of alternate P/C from HHS
YOUTH_MOTHER: If bio mom in household MOTHER=1, if adoptive mom in household MOTHER=2
YOUTH_FATHER: If bio or adopted dad in household FATHER=1, if adoptive father in household,
FATHER=2
YOUTH_BIOMOMUID: Part of YOUTHROSTER where BIODADID=HHID of person identified as female
and biological parent of youth
YOUTH_BIODADUID: Part of YOUTHROSTER where BIODADID=HHID of person identified as male and
biological parent of youth

HHSINFORMANT_UID: Roster ID of HHS informant
General Programming Instructions
All items are required.

Display DK “don’t know” and REF “prefer not to answer” items only after respondent attempts to
advance to the next screen without selecting/entering a response.

Capture item level timing.
Include a time/date stamp at beginning and end of module.
If the FI initiates this module, please start it in CAPI mode. The Disposition code will remain at 540
for the Parent/Caregiver instrument and sub-code 1001. Questions PINF_001 to PINF_010 are
designed to be completed by the FI in person using CAPI. Starting at question PINF_011 the
instrument switches to CASI for self-administration by the interviewer. In cases when the
respondent is not available or cannot complete the interview at that time and the parent needs to
complete the survey via the web, the interview will be triggered to switch to CAWI by Disposition
code 350 (and sub-code 1001 indicating that the P/C Web Survey invitation email has been
initiated). This code will automatically be triggered 1 day after the Disposition code for the CAPI
Youth Interview is noted as completed. This will not only help with initiating the web survey for the
parent or caregiver but also ensure that their interview is only started after a youth interview has
been completed.

PINF_001
ASK

All respondents

QUESTION TYPE

Radio button
CREATE FILL_CONDEC: IF MODE = CAPI, FILL_CONDEC:
1. CONTINUE
0. DECLINE
ELSE, IF MODE = CAWI, FILL_CONDEC:
1. Continue
0. Decline

FILLS (ENG)

FILLS (SPAN)

ENGLISH

CREATE FILL_CONDEC: IF MODE = CAPI, FILL_CONDEC:
1. CONTINUE
0. DECLINE
ELSE, IF MODE = CAWI, FILL_CONDEC:
1. Continuar
0. Negarse

The Bureau of Labor Statistics estimates that it will take between 60-90 minutes per respondent to
complete this survey. If you have any comments regarding this estimate or any other aspect of the
survey including suggestions for reducing the time needed to respond, you may send them to the
Bureau of Labor Statistics, National Longitudinal Surveys (OMB No. xxx, Exp. xxx) at
NLSY27info@bls.gov.
^{FILL_CONDEC}

SPANISH

La Oficina de Estadísticas Laborales calcula que cada participante tardará entre 60 y 90 minutos en
completar esta encuesta. Si tiene algún comentario sobre esta estimación o sobre cualquier otro
aspecto de la encuesta, incluidas sugerencias para reducir el tiempo necesario para responder, puede
enviarlo a la Oficina de Estadísticas Laborales, Encuestas Longitudinales Nacionales (n.º de OMB xxx,
exp. xxx) a NLSY27info@bls.gov.
^{FILL_CONDEC}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN

CONSENT

NEXT

If PINF_001 = 1: PINF_002
Else END

PINF_002
ASK

All respondents

QUESTION TYPE

Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
DO NOT DISPLAY SCREEN.
PROGRAM. NOTES

RECORD INTERVIEW DATE AS [DOI]
UPDATE YOUTH_CURRENTAGE: IF YOUTHDOB NOT MISSING, THEN CALCULATE
CURRENTAGE BY SUBTRACTING YOUTH_DOB FROM TODAY’S DATE/365.
Else set YOUTH_CURRENTAGE=YOUTH_AGE

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN
NEXT

PINF_001
PINF_003

PINF_003
ASK

All respondents

QUESTION TYPE

Radio button
Create ﬁll, FILL_SPCNAME: Fill with ‘SPCNAME’ from sample preload
CREATE FILL_PCSELECT: IF MODE = CAPI, FILL_PCSELECT:
INTERVIEWER: THE PARENT CHOSEN TO RESPOND TO THIS INTERVIEW IS
^{Fill_SPCNAME}.
IS THIS THE CORRECT PERSON?
1. YES
0. NO
ELSE, IF MODE = CAWI, FILL_PCSELECT:
For this interview, we want to ensure that we are talking to the right person. Are you
[FILL ‘SPCNAME’]?
1. Yes
0. No

FILLS (ENG)

Create ﬁll, FILL_SPCNAME: Fill with ‘SPCNAME’ from sample preload

FILLS (SPAN)

CREATE FILL_PCSELECT: IF MODE = CAPI, FILL_PCSELECT:
INTERVIEWER: THE PARENT CHOSEN TO RESPOND TO THIS INTERVIEW IS
^{Fill_SPCNAME}.
IS THIS THE CORRECT PERSON?
1. YES
0. NO
ELSE, IF MODE = CAWI, FILL_PCSELECT:
Para esta entrevista, queremos asegurarnos de hablar con la persona adecuada. ¿Es
usted [FILL ‘SPCNAME’]?
1. Sí
0. No

ENGLISH

^{FILL_PCSELECT}

SPANISH

^{FILL_PCSELECT}

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

If PINF_003=1, set:
RPC_UID=SPCUID.
PCNAME=SPCNAME
PCPHONE=SPCPHONE
PCEMAIL=SPCEMAIL
PCSEX=SPCSEX
PCAGE=SPCAGE
PCMART=SPCMART
PCPART=SPCPART
PCEDUC=SPCEDUC
PCSPOUSE=SPCSPOUSE

PCPARTNER=SPCPARTNER
PCSPOUSEID=SPCSPOUSEID
PCPARTNERID=SPCPARTNERID
Create variable YOUTH_RPCPLG and add to the youth roster for each youth.
Set YOUTH_RPCPLG= HH_YOUTHPLG_# for the household member with
HH_UID=RPC_UID in relation to that youth
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN

PINF_002

NEXT

If PINF_003 = 1 and If RPC_UID ≠ HHSINFORMANT_UID: PINF_006
Else if PINF_003=1 and RPC_UID = HHSINFORMANT_UID: PINF_010
Else, if CAWI and PINF_003 = 0, DK or REF: PINF_072
Else if ALTPCUID is missing: END
Else PINF_004

PINF_004
ASK

MODE = CAPI AND PINF_003 =0

QUESTION TYPE

Radio button

FILLS (ENG)

Create ﬁll, FILL_ALTPCNAME: ‘ALTPCNAME’

FILLS (SPAN)
Create ﬁll, FILL_ALTPCNAME: ‘ALTPCNAME’
INTERVIEWER: IS ^{FILL_ALTPCNAME} AVAILABLE TO COMPLETE THE SURVEY?
ENGLISH
1. YES
0. NO
INTERVIEWER: IS ^{FILL_ALTPCNAME} AVAILABLE TO COMPLETE THE SURVEY?
SPANISH
1. YES
0. NO
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI

NOTES
LEAD-IN

MODE = CAPI, PINF_003 = 0

NEXT

If PINF_004 = 1: PINF_005
Else PINF_071

PINF_005
ASK

IF PINF_004 = 1

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll, FILL_SPCNAME from PINF_003
Use ﬁll, FILL_ALTPCNAME from PINF_004

FILLS (SPAN)

Use ﬁll, FILL_SPCNAME from PINF_003
Use ﬁll, FILL_ALTPCNAME from PINF_004

ENGLISH

SPANISH

[INTERVIEWER INSTRUCTIONS: FROM THE LIST OF PARENT/CAREGIVER NAMES BELOW, CHOOSE THE
CORRECT PERSON SELECTED TO DO THE SURVEY.]
1. ^{Fill_SPCNAME}
2. ^{Fill_ALTPCNAME}
[INTERVIEWER INSTRUCTIONS: FROM THE LIST OF PARENT/CAREGIVER NAMES BELOW, CHOOSE THE
CORRECT PERSON SELECTED TO DO THE SURVEY.]
1. ^{Fill_SPCNAME}
2. ^{Fill_ALTPCNAME}

RANGE
LIMITS
LOOP MAX
If PINF_005=1, Set:

PROGRAM. NOTES

RPC_UID=SPC
PCNAME=SPCNAME
PCPHONE=SPCPHONE
PCEMAIL=SPCEMAIL
PCSEX=SPCSEX
PCAGE=SPCAGE
PCMART=SPCMART
PCPART=SPCPART
PCEDUC=SPCEDUC
PCSPOUSE=SPCSPOUSE
PCPARTNER=SPCPARTNER
PCSPOUSEID=SPCSPOUSEID
PCPARTNERID=SPCPARTNERID
Else if PINF_005=2, set:
RPC_UID=ALTPC
PCNAME=ALTPCNAME
PCPHONE=ALTPCPHONE
PCEMAIL=ALTPCEMAIL
PCSEX=ALTPCSEX
PCAGE=ALTPCAGE
PCMART=ALTPCMART
PCPART=ALTPCPART
PCEDUC=ALTPCEDUC

PCSPOUSE=ALTPCSPOUSE
PCPARTNER=ALTPCPARTNER
PCSPOUSEID=ALTPSPOUSEID
PCPARTNERID=ALTPCPARTNERID
Create variable YOUTH_RPCPLG and add to the youth roster for each youth.
Set YOUTH_RPCPLG= HH_YOUTHPLG_# for the household member with
HH_UID=RPC_UID in relation to that youth
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI

NOTES
LEAD-IN

If PINF_004 = 1

NEXT

If RPC_UID ≠ HHSINFORMANT_UID: PINF_006
If RPC_UID = HHSINFORMANT_UID: PINF_010

PINF_006
RPC_UID ≠ HHSINFORMANT_UID AND (PINF_003=1 or PINF_004=1)

ASK
QUESTION
TYPE

Radio button
Create ﬁll, FILL_ADDRESS1: Fill with ‘ADDRESS1’ from sample preload
Create ﬁll, FILL_ADDRESS2: Fill with ‘ADDRESS1’ from sample preload
Create ﬁll, FILL_CITY: Fill with ‘CITY’ from sample preload
Create ﬁll, FILL_ZIP: Fill with ‘ZIP’ from sample preload
Create FILL_CAPI: If MODE = CAPI, FILL_CAPI:

FILLS (ENG)

INTERVIEWER: SHOW ADDDRESS BELOW TO PARENT/CAREGIVER. ONLY MINOR CHANGES LIKE
CHANGING “APARTMENT” TO “UNIT” SHOULD BE MADE. IF THE PARTICIPANT INDICATES THAT THE
ADDRESS NUMBER, STREET, OR UNIT NUMBER IS INCORRECT, YOU SHOULD PAUSE THE
INTERVIEW AND CALL YOUR FS.
1.
0.

YES
NO

Else, if MODE = CAWI, FILL_CAPI:
1.
0.

Yes
No

Create ﬁll, FILL_ADDRESS1: Fill with ‘ADDRESS1’ from sample preload
Create ﬁll, FILL_ADDRESS2: Fill with ‘ADDRESS1’ from sample preload
Create ﬁll, FILL_CITY: Fill with ‘CITY’ from sample preload
Create ﬁll, FILL_ZIP: Fill with ‘ZIP’ from sample preload
Create FILL_CAPI: If MODE = CAPI, FILL_CAPI:

FILLS (SPAN)

INTERVIEWER: SHOW ADDDRESS BELOW TO PARENT/CAREGIVER. ONLY MINOR CHANGES LIKE
CHANGING “APARTMENT” TO “UNIT” SHOULD BE MADE. IF THE PARTICIPANT INDICATES THAT THE
ADDRESS NUMBER, STREET, OR UNIT NUMBER IS INCORRECT, YOU SHOULD PAUSE THE
INTERVIEW AND CALL YOUR FS.
1.
0.

YES
NO

Else, if MODE = CAWI, FILL_CAPI:
1.
0.

Sí
No

The address we have recorded for you is listed below.
ENGLISH

Is all of your address information correct?
^{FILL_CAPI}

Street: ^{FILL_ADDRESS1}
^{FILL_ADDRESS2}
City:

^{FILL_CITY}

Zip code: ^{FILL_ZIP}
La dirección que registramos figura a continuación.
¿Son correctos todos los datos de su dirección?
^{FILL_CAPI}
SPANISH

Calle:

^{FILL_ADDRESS1}
^{FILL_ADDRESS2}

Ciudad: ^{FILL_CITY}
Código postal: ^{FILL_ZIP}
RANGE
LIMITS
LOOP MAX
PROGRAM.
NOTES
CHECK (ENG)
CHECK (SPAN)
HELP
TEXT (ENG)
HELP
TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN

PINF_003 = 1, PINF_005

NEXT

If PINF_006 = 0: f_PINF_007
Else PINF_008

f_PINF_007
ADDRESS1/ADDRESS2/CITY/ZIP
PINF_006 = 0
ASK
QUESTION TYPE

FILLS (ENG)

ADDRESS1: Text and Numeric
ADDRESS2: Text and Numeric
City: Text
Zip: Numeric
FILL_ADDRESS1: Fill with ‘ADDRESS1’ from sample preload
FILL_ADDRESS2: Fill with ‘ADDRESS1’ from sample preload
FILL_CITY: Fill with ‘CITY’ from sample preload
FILL_ZIP: Fill with ‘ZIP’ from sample preload
Create FILL_INTINST: FILL_INTINST: If MODE = CAPI, FILL_INTINST:
INTERVIEWER: USE THE SPACES BELOW TO CORRECT ANY ADDRESS INFORMATION.
Else, if MODE = CAWI, FILL_INTINST:
Please use the spaces below to correct your address information.
FILL_ADDRESS1: Fill with ‘ADDRESS1’ from sample preload
FILL_ADDRESS2: Fill with ‘ADDRESS1’ from sample preload
FILL_CITY: Fill with ‘CITY’ from sample preload
FILL_ZIP: Fill with ‘ZIP’ from sample preload

FILLS (SPAN)

Create FILL_INTINST: FILL_INTINST: If MODE = CAPI, FILL_INTINST:
INTERVIEWER: USE THE SPACES BELOW TO CORRECT ANY ADDRESS INFORMATION.
Else, if MODE = CAWI, FILL_INTINST:
Use los espacios de abajo para corregir la información de su dirección.

^{FILL_INTINST}

ENGLISH

Street: ^{FILL_ADDRESS1} [ADDRESS1]
^{FILL_ADDRESS2} [ADDRESS2]
City:

^{FILL_CITY} [CITY]

Zip code: ^{FILL_ZIP} [ZIP]
^{FILL_INTINST}
Calle:
SPANISH

^{FILL_ADDRESS1} [ADDRESS1]
^{FILL_ADDRESS2} [ADDRESS2]

Ciudad: ^{FILL_CITY} [CITY]
Código postal: ^{FILL_ZIP} [ZIP]
RANGE

ZIP: 00001 TO 99999

LIMITS

ADDRESS1: Max 60 characters
ADDRESS2: Max 60 characters
CITY: Max 60 characters
ZIP: Max 5 digits

LOOP MAX
PROGRAM. NOTES

ALLOW RESPONDENT/INTERVIEWER TO EDIT EACH PIECE OF ADDRESS INFORMATION
LISTED ABOVE

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN
NEXT

If PINF_006 = 0
PINF_008

PINF_008
ASK

RPC_UID ≠ HHSINFORMANT_UID

QUESTION TYPE

Radio
Create ﬁll, FILL_PCPHONE: Fill with ‘PCPHONE’ from PINF_005
Create FILL_YESNO: If MODE = CAPI, FILL_YESNO:
1. YES
0. NO
Else, if MODE = CAWI, FILL_YESNO:
1. Yes
0. No

FILLS (ENG)

FILLS (SPAN)

Create ﬁll, FILL_PCPHONE: Fill with ‘PCPHONE’ from PINF_005
Create FILL_YESNO: If MODE = CAPI, FILL_YESNO:
1. YES
0. NO
Else, if MODE = CAWI, FILL_YESNO:
1. Sí
0. No
The telephone number we have recorded for you is ^{FILL_PCPHONE}

ENGLISH

Is your telephone number correct?
^{FILL_YESNO}
El número de teléfono que tenemos registrado es ^{FILL_PCPHONE}

SPANISH

¿Es correcto su número de teléfono?
^{FILL_YESNO}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Phone number should be displayed with hyphens after 3rd and 6th digit (XXX-XXX-XXXX)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN

PINF_006, PINF_007

NEXT

If PINF_008 = 0: PINF_009;
else PINF_009a

PINF_009
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_008 = 0

QUESTION TYPE

Numeric
Create FILL_CORPHONE: IF MODE = CAPI, FILL_CORPHONE:
INTERVIEWER: ENTER THE CORRECT TELEPHONE NUMBER BELOW.
ENTER TELEPHONE NUMBER
Else, if MODE = CAWI, FILL_CORPHONE:
Please use the space below to correct your telephone number.

FILLS (ENG)

FILLS (SPAN)

Telephone:
Create FILL_CORPHONE: IF MODE = CAPI, FILL_CORPHONE:
INTERVIEWER: ENTER THE CORRECT TELEPHONE NUMBER BELOW.
ENTER TELEPHONE NUMBER
Else, if MODE = CAWI, FILL_CORPHONE:
Use el espacio de abajo para corregir su número de teléfono.
Teléfono:

ENGLISH

^{FILL_CORPHONE} __________

SPANISH

^{FILL_CORPHONE} __________

RANGE

PINF_009: 0000000001 TO 9999999999

LIMITS

PINF_009: Max 10 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HARD CHECK: If less than 10 digits are entered, or if all of the same digit is entered (i.e.,
1111111111), display: ‘Please enter a valid telephone number, including area code’.
HARD CHECK: If less than 10 digits are entered, or if all of the same digit is entered (i.e.,
1111111111), display: ‘Ingrese un número de teléfono válido e incluya el código de área’.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN

If PINF_008 = 0

NEXT

Else if RPC_UID=HHSINFORMANT_UID: PINF_010
Else PINF_009a

PINF_009a
ASK

RPC_UID≠HHSINFORMANT_UID

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PINF_008: FILL_YESNO

FILLS (SPAN)
Use ﬁll from PINF_008: FILL_YESNO
May we text you at this number with important information about this study? You may opt out at any
time to stop receiving text messages. Carrier messaging and data fees may apply.
ENGLISH
^{FILL_YESNO}

SPANISH

¿Podemos enviarle mensajes de texto a este número con información importante sobre el estudio?
Puede optar dejar de recibir mensajes de texto en cualquier momento. Pueden aplicarse tarifas de
mensajería y datos del operador.
^{FILL_YESNO}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

I

CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI

NOTES
LEAD-IN
NEXT

PINF_008, PINF_009
PINF_010

PINF_010
ASK

AllPINF_003=1 or PINF_004=1

QUESTION TYPE

Informational
Create FILL_PINFINTRO: If MODE = CAPI: FILL_PINFINTRO: For the rest of the interview,
I’ll hand you the laptop so that you can enter your answers yourself. After I explain a
few of the features that you will be using you will answer the rest of the questions
yourself, in private.
Else, if MODE = CAWI, FILL_PINFINTRO: Now that we have conﬁrmed your information we
will go on to the rest of the interview. Please answer these questions in private.

FILLS (ENG)

Create FILL_RETURN: IF MODE = CAPI: FILL_RETURN: Then you can return the laptop to
me.
[INTERVIEWER: CLICK NEXT AND HAND LAPTOP TO RESPONDENT]
Else, if MODE = CAWI, FILL_RETURN: BLANK

FILLS (SPAN)

Create FILL_PINFINTRO: If MODE = CAPI: FILL_PINFINTRO: Para el resto de la entrevista,
le pasaré la computadora portátil para que usted que pueda ingresar las respuestas
por su cuenta. Después de que le explique algunas de las funciones que usará,
responderá el resto de las preguntas por su cuenta, en privado.
Else, if MODE = CAWI, FILL_PINFINTRO: Ahora que hemos conﬁrmado su información,
pasaremos al resto de la entrevista. Responda estas preguntas en privado.
Create FILL_RETURN: IF MODE = CAPI: FILL_RETURN: Cuando termine, puede devolverme
la computadora portátil.
[INTERVIEWER: CLICK NEXT AND HAND LAPTOP TO RESPONDENT]
Else, if MODE = CAWI, FILL_RETURN: BLANK

ENGLISH
SPANISH

^{FILL_PINFINTRO}
When you are done with the survey and click “Submit,” your responses will be locked so that no one
can see how you answered the questions. ^{FILL_RETURN}
^{FILL_PINFINTRO}
Cuando haya terminado la encuesta y haga clic en “Submit” (Enviar), sus respuestas quedarán
bloqueadas para que nadie pueda ver cómo respondió las preguntas. ^{FILL_RETURN}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD-IN

PINF_005, PINF_009, PINF_008, PINF_009a

NEXT

PINF_010a

PINF_010a
ASK

PINF_003=1 or PINF_004=1

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
To protect your privacy, if you need to pause the survey for any reason, you will need a PIN to restart
the survey where you left oﬀ. Please choose a four-digit number you will remember or write the
number down somewhere safe. This PIN is unique to you and will help keep your information
private. Please do not share it with others.
ENGLISH

Enter 4-digit PIN:

[PINF_010a_PIN]

Re-enter PIN:

[PINF_010a_CONFIRM]

Para proteger su privacidad, si necesita pausar la encuesta por cualquier motivo, necesitará un PIN
para retomar la encuesta en donde la dejó. Elija un número de cuatro dígitos que pueda recordar o
anótelo en un lugar seguro. Este PIN es único a usted y le ayudará a mantener la privacidad de su
información. No la comparta con nadie.
SPANISH

Ingrese su PIN de 4 dígitos:
Vuelva a ingresar su PIN:

[PINF_010a_PIN]
[PINF_010a_CONFIRM]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
If PINF_010a_PIN=0000, display hard check:
The PIN cannot be all zeros. Please select a diﬀerent PIN.

CHECK (ENG)

If PINF_010a_PIN less than 4 digits, display hard check:
Please create a pin with 4 digits.
If PINF_010a_PIN≠PINF_010a_CONFIRM, display hard check:
The PINs you entered don’t match. Please re-enter the same 4-digit number to create
your PIN.
If PINF_010a_PIN=0000, display hard check: El PIN no puede ser todos ceros. Seleccione
un PIN diferente.

CHECK (SPAN)

If PINF_010a_PIN less than 4 digits, display hard check: Cree un PIN de 4 dígitos.
If PINF_010a_PIN≠PINF_010a_CONFIRM, display hard check: Los PIN que ingresó no
coinciden. Vuelva a ingresar el mismo número de 4 dígitos para crear su PIN.

HELP TEXT (ENG)
HELP TEXT (SPAN)

MODE

CAPI, CAWI

NOTES
LEAD-IN
NEXT

PINF_010
PINF_011

PINF_011
ASK

PINF_003=1 or PINF_004=1

QUESTION TYPE

Informational

FILLS (ENG)

Create FILL_PINFINTRO2: If MODE = CAPI: FILL_PINFINTRO2: click the [Back] button.
If you have questions about how to use the laptop, please ask me now. Otherwise, click
the [Next] button to continue on your own.
Else, if MODE = CAWI, FILL_PINFINTRO2: click the [Back] button.

FILLS (SPAN)

Create FILL_PINFINTRO2: If MODE = CAPI: FILL_PINFINTRO2: haga clic el botón “Back”
(Atrás). Si tiene alguna duda sobre cómo usar la computadora portátil, pregúnteme
ahora. De lo contrario, haga clic el botón “Next” (Siguiente) para continuar por su
cuenta.
Else, if MODE = CAWI, FILL_PINFINTRO2: click the [Back] button.
Now we will go over a few instructions that will help you complete the survey.

ENGLISH

Most questions in this section allow you to click on your response. However, some questions
will require you to type in a number for your response. For these questions, please click on
the text box for your answer, and type in your response. When you are done, please click the
[Next] button to continue.
If you want to go back to a previous question, ^{FILL_PINFINTRO2}
Ahora, repasaremos algunas instrucciones que lo(a) ayudarán a completar la encuesta.

SPANISH

La mayoría de las preguntas de esta sección le permiten hacer clic en su respuesta. Sin
embargo, algunas preguntas requerirán que escriba un número para su respuesta. Para estas
preguntas, haga clic en el cuadro de texto para escribir su respuesta. Cuando termine, haga
clic en el botón “Next” (Siguiente) para continuar.
Si desea volver a una pregunta anterior, ^{FILL_PINFINTRO2}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_010a

NEXT

If RPC_UID ≠ HHSINFORMANT_UID: PINF_012;
Else: PINF_031_LOOP_BEGIN

PINF_012
ASK

RPC_UID ≠ HHSINFORMANT_UID

QUESTION TYPE

Radio
Create ﬁll, FILL_HHSInformant: Fill with 'HHSInformant' from sample preload
Use ﬁll created in PINF_003, FILL_PCNAME
Create ﬁll, FILL_PCSEX:
If PCSEX=1 then FILL_PCSEX: ‘male’
Else if PCSEX=2 then FILL_PCSEX: ‘female’
Else FILL_PCSEX: ‘unknown’
Create ﬁll,
If PCAGE not missing, FILL_PCAGE: ‘PCAGE’ from PINF_005
Else FILL_PCAGE: ‘unknown’
Create ﬁll, FILL_SPOUSENAME: Fill with ‘PCSPOUSE’ from PINF_005
Create ﬁll, FILL_PCPARTNER: Fill with ‘PCPARTNER’ from PINF_005

FILLS (ENG)

Create ﬁll, FILL_PCEDUC:
If PCEDUC=0, FILL_PCEDUC= ‘none’
Else if PCEDUC=1, FILL PCEDUC= ‘high school equivalency, such as GED (General
Education Development) or HiSET (High School Equivalency Test)’
Else if PCEDUC=2, FILL_PCEDUC= ‘a high school diploma (Regular 12-year program)’
Else if PCEDUC=3, FILL_PCEDUC= ‘Associate/Junior college (AA, AS)’
Else if PCEDUC=4, FILL_PCEDUC= ‘a bachelor's degree (BA, BS)’
Else if PCEDUC=5, FILL_PCEDUC= ‘a master's degree (MA, MBA, MS)’
Else if PCEDUC=6, FILL_PCEDUC= ‘a doctoral degree (PhD, EdD)’
Else if PCEDUC=7, FILL_PCEDUC= ‘a professional degree (MD, DDS, JD)’
Else FILL_PCEDUC= ‘unknown’
Create ﬁll, FILL_PCMARSTAT.
If PCMART=1, FILL_PCMARSTAT= ‘You are married’
Else if PCMART=2, FILL PCMARSTAT= ‘You are separated’
Else if PCMART=3, FILL_PCMARSTAT= ‘You are divorced’
Else if PCMART=4, FILL_PCMARSTAT= ‘You are widowed’
Else if PCMART=0, FILL_PCMARSTAT= ‘You are never married’
Else FILL_PCMARSTAT= ‘Your marital status was not reported’
Create ﬁll, FILL_PCPART: If PCSPOUSE not missing, FILL_PCPART: ' to
^{FILL_SPOUSENAME}.';
Else, if PCPART = 1 or 2, FILL_PCPART: ‘.’
Else, if PCPART = 3, FILL_PCPART: ‘and you are living with your partner,
^{FILL_PCPARTNER}.’
Else, FILL_PCPART: ‘.’

FILLS (SPAN)

Create ﬁll, FILL_HHSInformant: Fill with 'HHSInformant' from sample preload
Use ﬁll created in PINF_003, FILL_PCNAME

Create ﬁll, FILL_PCSEX:
If PCSEX=1 then FILL_PCSEX: ‘masculino’
Else if PCSEX=2 then FILL_PCSEX: ‘femenina’
Else FILL_PCSEX: ‘desconocido’
Create ﬁll,
If PCAGE not missing, FILL_PCAGE: ‘PCAGE’ from PINF_005
Else FILL_PCAGE: ‘desconocido’
Create ﬁll, FILL_SPOUSENAME: Fill with ‘PCSPOUSE’ from PINF_005
Create ﬁll, FILL_PCPARTNER: Fill with ‘PCPARTNER’ from PINF_005
Create ﬁll, FILL_PCEDUC:
If PCEDUC=0, FILL_PCEDUC= ‘ninguno’
Else if PCEDUC=1, FILL PCEDUC= ‘un título equivalente al de la escuela
secundaria/preparatoria, como el Desarrollo de Educación General (GED, por sus siglas
en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por sus siglas en
inglés)’
Else if PCEDUC=2, FILL_PCEDUC= ‘un diploma de escuela secundaria/preparatoria
(programa regular de 12 años)’
Else if PCEDUC=3, FILL_PCEDUC= ‘un título de dos años (Associate)/escuela semisuperior
(AA, AS, por sus siglas en inglés)’
Else if PCEDUC=4, FILL_PCEDUC= ‘un título de cuatro años (BA, BS, por sus siglas en
inglés)’
Else if PCEDUC=5, FILL_PCEDUC= ‘una maestría (MA, MS, por sus siglas en inglés)’
Else if PCEDUC=6, FILL_PCEDUC= ‘un doctorado (PhD, EdD, por sus siglas en inglés)’
Else if PCEDUC=7, FILL_PCEDUC= ‘un título profesional (MD, DDS, JD, por sus siglas en
inglés)’
Else FILL_PCEDUC= ‘unknown’
Create ﬁll, FILL_PCMARSTAT.
If PCMART=1, FILL_PCMARSTAT= ‘Está casado(a)’
Else if PCMART=2, FILL PCMARSTAT= ‘Está separado(a)’
Else if PCMART=3, FILL_PCMARSTAT= ‘Está divorciado(a)’
Else if PCMART=4, FILL_PCMARSTAT= ‘Es viudo(a)’
Else if PCMART=0, FILL_PCMARSTAT= ‘Nunca se casó’
Else FILL_PCMARSTAT= ‘No se informó su estado civil’
Create ﬁll, FILL_PCPART: If PCPART = 1 and PCSPOUSE not missing, FILL_PCPART: ' con
^{FILL_SPOUSENAME}.';
Else, if PCPART = 1 or 2, FILL_PCPART: ‘.’
Else, if PCPART = 3, FILL_PCPART: ‘y vive con su pareja, ^{FILL_PCPARTNER}.’
Else, FILL_PCPART: ‘.’
Here is the information that ^{Fill_HHSInformant} provided about you. Your name is
^{Fill_PCNAME}, your sex is ^{Fill_PCSEX}, you are ^{Fill_PCAGE}.
^{FILL_PCMARSTAT}^{}Fill_PCPART} The highest educational degree you have completed is
^{Fill_PCEDUC}.
ENGLISH

Is all of this information correct?
1. Yes
0. No

Esta es la información que ^{Fill_HHSInformant} nos dio sobre usted. Su nombre es
^{Fill_PCNAME}, su sexo es ^{Fill_PCSEX}, usted es ^{Fill_PCAGE}.
^{FILL_PCMARSTAT}^{Fill_PCPART}. El título educativo más alto que completó es
^{Fill_PCEDUC}.
SPANISH

¿Es correcta toda esta información?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_011

NEXT

If PINF_012=1: PINF_031_LOOP_BEGIN
Else f_PINF_013

f_PINF_013
PINF_013_1/PINF_013_2/PINF_013_3/PINF_013_4/PINF_013_5/PINF_013_6/PINF_013_7
ASK
RPC_UID ≠ HHSINFORMANT_UID AND PINF_012 = 0
QUESTION TYPE

Checkbox

FILLS (ENG)
FILLS (SPAN)
Which information is not correct? Select all information that is not correct from list below.
Name [PINF_013_1]
Sex [PINF_013_2]
Age [PINF_013_3]
ENGLISH
Marital Status [PINF_013_4]
Information on partner or spouse [PINF_013_5]
Highest educational degree received [PINF_013_6]
None, all information is correct [PINF_013_7]
¿Qué parte no está bien? Seleccione de la siguiente lista toda la información que no sea correcta.
Nombre [PINF_013_1]
Sexo [PINF_013_2]
Edad [PINF_013_3]
SPANISH
Estado civil [PINF_013_4]
Información sobre pareja/cónyuge [PINF_013_5]
Título educativo más alto recibido [PINF_013_6]
Nada, toda la información es correcta [PINF_013_7]
RANGE
LIMITS
LOOP MAX
Display PINF_013_7 if left blank.
PROGRAM. NOTES

Allow multiple responses for 1 through 6. If 7 selected, do not allow another response 16 and vice versa (i.e., 7 is exclusive).
Code variable as 1 if item is checked, 0 if not checked.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_012 = 0

NEXT

If PINF_013_1=1: f_PINF_014
Else if PINF_013_2=1: PINF_015
Else if PINF_013_3=1: PINF_016
Else if PINF_013_4=1: PINF_017
Else if PINF_013_5=1: PINF_021
Else if PINF_013_6=1: PINF_029

Else: : PINF_031_LOOP_BEGIN

f_PINF_014
PINF_014_FN/PINF_014_LN
ASK
If RPC_UID ≠ HHSINFORMANT_UID AND PINF_013_1=1
PINF_014_FN: Text
QUESTION TYPE
PINF_014_LN: Text
FILLS (ENG)
FILLS (SPAN)
What is your name?
ENGLISH

First name: __________ [PINF_014_FN]
Last name: __________ [PINF_014_LN]
¿Cuál es su nombre?

SPANISH

Nombre: __________ [PINF_014_FN]
Apellido: __________ [PINF_014_LN]

RANGE
LIMITS

PINF_014_FN: Max 30 characters
PINF_014_LN: Max 30 characters

LOOP MAX
PROGRAM. NOTES

SET PCNAME = PINF_014_FN AND PINF_014_LN

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_013

NEXT

If PINF_013_2=1: PINF_015
Else if PINF_013_3=1: PINF_016
Else if PINF_013_4=1: PINF_017
Else if PINF_013_5=1: PINF_021
Else if PINF_013_6=1: PINF_029
Else PINF_031_LOOP_BEGIN

PINF_015
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_013_2=1

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
What is your sex?
ENGLISH

1. Male
2. Female
¿Cuál es su sexo?

SPANISH

1. Masculino
2. Femenina

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

If PINF_015 ≠ DK or REF, SET PCSEX = PINF_015

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_013, PINF_014

NEXT

If PINF_013_3=1: PINF_016
Else if PINF_013_4=1: PINF_017
Else if PINF_013_5=1: PINF_021
Else if PINF_013_6=1: PINF_029
Else PINF_031_LOOP_BEGIN

PINF_016
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_013_3=1

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
ENGLISH

What is your correct age? __________

SPANISH

¿Cuál es su edad correcta? __________

RANGE

PINF_016: 001 to 120

LIMITS

PINF_016: Max 3 digits

LOOP MAX
PROGRAM. NOTES

If PINF_016 ≠ DK or REF, SET PCAGE = PINF_016

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

If PINF_016 out of range, display hard check:
‘Please enter an age between 1 and 120.’
If PINF_016 out of range, display hard check:
‘Ingrese una edad entre 1 y 120.’
CASI, CAWI

NOTES
LEAD-IN

f_PINF_013, f_PINF_014. PINF_015

NEXT

If PINF_013_4=1: PINF_017
Else if PINF_013_5=1: PINF_021
Else if PINF_013_6=1: PINF_029
Else PINF_031_LOOP_BEGIN

PINF_017
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_013_4=1

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
What is your marital status? Are you ...
1. Married
2. Separated
ENGLISH

3. Divorced
4. Widowed
0. Never married
¿Cuál es su estado civil? ¿Está usted...?
1. Casado(a)
2. Separado(a)

SPANISH

3. Divorciado(a)
4. Viudo(a)
0. Nunca se casó

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

If PINF_017≠ DK or REF, SET PCMART=PINF_017

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_013, PINF_014. PINF_015, PINF_016

NEXT

If PINF_017=1: PINF_018
Else if PINF_017=2: PINF_024
Else if PINF_017=0 or 3 or 4: PINF_021
Else if PINF_013_5=1: PINF_021
Else if PINF_013_6=1: PINF_029
Else PINF_031_LOOP_BEGIN

PINF_018
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_017 = 1

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Is your spouse living in the household?
ENGLISH

1. Yes
0. No
¿Vive su cónyuge en el hogar?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

If PINF_017 = 1

NEXT

If PINF_018 = 1: PINF_019
Else PINF_021

PINF_019
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_018 = 1

QUESTION TYPE

Radio with special response option

FILLS (ENG)
FILLS (SPAN)

Create ﬁll, FILL_ADULTLIST: Radio button list of HHNAME(s) from ADULTROSTER minus
HHNAME of the respondent
Create ﬁll, FILL_ADULTLIST: Radio button list of HHNAME(s) from ADULTROSTER minus
HHNAME of the respondent
What is your spouse's name? Select from the list below.
^{FILL_ADULTLIST}

ENGLISH
-9. My spouse is not listed on the roster.
¿Cómo se llama su cónyuge? Seleccione de la siguiente lista.
^{FILL_ADULTLIST}
SPANISH
-9. Mi cónyuge no figura en la lista.
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

SHOW NUMBERED LIST OF NAMES PROVIDED BY INFORMANT IN HOUSEHOLD ROSTER.
IF -9 NOT SELECTED, UPDATE PCSPOUSE WITH HHNAME SELECTED IN PINF_019

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_018 = 1

NEXT

If PINF_019 = -9: f_PINF_020
Else PINF_025

f_PINF_020
PINF_020_FN/PINF_020_LN
RPC_UID ≠ HHSINFORMANT_UID AND PINF_019 = -9
ASK
QUESTION TYPE

PINF_020_FN: Text
PINF_020_LN: Text

FILLS (ENG)
FILLS (SPAN)
Please enter your spouse's name.
ENGLISH

First name: __________ [PINF_020_FN]
Last name: __________ [PINF_020_LN]
Ingrese el nombre de su cónyuge.

SPANISH

Nombre: __________ [PINF_020_FN]
Apellido: __________ [PINF_020_LN]

RANGE
LIMITS

PINF_020_FN: Max 30 characters
PINF_020_LN: Max 30 characters

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_019 = -9

NEXT

If PINF_013_6=1: PINF_029;
Else: PINF_031_LOOP_BEGIN

PINF_021
ASK

PINF_013_5=1 or (PINF_017 = 0 or 3 or 4) or (PINF_017=1 and PINF_018≠1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Do you have a spouse or partner living in the household?
1. Yes, spouse
ENGLISH

2. Yes, partner
0. No
¿Tiene cónyuge o pareja que viva en el hogar?
1. Sí, cónyuge

SPANISH

2. Sí, pareja
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_017 = 0 or 2, PINF_018≠1

NEXT

If PINF_021 = 1 or 2: PINF_022
Else PINF_024

PINF_022
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_021 = 1 OR 2

QUESTION TYPE

Radio with special radio response option

FILLS (ENG)

Use ﬁll from PINF_019: FILL_ADULTLIST

FILLS (SPAN)

Use ﬁll from PINF_019: FILL_ADULTLIST
What is your spouse or partner's name? Select from the list below.

ENGLISH

^{FILL_ADULTLIST}
-9. My spouse or partner is not listed on the roster
¿Cómo se llama su cónyuge o pareja? Seleccione de la siguiente lista.

SPANISH

^{FILL_ADULTLIST}
-9. Mi cónyuge o pareja no figura en la lista

RANGE
LIMITS
LOOP MAX
SHOW NUMBERED LIST OF NAMES PROVIDED BY INFORMANT IN HOUSEHOLD ROSTER.
DO NOT DISPLAY RPC_UID (RESPONDING PARTICIPANT) ON THE LIST.
PROGRAM. NOTES

CREATE VAR PARSPARID (UNIQUE ID) FOR NEW PARTNER. SET PARSPARID=HHID FOR
SELECTED ROSTER MEMBER IN PINF_022.
IF PINF_021=1, UPDATE PCSPOUSE=PINF_022 and PCSPOUSEID=HHID(PINF_022).
IF PINF_021=2, UPDATE PCPARTNER=PINF_022 and PCPARTNERID=HHID(PINF_022).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_021 = 1 or 2

NEXT

If PINF_022=-9: f_PINF_023
Else if PINF_017 = 0 OR 2: PINF_024
Else PINF_025

f_PINF_023
PINF_023_FN/PINF_023_LN
ASK
IF RPC_UID ≠ HHSINFORMANT_UID AND PINF_022 = -9
PINF_023_FN: Text
QUESTION TYPE
PINF_023_LN: Text
FILLS (ENG)
FILLS (SPAN)
Please enter your spouse or partner's name.
ENGLISH

First name: __________ [PINF_023_FN]
Last name: __________ [PINF_023_LN]
Ingrese el nombre de su cónyuge/pareja.

SPANISH

Nombre: __________ [PINF_023_FN]
Apellido: __________ [PINF_023_LN]

RANGE
LIMITS

PINF_023_FN: Max 30 characters
PINF_023_LN: Max 30 characters

LOOP MAX
PROGRAM. NOTES

CREATE VAR PARSPARID (UNIQUE ID) FOR NEW PARTNER.
IF PINF_021=1, UPDATE PCSPOUSE=f_PINF_023.
IF PINF_021=2, UPDATE PCPARTNER=f_PINF_023

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_022 = -9

NEXT

If PINF_013_6=1: PINF_029;
Else: PINF_031_LOOP_BEGIN

PINF_024
ASK

PINF_017 = 0 OR 2 or PINF_021 =0 or DK or REF

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Are you currently in a cohabiting relationship?

ENGLISH

By cohabitating relationships, we mean romantic or sexual relationships in which partners
establish one household and live together for a period of at least three months.
1. Yes
0. No
¿Tiene en este momento una relación de convivencia?

SPANISH

Por “relaciones de convivencia” nos referimos a las relaciones románticas o sexuales en las
que los miembros de la pareja establecen un hogar y viven juntos durante un período de al
menos tres meses.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_017, PINF_021
PINF_025

PINF_025
ASK

RPC_UID ≠ HHSINFORMANT_UID

QUESTION TYPE

Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
This is a computer check. Do not display this screen.
PROGRAM. NOTES

CREATE OLDPARSPARID=PCPARTNERID: Household ID of parent/caregiver spouse or
partner from the household screener.
NEW SPOUSE/PARTNER IDENTIFIED FOR THE RESPONDING PARENT:
1. PARSPARID ≠ OLDPARSPARID
0. PARSPARID = OLDPARSPARID

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_019, PINF_020, PINF_022, PINF_023, PINF_024

NEXT

If PINF_025=1: PINF_026
Else if PINF_013_6 = 1: PINF_029
Else: PINF_031_LOOP_BEGIN

PINF_026
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_025 = 1

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Do you need to correct the name of your spouse/partner?
ENGLISH

1. Yes
0. No
¿Necesita corregir el nombre de su cónyuge/pareja?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_025 = 1

NEXT

If PINF_026 = 1: PINF_027
Else if PINF_013_6 = 1: PINF_029
Else: PINF_031_LOOP_BEGIN

PINF_027
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_026 = 1

QUESTION TYPE

Radio with button special radio response option

FILLS (ENG)

Use ﬁll from PINF_019: FILL_ADULTLIST

FILLS (SPAN)

Use ﬁll from PINF_019: FILL_ADULTLIST
What is your spouse or partner's name? Select from the list below.

ENGLISH

^{FILL_ADULTLIST}
-9. My spouse or partner is not listed on the roster
¿Cómo se llama su cónyuge o pareja? Seleccione de la siguiente lista.

SPANISH

^{FILL_ADULTLIST}
-9. Mi cónyuge o pareja no figura en la lista

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

SHOW NUMBERED LIST OF NAMES PROVIDED BY INFORMANT IN HOUSEHOLD ROSTER.
If PINF_021=1, UPDATE PCSPOUSE=PINF_027.
If PINF_021=2, UPDATE PCPARTNER=PINF_027

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_026

NEXT

If PINF_027=-9: f_PINF_028
Else If PINF_013_6=1: PINF_029
Else: PINF_031_LOOP_BEGIN

f_PINF_028
PINF_028_FN/PINF_028_LN
ASK
RPC_UID ≠ HHSINFORMANT_UID AND PINF_027 = -9
QUESTION TYPE

Text

FILLS (ENG)
FILLS (SPAN)
Please enter your spouse's name.
ENGLISH

First name: __________ [PINF_028_FN]
Last name: __________ [PINF_028_LN]
Ingrese el nombre de su cónyuge.

SPANISH

Nombre: __________[PINF_028_FN]
Apellido: __________ [PINF_028_LN]

RANGE
LIMITS

PINF_028_FN: Max 30 characters
PINF_028_LN: Max 30 characters

LOOP MAX
PROGRAM. NOTES

UPDATE PCSPOUSE = f_PINF_028

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_027 = -9
If PINF_013_6=1: PINF_029; else PINF_031_LOOP_BEGIN

PINF_029
ASK

RPC_UID ≠ HHSINFORMANT_UID AND PINF_013_6 = 1

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
What is the highest educational degree that you have received?
0.  None
1.  High school equivalency such as GED (General Education Development) or HiSET (High
School Equivalency Test)
2.  High school diploma (Regular 12-year program)
ENGLISH

3. Associate/Junior college (AA, AS)
4.  Bachelor's degree (BA, BS)
5. Master's degree (MA, MBA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
¿Cuál es el título educativo más alto que ha recibido?
0.  Ninguno
1.  Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de
Educación General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela
Secundaria (HiSET, por sus siglas en inglés)
2.  Diploma de escuela secundaria/preparatoria (programa regular de 12 años)

SPANISH

3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4.  Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MBA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

If PINF_029≠DK or REF, SET PCEDUC = PINF_029

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI, CAWI

LEAD-IN
NEXT

PINF_013, PINF_014, PINF_015, PINF_016, PINF_017, PINF_025, PINF_026, PINF_027,
PINF_028
PINF_031_LOOP_BEGIN

PINF_031_LOOP_BEGIN
ASK

PINF_003=1 or PINF_004=1 (Begin PINF LOOP 1)

QUESTION TYPE

Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
This is a computer check. Do not display this screen.
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_011, f_PINF_013, f_PINF_014, PINF_015, PINF_016, PINF_017, PINF_025, PINF_026,
PINF_029
If RPC_UID ≠ HHSINFORMANT_UID: f_PINF_032
Else PINF_041

f_PINF_032_#
PINF_032_#/PINF_032_OTHER_#
ASK
RPC_UID ≠ HHSINFORMANT_UID (continue PINF LOOP 1)
PINF_032_#: Radio
QUESTION TYPE
PINF_032_OTHER_#: Text
FILLS (ENG)
Create ﬁll, FILL_YOUTHNAME_#: Fill with YOUTHNAME_# from sample preload
FILLS (SPAN)

Create ﬁll, FILL_YOUTHNAME_#: Fill with YOUTHNAME_# from sample preload
What is your relationship to ^{YOUTHNAME_#}?
1. Biological parent
2. Step-parent
3. Adoptive parent
4. Relative guardian

ENGLISH

5. Foster parent
6. Non-relative guardian
7. Parental figure relative
8. Parental figure non-relative
99. Other
Please tell us your relationship to ^{YOUTHNAME_#}: _______________________________
[PINF_032_OTHER_#]
¿Cuál es su relación con ^{YOUTHNAME_#}?
1. Padre/madre biológico(a)
2. Padrastro/madrastra
3. Padre/madre adoptivo(a)
4. Tutor(a) familiar

SPANISH

5. Padre/madre de cuidado temporal
6. Tutor(a) no familiar
7. Figura parental familiar
8. Figura parental no familiar
99. Otro
Díganos su relación con ^{YOUTHNAME_#}: _______________________________
[PINF_032_OTHER_#]

RANGE
LIMITS

PINF_032_OTHER_#: Max 60 characters

LOOP MAX

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
Update HH_YOUTHPLG and YOUTH_RPCPLG with the response to PINF_032
If PINF_032_# = 99, display PINF_032_OTHER textbox with label: Please tell us your
relationship to ^{YOUTHNAME_#}:

PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_031_LOOP_BEGIN
PINF_033_#

PINF_033_#
ASK

RPC_UID ≠ HHSINFORMANT_UID (continue PINF LOOP 1)

QUESTION TYPE

Informational

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)
ENGLISH

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
We now need to verify some information about ^{Fill_YOUTHNAME_#}. Please tell us if the
following information is correct ...

SPANISH

Ahora necesitamos verificar información sobre ^{Fill_YOUTHNAME_#}. Díganos si la siguiente
información es correcta...

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
Create variable PINFLOOP1[#].YOUTH_UID=YOUTH_UID_#

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_031_LOOP_BEGIN, PINF_032_#
PINF_034_#

PINF_034_#
ASK
QUESTION TYPE

FILLS (ENG)

FILLS (SPAN)

ENGLISH

RPC_UID ≠ HHSINFORMANT_UID (continue PINF LOOP 1)
Radio
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create ﬁll, FILL_YOUTHDOB_#: Fill with long form of 'YOUTHDOB_#’ (e.g. January 1,
2012) from sample preload
Use ﬁll, created in PINF_002: Fill_CURRENTAGE_#
Create ﬁll, FILL_YOUTHSEX_#: If YOUTHSEX_#=1, FILL_YOUTHSEX_#: ‘male’;
Else, if YOUTHSEX_#=2, FILL_YOUTHSEX_#: ‘female’;
Else, FILL_YOUTHSEX_#: ‘unknown’
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create ﬁll, FILL_YOUTHDOB_#: Fill with long form of 'YOUTHDOB_#’ (e.g. January 1,
2012) from sample preload
Use ﬁll, created in PINF_002: Fill_CURRENTAGE_#
Create ﬁll, FILL_YOUTHSEX_#: If YOUTHSEX_#=1, FILL_YOUTHSEX_#: ‘masculino’;
Else, if YOUTHSEX_#=2, FILL_YOUTHSEX_#: ‘femenina’;
Else, FILL_YOUTHSEX_#: ‘desconocido’
^{Fill_YOUTHNAME_#} was born on ^{Fill_YOUTHDOB_#}. That makes ^{Fill_YOUTHNAME_#}
^{Fill_CURRENTAGE_#} today. Their sex is ^{Fill_YOUTHSEX_#}. Is this all correct?
1. Yes
0. No

SPANISH

^{Fill_YOUTHHNAME_#} nació el ^{Fill_YOUTHDOB_# }. Con esta información,
^{Fill_YOUTHNAME_#} tiene ^{Fill_CURRENTAGE_#} hoy. El sexo es ^{Fill_YOUTHSEX_#}. ¿Es
todo esto correcto?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_033_#

NEXT

If PINF_034_#=0: f_PINF_035_#
Else PINF_043_#

f_PINF_035_#
PINF_035_1_#/PINF_035_2_#/PINF_035_3_#
PINF_034_# = 0 (continue PINF LOOP 1)
ASK
QUESTION TYPE

Checkbox

FILLS (ENG)
FILLS (SPAN)
Which information is not correct? Choose all information not correct from the list below and
click “Next” to continue.
ENGLISH

1. Spelling of name (name correct) [PINF_035_1_#]
2. Sex [PINF_035_2_#]
3. Date of birth [PINF_035_3_#]
¿Qué parte no está bien? Elija toda la información que no sea correcta de la lista que aparece
a continuación y haga clic en “Next” (Siguiente) para continuar.

SPANISH

1. Ortografía del nombre (nombre correcto) [PINF_035_1_#]
2. Sexo [PINF_035_2_#]
3. Fecha de nacimiento [PINF_035_3_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
Allow multiple responses. Code variable as 1 if checked, 0 if not.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

NEXT

PINF_034_# =0
If PINF_035_1_# = 1: PINF_036_#
Else if PINF_035_2_# = 1: PINF_037_#
Else if PINF_035_3_# = 1: f_PINF_038_#
Else PINF_043_#

PINF_036_#
ASK

PINF_035_1_#=1 (continue PINF LOOP 1)

QUESTION TYPE

Text

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

ENGLISH

What is the correct spelling of ^{YOUTHNAME_#}'s name? Please enter the correct spelling of
“^{YOUTHNAME_#}” and then click “Next” to continue.
First name: ____________________

SPANISH

¿Cuál es la ortografía correcta del nombre de ^{YOUTHNAME_#}? Ingrese la ortografía
correcta de “^{YOUTHNAME_#}” y haga clic en “Next” (Siguiente) para continuar.
Nombre: ____________________

RANGE
LIMITS

PINF_036_#: Max 30 characters

LOOP MAX

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
If PINF_036_#≠DK or REF, Update YOUTHNAME_#

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_035_#
If PINF_035_2_# = 1: PINF_037_#
Else if PINF_035_3_# = 1: f_PINF_038_#
Else: PINF_043_#

PINF_037_#
ASK

PINF_035_2_# = 1 (continue PINF LOOP 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
What is ^{FILL_YOUTHNAME_#}’s sex?

ENGLISH

1. Male
2. Female
¿Cuál es el sexo de ^{FILL_YOUTHNAME_#}?

SPANISH

1. Masculino
2. Femenina

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
Update YOUTHSEX_#

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

f_PINF_035_#, PINF_036_#

NEXT

If PINF_035_3_# = 1: f_PINF_038_#
Else: PINF_043_#

f_PINF_038_#
PINF_038_MONTH_#/PINF_038_DAY_#/PINF_038_YEAR_#
ASK
RPC_UID ≠ HHSINFORMANT_UID AND PINF_035_3_# = (continue PINF LOOP 1)
PINF_038_MONTH_#: Dropdown
QUESTION TYPE
PINF_038_DAY_#: Numeric
PINF_038_YEAR_#: Dropdown
FILLS (ENG)
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
FILLS (SPAN)

ENGLISH

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
What is ^{YOUTHNAME_#}'s correct date of birth?
Month: {-Select-} [PINF_038_MONTH_#]
Day _________ [PINF_038_DAY_#]
Year {-Select-} [PINF_038_YEAR_#]
¿Cuál es la fecha de nacimiento correcta de ^{YOUTHNAME_#}?

SPANISH

RANGE (ENG)

RANGE (SPAN)

Mes: {-Seleccione-} [PINF_038_MONTH_#]
Día _________ [PINF_038_DAY_#]
Año {-Seleccione-} [PINF_038_YEAR_#]
PINF_038_MONTH_#: List months in order: 1 = “January”, 2 = “February”, … 12 =
“December”
(Span)
1 = “January
2 = “February”
3 = “March”
4 = “April”
5 = “May”
6 = “June”
7 = “July”
8 = “August”
9 = “September”
10 = “October”
11 = “November”
12 = “December”
PINF_038_DAY_#: 1-31
PINF_038_YEAR_#: List years 2008-2017 in reverse chronological order
PINF_038_MONTH_#: List months in order: 1 = “Enero”, 2 = “Febrero”, … 12 =
“Diciembre”
(Span)
1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”

LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

11 = “Noviembre”
12 = “Diciembre”
PINF_038_DAY_#: 1-31
PINF_038_YEAR_#: List years 2008-2017 in reverse chronological order
PINF_038_DAY_#: Max 2 digits
15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF f_PINF_038_# NOT MISSING, THEN CALCULATE AGE ON DATE OF INTERVIEW BY
SUBTRACTING YOUTHDOB_# FROM TODAY’S DATE, AND UPDATE CURRENTAGE_#. IF
f_PINF_038_# NOT MISSING, Update YOUTHDOB_# to f_PINF_038_#
If any ﬁeld= DK or REF, DISPLAY SOFT CHECK:
Your answers are very important. Please consider entering a response.
If any ﬁeld= DK or REF, DISPLAY SOFT CHECK:
Sus respuestas son muy importantes. Ingrese una respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

f_PINF_035_#, PINF_036_#, PINF_037_#

NEXT

If PINF_038_MONTH_#≠-DK or REF and PINF_038_YEAR_#≠DK or REF: PINF_040_#
Else : PINF_043_#

PINF_040_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)

ENGLISH

RPC_UID ≠ HHSINFORMANT_UID AND PINF_038_MONTH_#≠-DK or REF and
PINF_038_YEAR_#≠DK or REF) (continue PINF LOOP 1)
Radio
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Use ﬁll, created in PINF_002: Fill_CURRENTAGE_#
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Use ﬁll, created in PINF_002: Fill_CURRENTAGE_#
This would make ^{Fill_YOUTHNAME_#} ^{Fill_CURRENTAGE_#}. Is that correct?
1. Yes
0. No
Con esta información, ^{Fill_YOUTHNAME_#} tendría ^{Fill_CURRENTAGE_#}. ¿Es eso
correcto?

SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF RESPONDENT ANSWERS "NO" (PINF_040_#=0), DISPLAY HARD CHECK WITH LINK TO
RETURN TO f_PINF_038_# ‘Click here to Update Date of Birth’
(link is included in ‘Update Date of Birth’)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_038
PINF_043_#

PINF_041_#
ASK

RPC_UID = HHSINFORMANT_UID (continue PINF LOOP 1)

QUESTION TYPE

Radio
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create ﬁll, FILL_YOUTHPLG_#: If HH_YOUTHPLG_# =1, FILL_YOUTHPLG_#: ‘biological
parent’;
Else, if HH_YOUTHPLG_# =2, FILL_YOUTHPLG_#: ‘step-parent’’;
Else, if HH_YOUTHPLG_# =3, FILL_YOUTHPLG_#: ‘adoptive parent’;
Else, if HH_YOUTHPLG_# =4, FILL_YOUTHPLG_#: ‘foster parent’;
Else, if HH_YOUTHPLG_# =5, FILL_YOUTHPLG_#: ‘legal guardian’;
Else if HH_YOUTHPLG_#=6, FILL_YOUTHPLG_#: ‘mother ﬁgure’
Else if HH_YOUTHPLG_#=7, FILL_YOUTHPLG_#: ‘father ﬁgure’
Else if HH_YOUTHPLG_#=8, FILL_YOUTHPLG_#: ‘relative guardian’
Else if HH_YOUTHPLG_#=9, FILL_YOUTHPLG_#: ‘non-relative guardian’
Else, FILL_YOUTHPLG_#: ‘unknown’
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create ﬁll, FILL_YOUTHPLG_#: If HH_YOUTHPLG_# =1, FILL_YOUTHPLG_#: ‘padre/madre
biológico(a)’;
Else, if HH_YOUTHPLG_# =2, FILL_YOUTHPLG_#: ‘padrastro/madrastra’’;
Else, if HH_YOUTHPLG_# =3, FILL_YOUTHPLG_#: ‘padre/madre adoptivo(a)’;
Else, if HH_YOUTHPLG_# =4, FILL_YOUTHPLG_#: ‘padre/madre de cuidado temporal’;
Else, if HH_YOUTHPLG_# =5, FILL_YOUTHPLG_#: ‘tutor(a) legal’;
Else if HH_YOUTHPLG_#=6, FILL_YOUTHPLG_#: ‘ﬁgura materna’
Else if HH_YOUTHPLG_#=7, FILL_YOUTHPLG_#: ‘ﬁgura paterna’
Else if HH_YOUTHPLG_#=8, FILL_YOUTHPLG_#: ‘tutor(a) pariente’
Else if HH_YOUTHPLG_#=9, FILL_YOUTHPLG_#: ‘tutor(a) no pariente’
Else, FILL_YOUTHPLG_#: ‘se desconoce’

FILLS (ENG)

FILLS (SPAN)

ENGLISH

My information says that your relationship to ^{Fill_YOUTHNAME_#} is ^{Fill_YOUTHPLG_#}.
Is this correct?
1. Yes
0. No

SPANISH

Mi información dice que su relación con ^{Fill_YOUTHNAME_#} es la de ^{Fill_YOUTHPLG_#}.
¿Es esto correcto?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_034_#, PINF_035_#, PINF_036_#, PINF_037_#, PINF_040_#

NEXT

If PINF_041_# = 1: PINF_043_#;
Else PINF_042_#

f_PINF_042_#
PINF_042_#/PINF_042_OTHER_#
ASK
PINF_041≠1 (continue PINF LOOP 1)
PINF_042_#: Radio
QUESTION TYPE
PINF_042_OTHER_#: Text
FILLS (ENG)
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
What is your relationship to ^{Fill_YOUTHNAME_#}? If more than one of these categories
apply, please choose the one that appears first in the list.
1. Biological parent
2. Step-parent
3. Adoptive parent
4. Relative guardian

ENGLISH

5. Foster parent
6. Non-relative guardian
7. Parental figure relative
8. Parental figure non-relative
9. Other
Please tell us your relationship to ^{YOUTHNAME_#}: _______________________________
[PINF_042_OTHER]
¿Cuál es su relación con ^{Fill_YOUTHNAME_#}? Si se aplica más de una de estas categorías,
elija la que aparezca en primer lugar en la lista.
1. Padre/madre biológico(a)
2. Padrastro/madrastra
3. Padre/madre adoptivo(a)
4. Tutor(a) familiar

SPANISH

5. Padre/madre de cuidado temporal
6. Tutor(a) no familiar
7. Figura parental familiar
8. Figura parental no familiar
9. Otros
Díganos su relación con ^{YOUTHNAME_#}: _______________________________
[PINF_042_OTHER]

RANGE
LIMITS

PINF_042_OTHER_#: Max 60 characters

LOOP MAX

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

PROGRAM. NOTES

IF PINF_042_# = 9, display PINF_042_OTHER_#: ‘Please tell us your relationship to
^{YOUTHNAME_#}.
(SPAN)
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF PINF_042_# = 9, display PINF_042_OTHER_#: ‘Díganos su relación con
^{YOUTHNAME_#}.
Update HH_YOUTHPLG and YOUTH_RPCPLG with the response to PINF_042
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

If PINF_041_#
PINF_043_#

PINF_043_#
ASK
QUESTION TYPE
FILLS (ENG)

FILLS (SPAN)

ENGLISH

All (Continue PINF LOOP 1)
Radio
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create ﬁll, FILL_YOUTHPLG2_#: If HH_YOUTHPLG_# =1, FILL_YOUTHPLG2_#: ‘Other than
you, does another’;
Else, FILL_YOUTHPLG2_#: ‘Does a’
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create ﬁll, FILL_YOUTHPLG2_#: If HH_YOUTHPLG_# =1, FILL_YOUTHPLG2_#: ‘Aparte de
usted, ¿otro(a)’;
Else, FILL_YOUTHPLG2_#: ‘¿Otro(a)’
^{Fill_YOUTHPLG2_#} biological parent of ^{Fill_YOUTHNAME_#} live at this address?
1. Yes
0. No

SPANISH

^{Fill_YOUTHPLG2_#} padre/madre biológico(a) de ^{Fill_YOUTHNAME_#} vive en esta
dirección?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF LOOP 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

NEXT

PINF_031_LOOP_BEGIN, PINF_034_#, PINF_035_#, PINF_036_#, PINF_037_#,
PINF_038_#, PINF_040_#, PINF_041_#, PINF_042_#
If PINF_043_# = 1 and other HH member with YOUTHPLG=1: PINF_044_#;
Else if PINF_043_# = 1 AND No other HH member with YOUTHPLG=1: PINF_045_#;
Else if LOOPNUMBER>1: PINF_046_#;
Else if MOTHER≠1: PINF_048_#;
else if FATHER ≠1: PINF_059_#;
else PINF_068_#

PINF_044_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)

ENGLISH

PINF_043_# = 1 and (YOUTH_MOTHER=1 or YOUTH_FATHER=1) (Continue PINF Loop 1)
Radio
Use ﬁll, created in PINF_032_#: FILL_YOUTHNAME_#
Create 'FILL_HHNAMEPLG_#': Fill HH_NAME_# from preload where HH_YOUTHPLG_#=1
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Create 'FILL_HHNAMEPLG_#': Fill HHNAME_# from preload where YOUTHPLG_#=1
I have ^{Fill_HHNAMEPLG_#}_#}, ^{Fill_YOUTHNAME_#}’s biological parent, as living in the
household. Is this correct?
1. Yes
0. No

SPANISH

Registré a ^{Fill_HHNAMEPLG_#} como padre/madre biológico(a) de ^{Fill_YOUTHNAME_#}
que vive en el mismo hogar. ¿Es esto correcto?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

If PINF_043_#=1
If PINF_044_# = 1 (yes): PINF_068_#; Else PINF_045_#

PINF_045_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)
ENGLISH

PINF_044_# = 0 OR ((PINF_043=1_# AND (BIOMOMID= missing or BIODADID=missing))
(Continue PINF Loop 1)
Radio
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME
Use ﬁll from PINF_019: FILL_ADULTLIST
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME
Use ﬁll from PINF_019: FILL_ADULTLIST
Who is ^{Fill_YOUTHNAME}'s biological parent who lives here?
^{FILL_ADULTLIST}
¿Cuál es el padre/madre biológico(a) de ^{Fill_YOUTHNAME} que vive aquí?

SPANISH

^{FILL_ADULTLIST}

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
SHOW LIST OF PARENTS, OTHER LEGAL GUARDIANS, OR CAREGIVERS COLLECTED IN
HOUSEHOLD SCREENER AND ALLOW R TO SELECT NUMBER CORRESPONDING TO
PERSON ON THE LIST. IF HHSEX=2 FOR SELECTED HOUSEHOLD MEMBER, SET
YOUTH_MOTHER=1; IF HHSEX=1 FOR SELECTED HOUSEHOLD MEMBER, SET
YOUTH_FATHER=1; IF HHSEX=2 FOR SELECTED HOUSEHOLD MEMBER, SET
YOUTH_BIOMOMUID=HH_UID. IF HHSEX=1 FOR SELECTED HOUSEHOLD MEMBER, SET
YOUTH_BIODADUID=HH_UID.
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_043_#, PINF_044_#

NEXT

IF YOUTH_MOTHER≠1: PINF_048_#; else if YOUTH_FATHER≠1: PINF_059_#; Else
PINF_068_#

PINF_046_#
ASK

LOOPNUMBER>1 AND YOUTH_MOTHER≠1 (Continue PINF Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

ENGLISH

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Does ^{Fill_YOUTHNAME_#} have the same biological mother as any of the other youth we
have talked about already?
1. Yes
0. No

SPANISH

¿Tiene ^{Fill_YOUTHNAME_#} la misma madre biológica que alguno(a) de las otros(as)
jóvenes de los(as) que ya hemos hablado?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_043_#
If PINF_046_#=1: PINF_047_#; Else PINF_048_#

PINF_047_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)

PINF_046_#=1 (Continue PINF Loop 1)
Checkbox
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
FILL Each YOUTHNAME from YOUTHROSTER
Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
FILL Each YOUTHNAME from YOUTHROSTER
With which youth does ^{Fill_YOUTHNAME_#} share a biological mother?
1. ^{Fill_YOUTHNAME_#}

ENGLISH

2. ^{Fill_YOUTHNAME_#}
3. ^{Fill_YOUTHNAME_#}
Etc.
0. None of the above
¿Con qué joven(es) comparte ^{Fill_YOUTHNAME_#} una madre biológica?
1. ^{Fill_YOUTHNAME_#}

SPANISH

2. ^{Fill_YOUTHNAME_#}
3. ^{Fill_YOUTHNAME_#}
Etc.
0. Ninguno(a) de las anteriores

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
DISPLAY YOUTHNAME OF ALL YOUTHS THAT HAVE ALREADY BEEN LOOPED. UPDATE
NONRESROSTER, ADD YOUTHID TO NEXT AVAILABLE NRYOUTH# VARIABLE
Allow multiple selection for all YOUTHNAME entries, excluding 0. If 0, do not allow other
entries to be checked, and vice versa.
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_046_#=1

NEXT

If PINF_047_#=0 or DK or REF: PINF_048_#
else if YOUTH_FATHER≠1: PINF_057_#
Else PINF_068_#

PINF_048_#
ASK

MOTHER≠1YOUTH_MOTHER≠1 and (PINF_046_# ≠1 or PINF_047_#=0 or DK or REF)

QUESTION TYPE

Text

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)
ENGLISH
SPANISH

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Can you tell me the first name of ^{Fill_YOUTHNAME_#}'s biological mother?
Enter first name: __________
¿Puede decirme el primer nombre de la madre biológica de ^{Fill_YOUTHNAME_#}
Ingrese el nombre: __________

RANGE
LIMITS

Max 30 characters

LOOP MAX

15
CREATE VAR BIOMOMNAME_# FOR YOUTH AND SET EQUAL TO ‘PINF_048_#’.

PROGRAM. NOTES

LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_043_#, PINF_045_#, PINF_046_#, PINF_047_#

NEXT

If PINF_048_# = DK or REF and If YOUTH_FATHER=1: PINF_068_#;
Else If PINF_048_# = DK or REF and YOUTH_FATHER≠1: PINF_059_#;
Else PINF_049_#

PINF_049_#
ASK

PINF_046_# ≠1 and PINF_048_# ≠ DK or REF (Continue PINF Loop 1)

QUESTION TYPE

Numeric with special response option

FILLS (ENG)

Create ﬁll, FILL_BIOMOMNAME_#: Fill with 'BIOMOMNAME_#’ created in PINF_048_#.

FILLS (SPAN)

Create ﬁll, FILL_BIOMOMNAME_#: Fill with 'BIOMOMNAME_#’ created in PINF_048_#.
How far does ^{Fill_BIOMOMNAME_#} live from here?

ENGLISH

Enter number of miles __________
-9. Youth's biological mother is deceased
¿A qué distancia vive ^{Fill_BIOMOMNAME_#} de aquí?

SPANISH

Ingrese el número de millas __________
-9. La madre biológica de los(as) jóvenes ha fallecido

RANGE

00000-99999

LIMITS

Max 5 digits

LOOP MAX

15
CREATE VAR BIOMOMDECEASED_#. IF PINF_049_#=-9 SET BIOMOMDECEASED_#=1, ELSE
SET BIOMOMDECEASED_#=0

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
If out of range, display hard check “Please enter a number of miles between 0 and
99,999.”
If out of range, display hard check “Introduzca un número de millas entre 0 y 99,000.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

If PINF_048_#
If PINF_049_# = -9: PINF_050_#; Else: PINF_052_#

PINF_050_#
ASK

PINF_049_#= -9 (Continue PINF Loop 1)

QUESTION TYPE

Dropdown

FILLS (ENG)

Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’

FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
In what year did she die?
Select year: { - Select - }
¿En qué año murió?
Seleccione el año: { - Seleccione - }
List years 2008 to 2030 in reverse chronological order: 2030, 2029, 2028, 2027, … 2008
(Do not display future years)
Max 4 digits
15
DO NOT DISPLAY YEARS THAT ARE IN THE FUTURE ON DOI.
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
HARD CHECK: IF ENTRY IS OUTSIDE OF RANGE OR IN FUTURE ON DOI, DISPLAY: ‘Please
enter a year between 2008 and ^{FILL_INTERVIEWYEAR}.}’
HARD CHECK: IF ENTRY IS OUTSIDE OF RANGE OR IN FUTURE ON DOI, DISPLAY: ‘Ingrese
un año entre 2008 y ^{FILL_INTERVIEWYEAR}.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_049_# = -9
PINF_051_#

PINF_051_#
ASK

PINF_049_# =-9 (Continue PINF Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

ENGLISH
SPANISH

What was ^{Fill_BIOMOMNAME_#}'s age when she died?
Enter age in years: __________
¿Qué edad tenía ^{Fill_BIOMOMNAME_#} cuando murió?
Ingrese la edad en años: __________

RANGE

12-120

LIMITS

Max 3 digits

LOOP MAX

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_050_#
PINF_054_#

PINF_052_#
ASK

PINF_046_# ≠1 and PINF_048_# ≠ DK or REF and PINF_049_# ≠-9 (Continue PINF Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

ENGLISH
SPANISH

How old was ^{Fill_[BIOMOMNAME_#} on her last birthday?
Enter age in years: __________
¿Qué edad tenía ^{Fill_[BIOMOMNAME_#} en su último cumpleaños?
Ingrese la edad en años: __________

RANGE

18-120

LIMITS

Max 3 digits

LOOP MAX

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_049_#
PINF_053_#

PINF_053_#

QUESTION TYPE

YOUTH_MOTHER ≠1 and PINF_046_# ≠1 and PINF_048_# ≠ DK or REF and PINF_049_# ≠9 (Continue PINF Loop 1)
Radio

FILLS (ENG)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

ASK

What is ^{BIOMOMNAME_#}'s marital status?
1. Married
ENGLISH

2. Separated
3. Divorced
4. Widowed
0. Never married
¿Cuál es el estado civil de ^{BIOMOMNAME_#}?
1. Casada

SPANISH

2. Separada
3. Divorciada
4. Viuda
0. Nunca se casó

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_052_#
PINF_054_#

PINF_054_#
ASK
QUESTION TYPE

FILLS (ENG)

FILLS (SPAN)

YOUTH_MOTHER ≠1 and (PINF_046_# ≠1 or PINF_047 = 0) and PINF_048_# ≠ DK or REF
(Continue PINF Loop 1)
Radio
Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#
Create ﬁll, FILL_BIOMOMDECEASED: If 'BIOMOMDECEASED_#’=1,
FILL_BIOMOMDECEASED: ‘was’;
Else, FILL_BIOMOMDECEASED: ‘is’.
Create ﬁll, FILL_BIOMOMDECEASED2: If 'BIOMOMDECEASED_#’=1,
FILL_BIOMOMDECEASED2: ‘had’;
Else, FILL_BIOMOMDECEASED2: ‘has’
Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#
Create ﬁll, FILL_BIOMOMDECEASED: If 'BIOMOMDECEASED_#’=1,
FILL_BIOMOMDECEASED: ‘fue’;
Else, FILL_BIOMOMDECEASED: ‘es’.
Create ﬁll, FILL_BIOMOMDECEASED2: If 'BIOMOMDECEASED_#’=1,
FILL_BIOMOMDECEASED2: ‘consiguió’;
Else, FILL_BIOMOMDECEASED2: ‘ha conseguido’
What ^{Fill_BIOMOMDECEASED} the highest educational degree that ^{Fill_BIOMOMNAME_#}
^{Fill_BIOMOMDECEASED2} received?
1. High school equivalency such as GED (General Education Development) or HiSET (High
School Equivalency Test)
2. High school diploma (Regular 12-year program)

ENGLISH

3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
0. None
¿Cuál ^{Fill_BIOMOMDECEASED} el título educativo más alto que ^{Fill_BIOMOMNAME_#}
^{Fill_BIOMOMDECEASED2}?
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de
Educación General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela
Secundaria (HiSET, por sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)

SPANISH

3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)
0. Ninguno

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_053_#, PINF_051_#
If PINF_049_#=-9: PINF_056_#; ELSE, PINF_055_#

PINF_055_#

QUESTION TYPE

YOUTH_MOTHER ≠1 and PINF_046_# ≠1 and PINF_048_# ≠ DK or REF and PINF_049≠-9
(Continue PINF Loop 1)
Radio

FILLS (ENG)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#

ASK

Is ^{Fill_BIOMOMNAME_#} currently working full-time, part-time, or not at all?
ENGLISH

1. Full-time
2. Part-time
0. Not at all
¿^{Fill_BIOMOMNAME_#} trabaja en este momento a tiempo completo, a tiempo parcial o no
trabaja en absoluto?

SPANISH

1. Tiempo completo
2. Tiempo parcial
0. No trabaja

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_054_#
PINF_056_#

PINF_056_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)

YOUTH_MOTHER ≠1 and PINF_046_# ≠1 and PINF_048_# ≠ DK or REF and (Continue
PINF Loop 1)
Checkbox
Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#
Use ﬁll, created in PINF_54_#: FILL_BIOMOMDECEASED
Use ﬁll, created in PINF_49_#: FILL_BIOMOMNAME_#
Use ﬁll, created in PINF_54_#: FILL_BIOMOMDECEASED
What ^{Fill_BIOMOMDECEASED} ^{Fill_BIOMOMNAME_#}’s race and/or ethnicity? Select all
that apply.
1. American Indian or Alaska Native?
2. Asian?

ENGLISH

3. Black or African American?
4. Hispanic or Latino?
5. Middle Eastern or North African?
6. Native Hawaiian or Pacific Islander?
7. White?
¿Cuál ^{Fill_BIOMOMDECEASED} la raza y/o el origen étnico de ^{Fill_BIOMOMNAME_#}?
Seleccione todas las opciones que correspondan.
1. Indígena de las Américas o nativa de Alaska
2. Asiática

SPANISH

3. Negra o afroamericana
4. Hispana o latina
5. De Medio Oriente o África del norte
6. Nativa de Hawái o de otras islas del Pacífico
7. Blanca

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
Allow multiple responses to be selected.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_054_#, PINF_055_#

NEXT

If LOOPNUMBER>1 and YOUTH_FATHER≠1: PINF_057_#; Else if YOUTH_FATHER≠1:
PINF_059_#; Else PINF_068_#

PINF_057_#
ASK

LOOPNUMBER>1 AND YOUTH_FATHER≠1 (Continue PINF Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

ENGLISH

Does ^{Fill_YOUTHNAME_#} have the same biological father as any of the other youth we
have talked about already?
1. Yes
0. No

SPANISH

¿Tiene ^{Fill_YOUTHNAME_#} el mismo padre biológico que alguno(a) de las otros(as) jóvenes
de los(as) que ya hemos hablado?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_47_#, PINF_056_#
If PINF_057_#=1: PINF_058_#; Else PINF_059_#

PINF_058_#
ASK

PINF_057_# =1 (Continue PINF Loop 1)

QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
With which youth does ^{Fill_YOUTHNAME_#} share a biological father?
1. ^[Fill_YOUTHNAME_#}

ENGLISH

2. ^[Fill_YOUTHNAME_#}
3. ^[Fill_YOUTHNAME_#}
Etc.
0. None of the above
¿Con qué joven(es) comparte ^{Fill_YOUTHNAME_#} un padre biológico?
1. ^[Fill_YOUTHNAME_#}

SPANISH

2. ^[Fill_YOUTHNAME_#}
3. ^[Fill_YOUTHNAME_#}
Etc.
0. Ninguno de las anteriores

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
DISPLAY YOUTHNAME_# OF ALL YOUTHS THAT HAVE ALREADY BEEN LOOPED
Allow multiple responses for all entries other than 0. If 0 is selected, do not allow any
other entries to be selected, and vice versa.
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_057_#=1
If PINF_058_#=0 or DK or REF: PINF_059_#; else PINF_068_#

PINF_059_#

QUESTION TYPE

YOUTH_FATHER≠1 and (PINF_057_# ≠1 or PINF_058_#=0 or DK or REF) (continue PINF
Loop 1)
Text

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

ASK

ENGLISH
SPANISH

Can you tell me the first name of ^{Fill_YOUTHNAME_#}'s biological father?
Enter first name: __________
¿Puede decirme el primer nombre del padre biológico de ^{Fill_YOUTHNAME_#}?
Ingrese el nombre: __________

RANGE
LIMITS

Max 30 characters

LOOP MAX

15
CREATE VAR BIODADNAME_# for youth, set equal to ‘PINF_059_#’

PROGRAM. NOTES

LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_043_#, PINF_045_#, PINF_048_#, PINF_056_#, PINF_057_#, PINF_058_#
If PINF_059_# = DK or REF: PINF_068_#; Else PINF_060_#

PINF_060_#
ASK

PINF_057_# ≠1 and PINF_059_# ≠ DK or REF (Continue PINF Loop 1)

QUESTION TYPE

Numeric Radio with special response option

FILLS (ENG)

Create ﬁll, FILL_BIODADNAME_#: Fill with ' BIODADNAME_#’ created in PINF_059_#.

FILLS (SPAN)

Create ﬁll, FILL_BIODADNAME_#: Fill with ' BIODADNAME_#’ created in PINF_059_#.
How far does ^{Fill_BIODADNAME_#} live from here?

ENGLISH

Enter number of miles __________
-9. Youth's biological father is deceased
¿A qué distancia vive ^{Fill_BIODADNAME_#} de aquí?

SPANISH

Ingrese el número de millas __________
-9. El padre biológico de los(as) jóvenes ha fallecido

RANGE

00000-99999

LIMITS

Max 5 digits

LOOP MAX

15
CREATE VAR BIODADDECEASED_#. IF PINF_060_#=-9 SET BIODADDECEASED_#=1; ELSE
SET BIODADDECEASED_#=0

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
If response out of range, display hard check: “Please enter a number of miles between 0
and 99,999.”
If out of range, display hard check “Introduzca un número de millas entre 0 y 99,000.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_059_#
If PINF_060_# = -9: PINF_061_#; Else PINF_063_#

PINF_061_#
ASK

PINF_060_# = -9 (Continue PINF Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’

FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
In what year did he die?
Select year: { - Select - }
¿En qué año murió?
Seleccione el año: { - Seleccione - }
List years 2008 to 20530 in reverse chronological order: 2030, 2029, 2028, 2027, 2026,
2025, 2024, 2023 … 2008 (Do not display future years)
Max 4 digits
15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
HARD CHECK: IF ENTRY IS OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY: ‘Please
enter a year between 2008 and ^{FILL_INTERVIEWYEAR}DD.’
HARD CHECK: IF ENTRY IS OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY: ‘Ingrese
un año entre 2008 y ^{FILL_INTERVIEWYEAR}.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_060_# = -9
PINF_062_#

PINF_062_#
ASK

PINF_060_#=-9 (Continue PINF Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

ENGLISH
SPANISH
RANGE

What was ^{Fill_BIODADNAME_#}'s age when he died?
Enter age in years: __________
¿Qué edad tenía ^{Fill_BIODADNAME_#}cuando murió?
Ingrese la edad en años: __________
12-120

LIMITS

Max 3 digits

LOOP MAX

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_061_#
PINF_065_#

PINF_063_#
ASK

PINF_057_# ≠1 and PINF_059_# ≠ DK or REF and PINF_060_#≠-9 (Continue PINF Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

ENGLISH
SPANISH

How old was ^{Fill_BIODADNAME_#} on his last birthday?
Enter age in years: __________
¿Qué edad tenía ^{Fill_BIODADNAME_#} en su último cumpleaños?
Ingrese la edad en años: __________

RANGE

18-120

LIMITS

Max 3 digits

LOOP MAX

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_060_#
PINF_064_#

PINF_064_#

QUESTION TYPE

PINF_057_# ≠1 and PINF_059_# ≠ DK or REF and PINF_060_# ≠ -9 (Continue PINF Loop
1)
Radio

FILLS (ENG)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

ASK

What is ^{Fill_BIODADNAME_#}'s marital status?
1. Married
ENGLISH

2. Separated
3. Divorced
4. Widowed
0. Never married
¿Cuál es el estado civil de ^{Fill_BIODADNAME_#}?
1. Casado

SPANISH

2. Separado
3. Divorciado
4. Viudo
0. Nunca se casó

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_063_#
PINF_065_#

PINF_065_#
ASK
QUESTION TYPE

FILLS (ENG)

FILLS (SPAN)

YOUTH_FATHER≠1 and PINF_057_# ≠1 and PINF_059_# ≠ DK or REF (Continue PINF Loop
1)
Radio
Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#
Create ﬁll, FILL_BIODADDECEASED: If 'BIODADDECEASED_#’=1, FILL_BIODADDECEASED:
‘was’;
Else, FILL_BIODADDECEASED: ‘is’
Create ﬁll, FILL_BIODADDECEASED2: If 'BIODADDECEASED_#’=1,
FILL_BIODADDECEASED2: ‘had’;
Else, FILL_BIODADDECEASED2: ‘has’
Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#
Create ﬁll, FILL_BIODADDECEASED: If 'BIODADDECEASED_#’=1, FILL_BIODADDECEASED:
‘fue’;
Else, FILL_BIODADDECEASED: ‘es’
Create ﬁll, FILL_BIODADDECEASED2: If 'BIODADDECEASED_#’=1,
FILL_BIODADDECEASED2: ‘consiguió’;
Else, FILL_BIODADDECEASED2: ‘consiguió’
What ^{Fill_BIODADDECEASED} the highest educational degree that ^{Fill_BIODADNAME_#}
^{Fill_BIODADDECEASED2} received?
1. High school equivalency such as GED (General Education Development) or HiSET (High
School Equivalency Test)
2. High school diploma (Regular 12-year program)

ENGLISH

3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
0. None
¿Cuál ^{Fill_BIODADDECEASED} el título educativo más alto que ^{Fill_BIODADNAME_#}
^{Fill_BIODADDECEASED2}?
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de
Educación General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela
Secundaria (HiSET, por sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)

SPANISH

3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)
0. Ninguno

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_062_#, PINF_064_#
If PINF_060_#=-9: PINF_067_#; PINF_066_#

PINF_066_#
ASK

PINF_057_# ≠1 and PINF_059_# ≠ DK or REF and PINF_060_# ≠ -9 (Continue PINF Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#
Is ^{Fill_BIODADNAME_#} currently working full-time, part-time, or not at all?

ENGLISH

1. Full-time
2. Part-time
0. Not at all

¿^{Fill_BIODADNAME_#} trabaja en este momento a tiempo completo, a tiempo parcial o no
trabaja en absoluto?

SPANISH

1. Tiempo completo
2. Tiempo parcial
0. No trabaja

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_065_#
PINF_067_#

PINF_067_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)

YOUTH_FATHER≠1 and PINF_057_# ≠1 and PINF_059_# ≠ DK or REF (Continue PINF Loop
1)
Radio
Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#
Use ﬁll, created in PINF_65_#: FILL_BIODADDECEASED
Use ﬁll, created in PINF_60_#: FILL_BIODADNAME_#
Use ﬁll, created in PINF_65_#: FILL_BIODADDECEASED
What ^{Fill_BIODADDECEASED} ^{Fill_BIODADNAME_#}’s race and/or ethnicity? Select all that
apply.
1. American Indian or Alaska Native
2. Asian

ENGLISH

3. Black or African American
4. Hispanic or Latino
5. Middle Eastern or North African
6. Native Hawaiian or Pacific Islander
7. White
¿Cuál ^{Fill_BIODADDECEASED} la raza y/o el origen étnico de ^{Fill_BIODADNAME_#}?
Seleccione todas las opciones que correspondan.
1. Indígena de las Américas o nativo de Alaska
2. Asiático

SPANISH

3. Negro o afroamericano
4. Hispano o latino
5. De Medio Oriente o África del norte
6. Nativo de Hawái o de otras islas del Pacífico
7. Blanco

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_066_#, PINF_065_#
PINF_068_#

PINF_068_#
ASK

All

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
This is a computer check, do not display screen.
IF YOUTH_MOTHER≠1 OR 2 AND YOUTH_FATHER≠1 OR 2 FOR YOUTH IN THE
HOUSEHOLD, SET PINF_068_# = 1. ELSE, SET PINF_068_# = 0.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_043_#, PINF_044_#, PINF_045_#, PINF_047_#, PINF_048_#, PINF_056_#,
PINF_058_#, PINF_059_#,
If PINF_068_# = 1: PINF_069_#; Else PINF_070_LOOP_END

PINF_069_#
ASK

PINF_068_#=1 (Continue PINF Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#

FILLS (SPAN)

Use ﬁll, created in PINF_32_#: FILL_YOUTHNAME_#
Is ^{Fill_YOUTHNAME_#} currently living without any parent or guardian figure?

ENGLISH

1. Yes
0. No

¿Vive ^{Fill_YOUTHNAME_#} en este momento sin ninguna figura paterna/materna o tutor(a)?
SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1 f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PINF_068_#
PINF_070_LOOP_END

PINF_070_LOOP_END
ASK

All (End PINF Loop 1)

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
LOOP THROUGH PINF Loop 1: f_PINF_032_# - PINF_069_# for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
CREATE NON-RESIDENT PARENT ROSTER NONRESROSTER WITH FOLLOWING VARIABLES:
NONRES_PARENT_UID (Unique ID for each non-residential parent)
NONRES_NAME (Equal to BIOMOMNAME OR BIODADNAME)
NONRES_SEX (IF BIOMOM NONRESSEX=2, IF BIODAD NONRESSEX=1)
NONRES_DECEASED=1 if BIODADDECEASED or BIOMOMDECEASED=1, else 0
NONRES_YOUTH1_UID= YOUTH_UID for eligible youth aﬃliated with this parent
NONRES_YOUTH1NAME= YOUTHNAME for ﬁrst youth associated with non-res parent
NONRES_YOUTH2_UID= YOUTH_UID for eligible youth aﬃliated with this parent
NONRES_YOUTH2NAME= YOUTHNAME for second youth associated with non-res parent
NONRES_YOUTH3_UID= YOUTH_UID for eligible youth aﬃliated with this parent
NONRES_YOUTH3NAME= YOUTHNAME for third youth associated with non-res parent
NONRES_YOUTH4_UID= YOUTH_UID for eligible youth aﬃliated with this parent
NONRES_YOUTH4NAME= YOUTHNAME for fourth youth associated with non-res parent
Etc.
CREATE VAR NONRESCOUNT AND SET EQUAL TO NUMBER OF NON-RESIDENTIAL
PARENTS ON NONRESROSTER

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN

PINF_068_#, PINF_069_#

NEXT

If LOOPNUMBER 1, FILL_CJFIRST: ‘ﬁrst’;
FILLS (ENG)
ELSE; FILL_CJFIRST: BLANK
Use ﬁll, FILL_INTERVIEWYEAR from PFAM_004: ‘DOI_YEAR’
CREATE FILL_CJFIRST: IF PFAM_022 > 1, FILL_CJFIRST: ‘primera vez’;
FILLS (SPAN)
ELSE; FILL_CJFIRST: BLANK
Use ﬁll, FILL_INTERVIEWYEAR from PFAM_004: ‘DOI_YEAR’
Thinking of the ^{FILL_CJFIRST} time that you served time in prison, jail, or some other correctional
facility, when did you enter the jail, prison, or correctional facility (month and year)?
ENGLISH

It may be helpful to refer to the calendar. Remember you can always access the calendar by clicking on
the button at the top left of the screen.
Month: {Select} [PFAM_CJ_FIRST_START_MO]
Year: ___________ [PFAM_CJ_FIRST_START_YR]
Pensando en la ^{FILL_CJFIRST} que cumplió una condena en la cárcel, prisión o algún otro centro
penitenciario, ¿cuándo ingresó en la cárcel, prisión o centro penitenciario (mes y año)?

SPANISH

Podría ser útil consultar el calendario. Recuerde que siempre puede acceder al calendario haciendo clic
en el botón ubicado en la parte superior izquierda de la pantalla.
Mes: {Seleccione} [PFAM_CJ_FIRST_START_MO]
Año: ___________ [PFAM_CJ_FIRST_START_YR]

RANGE
LIMITS

PFAM_CJ_FIRST_START_MO: Month entries in order: January, February, March, etc.
through December
PFAM_CJ_FIRST_START_YR: 1900 - 2030
PFAM_CJ_FIRST_START_YR: Max 4 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “Entered Prison or Jail”.
HARD CHECK: IF PFAM_CJ_FIRST_START_YR OUT OF RANGE, DISPLAY: Please enter a year
between 1900 and ^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.
SOFT CHECK: If PFAM_023_YR before PCDOBYEAR, DISPLAY: Time spent in a correctional
facility should be after you were born. Please update your answer, if necessary.
HARD CHECK: IF PFAM_CJ_FIRST_START_YR OUT OF RANGE, DISPLAY: Ingrese un año
entre el 1900 y ^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.
SOFT CHECK: If PFAM_023_YR before PCDOBYEAR, DISPLAY: El tiempo pasado en un
correccional debe ser posterior a su nacimiento. Actualice su respuesta, de ser necesario.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_022
f_PFAM_024

f_PFAM_024
PFAM_024 _MO/PFAM_024_YR
ASK
PFAM_022 >0
PFAM_CJ_024_MO: Dropdown
QUESTION TYPE
PFAM_CJ_024_YR: Numeric
CREATE FILL_CJFIRST: IF PFAM_022 > 1, FILL_CJFIRST: ‘ﬁrst’;
FILLS (ENG)
ELSE, FILL_CJFIRST: BLANK
Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
CREATE FILL_CJFIRST: IF PFAM_022 > 1, FILL_CJFIRST: ‘primera vez’
FILLS (SPAN)
ELSE, FILL_CJFIRST: BLANK
Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
This date has been automatically added to your calendar in the row for “Residence” marked by
“Entered Prison or Jail.”
ENGLISH

That ^{FILL_CJFIRST} time that you served time in prison, jail, or some other correctional facility, when
did you leave the jail, prison, or correctional facility?
Month: {Select} [PFAM_024_MO]
Year: ___________ [PFAM_024_YR]
Esta fecha se ha añadido automáticamente a su calendario en la fila de “Residence” (Residencia),
marcada como “Entered Prison or Jail” (Ingresó en una prisión o cárcel).

SPANISH

Respecto de esa ^{FILL_CJFIRST} que cumplió una condena en la cárcel, prisión o algún otro centro
correccional, ¿cuándo salió de la cárcel, la prisión o del centro correccional?
Mes: {Seleccione} [PFAM_024_MO]
Año: ___________ [PFAM_024_YR]

RANGE
LIMITS

PFAM_024_MO: Month entries in order: January, February, March, etc. through
December
PFAM_024_YR: 1900 - 2030
PFAM_024_YR: Max 4 digits

LOOP MAX
PROGRAM. NOTES

DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “Left Prison or Jail”. FOR
[DROPDOWN] MONTH PLEASE USE A STANDARD LIST OF MONTHS FOR PARTICIPANTS TO
SELECT WITH TEXT LABELS AND ASSIGNED TO THE NUMBER OF THE MONTH 1-12.
HARD CHECK: IF PFAM_024_YR OUT OF RANGE, DISPLAY: Please enter a year between
1900 and ^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.

CHECK (ENG)

HARD CHECK: If month/year combination reported in PFAM_024 is BEFORE month/year
combination reported in PFAM_023, display: The date that you left a correctional facility
should be after the date that you entered the correctional facility. Please update your
answer, as appropriate.
SOFT CHECK: If PFAM_024_YR before PCDOBYEAR, DISPLAY: Time spent in a correctional
facility should be after you were born. Please update your answer, if necessary.

HARD CHECK: IF PFAM_024_YR OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.
CHECK (SPAN)

HARD CHECK: If month/year combination reported in PFAM_024 is BEFORE month/year
combination reported in PFAM_023, display: La fecha de salida del centro penitenciario
debe ser posterior a la fecha de ingreso. Actualice su respuesta según corresponda.
SOFT CHECK: If PFAM_024_YR before PCDOBYEAR, DISPLAY: El tiempo pasado en un
correccional debe ser posterior a su nacimiento. Actualice su respuesta, de ser necesario.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_023
PFAM_025

PFAM_025
ASK

PFAM_022 = 1-99

QUESTION TYPE

Informational

FILLS (ENG)
FILLS (SPAN)
This date has been automatically added to your calendar in the row for “Residence” marked by “Left
ENGLISH Prison or Jail”
SPANISH

Esta fecha se ha añadido automáticamente a su calendario en la fila de “Residence” (Residencia),
marcada como “Left Prison or Jail” (Salió de la prisión o cárcel).

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_024
IF PFAM_022 > 1: f_PFAM_026;
ELSE: PFAM_028

f_PFAM_026
PFAM_026_MO/PFAM_026_YR
ASK
PFAM_022 > 1
PFAM_026_MO: Dropdown
QUESTION TYPE
PFAM_026_YR: Numeric
FILLS (ENG)
Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
FILLS (SPAN)
Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
Thinking of the most recent time that you served time in prison, jail, or some other correctional
facility, when did you enter the jail, prison, or correctional facility (month and year)?
ENGLISH

Month: {Select} [PFAM_026_MO]
Year: ___________ [PFAM_026_YR]
Pensando en la vez más reciente que cumplió una condena en la cárcel, prisión o algún otro centro
penitenciario, ¿cuándo ingresó en la cárcel, prisión o centro penitenciario (mes y año)?

SPANISH

Mes: {Seleccione} [PFAM_026_MO]
Año: ___________ [PFAM_026_YR]

RANGE
LIMITS

PFAM_026_MO: Month entries in order: January, February, March, etc. through
December
PFAM_026_YR: 1900 - 2030
PFAM_026_YR: Max 4 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “Entered Prison or Jail”.
HARD CHECK: IF PFAM_026_YR OUT OF RANGE, DISPLAY: Please enter a year between
1900 and ^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.
SOFT CHECK: If PFAM_026_YR before PCDOBYEAR, DISPLAY: Time spent in a correctional
facility should be after you were born. Please update your answer, if necessary.
HARD CHECK: IF PFAM_026_YR OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.
SOFT CHECK: If PFAM_026_YR before PCDOBYEAR, DISPLAY: El tiempo pasado en un
correccional debe ser posterior a su nacimiento. Actualice su respuesta, de ser necesario.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_022 > 1; PFAM_025
f_PFAM_027

f_PFAM_027
PFAM_027 _MO/PFAM_027_YR
ASK
PFAM_022 > 1
PFAM_027_MO: Dropdown
QUESTION TYPE
PFAM_027_YR: Numeric
FILLS (ENG)
Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
FILLS (SPAN)
Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
This date has been automatically added to your calendar in the row for “Residence” marked by
“Entered Prison or Jail”
ENGLISH

The most recent time that you served time in prison, jail, or some other correctional facility, when did
you leave the jail, prison, or correctional facility?
Month: {Select} [PFAM_027_MO]
Year: ___________ [PFAM_027_YR]
Esta fecha se ha añadido automáticamente a su calendario en la fila de “Residence” (Residencia),
marcada como “Entered Prison or Jail” (Ingresó en una prisión o cárcel).

SPANISH

Esa vez más reciente que cumplió una condena en la cárcel, prisión o algún otro centro correccional,
¿cuándo fue que salió de la cárcel, la prisión o del centro correccional?
Mes: {Seleccione} [PFAM_027_MO]
Año: ___________ [PFAM_027_YR]

RANGE
LIMITS

PFAM_027_MO: Month entries in order: January, February, March, etc. through
December
PFAM_027_YR: 1900 - 2030
PFAM_027_YR: Max 4 digits

LOOP MAX
PROGRAM. NOTES

DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “Left Prison or Jail”.
HARD CHECK: IF PFAM_027_YR OUT OF RANGE, DISPLAY: Please enter a year between
1900 and ^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.

CHECK (ENG)

HARD CHECK: If month/year combination reported in PFAM_027 is BEFORE month/year
combination reported in PFAM_026, display: The date that you left a correctional facility
should be after the date that you entered the correctional facility. Please update your
answer, as appropriate.
SOFT CHECK: If PFAM_027_YR before PCDOBYEAR, DISPLAY: Time spent in a correctional
facility should be after you were born. Please update your answer, if necessary.
HARD CHECK: IF PFAM_027_YR OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.

HARD CHECK: If month/year combination reported in PFAM_027 is BEFORE month/year
combination reported in PFAM_026, display: La fecha de salida del centro penitenciario
debe ser posterior a la fecha de ingreso. Actualice su respuesta según corresponda.
SOFT CHECK: If PFAM_027_YR before PCDOBYEAR, DISPLAY: El tiempo pasado en un
correccional debe ser posterior a su nacimiento. Actualice su respuesta, de ser necesario.
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_026
PFAM_028

PFAM_028
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Now we would like to ask about your family when you were growing up.
Did you live with both biological parents together from birth until age 14?
ENGLISH
1. Yes
0. No
Ahora, quisiera hacerle preguntas sobre su familia cuando crecía.
¿Vivió con ambos padres/madres biológicos(as) juntos desde su nacimiento hasta los 14 años?
SPANISH
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_021=0; PFAM_025, f_PFAM_027, PFAM_022=0
IF PFAM_028 = 0: PFAM_029;
ELSE: PFAM_033

PFAM_029
ASK

PFAM_028 = 0

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Which parent didn't you always live with?
ENGLISH

1. Biological Mother
2. Biological Father
3. Both
¿Con qué padre/madre no ha vivido siempre?

SPANISH

1. Madre biológica
2. Padre biológico
3. Ambos(as)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_028=0
f_PFAM_030

f_PFAM_030
PFAM_030/PFAM_030_OTHER
ASK
PFAM_028 = 0
PFAM_030: Radio button
QUESTION TYPE
PFAM_030_OTHER: Text
CREATE FILL_PARLIVE: IF PFAM_029 = 1, FILL_PARLIVE: ‘your mother’;
ELSE, IF PFAM_029 = 2, FILL_PARLIVE: ‘your father’;
FILLS (ENG)
ELSE, IF PFAM_029 = 3, FILL_PARLIVE: ‘both parents’;
ELSE, FILL_PARLIVE: ‘your parent or parents’
CREATE FILL_PARLIVE: IF PFAM_029 = 1, FILL_PARLIVE: ‘su madre’;
ELSE, IF PFAM_029 = 2, FILL_PARLIVE: ‘su padre’;
FILLS (SPAN)
ELSE, IF PFAM_029 = 3, FILL_PARLIVE: ‘ambos(as)’;
ELSE, FILL_PARLIVE: ‘su padre/madre o padres/madres’
What was the reason you did not live with ^{FILL_PARLIVE}?

ENGLISH

1.
2.
3.
4.
5.

One or both parents died
Parents became separated or divorced
I was adopted
I left home
Some other reason

Please tell us the other reason you did not live with ^{FILL_PARLIVE}.
_____________________________ [PFAM_030_OTHER]
¿Cuál fue la razón por la que no vivió con ^{FILL_PARLIVE}?

SPANISH

1.
2.
3.
4.
5.

Uno(a) o ambos(as) murieron
Los(as) padres/madres se separaron o divorciaron
Fui adoptado(a)
Me fui de casa
Alguna otra razón

Díganos la otra razón por la que no vivió con ^{FILL_PARLIVE}. _____________________________
[PFAM_030_OTHER]
RANGE
LIMITS

PFAM_030_OTHER: Max 120 characters

LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)

If PFAM_030 = 5, DISPLAY PFAM_030_OTHER: Please tell us the other reason you did not
live with ^{FILL_PARLIVE}.
SPAN: Díganos la otra razón por la que no vivió con ^{FILL_PARLIVE}.

MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_029
IF PFAM_029 = 1 OR 3: f_PFAM_031;
ELSE: f_PFAM_032

f_PFAM_031
PFAM_031 / PFAM_031_0 / PFAM_031_1 / PFAM_031_2 / PFAM_031_AND1 / PFAM_031_3 / PFAM_031_4 /
PFAM_031_AND2 / PFAM_031_5 / PFAM_031_6 / PFAM_031_AND3 / PFAM_031_7 / PFAM_031_8
ASK
PFAM_029 = 1 or 3
PFAM_031: Radio button
PFAM_031_0: Text
PFAM_031_1: Numeric
PFAM_031_2: Numeric
PFAM_031_AND1: Radio button
PFAM_031_3: Numeric
QUESTION TYPE
PFAM_031_4: Numeric
PFAM_031_AND2: Radio button
PFAM_031_5: Numeric
PFAM_031_6: Numeric
PFAM_031_AND3: Radio button
PFAM_031_7: Numeric
PFAM_031_8: Numeric
FILLS (ENG)
FILLS (SPAN)
Did you ever live with your biological mother from birth until age 14? [PFAM_031]
1. Yes
0. No

At what ages did you live with your biological mother? [PFAM_031_0]
From age:_____ [PFAM_031_1]
To age:_____ [PFAM_031_2]

ENGLISH

Did you live with your biological mother at another age? [PFAM_031_AND1]
1. Yes
0. No
From age:_____ [PFAM_031_3]
To age: _____ [PFAM_031_4]
Did you live with your biological mother at another age? [PFAM_031_AND2]
1. Yes
0. No
From age:_____ [PFAM_031_5]
To age:_____ [PFAM_031_6]

Did you live with your biological mother at another age? [PFAM_031_AND3]
1. Yes
0. No
From age:_____ [PFAM_031_7]
To age:_____ [PFAM_031_8]
Desde su nacimiento hasta los 14 años, ¿vivió alguna vez con su madre biológica? [PFAM_031]
1. Sí
0. No
¿A que edades vivió con su madre biológica? [PFAM_031_0]
Desde la edad: _____ [PFAM_031_1]
Hasta la edad:_____ [PFAM_031_2]
¿Vivió con su madre biológica a otra edad? [PFAM_031_AND1]
1. Sí
0. No
SPANISH

Desde la edad:_____ [PFAM_031_3]
Hasta la edad: _____ [PFAM_031_4]
¿Vivió con su madre biológica a otra edad? [PFAM_031_AND2]
1. Sí
0. No
Desde la edad:_____ [PFAM_031_5]
Hasta la edad: _____ [PFAM_031_6]
¿Vivió con su madre biológica a otra edad? [PFAM_031_AND3]
1. Sí
0. No

RANGE

LIMITS

Desde la edad:_____ [PFAM_031_7]
Hasta la edad: _____ [PFAM_031_8]
PFAM_031_1: 0-99
PFAM_031_2: 0-99
PFAM_031_3: 0-99
PFAM_031_4: 0-99
PFAM_031_5: 0-99
PFAM_031_6: 0-99
PFAM_031_7: 0-99
PFAM_031_8: 0-99
PFAM_031_1: Max 2 digits
PFAM_031_2: Max 2 digits

PFAM_031_3: Max 2 digits
PFAM_031_4: Max 2 digits
PFAM_031_5: Max 2 digits
PFAM_031_6: Max 2 digits
PFAM_031_7: Max 2 digits
PFAM_031_8: Max 2 digits
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)

SHOW PFAM_031
If PFAM_031 = 1: DISPLAY PFAM_031_0, PFAM_031_1, PFAM_031_2, AND
PFAM_031_AND1
If PFAM_031_AND1 IS CHECKED, DISPLAY PFAM_031_3 AND PFAM_031_4 AND
PFAM_031_AND2 ON THE SAME SCREEN.
IF PFAM_031_AND2 IS CHECKED, DISPLAY PFAM_031_5 AND PFAM_031_6 AND
PFAM_031_AND3.
IF PFAM_031_AND3 IS CHECKED, DISPLAY PFAM_031_7 AND _PFAM_031_8.
IF PFAM_031_1> PCAGE OR
PFAM_031_2 > PCAGE OR
PFAM_031_3 > PCAGE OR
PFAM_031_4 > PCAGE OR
PFAM_031_5 > PCAGE OR
PFAM_031_6 > PCAGE OR
PFAM_031_7 > PCAGE OR
PFAM_031_8 > PCAGE OR, DISPLAY HARD CHECK:
Please enter an age equal to or less than your current age.
IF PFAM_031_1> PFAM_031_2 OR
PFAM_031_3 > PFAM_031_4 OR
PFAM_031_5 > PFAM_031_6 OR
PFAM_031_7 > PFAM_031_8, DISPLAY HARD CHECK:
The age you stopped living with your biological mother should be after the age you
began living with your biological mother. Please update your answer.
If age ranges entered in each set (e.g., PFAM_031_1 through PFAM_031_2) overlap
with an age range entered in another set (e.g., PFAM_031_3 through PFAM_031_4),
display hard check: “The ages you entered overlap. Please review your answers.”

CHECK (SPAN)

If age entered in any ﬁeld is >14, display hard check: “This question asks about birth
until the age of 14. Please review your answers.”
IF PFAM_031_1> PCAGE OR
PFAM_031_2 > PCAGE OR
PFAM_031_3 > PCAGE OR
PFAM_031_4 > PCAGE OR
PFAM_031_5 > PCAGE OR
PFAM_031_6 > PCAGE OR
PFAM_031_7 > PCAGE OR
PFAM_031_8 > PCAGE OR, DISPLAY HARD CHECK:
Ingrese una edad igual o inferior a su edad actual.
IF PFAM_031_1> PFAM_031_2 OR
PFAM_031_3 > PFAM_031_4 OR
PFAM_031_5 > PFAM_031_6 OR

PFAM_031_7 > PFAM_031_8, DISPLAY HARD CHECK: La edad en la que dejó de vivir
con su madre biológica debe ser después de la edad en que empezó a vivir con su
madre biológica. Actualice su respuesta.
If age ranges entered in each set (e.g., PFAM_031_1 through PFAM_031_2) overlap
with an age range entered in another set (e.g., PFAM_031_3 through PFAM_031_4),
display hard check: “Las edades ingresadas se superponen. Revise sus respuestas.”
If age entered in any ﬁeld is >14, display hard check: “Esta pregunta se reﬁere al
nacimiento hasta los 14 años. Revise sus respuestas.”
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_030
IF PFAM_029 = 2 or 3: f_PFAM_032;
ELSE: PFAM_033

f_PFAM_032
PFAM_032 / PFAM_032_0 / PFAM_032_1 / PFAM_032_2 / PFAM_032_AND1 / PFAM_032_3 / PFAM_032_4 /
PFAM_032_AND2 / PFAM_032_5 / PFAM_032_6 / PFAM_032_AND3 / PFAM_032_7/PFAM_032_8
ASK
PFAM_029 = 2 or 3
PFAM_032: Radio button
PFAM_032_0: Text
PFAM_032_1: Numeric
PFAM_032_2: Numeric
PFAM_032_AND1: Radio button
PFAM_032_3: Numeric
QUESTION TYPE
PFAM_032_4: Numeric
PFAM_032_AND2: Radio button
PFAM_032_5: Numeric
PFAM_032_6: Numeric
PFAM_032_AND3: Radio button
PFAM_032_7: Numeric
PFAM_032_8: Numeric
FILLS (ENG)
FILLS (SPAN)
Did you ever live with your biological father from birth until age 14? [PFAM_032]
1. Yes
0. No
At what ages did you live with your biological father? [PFAM_032_0]
From age:_____ [PFAM_032_1]
To age:_____ [PFAM_032_2]

ENGLISH

Did you live with your biological father at another age? [PFAM_032_AND1]
1. Yes
0. No
From age:_____ [PFAM_032_3]
To age: _____ [PFAM_032_4]
Did you live with your biological father at another age.?. [PFAM_032_AND2]
1. Yes
0. No
From age:_____ [PFAM_032_5]
To age:_____ [PFAM_032_6]
Did you live with your biological father at another age? [PFAM_032_AND3]
From age:_____ [PFAM_032_7]
To age:_____ [PFAM_032_8]

Desde su nacimiento hasta los 14 años, ¿vivió alguna vez con su madre biológica? [PFAM_032]
1. Sí
0. No
¿A que edades vivió con su padre biológico? [PFAM_032_0]
Desde la edad: _____ [PFAM_032_1]
Hasta la edad:_____ [PFAM_032_2]
¿Vivió con su padre biológico a otra edad? [PFAM_032_AND1]
1. Sí
0. No
SPANISH

Desde la edad:_____ [PFAM_032_3]
Hasta la edad: _____ [PFAM_032_4]
¿Vivió con su padre biológico a otra edad? [PFAM_032_AND2]
1. Sí
0. No
Desde la edad:_____ [PFAM_032_5]
Hasta la edad: _____ [PFAM_032_6]
¿Vivió con su padre biológico a otra edad? [PFAM_032_AND3]
1. Sí
0. No

RANGE

LIMITS

Desde la edad:_____ [PFAM_032_7]
Hasta la edad: _____ [PFAM_032_8]
PFAM_032_1: 0-99
PFAM_032_2: 0-99
PFAM_032_3: 0-99
PFAM_032_4: 0-99
PFAM_032_5: 0-99
PFAM_032_6: 0-99
PFAM_032_7: 0-99
PFAM_032_8: 0-99
PFAM_032_1: Max 2 digits
PFAM_032_2: Max 2 digits
PFAM_032_3: Max 2 digits
PFAM_032_4: Max 2 digits
PFAM_032_5: Max 2 digits
PFAM_032_6: Max 2 digits
PFAM_032_7: Max 2 digits
PFAM_032_8: Max 2 digits

LOOP MAX
PROGRAM. NOTES

SHOW PFAM_032

If PFAM_032 = 1: DISPLAY PFAM_032_0, PFAM_032_1, PFAM_032_2 AND
PFAM_032_AND1
If PFAM_032_AND1 IS CHECKED, DISPLAY PFAM_032_3 AND PFAM_032_4 AND
PFAM_032_AND2 ON THE SAME SCREEN.
IF PFAM_032_AND2 IS CHECKED, DISPLAY PFAM_032_5 AND PFAM_032_6 AND
PFAM_032_AND3.
IF PFAM_032_AND3 IS CHECKED, DISPLAY PFAM_032_7 AND _PFAM_032_8.
IF PFAM_032_1> PCAGE OR
PFAM_032_2 > PCAGE OR
PFAM_032_3 > PCAGE OR
PFAM_032_4 > PCAGE OR
PFAM_032_5 > PCAGE OR
PFAM_032_6 > PCAGE OR
PFAM_032_7 > PCAGE OR
PFAM_032_8 > PCAGE OR, DISPLAY HARD CHECK:
Please enter an age equal to or less than your current age.
CHECK (ENG)

IF PFAM_032_1> PFAM_032_2 OR
PFAM_032_3 > PFAM_032_4 OR
PFAM_032_5 > PFAM_032_6 OR
PFAM_032_7 > PFAM_032_8, DISPLAY HARD CHECK:
The age you stopped living with your biological father should be after the age you began
living with your biological father. Please update your answer.
If age ranges entered in each set (e.g., PFAM_032_1 through PFAM_032_2) overlap with
an age range entered in another set (e.g., PFAM_032_3 through PFAM_032_4), display
hard check: “The ages you entered overlap. Please review your answers.”

CHECK (SPAN)

If age entered in any ﬁeld is >14, display hard check: “This question asks about birth until
the age of 14. Please review your answers.”
IF PFAM_032_1> PCAGE OR
PFAM_032_2 > PCAGE OR
PFAM_032_3 > PCAGE OR
PFAM_032_4 > PCAGE OR
PFAM_032_5 > PCAGE OR
PFAM_032_6 > PCAGE OR
PFAM_032_7 > PCAGE OR
PFAM_032_8 > PCAGE OR, DISPLAY HARD CHECK:
Ingrese una edad igual o inferior a su edad actual.
IF PFAM_032_1> PFAM_032_2 OR
PFAM_032_3 > PFAM_032_4 OR
PFAM_032_5 > PFAM_032_6 OR
PFAM_032_7 > PFAM_032_8, DISPLAY HARD CHECK:
La edad en la que dejó de vivir con su padre biológico debe ser después de la edad en
que empezó a vivir con su padre biológico. Actualice su respuesta.
If age ranges entered in each set (e.g., PFAM_032_1 through PFAM_032_2) overlap with
an age range entered in another set (e.g., PFAM_032_3 through PFAM_032_4), display
hard check: “Las edades ingresadas se superponen. Revise sus respuestas.”
If age entered in any ﬁeld is >14, display hard check: “Esta pregunta se reﬁere al
Nacimiento hasta los 14 años. Revise sus respuestas.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_030, f_PFAM_031
PFAM_033

PFAM_033
ASK

All respondents

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
How many brothers and sisters do you have in total? Please include full, half- and step-siblings even if
you never lived with them.
ENGLISH

Number of brothers and sisters: ___________

¿Cuántos(as) hermanos(as) tiene en total? Incluya a los(as) hermanos(as) de sangre, medios(as)
hermanos(as) o hermanastros(as) aunque nunca haya vivido con ellos(as).
SPANISH

Número de hermanos(as): ___________

RANGE

0-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_028, f_PFAM_031, f_PFAM_032
PFAM_034

PFAM_034
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Which of the following best describes the community in which you were living at age 14?

ENGLISH

1.
2.
3.
4.
5.
6.

Large or mid-sized city (At least 100,000 residents)
Suburb
Small city or town
Rural area
Indian reservation
Military base

¿Cuál de las siguientes opciones describe mejor la comunidad en la que vivía a los 14 años?

SPANISH

1.
2.
3.
4.
5.
6.

Ciudad grande o mediana (al menos 100,000 habitantes)
Suburbio
Pequeña ciudad o pueblo
Zona rural
Reserva indígena
Base militar

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_033
PFAM_035

PFAM_035
ASK

All respondents

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Next, there are a few questions about your parents. In what year was your mother born?
ENGLISH

Year: ________________
Las siguientes preguntas son sobre sus padres/madres. ¿En qué año nació su madre?

SPANISH

Año: ________________

RANGE

1880-2000

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_034
If PFAM_035=DK or REF: PFAM_036;
Else: PFAM_037

PFAM_036
ASK

If PFAM_035=-1, -2

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Do you know about what year she was born? An estimate would be helpful.
ENGLISH
Year: ________________
¿Sabe aproximadamente en qué año nació? Una estimación sería útil.
SPANISH
Año: ________________
RANGE
1880-2000
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_035
PFAM_037

PFAM_037
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
What is the highest educational degree that your mother received?

ENGLISH

0. None
1. High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2. High school diploma (Regular 12-year program)
3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MBA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
¿Cuál es el título educativo más alto que obtuvo su madre?

SPANISH

0. Ninguno
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MBA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_035, PFAM_036
PFAM_038

PFAM_038
ASK

All respondents

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Next are a few questions about your father.
ENGLISH

In what year was your father born?
Year: ________________
Las siguientes preguntas son sobre su padre.

SPANISH

¿En qué año nació su padre?
Año: ________________

RANGE

1880-2000

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_037
If PFAM_038=DK or REF: PFAM_039;
Else: PFAM_040

PFAM_039
ASK

If PFAM_038=DK or REF

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Do you know about what year he was born? An estimate would be helpful.
ENGLISH

Year: ________________
¿Sabe aproximadamente en qué año nació? Una estimación sería útil.

SPANISH

Año: ________________

RANGE

1880-2000

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_038
PFAM_040

PFAM_040
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
What is the highest educational degree that your father received?

ENGLISH

0. None
1. High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2. High school diploma (Regular 12-year program)
3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MBA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
¿Cuál es el título educativo más alto que obtuvo su padre?

SPANISH

0. Ninguno
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MBA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_038, PFAM_039
IF PCSPOUSEID=missing AND PCPARTNERID=missing: PFAM_072; Else: PFAM_041

PFAM_041
ASK

If PCSPOUSEID≠missing OR PCPARTNERID≠missing

QUESTION TYPE

Radio button
CREATE FILL: PCSPOUSENAME from preload information
CREATE FILL: PCPARTNERNAME from preload information
FILLS (ENG)
CREATE FILL_SPNAME: IF PCSPOUSENAME ≠ missing, FILL_SPNAME: ^{PCSPOUSENAME}
ELSE, IF PCPARTNERNAME ≠ MISSING, FILL_SPNAME: ^{PCPARTNERNAME}
ELSE, FILL_SPNAME: your PCSPOUSE or partner
CREATE FILL: PCSPOUSENAME from preload information
CREATE FILL: PCPARTNERNAME from preload information
FILLS (SPAN)
CREATE FILL_SPNAME: IF PCSPOUSENAME ≠ missing, FILL_SPNAME: ^{PCSPOUSENAME}
ELSE, IF PCPARTNERNAME ≠ MISSING, FILL_SPNAME: ^{PCPARTNERNAME}
ELSE, FILL_SPNAME: su cónyuge o pareja
The next few questions are about ^{FILL_SPNAME}'s background.

ENGLISH

Was ^{FILL_SPNAME} born in the United States or its territories?
1. Yes
0. No
Las siguientes preguntas son sobre los antecedentes de ^{FILL_SPNAME}.

SPANISH

¿Nació ^{FILL_SPNAME} en los Estados Unidos o en sus territorios?
1. Sí

0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_040
IF PFAM_041=1: PFAM_043;
Else if PFAM_041=0: f_PFAM_042
Else: PFAM_045

f_PFAM_042
PFAM_042a / PFAM_042OTHER
ASK
If PFAM_041 = 0
QUESTION TYPE
FILLS (ENG)

FILLS (SPAN)

ENGLISH

Dropdown / Textbox
CREATE FILL: PCSPOUSENAME from preload information
CREATE FILL_SPNAME: IF PCSPOUSE ≠ missing, FILL_SPNAME: ^{PCSPOUSE}
ELSE, IF PCPARTNER ≠ MISSING, FILL_SPNAME: ^{PCPARTNER}
ELSE, FILL_SPNAME: ‘your spouse or partner’
CREATE FILL: PCSPOUSENAME from preload information
CREATE FILL_SPNAME: IF PCSPOUSE ≠ missing, FILL_SPNAME: ^{PCSPOUSE}
ELSE, IF PCPARTNER ≠ MISSING, FILL_SPNAME: ^{PCPARTNER}
ELSE, FILL_SPNAME: su cónyuge o pareja
In which country was ^{FILL_SPNAME} born?
{ - Select - } [PFAM_042a]
Enter country in which ^{FILL_SPNAME} was born: ___________ [PFAM_042OTHER]
¿En qué país nació ^{FILL_SPNAME}?

SPANISH

{ - Seleccione - } [PFAM_042a]
Ingrese el país en el que nació ^{FILL_SPNAME}: ___________ [PFAM_042OTHER]

RANGE

COUNTRYLIST

LIMITS

PFAM_042OTHER = max 50 characters

LOOP MAX
PROGRAM. NOTES

ONLY DISPLAY PFAM_042OTHER if PFAM_042a = 197

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

If PFAM_041 = 0
If PFAM_042a=187: f_PFAM_043;
Else: PFAM_044

f_PFAM_043
PFAM_043a / PFAM_043OTHER
ASK
If PFAM_041 = 1 or PFAM_042a = 187
QUESTION TYPE

Dropdown / Textbox

FILLS (ENG)
FILLS (SPAN)
In what state or territory was ^{FILL_SPNAME} born?
ENGLISH

{ - Select - } [PFAM_043a]
Enter other location where ^{FILL_SPNAME} was born: ___________ [PFAM_043OTHER]
¿En qué estado o territorio nació ^{FILL_SPNAME} ?

SPANISH

{ - Seleccione - } [PFAM_043a]
Ingrese otra ubicación donde nació ^{FILL_SPNAME}: ___________ [PFAM_043OTHER]

RANGE

STATEEXPAND

LIMITS

PFAM_043OTHER = max 50 characters

LOOP MAX
PROGRAM. NOTES

ONLY DISPLAY PFAM_043OTHER IF PFAM_043A = 0

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

If PFAM_041 = 1, PFAM_042 = 187
If PFAM_043a=0, 52, 53, 54, 55, or 56: PFAM_044;
Else: PFAM_045

PFAM_044
ASK

If PFAM_041= 0 or PFAM_043 = 0, 52, 53, 54, 55, or 56

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR

FILLS (SPAN)
ENGLISH

Use ﬁll from f_PFAM_004: FILL_INTERVIEWYEAR
In what year did ^{FILL_SPNAME} first come to the United States to live?
Year: ________________
¿En qué año llegó ^{FILL_SPNAME} por primera vez a vivir a los Estados Unidos?

SPANISH

Año: ________________

RANGE

1900-2030

LIMITS

Max 4 digits

LOOP MAX
PROGRAM. NOTES
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a year between 1900 and
^{FILL_INTERVIEWYEAR}.
CHECK (ENG)

HARD CHECK: IF PFAM_044 IS IN THE FUTURE ON DOI, DISPLAY: You have entered a date
in the future. Please enter a date in the past.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

HARD CHECK: IF PFAM_044 IS IN THE FUTURE ON DOI, DISPLAY: Ingresó una fecha en el
futuro. Ingrese una fecha en el pasado.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

If PFAM_041= 0 or PFAM_043 = 0, 52, 53, 54, 55, or 56
PFAM_045

PFAM_045
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Does ^{FILL_SPNAME} now speak any language other than English at home?
ENGLISH

1. Yes
0. No
¿Habla ^{FILL_SPNAME} ahora en casa algún idioma que no sea el inglés?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f PFAM_041, f_PFAM_043, PFAM_044
IF PFAM_045 = 1: f_PFAM_046;
ELSE: PFAM_047

f_PFAM_046
PFAM_046ARA/PFAM_046CHI/PFAM_046FRE/PFAM_046GRM/PFAM_046GRK/PFAM_046HEB/PFAM_046ITA/P
FAM_046JPN/PFAM_046KOR/PFAM_046NOR/PFAM_046POL/PFAM_046POR/PFAM_046RUS/PFAM_046SPA/P
FAM_046SWE/PFAM_046VIET/PFAM_046OTH/PFAM_046OTH_TX
ASK
PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING
QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)

ENGLISH

USE FILL_SPNAME CREATED IN PFAM_041
What language(s) does ^{FILL_SPNAME} speak at home? Please select all that
apply.
1. Arabic [PFAM_046ARA]
2. Chinese [PFAM_046CHI]
3. French [PFAM_046FRE]
4. German [PFAM_046GRM]
5. Greek [PFAM_046GRK]
6. Hebrew [PFAM_046HEB]
7. Italian [PFAM_046ITA]
8. Japanese [PFAM_046JPN]
9. Korean [PFAM_046KOR]
10. Norwegian [PFAM_046NOR]
11. Polish [PFAM_046POL]
12. Portuguese [PFAM_046POR]
13. Russian [PFAM_046RUS]
14. Spanish [PFAM_046SPA]
15. Swedish [PFAM_046SWE]
16. Vietnamese [PFAM_046VIE]
17. Other [PFAM_046OTH]
Please specify: ____________________________ [PFAM_046OTH_TX]
¿Qué idioma(s) habla ^{FILL_SPNAME} en casa? Seleccione todas las que
correspondan.

SPANISH

1. Árabe [PFAM_046ARA]
2. Chino [PFAM_046CHI]
3. Francés [PFAM_046FRE]
4. Alemán [PFAM_046GRM]
5. Griego [PFAM_046GRK]
6. Hebreo [PFAM_046HEB]
7. Italiano [PFAM_046ITA]
8. Japonés [PFAM_046JPN]
9. Coreano [PFAM_046KOR]
10. Noruego [PFAM_046NOR]
11. Polaco [PFAM_046POL]
12. Portugués [PFAM_046POR]
13. Ruso [PFAM_046RUS]
14. Español [PFAM_046SPA]
15. Sueco [PFAM_046SWE]
16. Vietnamita [PFAM_046VIE]
17. Otros [PFAM_046OTH]

Especifique: ____________________________ [PFAM_046OTH_TX]
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Code variable as 1 if checked, 0 if not.
Only display PFAM_046OTH_TX IF f_PFAM_046OTH = 1 (checked)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_045 = 1
f_PFAM_047

f_PFAM_047
PFAM_047AMI/PFAM_047ASI/PFAM_047BLA/PFAM_047HIS/PFAM_047MID/PFAM_047PAC/PFAM_047WHT
ASK
PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING
QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)

ENGLISH

USE FILL_SPNAME CREATED IN PFAM_041
What is ^{FILL_SPNAME}’s race and/or ethnicity? Select all that apply.
1.
2.
3.
4.
5.
6.
7.

American Indian or Alaska Native [PFAM_047AMI]
Asian [PFAM_047ASI]
Black or African American [PFAM_047BLA]
Hispanic or Latino[PFAM_047HIS]
Middle Eastern or North African [PFAM_047MID]
Native Hawaiian or Pacific Islander [PFAM_047PAC]
White [PFAM_047WHT]

¿Cuál es la raza y/o el origen étnico de ^{FILL_SPNAME}? Seleccione todas las opciones que
correspondan.

SPANISH

1.
2.
3.
4.
5.
6.
7.

Indígena de las Américas o nativo(a) de Alaska [PFAM_047AMI]
Asiático(a) [PFAM_047ASI]
Negro(a) o afroamericano(a) [PFAM_047BLA]
Hispano(a) o latino(a)[PFAM_047HIS]
De Medio Oriente o África del norte [PFAM_047MID]
Nativo(a) de Hawái o de otras islas del Pacífico [PFAM_047PAC]
Blanco(a) [PFAM_047WHT]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_046, PFAM_045
PFAM_048

PFAM_048
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
What is ^{FILL_SPNAME}’s sex?
ENGLISH

1. Male
2. Female
¿Cuál es el sexo de ^{FILL_SPNAME}?

SPANISH

1. Masculino
2. Femenina

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_047
PFAM_049

PFAM_049
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
And now a few questions about ^{FILL_SPNAME}’s religious background. First, in what religion was
^{FILL_SPNAME} raised? If more than one, please select the most recent religion that ^{FILL_SPNAME}
practiced as a child.

ENGLISH

1. Protestant (for example, Baptist, Methodist, Non-denominational or independent, Lutheran,
Presbyterian, Pentecostal, Episcopalian, Reformed, Church of Christ, etc.)
2. Roman Catholic
3. Church of Jesus Christ of Latter-day Saints or LDS. (Mormon)
4. Orthodox (such as Greek, Russian, or some other Orthodox church)
5. Jewish
6. Muslim
7. Buddhist
8. Hindu
9. Atheist
10. Agnostic
11. Something else
12. Nothing in particular
Ahora, le haré algunas preguntas sobre el contexto religioso de ^{FILL_SPNAME}. En primer lugar, ¿con
qué religión creció ^{FILL_SPNAME}? Si hay más de una, seleccione la religión más reciente que
^{FILL_SPNAME} practicó durante su infancia.

SPANISH

1. Protestante (por ejemplo, bautistas, metodistas, no denominacionales o independiente, luteranos,
presbiterianos, pentecostales, episcopales, reformados, Iglesia de Cristo, etc.)
2. Iglesia Católica Romana
3. Iglesia de Jesucristo de los Santos de los Últimos Días o LDS, por sus siglas en inglés, (Mormón(a))
4. Iglesia Ortodoxa (como la griega, la rusa o alguna otra iglesia ortodoxa)
5. Judío(a)
6. Musulmán(a)
7. Budista
8. Hindú
9. Ateo(a)
10. Agnóstico(a)
11. Otra
12. Ninguna en particular

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_048
IF PFAM_049=1, 2, 3, 4 OR 11: PFAM_050;
Else: PFAM_051

PFAM_050
ASK

PFAM_049=1, 2, 3, 4 OR 11

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Was ^{FILL_SPNAME} raised as a born-again or evangelical Christian, or not?
ENGLISH

1. Yes, born-again, or evangelical Christian
0. No, not born-again or evangelical Christian
¿Creció ^{FILL_SPNAME} como cristiano(a) renacido(a) o evangélico(a), o no?

SPANISH

1. Sí, cristiano(a) renacido(a) o cristiano(a) evangélico(a)
0. No, ni cristiano(a) renacido(a) ni cristiano(a) evangélico(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_049 = 1, 2, 3, 4, 11
PFAM_051

PFAM_051
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
What is ^{FILL_SPNAME}’s current religious preference, if any? First, in what religion was
^{FILL_SPNAME} raised? If more than one, please select the most recent religion that ^{FILL_SPNAME}
practices now.

ENGLISH

1. Protestant (for example, Baptist, Methodist, Non-denominational or independent, Lutheran,
Presbyterian, Pentecostal, Episcopalian, Reformed, Church of Christ, etc.)
2. Roman Catholic
3. Church of Jesus Christ of Latter-day Saints or LDS. (Mormon)
4. Orthodox (such as Greek, Russian, or some other Orthodox church)
5. Jewish
6. Muslim
7. Buddhist
8. Hindu
9. Atheist
10. Agnostic
11. Something else
12. Nothing in particular
¿Cuál es la preferencia religiosa actual de ^{FILL_SPNAME}, si es que tiene alguna? En primer lugar,
¿con qué religión creció ^{FILL_SPNAME}? Si hay más de una, seleccione la religión más reciente que
^{FILL_SPNAME} practica actualmente.

SPANISH

1. Protestante (por ejemplo, bautistas, metodistas, no denominacionales o independiente, luteranos,
presbiterianos, pentecostales, episcopales, reformados, Iglesia de Cristo, etc.)
2. Iglesia Católica Romana
3. Iglesia de Jesucristo de los Santos de los Últimos Días o LDS, por sus siglas en inglés. (Mormón(a))
4. Iglesia Ortodoxa (como la griega, la rusa o alguna otra iglesia ortodoxa)
5. Judío(a)
6. Musulmán(a)
7. Budista
8. Hindú
9. Ateo(a)
10. Agnóstico(a)
11. Otra
12. Ninguna en particular

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_049, PFAM_050
IF PFAM_051=1, 2, 3, 4 OR 11: PFAM_052;
Else: PFAM_053

PFAM_052
ASK

PFAM_051=1, 2, 3, 4 OR 11

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Would ^{FILL_SPNAME} currently describe themselves as a born-again or evangelical Christian, or not?
ENGLISH

1. Yes, born-again, or evangelical Christian
0. No, not born-again or evangelical Christian
¿Se describiría ^{FILL_SPNAME} en este momento como cristiano(a) renacido(a) o evangélico(a), o no?

SPANISH

1. Sí, cristiano(a) renacido(a) o cristiano(a) evangélico(a)
0. No, ni cristiano(a) renacido(a) ni cristiano(a) evangélico(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_051 = 1, 2, 3, 4, 11
PFAM_053

PFAM_053
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
In the past 12 months, how often has ^{FILL_SPNAME} attended a worship service (like a church,
synagogue or mosque service or mass)?

ENGLISH

1.   Never
2.   Once or twice
3.   Less than once a month / 3-12 times
4.   About once a month / 12 times
5.   About twice a month / 24 times
6.   About once a week
7.   Several times a week
8.   Every day
En los últimos 12 meses, ¿con qué frecuencia ha asistido ^{FILL_SPNAME} a un servicio religioso (como
un servicio o misa de iglesia, sinagoga o mezquita)?

SPANISH

1.   Nunca
2.   Una o dos veces
3.   Menos de una vez al mes (3-12 veces)
4.   Aproximadamente una vez al mes (12 veces)
5.   Unas dos veces al mes (24 veces)
6.   Alrededor de una vez por semana
7.   Varias veces a la semana
8.   Todos los días

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_051, PFAM_052
PFAM_054

PFAM_054
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Did ^{FILL_SPNAME} ever serve time in prison, jail, or some other correctional facility as a juvenile or
adult?
ENGLISH

1.
0.

Yes
No

¿Alguna vez estuvo ^{FILL_SPNAME} en prisión, en la cárcel o en algún otro centro penitenciario como
menor o adulto?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_053
IF PFAM_054 = 1: PFAM_055,
ELSE: PFAM_058

PFAM_055
ASK

PFAM_054 = 1

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
How many times did ^{FILL_SPNAME} serve time in prison, jail, or some other correctional facility?
ENGLISH

Number of Times: _________
¿Cuántas veces estuvo ^{FILL_SPNAME} en prisión, en la cárcel o en algún otro centro penitenciario?

SPANISH

Número de veces: _________

RANGE

1-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)

IF OUT OF RANGE, DISPLAY: Previously you reported that ^{FILL_SPNAME} served time in
jail, prison or other correctional facility. If this is not correct, please click here to update
your response. [DISPLAY LINK TO RETURN TO PFAM_054: ‘Update response’]
IF OUT OF RANGE, DISPLAY: Antes, usted informó que ^{FILL_SPNAME} cumplió una
condena en la cárcel, prisión u otro centro penitenciario. Si esto no es correcto, haga clic
aquí para actualizar su respuesta. [DISPLAY LINK TO RETURN TO PFAM_054: ‘Actualizar
respuesta’]

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_054 = 1
f_PFAM_056

f_PFAM_056
PFAM_056_MO/PFAM_056_YR
ASK
PFAM_054 = 1
PFAM_056_MO: Dropdown
QUESTION TYPE
PFAM_056_YR: Numeric
CREATE FILL_CJRECENT: IF PFAM_055 > 1, FILL_CJRECENT: ‘most recent’;
ELSE; FILL_CJRECENT: BLANK
FILLS (ENG)
USE FILL_SPNAME CREATED IN PFAM_041
Use ﬁll created in f_PFAM_004: FILL_INTERVIEWYEAR
CREATE FILL_CJRECENT: IF PFAM_055 > 1, FILL_CJRECENT: ‘más reciente’
ELSE; FILL_CJRECENT: BLANK
FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Use ﬁll created in f_PFAM_004: FILL_INTERVIEWYEAR
Thinking of the ^{FILL_CJRECENT} time that ^{FILL_SPNAME} served time in prison, jail, or some other
correctional facility, when did ^{FILL_SPNAME} enter the jail, prison, or correctional facility?
ENGLISH

SPANISH

Month: {Select} [PFAM_056_MO]
Year: ___________ [PFAM_056_YR]
Pensando en la vez ^{FILL_CJRECENT} que cumplió una condena en la cárcel, prisión o algún otro
centro penitenciario, ¿cuándo fue que ^{FILL_SPNAME} ingresó en la cárcel, prisión o centro
penitenciario?
Mes: {Seleccione} [PFAM_056_MO]
Año: ___________ [PFAM_056_YR]

RANGE
LIMITS

PFAM_056_MO: Month entries in order: January, February, March, etc. through
December
PFAM_056_YR: 1900 - 2030
PFAM_056_YR: Max 4 digits

LOOP MAX
PROGRAM. NOTES

DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “^{FILL_SPNAME} entered
Prison or Jail”.
SPAN: “^{FILL_SPNAME} ingresó en prisión o en la cárcel”.
HARD CHECK: IF PFAM_056_YR OUT OF RANGE, DISPLAY: Please enter a year between
1900 – ^{FILL_INTERVIEWYEAR}.

CHECK (ENG)

HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.
HARD CHECK: IF PFAM_056_YR OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_055
f_PFAM_057

f_PFAM_057
PFAM_057 _MO/PFAM_057_YR
ASK
PFAM_054 = 1
PFAM_057_MO: Dropdown
QUESTION TYPE
PFAM_057_YR: Numeric
USE FILL_SPNAME CREATED IN PFAM_041
FILLS (ENG)
Use ﬁll created in f_PFAM_004: FILL_INTERVIEWYEAR
Use ﬁll created in f_PFAM_056: FILL_CJRECENT
USE FILL_SPNAME CREATED IN PFAM_041
FILLS (SPAN)
Use ﬁll created in f_PFAM_004: FILL_INTERVIEWYEAR
Use ﬁll created in f_PFAM_056: FILL_CJRECENT
The ^{FILL_CJRECENT} time that ^{FILL_SPNAME} served time in prison, jail, or some other correctional
facility, when did ^{FILL_SPNAME} leave the jail, prison, or correctional facility?
ENGLISH

Month: {Select} [PFAM_057_MO]
Year: ___________ [PFAM_057_YR]
-9. My spouse or partner is still in prison, jail, or other correctional facility.
Pensando en la vez ^{FILL_CJRECENT} que cumplió una condena en la cárcel, prisión o algún otro
centro penitenciario, ¿cuándo fue que ^{FILL_SPNAME} salió de la cárcel, prisión o centro
penitenciario?

SPANISH

Mes: {Seleccione} [PFAM_057_MO]
Año: ___________ [PFAM_057_YR]
-9. Mi cónyuge o pareja sigue en prisión, en la cárcel o en otro centro penitenciario.

RANGE
LIMITS

PFAM_057_MO: Month entries in order: January, February, March, etc. through
December
PFAM_057_YR: 1900 - 2030
PFAM_057_YR: Max 4 digits

LOOP MAX

PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

HELP TEXT (ENG)
HELP TEXT (SPAN)

DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “^{FILL_SPNAME} left Prison or
Jail”.
SPAN: “^{FILL_SPNAME} salió de la prisión o cárcel”.
HARD CHECK: IF PFAM_057_YR OUT OF RANGE, DISPLAY: Please enter a year between
1900 ^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.
HARD CHECK: IF PFAM_057_YR OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una fecha
en el futuro. Ingrese una fecha en el pasado.

MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_056
PFAM_058

PFAM_058
ASK

PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Next there are some questions about ^{FILL_SPNAME}’s family when they were growing up.
ENGLISH

Did ^{FILL_SPNAME} live with both biological parents together from birth until age 14?
1.
0.

Yes
No

Las siguientes preguntas son sobre la familia de ^{FILL_SPNAME} cuando estaba creciendo.

SPANISH

¿Vivió ^{FILL_SPNAME} con ambos padres/madres biológicos(as) juntos desde su nacimiento hasta los
14 años?
1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_053; PFAM_054 = 0, f_PFAM_057
IF PFAM_058 = 0: PFAM_059,
ELSE: PFAM_063

PFAM_059
ASK

PFAM_058 = 0

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Which parent didn't they always live with?
ENGLISH

1. Biological Mother
2. Biological Father
3. Both
¿Con qué padre/madre no vivió siempre?

SPANISH

1. Madre biológica
2. Padre biológico
3. Ambos(as)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_058 = 0
f_PFAM_060

f_PFAM_060
PFAM_060/PFAM_060_OTHER
ASK
PFAM_059 = 1, 2 or 3
PFAM_060: Radio button
QUESTION TYPE
PFAM_060_OTHER: Text
CREATE FILL_SPPARLIVE: IF PFAM_059 = 1, FILL_SPPARLIVE: their mother;
ELSE, IF PFAM_059 = 2, FILL_SPPARLIVE: their father;
FILLS (ENG)
ELSE, IF PFAM_059 = 3, FILL_SPPARLIVE: both parents;
ELSE, FILL_SPPARLIVE: their parent or parents
CREATE FILL_SPPARLIVE: IF PFAM_059 = 1, FILL_SPPARLIVE: su madre;
ELSE, IF PFAM_059 = 2, FILL_SPPARLIVE: su padre;
FILLS (SPAN)
ELSE, IF PFAM_059 = 3, FILL_SPPARLIVE: ambos(as) padres/madres;
ELSE, FILL_SPPARLIVE: su padre/madre o padres/madres
What was the reason they did not live with ^{FILL_SPPARLIVE}?

ENGLISH

1.
2.
3.
4.
5.

One or both parents died
Parents became separated or divorced
They were adopted
They left home
Some other reason

Please tell us the other reason they did not live with their ^{FILL_SPPARLIVE}:
__________________________ [PFAM_060_OTHER]
¿Cuál fue la razón por la que no vivió con ^{FILL_SPPARLIVE}?

SPANISH

1.
2.
3.
4.
5.

Uno(a) o ambos(as) murieron
Los(as) padres/madres se separaron o divorciaron
Fue adoptado(a)
Se fue de casa
Alguna otra razón

Díganos la otra razón por la que no vivió con ^{FILL_SPPARLIVE}: __________________________
[PFAM_060_OTHER]
RANGE
LIMITS

PFAM_060_OTHER: Max 120 characters

LOOP MAX

PROGRAM. NOTES

If PFAM_060= 5, DISPLAY PFAM_030_OTHER: Please tell us the other reason you did not
live with ^{FILL_SPPARLIVE }.
SPAN: Díganos la otra razón por la que no vivió con ^{FILL_SPPARLIVE }.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_059
If PFAM_059=1 or 3: f_PFAM_061; Else PFAM_062

f_PFAM_061
PFAM_061 / PFAM_061_0 / PFAM_061_1/ / PFAM_061_2/ / PFAM_061_AND1/ / PFAM_061_3/ /
PFAM_061_4/ / PFAM_061_AND2 / PFAM_061_5/ / PFAM_061_6/ / PFAM_061_AND3 / PFAM_061_7/ /
PFAM_061_8
ASK
PFAM_059 = 1 or 3
PFAM_061: Radio button
PFAM_061_0: Text
PFAM_061_1: Numeric
PFAM_061_2: Numeric
PFAM_061_AND1: Radio button
PFAM_061_3: Numeric
QUESTION TYPE
PFAM_061_4: Numeric
PFAM_061_AND2: Radio button
PFAM_061_5: Numeric
PFAM_061_6: Numeric
PFAM_061_AND3: Radio button
PFAM_061_7: Numeric
PFAM_061_8: Numeric
FILLS (ENG)
USE FILL_SPNAME CREATED IN PFAM_041
FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
At what ages did ^{FILL_SPNAME} live with their biological mother?
Enter ages into the text boxes below or select "My spouse or partner never lived with their biological
mother."
If your spouse or partner lived with their biological mother more than once, please enter the ages into
the text boxes then select "^{FILL_SPNAME} lived with their biological mother at another age" to enter
another age range.

ENGLISH

From age:_____ [PFAM_061_1]
To age:_____ [PFAM_061_2]
-9. My spouse or partner never lived with their biological mother.
^{FILL_SPNAME} lived with their biological mother at another age. [PFAM_061_AND1]
And from age:_____ [PFAM_061_3]
To age: _____ [PFAM_061_4]
^{FILL_SPNAME} lived with their biological mother at another age. [PFAM_061_AND2]
From age:_____ [PFAM_061_5]
To age:_____ [PFAM_061_6]
^{FILL_SPNAME} lived with their biological mother at another age. [PFAM_061_AND3]

From age:_____ [PFAM_061_7]
To age:_____ [PFAM_061_8]
¿A qué edad vivía ^{FILL_SPNAME} con su madre biológica?
Ingrese las edades en los cuadros de texto a continuación o seleccione "Mi cónyuge o pareja nunca
vivió con su madre biológica".
Si su cónyuge o pareja vivió con su madre biológica más de una vez, ingrese las edades en los cuadros
de texto y luego seleccione "^{FILL_SPNAME} vivió con su madre biológica a otra edad" para ingresar
otro rango de edad.
Desde de la edad:_____ [PFAM_061_1]
Hasta la edad: _____ [PFAM_061_2]
-9. Mi cónyuge o pareja nunca ha vivido con su madre biológica.
SPANISH

^{FILL_SPNAME} vivió con su madre biológica a otra edad. [PFAM_061_AND1]
Y desde la edad:_____ [PFAM_061_3]
Hasta la edad: _____ [PFAM_061_4]
^{FILL_SPNAME} vivió con su madre biológica a otra edad. [PFAM_061_AND2]
Desde la edad: _____ [PFAM_061_5]
Hasta la edad:_____ [PFAM_061_6]
^{FILL_SPNAME} vivía con su madre biológica a otra edad. [PFAM_061_AND3]

RANGE

LIMITS

Desde la edad:_____ [PFAM_061_7]
Hasta la edad:_____ [PFAM_061_8]
PFAM_061_1: 0-99
PFAM_061_2: 0-99
PFAM_061_3: 0-99
PFAM_061_4: 0-99
PFAM_061_5: 0-99
PFAM_061_6: 0-99
PFAM_061_7: 0-99
PFAM_061_8: 0-99
PFAM_061_1: Max 2 digits
PFAM_061_2: Max 2 digits
PFAM_061_3: Max 2 digits
PFAM_061_4: Max 2 digits
PFAM_061_5: Max 2 digits
PFAM_061_6: Max 2 digits
PFAM_061_7: Max 2 digits
PFAM_061_8: Max 2 digits

LOOP MAX

PROGRAM. NOTES

SHOW PFAM_061
If PFAM_061 = 1: DISPLAY PFAM_061_0, PFAM_061_1, PFAM_061_2 AND
PFAM_061_AND1
If PFAM_061_AND1 IS CHECKED, DISPLAY PFAM_061_3 AND PFAM_061_4 AND
PFAM_061_AND2 ON THE SAME SCREEN.

CHECK (ENG)

IF PFAM_061_AND2 IS CHECKED, DISPLAY PFAM_061_5 AND PFAM_061_6 AND
PFAM_061_AND3.
IF PFAM_061_AND3 IS CHECKED, DISPLAY PFAM_061_7 AND _PFAM_061_8.
IF PFAM_061_1> PFAM_061_2 OR
PFAM_061_3 > PFAM_061_4 OR
PFAM_061_5 > PFAM_061_6 OR
PFAM_061_7 > PFAM_061_8, DISPLAY HARD CHECK:
The age your spouse or partner stopped living with their biological mother should be
after the age they began living with their biological mother. Please update your answer.
If age ranges entered in each set (e.g., PFAM_061_1 through PFAM_061_2) overlap with
an age range entered in another set (e.g., PFAM_061_3 through PFAM_061_4), display
hard check: “The ages you entered overlap. Please review your answers.”
If age entered in any ﬁeld is >14, display hard check: “This question asks about birth until
the age of 14. Please review your answers.”
IF PFAM_061_1> PFAM_061_2 OR
PFAM_061_3 > PFAM_061_4 OR
PFAM_061_5 > PFAM_061_6 OR
PFAM_061_7 > PFAM_061_8, DISPLAY HARD CHECK:
La edad en que su cónyuge o pareja dejó de vivir con su madre biológica debe ser
después de la edad en que empezó a vivir con su madre biológica. Actualice su respuesta.

CHECK (SPAN)

If age ranges entered in each set (e.g., PFAM_061_1 through PFAM_061_2) overlap with
an age range entered in another set (e.g., PFAM_061_3 through PFAM_061_4), display
hard check: “Las edades ingresadas se superponen. Revise sus respuestas.”
If age entered in any ﬁeld is >14, display hard check: “Esta pregunta se reﬁere al
nacimiento hasta los 14 años. Revise sus respuestas.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_060
IF PFAM_059 = 2 or 3: f_PFAM_062;
ELSE: PFAM_063

f_PFAM_062
PFAM_062 / PFAM_062_0 / PFAM_062_1 / PFAM_062_2 / PFAM_062_AND1 / PFAM_062_3 / PFAM_062_4 /
PFAM_062_AND2 / PFAM_062_5 / PFAM_062_6 / PFAM_062_AND3 / PFAM_062_7 / PFAM_062_8
ASK
PFAM_059 = 2 or 3
PFAM_062: Radio button
PFAM_062_0: Text
PFAM_062_1: Numeric
PFAM_062_2: Numeric
PFAM_062_AND1: Radio button
PFAM_062_3: Numeric
QUESTION TYPE
PFAM_062_4: Numeric
PFAM_062_AND2: Radio button
PFAM_062_5: Numeric
PFAM_062_6: Numeric
PFAM_062_AND3: Radio button
PFAM_062_7: Numeric
PFAM_062_8: Numeric
FILLS (ENG)
USE FILL_SPNAME CREATED IN PFAM_041
FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Did ^{FILL_SPNAME} live with their biological father from birth until age 14? [PFAM_062]
1. Yes
0. No

At what ages did ^{FILL_SPNAME} live with their biological father? [PFAM_062_0]
From age:_____ [PFAM_062_1]
To age:_____ [PFAM_062_2]

ENGLISH

Did ^{FILL_SPNAME} live with their biological father at another age? [PFAM_062_AND1]
1. Yes
0. No
From age:_____ [PFAM_062_3]
To age: _____ [PFAM_062_4]
Did ^{FILL_SPNAME} live with their biological father at another age? [PFAM_062_AND2]
1. Yes
0. No
From age:_____ [PFAM_062_5]
To age:_____ [PFAM_062_6]
Did ^{FILL_SPNAME} live with their biological father at another age? [PFAM_062_AND3]
1. Yes

0. No
From age:_____ [PFAM_062_7]
To age:_____ [PFAM_062_8]
Desde su nacimiento hasta los 14 años, ¿vivió ^{FILL_SPNAME} con su padre biológico?
1. Sí
0. No
¿A que edades vivió ^{FILL_SPNAME} con su padre biológico? [PFAM_62_0]
Desde la edad:_____ [PFAM_062_1]
Hasta la edad: _____ [PFAM_062_2]
¿Vivió ^{FILL_SPNAME} con su padre biológico a otra edad? [PFAM_062_AND1]
1. Sí
0. No
SPANISH

Desde la edad:_____ [PFAM_062_3]
Hasta la edad: _____ [PFAM_062_4]
¿Vivió ^{FILL_SPNAME} con su padre biológico a otra edad? [PFAM_062_AND2]
1. Sí
0. No
Desde la edad:_____ [PFAM_062_5]
Hasta la edad: _____ [PFAM_062_6]
¿Vivió ^{FILL_SPNAME} con su padre biológico a otra edad? [PFAM_062_AND3]
1. Sí
0. No

RANGE

LIMITS

Desde la edad:_____ [PFAM_062_7]
Hasta la edad: _____ [PFAM_062_8]
PFAM_062_1: 0-99
PFAM_062_2: 0-99
PFAM_062_3: 0-99
PFAM_062_4: 0-99
PFAM_062_5: 0-99
PFAM_062_6: 0-99
PFAM_062_7: 0-99
PFAM_062_8: 0-99
PFAM_062_1: Max 2 digits
PFAM_062_2: Max 2 digits
PFAM_062_3: Max 2 digits
PFAM_062_4: Max 2 digits
PFAM_062_5: Max 2 digits

PFAM_062_6: Max 2 digits
PFAM_062_7: Max 2 digits
PFAM_062_8: Max 2 digits
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

SHOW PFAM_062
If PFAM_062 = 1: DISPLAY PFAM_062_0, PFAM_062_1, PFAM_062_2 AND PFAM_062_AND1
If PFAM_062_AND1 IS CHECKED, DISPLAY PFAM_062_3 AND PFAM_062_4 AND
PFAM_062_AND2 ON THE SAME SCREEN.
IF PFAM_062_AND2 IS CHECKED, DISPLAY PFAM_062_5 AND PFAM_062_6 AND
PFAM_062_AND3.
IF PFAM_062_AND3 IS CHECKED, DISPLAY PFAM_062_7 AND _PFAM_062_8.
IF PFAM_062_1> PFAM_062_2 OR
PFAM_062_3 > PFAM_062_4 OR
PFAM_062_5 > PFAM_062_6 OR
PFAM_062_7 > PFAM_062_8, DISPLAY HARD CHECK:
The age your spouse or partner stopped living with their biological father should be after
the age they began living with their biological father. Please update your answer.
If age ranges entered in each set (e.g., PFAM_062_1 through PFAM_062_2) overlap with an
age range entered in another set (e.g., PFAM_062_3 through PFAM_062_4), display hard
check: “The ages you entered overlap. Please review your answers.”
If age entered in any ﬁeld is >14, display hard check: “This question asks about birth until
the age of 14. Please review your answers.”
IF PFAM_062_1> PFAM_062_2 OR
PFAM_062_3 > PFAM_062_4 OR
PFAM_062_5 > PFAM_062_6 OR
PFAM_062_7 > PFAM_062_8, DISPLAY HARD CHECK:
The age your spouse or partner stopped living with their biological father should be after
the age they began living with their biological father. Please update your answer.
If age ranges entered in each set (e.g., PFAM_062_1 through PFAM_062_2) overlap with an
age range entered in another set (e.g., PFAM_062_3 through PFAM_062_4), display hard
check: “The ages you entered overlap. Please review your answers.”
If age entered in any ﬁeld is >14, display hard check: “Esta pregunta se reﬁere al nacimiento
hasta los 14 años. Revise sus respuestas.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN

PFAM_060, f_PFAM_061

NEXT

PFAM_063

PFAM_063
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
How many brothers and sisters does ^{FILL_SPNAME} have in total? Please include full, half- and stepsiblings even if ^{FILL_SPNAME} never lived with them.
ENGLISH

Number of brothers and sisters: ___________

¿Cuántos hermanos(as) tiene ^{FILL_SPNAME} en total? Incluya a los(as) hermanos(as) de sangre,
medios(as) hermanos(as) o hermanastros(as) aunque ^{FILL_SPNAME} nunca haya vivido con ellos(as).
SPANISH

Número de hermanos(as): ___________

RANGE

0-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number corresponding to how
many siblings they have 0-99.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número correspondiente a cuántos
hermanos(as) tiene entre el 0 y el 99.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_058, f_PFAM_061, f_PFAM_062
PFAM_064

PFAM_064
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Which of the following best describes the community in which ^{FILL_SPNAME} was living at age 14?

ENGLISH

1.
2.
3.
4.
5.
6.

Large or mid-sized city (At least 100,000 residents)
Suburb
Small city or town
Rural area
Indian reservation
Military base

¿Cuál de las siguientes opciones describe mejor la comunidad en la que vivía ^{FILL_SPNAME} a los
14 años?

SPANISH

1.
2.
3.
4.
5.
6.

Ciudad grande o mediana (al menos 100,000 habitantes)
Suburbio
Pequeña ciudad o pueblo
Zona rural
Reserva indígena
Base militar

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_063
PFAM_065

PFAM_065
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Now I have a few questions about ^{FILL_SPNAME}'s parents.
ENGLISH

In what year was ^{FILL_SPNAME}'s mother born?
Year: ________________
Ahora tengo algunas preguntas sobre los padres de ^{FILL_SPNAME}.

SPANISH

¿En qué año nació la madre de ^{FILL_SPNAME}?
Año: ________________

RANGE

1880-2000

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_064
If PFAM_065=DK or REF: PFAM_066; Else: PFAM_067

PFAM_066
ASK

If PFAM_065=DK or REF

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Do you know about what year she was born? An estimate would be helpful.
ENGLISH
Year: ________________
¿Sabe aproximadamente en qué año nació? Una estimación sería útil.
SPANISH
Año:________________
RANGE
1880-2000
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_065
PFAM_067

PFAM_067
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
What is the highest educational degree that ^{FILL_SPNAME}’s mother received?

ENGLISH

0. None
1. High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2. High school diploma (Regular 12-year program)
3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MBA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
¿Cuál es el título educativo más alto que obtuvo la madre de ^{FILL_SPNAME}?

SPANISH

0. Ninguno
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MBA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_065, PFAM_066
PFAM_068

PFAM_068
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
Now, a few questions about ^{FILL_SPNAME}'s father.
ENGLISH

In what year was ^{FILL_SPNAME}'s father born?
Year: ________________
Ahora, unas preguntas sobre el padre de ^{FILL_SPNAME}.

SPANISH

¿En qué año nació el padre de ^{FILL_SPNAME}?
Año: ________________

RANGE

1880-2000

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_067
If PFAM_068=DK or REF: PFAM_069;
Else: PFAM_070

PFAM_069
ASK

If PFAM_068=DK or REF

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Do you know about what year he was born? An estimate would be helpful.
ENGLISH

Year: ________________
¿Sabe aproximadamente en qué año nació? Una estimación sería útil.

SPANISH

Año: ________________

RANGE

1880-2000

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1880-2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_068
PFAM_070

PFAM_070
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
What is the highest educational degree that ^{FILL_SPNAME}'s father received?

ENGLISH

0. None
1. High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2. High school diploma (Regular 12-year program)
3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MBA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional degree (MD, DDS, JD)
¿Cuál es el título educativo más alto que obtuvo el padre de ^{FILL_SPNAME}?

SPANISH

0. Ninguno
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MBA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_068, PFAM_069
PFAM_071

PFAM_071
ASK

If PCSPOUSEID ≠ MISSING OR PCPARTNERID ≠ MISSING

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_SPNAME CREATED IN PFAM_041

FILLS (SPAN)
USE FILL_SPNAME CREATED IN PFAM_041
How many times has ^{FILL_SPNAME} been legally married? Please include their current marriage if
they are married now.
ENGLISH
Number of Times: _________

SPANISH

¿Cuántas veces ha estado ^{FILL_SPNAME} casado(a) legalmente? Incluya su matrimonio actual si está
casado(a) en este momento.
Número de veces: _________

RANGE

0-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_070
PFAM_072

PFAM_072
ASK

All respondents (Begin PFAM Loop 1)

QUESTION TYPE

Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
This is a computer check. Do not display.
PFAM Loop 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_040, PFAM_071
PFAM_073_#

PFAM_073_#
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID (Continue
PFAM LOOP 1)
QUESTION TYPE
Informational
CREATE FILL_NONRES_NAME_#: preload from NONRESROSTER created in
PINF_070_LOOP_END
FILLS (ENG)
CREATE FILL_NRYOUTH: preload from YOUTH_NAME created in PINF_070_LOOP_END all
youth names (NONRES_YOUTH1_NAME, NONRES_YOUTH2_NAME, etc.) aﬃliated
with NONRES_NAME_#, separated by ‘and’.
CREATE FILL_NONRESNAME_#: preload from NONRESROSTER created in
PINF_070_LOOP_END
FILLS (SPAN)
CREATE FILL_NRYOUTH: preload from YOUTH_NAME created in PINF_070_LOOP_END all
youth names (NONRES_YOUTH1_NAME, NONRES_YOUTH2_NAME, etc.) aﬃliated
with NONRES_NAME_#, separated by ‘y’.
Now we would like to ask you some questions about the background of ^{FILL_NONRES_NAME_#],
ENGLISH biological parent of ^{FILL_NRYOUTH}.
ASK

SPANISH

Ahora, quisiera hacerle preguntas sobre los antecedentes de ^{FILL_NONRES_NAME_#], padre/madre
biológico(a) de ^{FILL_NRYOUTH}.

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom NONRES_PARENT_UID≠PCSPOUSEID
and NONRES_PARENT_UID≠PCPARTNERID until NONRESCOUNT is reached with 15 max.
Create variable PFAMLOOP1[#].NONRES_PARENT_UID= NONRES_PARENT_UID

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_072
PFAM_075

PFAM_075_#_#
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID
(Begin/End PFAM LOOP 1a)
QUESTION TYPE
Radio button
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (ENG)
CREATE FILL_YOUTHNAME_#_#: EACH YOUTH ASSOCIATED WITH NONRES_NAME_#,
USED TO CREATE FILL_NRYOUTH_# IN PFAM_073_#
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (SPAN)
CREATE FILL_YOUTHNAME_#_#: EACH YOUTH ASSOCIATED WITH NONRES_NAME_#,
USED TO CREATE FILL_NRYOUTH_# IN PFAM_073_#
Since ^{FILL_YOUTHNAME_#_#} turned 10 years old, have they had any contact with
^{FILL_NONRES_NAME_#}?
ASK

ENGLISH

By contact we mean in-person, a phone call between ^{FILL_NONRES_NAME_#} and the youth or a
letter from ^{FILL_NONRES_NAME_#}?
1. Yes
0. No
Desde que ^{FILL_YOUTHNAME_#_#} cumplió los 10 años, ¿ha tenido algún contacto con
^{FILL_NONRES_NAME_#}?

SPANISH

Por “contacto” entendemos contacto en persona, una llamada telefónica entre
^{FILL_NONRES_NAME_#} y el(la) joven o una carta de ^{FILL_NONRES_NAME_#}.

1. Sí
0. No
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
PFAM LOOP 1a: Repeat PFAM_075_#_# for all youth associated with this
NONRES_PARENT_UID with 15 max.
Create variable PFAMLOOP1a[#].YOUTH_UID= YOUTH_UID
IF PFAM_075_#_# = 1, SET PARCONTACT_#_# = 1

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_073
IF LOOPNUMBER< NUMBER OF YOUTH ATTACHED TO NONRES_PARENT_UID, RETURN TO
PFAM_074_#_#

ELSE, IF PFAM_075_#_#=1 for any youth: PFAM_077_#; Else PFAM_102

PFAM_077_#
ASK

PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Radio button
USE FILL_NONRES_NAME_# CREATED FROM PFAM_073_#

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED FROM PFAM_073_#

FILLS (SPAN)

Was ^{FILL_NONRES_NAME_#} born in the United States or its territories?
ENGLISH

SPANISH

1. Yes
0. No
¿Nació ^{FILL_NONRES_NAME_#} en los Estados Unidos o en sus territorios?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_075_#_#
IF PFAM_077_#=1: PFAM_079_#;
ELSE, IF PFAM_077_#=0: PFAM_078_#:
Else: PFAM_081_#

f_PFAM_078_#
PFAM_078a_# / PFAM_078OTHER_#
ASK
If PFAM_077_# = 0 (continue PFAM LOOP 1)
PFAM_078a_#: Dropdown
QUESTION TYPE
PFAM_078OTHER_#: Textbox
FILLS (ENG)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (SPAN)

ENGLISH

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
In which country was ^{FILL_NONRES_NAME_#} born?
{ - Select - } [PFAM_078a_#]
Enter country in which ^{FILL_NONRES_NAME} was born: ___________ [PFAM_078OTHER_#]
¿En qué país nació ^{FILL_NONRES_NAME_#}?

SPANISH

{ - Seleccione - } [PFAM_078a_#]
Ingrese el país en el que nació ^{FILL_NONRES_NAME}: ___________ [PFAM_078OTHER_#]

RANGE

COUNTRYLIST

LIMITS

PFAM_078OTHER_# = max 50 characters

LOOP MAX

15
Only display PFAM_078OTHER_# if PFAM_078a_# = 197

PROGRAM. NOTES

PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

If PFAM_077_# = 0
If PFAM_078_#=187: PFAM_079_#;
Else: PFAM_080_#

f_PFAM_079_#
PFAM_079a_# / PFAM_079OTHER_#
ASK
If PFAM_077_# = 1 or PFAM_078a_# = 187 (continue PFAM LOOP 1)
PFAM_079a_#: Dropdown
QUESTION TYPE
PFAM_079OTHER_#: Textbox
FILLS (ENG)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (SPAN)

ENGLISH

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
In what state or territory was ^{FILL_NONRES_NAME_#} born?
{ - Select - } [PFAM_079a_#]
Enter other location where ^{FILL_NONRES_NAME_#} was born: ___________
[PFAM_079OTHER_#]
¿En qué estado o territorio nació ^{FILL_NONRES_NAME_#}?

SPANISH

{ - Seleccione - } [PFAM_079a_#]
Ingrese otra ubicación donde nació ^{FILL_NONRES_NAME_#} : ___________
[PFAM_079OTHER_#]

RANGE

STATEEXPAND

LIMITS

PFAM_079OTHER_#: Max 50 characters

LOOP MAX

15
Only display PFAM_079OTHER_# if PFAM_079a_# = 0

PROGRAM. NOTES

PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

If PFAM_077_# = 1, PFAM_078_# = 187
If PFAM_079a_#=0, 52, 53, 54, 55, or 56: PFAM_080; Else: PFAM_081_#

PFAM_080_#
ASK
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)
ENGLISH

If PFAM_077_#= 0 or PFAM_079_# = 0, 52, 53, 54, 55, or 56 (continue PFAM LOOP 1)
Numeric
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
USE FILL_INTERVIEWYEAR CREATED IN PFAM_004
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
USE FILL_INTERVIEWYEAR CREATED IN PFAM_004
In what year did ^{FILL_NONRES_NAME_#} first come to the United States to live?
Year: ________________
¿En qué año llegó ^{FILL_NONRES_NAME_#} por primera vez a vivir a los Estados Unidos?

SPANISH

Año: ________________

RANGE

1900-2030

LIMITS

Max 4 digits

LOOP MAX

PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number between 1900^{FILL_INTERVIEWYEAR}.

CHECK (ENG)

HARD CHECK: If PFAM_080_# is in the future on DOI, display: You have entered a date in
the future. Please enter a date in the past.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número entre 1900 y
^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

HARD CHECK: If PFAM_080_# is in the future on DOI, display: Ingresó una fecha en el
futuro. Ingrese una fecha en el pasado.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_079_# = 0, 52, 53, 54, 55, or 56, PFAM_078_#
PFAM_081_#

PFAM_081_#

QUESTION TYPE

≠SPOUSEIDNONRES_PARENT_UID≠PCSPOUSEID and
≠PARTNERIDNONRES_PARENT_UID≠PCPARTNERID (Continue PFAM LOOP 1)
Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

ASK

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
What is ^{FILL_NONRES_NAME_#}’s sex?
ENGLISH

1. Male
2. Female
¿Cuál es el sexo de ^{FILL_NONRES_NAME_#}?

SPANISH

1. Masculino
2. Femenina

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_080_#
PFAM_082_#

PFAM_082_#

QUESTION TYPE

NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID (Continue
PFAM LOOP 1)
Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

ASK

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Next there are a few questions about ^{FILL_NONRES_NAME_#}'s religious background. First, in what
religion was ^{FILL_NONRES_NAME_#} raised? If more than one, please select the most recent religion
that ^{FILL_NONRES_NAME_#} practiced as a child.

ENGLISH

1. Protestant (for example, Baptist, Methodist, Non-denominational or independent, Lutheran,
Presbyterian, Pentecostal, Episcopalian, Reformed, Church of Christ, etc.)
2. Roman Catholic
3. Church of Jesus Christ of Latter-day Saints or LDS. (Mormon)
4. Orthodox (such as Greek, Russian, or some other Orthodox church)
5. Jewish
6. Muslim
7. Buddhist
8. Hindu
9. Atheist
10. Agnostic
11. Something else
12. Nothing in particular
Las siguientes preguntas son sobre el contexto religioso de ^{FILL_NONRES_NAME_#} En primer lugar,
¿con qué religión creció ^{FILL_NONRES_NAME_#} ? Si hay más de una, seleccione la religión más
reciente que ^{FILL_NONRES_NAME_#} practicó durante su infancia.

SPANISH

1. Protestante (por ejemplo, bautistas, metodistas, no denominacionales o independiente, luteranos,
presbiterianos, pentecostales, episcopales, reformados, Iglesia de Cristo, etc.)
2. Iglesia Católica Romana
3. Iglesia de Jesucristo de los Santos de los Últimos Días o LDS, por sus siglas en inglés. (Mormón(a))
4. Iglesia Ortodoxa (como la griega, la rusa o alguna otra iglesia ortodoxa)
5. Judío(a)
6. Musulmán(a)
7. Budista
8. Hindú
9. Ateo(a)
10. Agnóstico(a)
11. Otra
12. Ninguna en particular

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_081_#
IF PFAM_082_#=1, 2, 3, 4, OR 11: PFAM_083_#;
Else: PFAM_084_#

PFAM_083_#
ASK

IF PFAM_082_#=1, 2, 3, 4 OR 11 (Continue PFAM LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Was ^{FILL_NONRES_NAME_#} raised as a born-again or evangelical Christian, or not?
ENGLISH

1. Yes, born-again, or evangelical Christian
0. No, not born-again or evangelical Christian
¿Creció ^{FILL_NONRES_NAME_#} como cristiano(a) renacido(a) o evangélico(a), o no?

SPANISH

1. Sí, cristiano(a) renacido(a) o cristiano(a) evangélico(a)
0. No, ni cristiano(a) renacido(a) ni cristiano(a) evangélico(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_082_# = 1, 2, 3, 4, 11
PFAM_084_#

PFAM_084_#

QUESTION TYPE

NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID (Continue
PFAM LOOP 1)
Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

ASK

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Did ^{FILL_NONRES_NAME_#} ever serve time in prison, jail, or some other correctional facility as a
juvenile or adult?
ENGLISH

1. Yes
0. No
¿Alguna vez estuvo ^{FILL_NONRES_NAME_#} en prisión, en la cárcel o en algún otro centro
penitenciario como menor o adulto?

SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_082_#, PFAM_083_#
IF PFAM_084_# = 1: PFAM_085_#,
ELSE: PFAM_088_#

PFAM_085_#
ASK

PFAM_084_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
How many times did ^{FILL_NONRES_NAME_#} serve time in prison, jail, or some other correctional
facility?
ENGLISH
Number of Times: _________

SPANISH

¿Cuántas veces estuvo ^{FILL_NONRES_NAME_#} en prisión, en la cárcel o en algún otro centro
penitenciario?
Número de veces: _________

RANGE

1-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
IF OUT OF RANGE, DISPLAY: Previously you reported that ^{FILL_NONRES_NAME_#} } has
been in jail, prison or other correctional facility. If this is not correct, please click here to
update your response. [DISPLAY LINK TO RETURN TO PFAM_084_#: ‘Update response’]
IF OUT OF RANGE, DISPLAY: Antes, usted informó que ^{FILL_NONRES_NAME_#}} ha
estado en la cárcel, prisión u otro centro penitenciario. Si esto no es correcto, haga clic aquí
para actualizar su respuesta. [DISPLAY LINK TO RETURN TO PFAM_084_#: ‘Actualizar
respuesta’]

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_084_# = 1
f_PFAM_086_#

f_PFAM_086_#
PFAM_086_MO_#/PFAM_086_YR_#
ASK
PFAM_085_# ≠ 0 (Continue PFAM LOOP 1)
PFAM_086_MO_#: Dropdown
QUESTION TYPE
PFAM_086_YR_#: Numeric
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
USE FILL_INTERVIEWYEAR CREATED in PFAM_004
FILLS (ENG)
CREATE FILL_CJRECENT2: IF PFAM_085 > 1, FILL_CJRECEN2T: ‘most recent’;
ELSE; FILL_CJRECENT2: BLANK
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
USE FILL_INTERVIEWYEAR CREATED in PFAM_004
FILLS (SPAN)
CREATE FILL_CJRECENT2: IF PFAM_085 > 1, FILL_CJRECEN2T: ‘más reciente’;
ELSE; FILL_CJRECENT2: BLANK
Thinking of the ^{FILL_CJRECENT2} time that ^{FILL_NONRES_NAME_#} served time in prison, jail, or
some other correctional facility, when did ^{FILL_NONRES_NAME_#} enter the jail, prison, or
correctional facility?
ENGLISH
Month: {Select} [PFAM_086_MO_#]
Year: ___________ [PFAM_086_YR_#]

SPANISH

Pensando en la vez ^{FILL_CJRECENT2} que ^{FILL_NONRES_NAME_#} cumplió una condena en la
cárcel, prisión o algún otro centro penitenciario, ¿cuándo fue que ^{FILL_NONRES_NAME_#} ingresó
en la cárcel, prisión o centro penitenciario?
Mes: {Seleccione} [PFAM_086_MO_#]
Año: ___________[PFAM_086_YR_#]

RANGE
LIMITS

PFAM_086_#_MO: Month entries in order: January, February, March, etc. through
December
PFAM_086_YR_#: 1900 - 2030
PFAM_086_YR_#: Max 4 digits

LOOP MAX

15
DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “^{FILL_NONRES_NAME_#}
Entered Prison or Jail”.

PROGRAM. NOTES

PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF PFAM_086_YR_# OUT OF RANGE, DISPLAY: Please enter a year between
1900 - ^{FILL_INTERVIEWYEAR}.

CHECK (ENG)

CHECK (SPAN)

HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.
HARD CHECK: IF PFAM_086_YR_# OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.

HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_085_#
f_PFAM_087_#

f_PFAM_087_#
PFAM_087 _MO_#/PFAM_087_YR_#
ASK
PFAM_085_# ≠ 0 (Continue PFAM LOOP 1)
PFAM_087_MO_#: Dropdown
QUESTION TYPE
PFAM_087_YR_#: Numeric
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (ENG)
USE FILL_INTERVIEWYEAR CREATED in PFAM_004
Use ﬁll from f_PFAM_086: FILL_CJRECENT2
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (SPAN)
USE FILL_INTERVIEWYEAR CREATED in PFAM_004
Use ﬁll from f_PFAM_086: FILL_CJRECENT2
The {FILL_CJRECENT2} time that ^{FILL_NONRES_NAME_#} served time in prison, jail, or some other
correctional facility, when did ^{FILL_NONRES_NAME_#} leave the jail, prison, or correctional facility?
ENGLISH

Month: {Select} [PFAM_087_MO_#]
Year: ___________ [PFAM_087_YR_#]
-9. This parent is still in prison, jail, or other correctional facility.
Pensando en la vez {FILL_CJRECENT2} que ^{FILL_NONRES_NAME_#} cumplió una condena en la
cárcel, prisión o algún otro centro penitenciario, ¿cuándo fue que ^{FILL_NONRES_NAME_#} salió de
la cárcel, prisión o centro penitenciario?

SPANISH

Mes: {Seleccione} [PFAM_087_MO_#]
Año: ___________ [PFAM_087_YR_#]
-9. Este padre/madre sigue en prisión, en la cárcel o en otro centro penitenciario.

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)

PFAM_087_MO: Month entries in order: January, February, March, etc. through
December
PFAM_087_YR: 1900 - 2030
PFAM_087_YR: Max 4 digits
15
DISPLAY CALENDAR. ADD DATE TO CALENDAR WITH LABEL “^{FILL_NONRES_NAME_#} left
Prison or Jail”.
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF PFAM_087_YR_# OUT OF RANGE, DISPLAY: Please enter a year between
1900 – ^{FILL_INTERVIEWYEAR}.
HARD CHECK: If month/year combination is in the future on DOI, display: You have
entered a date in the future. Please enter a date in the past.
HARD CHECK: If month/year combination reported in PFAM_087 is BEFORE month/year
combination reported in PFAM_086, display: The date that this parent left a correctional
facility should be after the date that they entered the correctional facility.

HARD CHECK: IF PFAM_087_YR_# OUT OF RANGE, DISPLAY: Ingrese un año entre 1900 y
^{FILL_INTERVIEWYEAR}.
CHECK (SPAN)

HARD CHECK: If month/year combination is in the future on DOI, display: Ingresó una
fecha en el futuro. Ingrese una fecha en el pasado.
HARD CHECK: If month/year combination reported in PFAM_087 is BEFORE month/year
combination reported in PFAM_086, display: La fecha en la que este padre/madre salió del
centro penitenciario debe ser después de la fecha en que ingresó al centro penitenciario.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

f_PFAM_086
PFAM_088

PFAM_088_#
ASK

NON_RES_PARENT_LOOP(Continue PFAM LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Next there are some questions about ^{FILL_NONRES_NAME_#}’s family when they were growing up.
ENGLISH

Did ^{FILL_NONRES_NAME_#} live with both biological parents together from birth until age 14?
1. Yes
0. No
Las siguientes preguntas son sobre la familia de ^{FILL_NONRES_NAME_#} cuando estaba creciendo.

SPANISH

¿Vivió ^{FILL_NONRES_NAME_#} con ambos padres/madres biológicos(as) juntos desde su nacimiento
hasta los 14 años?
1. Sí

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_084_# = 0; PFAM_085_# = 0; PFAM_087_#
IF PFAM_088_# = 0: PFAM_089_#,
ELSE: PFAM_094_#

PFAM_089_#
ASK

PFAM_088_# = 0 (Continue PFAM LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Which parent didn't they always live with?
ENGLISH

1. Biological Mother
2. Biological Father
3. Both
¿Con qué padre/madre no vivió siempre?

SPANISH

1. Madre biológica
2. Padre biológico
3. Ambos(as)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_088_# = 0
f_PFAM_090_#

f_PFAM_090_#
PFAM_090_#/PFAM_090_OTHER_#
ASK
PFAM_089_# = 1, 2, 3 or DK or REF (Continue PFAM LOOP 1)
PFAM_090_#: Radio button
QUESTION TYPE
PFAM_090_#_OTHER: Text
CREATE FILL_NRPARLIVE: IF PFAM_089 = 1, FILL_NRPARLIVE: their mother;
ELSE, IF PFAM_089 = 2, FILL_NRPARLIVE: their father;
FILLS (ENG)
ELSE, IF PFAM_089 = 3, FILL_NRPARLIVE: both parents;
ELSE, FILL_NRPARLIVE: their parent or parents
CREATE FILL_NRPARLIVE: IF PFAM_089 = 1, FILL_NRPARLIVE: su madre;
ELSE, IF PFAM_089 = 2, FILL_NRPARLIVE: su padre;
FILLS (SPAN)
ELSE, IF PFAM_089 = 3, FILL_NRPARLIVE: ambos(as) padres/madres;
ELSE, FILL_NRPARLIVE: su padre/madre o padres/madres
What was the reason they did not live with ^{FILL_NRPARLIVE}?

ENGLISH

1.
2.
3.
4.
5.

One or both parents died
Parents became separated or divorced
They were adopted
They left home
Some other reason

Please tell us the other reason they did not live with their ^{FILL_SPPARLIVE}:
__________________________ [PFAM_090_OTHER_#]
¿Cuál fue la razón por la que no vivió con ^{FILL_NRPARLIVE}?

SPANISH

1.
2.
3.
4.
5.

Uno(a) o ambos(as) murieron
Los(as) padres/madres se separaron o divorciaron
Fue adoptado(a)
Se fue de casa
Alguna otra razón

Díganos la otra razón por la que no vivió con ^{FILL_SPPARLIVE}: __________________________
[PFAM_090_OTHER_#]
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

PFAM_060_OTHER: Max 120 characters
15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
IF PFAM_090_# = 5, DISPLAY PFAM_090_OTHER_#: Please tell us the other
reason they did not live with their ^{FILL_SPPARLIVE}:

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI / CAWI

LEAD-IN
NEXT

PFAM_089_#
If PFAM_089_#=1 or 3: f_PFAM_091_#;
Else if PFAM_089_#=2: f_PFAM_092_#
Else: PFAM_093

f_PFAM_091_#
PFAM_091 / PFAM_091_0 / PFAM_091_1_#/_# / PFAM_091_2_#/_# / PFAM_091_AND1_#/_# /
PFAM_091_3_#/_# / PFAM_091_4_#/_# / PFAM_091_AND2_#/_# / PFAM_091_5_#/_# / PFAM_091_6_#/_# /
PFAM_091_AND3_#/_# / PFAM_091_7_#/_# / PFAM_091_8_#
ASK
PFAM_089_# = 1 or 3 (Continue PFAM LOOP 1)
PFAM_091: Radio button
PFAM_091_0: Text
PFAM_091_#_1: Numeric
PFAM_091_#_2: Numeric
PFAM_091_#_AND1: Radio button
PFAM_091_#_3: Numeric
QUESTION TYPE
PFAM_091_#_4: Numeric
PFAM_091_#_AND2: Radio button
PFAM_091_#_5: Numeric
PFAM_091_#_6: Numeric
PFAM_091_#_AND3: Radio button
PFAM_091_#_7: Numeric
PFAM_091_#_8: Numeric
FILLS (ENG)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Did ^{FILL_NONRES_NAME_#} live with their biological mother from birth until age 14? [PFAM_091]
1. Yes
0. No

At what ages did ^{FILL_NONRES_NAME_#} live with their biological mother? [PFAM_091_0]
From age:_____ [PFAM_091_1_#]
To age:_____ [PFAM_091_2_#]

ENGLISH

Did this parent live with their biological mother at another age [PFAM_091_AND1_#]
1. Yes
0. No
From age:_____ [PFAM_091_3_#]
To age: _____ [PFAM_091_4_#]
Did this parent live with their biological mother at another age [PFAM_091_AND2_#]
1. Yes
0. No
From age:_____ [PFAM_091_5_#]
To age:_____ [PFAM_091_6_#]

Did this parent live with their biological mother at another age? [PFAM_091_AND3_#]
From age:_____ [PFAM_091_7_#]
To age:_____ [PFAM_091_8_#]
Desde su nacimiento hasta los 14 años, ¿vivió ^{FILL_NONRES_NAME_#} con su madre biológica?
[PFAM_091]
1. Sí
0. No
¿A que edades vivió ^{FILL_NONRES_NAME_#} con su madre biológica? [PFAM_091_0]
Desde la edad: _____ [PFAM_091_
1_#]
Hasta la edad:_____ [PFAM_091_2_#]
¿Vivió este padre/madre con su madre biológica a otra edad? [PFAM_091_AND1_#]
1. Sí
0. No
SPANISH

Desde la edad:_____ [PFAM_091_3_#]
Hasta la edad: _____ [PFAM_091_4_#]
¿Vivió este padre/madre con su madre biológica a otra edad? [PFAM_091_AND2]
1. Sí
0. No
Desde la edad:_____ [PFAM_091_5]
Hasta la edad: _____ [PFAM_091_6]
¿Vivió este padre/madre con su madre biológica a otra edad? [PFAM_091_AND3]
1. Sí
0. No

RANGE

LIMITS

Desde la edad:_____ [PFAM_091_7]
Hasta la edad: _____ [PFAM_091_8]
PFAM_091_#_1: 0-99
PFAM_091_#_2: 0-99
PFAM_091_#_3: 0-99
PFAM_091_#_4: 0-99
PFAM_091_#_5: 0-99
PFAM_091_#_6: 0-99
PFAM_091_#_7: 0-99
PFAM_091_#_8: 0-99
PFAM_091_#_1: Max 2 digits
PFAM_091_#_2: Max 2 digits
PFAM_091_#_3: Max 2 digits
PFAM_091_#_4: Max 2 digits

LOOP MAX

PROGRAM. NOTES

CHECK (ENG)

PFAM_091_#_5: Max 2 digits
PFAM_091_#_6: Max 2 digits
PFAM_091_#_7: Max 2 digits
PFAM_091_#_8: Max 2 digits
15
SHOW PFAM_091
If PFAM_091 = 1: DISPLAY PFAM_091_0, PFAM_091_1_#, PFAM_091_2_# AND
PFAM_091_AND1_#
If PFAM_091_AND1_# IS CHECKED, DISPLAY PFAM_091_3_# AND PFAM_091_4_# AND
PFAM_091_AND2_# ON THE SAME SCREEN.
IF PFAM_091_AND2_# IS CHECKED, DISPLAY PFAM_091_5_# AND PFAM_091_6_# AND
PFAM_091_AND3_#.
IF PFAM_091_AND3_# IS CHECKED, DISPLAY PFAM_091_7_# AND _PFAM_091_8_#.
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
IF PFAM_091_1> PFAM_091_2 OR
PFAM_091_3 > PFAM_091_4 OR
PFAM_091_5 > PFAM_091_6 OR
PFAM_091_7 > PFAM_091_8, DISPLAY HARD CHECK:
The age this parent stopped living with their biological mother should be after the age
they began living with their biological mother. Please update your answer.
If age ranges entered in each set (e.g., PFAM_091_1 through PFAM_091_2) overlap with
an age range entered in another set (e.g., PFAM_091_3 through PFAM_091_4), display
hard check: “The ages you entered overlap. Please review your answers.”
If age entered in any ﬁeld is >14, display hard check: “This question asks about birth until
the age of 14. Please review your answers.”
IF PFAM_091_1> PFAM_091_2 OR
PFAM_091_3 > PFAM_091_4 OR
PFAM_091_5 > PFAM_091_6 OR
PFAM_091_7 > PFAM_091_8, DISPLAY HARD CHECK: La edad en la que este padre/madre
dejó de vivir con su madre biológica debe ser después de la edad en que empezó a vivir
con su madre biológica. Actualice su respuesta.

CHECK (SPAN)

If age ranges entered in each set (e.g., PFAM_091_1 through PFAM_091_2) overlap with
an age range entered in another set (e.g., PFAM_091_3 through PFAM_091_4), display
hard check: “Las edades ingresadas se superponen. Revise sus respuestas.”
If age entered in any ﬁeld is >14, display hard check: “Esta pregunta se reﬁere al
nacimiento hasta los 14 años. Revise sus respuestas.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_090_#
IF PFAM_089_# = 2 or 3: f_PFAM_092_#;

ELSE: PFAM_093_#

f_PFAM_092_#
PFAM_092 / PFAM_092_0 / PFAM_092_1_#/_# / PFAM_092_2_#/_# / PFAM_092_AND1_#/_# /
PFAM_092_3_#/_# / PFAM_092_4_#/_# / PFAM_092_AND2_#/_# / PFAM_092_5_#/_# / PFAM_092_6_#/_#
/ PFAM_092_AND3_#/_# / PFAM_092_7_#/_# / PFAM_092_8_#
ASK
PFAM_089_# = 2 or 3 (Continue PFAM LOOP 1)
PFAM_092: Radio button
PFAM_092_0: Text
PFAM_092_1_#: Numeric
PFAM_092_2_#: Numeric
PFAM_092_AND1_#: Radio button
PFAM_092_3_#: Numeric
QUESTION TYPE
PFAM_092_4_#: Numeric
PFAM_092_AND2_#: Radio button
PFAM_092_5_#: Numeric
PFAM_092_6_#: Numeric
PFAM_092_AND3_#: Radio button
PFAM_092_7_#: Numeric
PFAM_092_8_#: Numeric
FILLS (ENG)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Did ^{FILL_NONRES_NAME_#} live with their biological father from birth until age 14? [PFAM_092]
1. Yes
0. No

At what ages did ^{FILL_NONRES_NAME_#} live with their biological father? [PFAM_092_0]
From age:_____ [PFAM_092_1_#]
To age:_____ [PFAM_092_2_#]
Did this parent live with their biological father at another age? [PFAM_092_AND1_#]
ENGLIS 1. Yes
0. No
H
From age:_____ [PFAM_092_3_#]
To age: _____ [PFAM_092_4_#]
Did this parent live with their biological father at another age?. [PFAM_092_AND2_#]
1. Yes
0. No
From age:_____ [PFAM_092_5_#]
To age:_____ [PFAM_092_6_#]
Did this parent live with their biological father at another age? [PFAM_092_AND3_#]
1. Yes

0. No
From age:_____ [PFAM_092_7_#]
To age:_____ [PFAM_092_8_#]
Desde su nacimiento hasta los 14 años, ¿vivió ^{FILL_NONRES_NAME_#} con su padre biológico?
[PFAM_092]
1. Sí
0. No
¿A que edades vivió ^{FILL_NONRES_NAME_#} con su padre biológico? [PFAM_092_0]
Desde la edad: _____
[PFAM_092_1_#]
Hasta la edad:_____ [PFAM_092_2_#]
¿Vivió este padre/madre con su padre biológico a otra edad? [PFAM_092_AND1_#]
1. Sí
0. No

SPANIS
H
Desde la edad:_____ [PFAM_092_3_#]
Hasta la edad: _____ [PFAM_092_4_#]
¿Vivió este padre/madre con su padre biológico a otra edad? [PFAM_092_AND2]
1. Sí
0. No
Desde la edad:_____ [PFAM_092_5]
Hasta la edad: _____ [PFAM_092_6]
¿Vivió este padre/madre con su padre biológico a otra edad? [PFAM_092_AND3]
1. Sí
0. No
Desde la edad:_____ [PFAM_092_7]
Hasta la edad: _____ [PFAM_092_8]
PFAM_092_1_#: 0-99
PFAM_092_2_#: 0-99
PFAM_092_3_#: 0-99
PFAM_092_4_#: 0-99
RANGE
PFAM_092_5_#: 0-99
PFAM_092_6_#: 0-99
PFAM_092_7_#: 0-99
PFAM_092_8_#: 0-99
PFAM_092_1_#: Max 2 digits
LIMITS
PFAM_092_2_#: Max 2 digits
PFAM_092_3_#: Max 2 digits

LOOP MAX

PFAM_092_4_#: Max 2 digits
PFAM_092_5_#: Max 2 digits
PFAM_092_6_#: Max 2 digits
PFAM_092_7_#: Max 2 digits
PFAM_092_8_#: Max 2 digits
15
SHOW PFAM_092
If PFAM_092 = 1: DISPLAY PFAM_092_0, PFAM_092_1_#, PFAM_092_2_#
AND PFAM_092_AND1_#
If PFAM_092_AND1_# IS CHECKED, DISPLAY PFAM_092_3_# AND
PFAM_092_4_# AND PFAM_092_AND2_# ON THE SAME SCREEN.

PROGRAM. NOTES

IF PFAM_092_AND2_# IS CHECKED, DISPLAY PFAM_092_5_# AND
PFAM_092_6_# AND PFAM_092_AND3_#.
IF PFAM_092_AND3_# IS CHECKED, DISPLAY PFAM_092_7_# AND
_PFAM_092_8_#.

CHECK (ENG)

CHECK (SPAN)

PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all nonresidential parents attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and
NONRES_PARENT_UID≠PCPARTNERID until NONRESCOUNT is reached with 15
max.
IF PFAM_092_1> PFAM_092_2 OR
PFAM_092_3 > PFAM_092_4 OR
PFAM_092_5 > PFAM_092_6 OR
PFAM_092_7 > PFAM_092_8, DISPLAY HARD CHECK:
The age this parent stopped living with their biological father should be after
the age they began living with their biological father. Please update your
answer.
If age ranges entered in each set (e.g., PFAM_092_1 through PFAM_092_2)
overlap with an age range entered in another set (e.g., PFAM_092_3 through
PFAM_092_4), display hard check: “The ages you entered overlap. Please
review your answers.”
If age entered in any ﬁeld is >14, display hard check: “This question asks
about birth until the age of 14. Please review your answers.”
IF PFAM_092_1> PFAM_092_2 OR
PFAM_092_3 > PFAM_092_4 OR
PFAM_092_5 > PFAM_092_6 OR
PFAM_092_7 > PFAM_092_8, DISPLAY HARD CHECK:
La edad en la que este padre/madre dejó de vivir con su padre biológico
debe ser después de la edad en que empezó a vivir con su padre
biológico. Actualice su respuesta.
If age ranges entered in each set (e.g., PFAM_092_1 through
PFAM_092_2) overlap with an age range entered in another set (e.g.,

PFAM_092_3 through PFAM_092_4), display hard check: “Las edades
ingresadas se superponen. Revise sus respuestas.”
If age entered in any ﬁeld is >14, display hard check: “Esta pregunta se
reﬁere al nacimiento hasta los 14 años. Revise sus respuestas.”
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN

PFAM_090_#, f_PFAM_091_#

NEXT

PFAM_093_#

PFAM_093_#
ASK

Any PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
How many brothers and sisters does ^{FILL_NONRES_NAME_#} have in total? Please include full, halfand step-siblings even if ^{FILL_NONRES_NAME_#} never lived with them.
ENGLISH

Number of brothers and sisters: ___________

¿Cuántos hermanos y hermanas tiene ^{FILL_NONRES_NAME_#} en total? Incluya a los(as)
hermanos(as) de sangre, medios(as) hermanos(as) o hermanastros(as) aunque
^{FILL_NONRES_NAME_#} nunca haya vivido con ellos.
SPANISH

Número de hermanos y hermanas: ___________

RANGE

0-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a number corresponding to how
many siblings ^{FILLNONRES_NAME_#} has 0-99.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un número correspondiente a
cuántos(as) hermanos(as) tiene ^{FILLNONRES_NAME_#} entre el 0 y el 99.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_088_#, f_PFAM_091_#, f_PFAM_092_#
PFAM_094_#

PFAM_094_#
ASK

PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Which of the following best describes the community in which ^{NONRES_NAME_#} was living at age
14?

ENGLISH

1.   Large or mid-sized city (At least 100,000 residents)
2.   Suburb
3.   Small city or town
4.   Rural area
5.   Indian reservation
6.   Military base

¿Cuál de las siguientes opciones describe mejor la comunidad en la que vivía ^{NONRES_NAME_#} a
los 14 años?

SPANISH

1.   Ciudad grande o mediana (al menos 100,000 habitantes)
2.   Suburbio
3.   Pequeña ciudad o pueblo
4.   Zona rural
5.   Reserva indígena
6.   Base militar

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_093_#
PFAM_095_#

PFAM_095_#
ASK

PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
The next few questions are about ^{NONRES_NAME_#}'s parents.
In what year was ^{NONRES_NAME_#}'s mother born?
ENGLISH

Year: ________________

Las siguientes preguntas son sobre los padres de ^{NONRES_NAME_#}.
¿En qué año nació la madre de ^{NONRES_NAME_#}?
SPANISH

Año: ________________

RANGE

1880-2000

LIMITS

Max 4 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a year between 1880 and 2000.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un año entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_094_#
PFAM_095_# = DK or REF: PFAM_096_#;
ELSE: PFAM_097_#

PFAM_096_#
ASK

PFAM_095_# = DK or REF (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Do you know about what year she was born? An estimate would be helpful.
ENGLISH

Year: ________________

¿Sabe aproximadamente en qué año nació? Una estimación sería útil.
SPANISH

Año: ________________

RANGE

1880-2000

LIMITS

Max 4 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a year between 1880 and 2000.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un año entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_095_# = DK or REF
PFAM_097_#

PFAM_097_#
ASK

PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
What is the highest educational degree that ^{NONRES_NAME_#}'s mother received?

ENGLISH

0.   None
1.    High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2.    High school diploma (Regular 12-year program)
3.    Associate/Junior college (AA, AS)
4.    Bachelor's degree (BA, BS)
5.   Master's degree (MA, MBA, MS)
6.   Doctoral degree (PhD, EdD)
7.   Professional degree (MD, DDS, JD)

¿Cuál es el título educativo más alto que obtuvo la madre de ^{NONRES_NAME_#}?

SPANISH

0.   Ninguno
1.    Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2.    Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3.    Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4.    Título de cuatro años (BA, BS, por sus siglas en inglés)
5.   Maestría (MA, MBA, MS, por sus siglas en inglés)
6.   Doctorado (PhD, EdD, por sus siglas en inglés)
7.   Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_095_#, PFAM_096_#
PFAM_098_#

PFAM_098_#
ASK

PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Next are a few questions about ^{NONRES_NAME_#}'s father.
In what year was ^{NONRES_NAME_#}'s father born?
ENGLISH

Year: ________________

Las siguientes preguntas son sobre el padre de ^{NONRES_NAME_#}.
¿En qué año nació el padre de ^{NONRES_NAME_#}?
SPANISH

Año: ________________

RANGE

1880-2000

LIMITS

Max 4 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a year between 1880 and 2000.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un año entre 1880 y 2000.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_097_#
PFAM_098_# = DK OR REF: PFAM_099_#;
ELSE: PFAM_100_#

PFAM_099_#
ASK

PFAM_098_# = DK or REF (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
Do you know about what year he was born? An estimate would be helpful.
ENGLISH

Year: ________________

¿Sabe aproximadamente en qué año nació? Una estimación sería útil.
SPANISH

Año: ________________

RANGE

1880-2000

LIMITS

Max 4 digits

LOOP MAX

CHECK (ENG)

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
HARD CHECK: IF OUT OF RANGE, DISPLAY: Please enter a year between 1880 and 2000.

CHECK (SPAN)

HARD CHECK: IF OUT OF RANGE, DISPLAY: Ingrese un año entre 1880 y 2000.

PROGRAM. NOTES

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_098_# = DK or REF
PFAM_100_#

PFAM_100_#
ASK

Any PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
What is the highest educational degree that ^{NONRES_NAME_#}'s father received?

ENGLISH

SPANISH

0.   None
1.    High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2.    High school diploma (Regular 12-year program)
3.    Associate/Junior college (AA, AS)
4.    Bachelor's degree (BA, BS)
5.   Master's degree (MA, MBA, MS)
6.   Doctoral degree (PhD, EdD)
7.   Professional degree (MD, DDS, JD)
¿Cuál es el título educativo más alto que obtuvo el padre de ^{NONRES_NAME_#}?
0.   Ninguno
1.    Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2.    Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3.    Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4.    Título de cuatro años (BA, BS, por sus siglas en inglés)
5.   Maestría (MA, MBA, MS, por sus siglas en inglés)
6.   Doctorado (PhD, EdD, por sus siglas en inglés)
7.   Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_098_#, PFAM_099_#
PFAM_101_#

PFAM_101_#
ASK

Any PFAM_075_#_# = 1 (Continue PFAM LOOP 1)

QUESTION TYPE

Numeric

FILLS (ENG)

USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#

FILLS (SPAN)
USE FILL_NONRES_NAME_# CREATED IN PFAM_073_#
How many times has ^{NONRES_NAME} been legally married? Please include their current marriage if
they are married now.
ENGLISH

Number of Times: ________________

¿Cuántas veces ha estado casado(a) legalmente ^{NONRES_NAME}? Incluya su matrimonio actual si
está casado(a) en este momento.
SPANISH

Número de veces: ________________

RANGE

0-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_100_#
PFAM_102_#

PFAM_102_#
ASK
QUESTION TYPE

NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID (End
PFAM LOOP 1)
Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
PFAM LOOP 1: Repeat PFAM_073_# through PFAM_101_# for all non-residential parents
attached to eligible youths in the household for whom
NONRES_PARENT_UID≠PCSPOUSEID and NONRES_PARENT_UID≠PCPARTNERID until
NONRESCOUNT is reached with 15 max.
This is a computer check. Do not display.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI / CAWI

NOTES
LEAD-IN
NEXT

PFAM_75_#_#, PFAM_076_#, PFAM_101_#
IF LOOP NUMBER < NONRESCOUNT: PFAM_072;
ELSE: PCAL_001

NLSY27 Specifications Formatting
Parent/Caregiver Survey, Parent Calendar
PRELOADS:
YOUTHROSTERNUM: Total number of eligible youth in YOUTHROSTER, HHS
PCMART: Parent’s marital status, PINF
PCPART: Indicator for residential partner, PINF
ADULTLIST: List of household members aged 18 and above, PINF
PCSPOUSE: Name of responding P/C spouse, PINF
PCPARTNER: Name of responding P/C unmarried partner, PINF
YOUTHDOBYOUTH_DOB: for each eligible youth
HHNAMEHH_NAME: names of all household members, HHS
ADULTROSTER: list of all adult household members from HHS
DERIVED VARIABLES:
PCPARTNUM - Count of reported spouses and cohabiting partners from partner roster; derived from
PCAL-011
PCPARTCURR – Flag for current partner/caregiver - set equal to 1 for current partner of
partner/caregiver, 0 for all others; derived from PCAL-011 and PCAL-012
TEENPARENT- Flag for whether responding parent/caregiver was under 18 when oldest eligible youth
was born

Paradata:
Capture item level timing.
Include a time/date stamp at beginning and end of module.
General Notes:
• Do not display response option numbers/letters.
• Do not display DK and REF on each screen at loading.
o If R tries to move forward without providing a response, display DK (‘Don’t know’) and REF (‘Prefer
not to answer’) on screen. For Spanish: display DK (‘No lo sé’) and REF (‘Prefiero no contestar’) on
screen
 Unless otherwise noted, include a soft prompt for R to respond or select DK/REF option:
“Your answers are very important. Please consider selecting a response.”
 For Spanish: “Sus respuestas son muy importantes. Considere la posibilidad de seleccionar
una respuesta.”
o If R still tries to move forward without answering, assign REF code to missing response.

PCAL_001
ASK

All respondents

QUESTION TYPE

Informational
Create ﬁll, FILL_PCAL_001_1
If YOUTHROSTERNUM=1, FILL_PCAL_001_1: “child”
Else, FILL_PCAL_001_1: “children”

FILLS (ENG)

Create ﬁll, FILL_PCAL_001_2
If YOUTHROSTERNUM=1, FILL_PCAL_001_2: “birth”
Else, FILL_PCAL_001_2: “births”
Create ﬁll, FILL_PCAL_001_3
If YOUTHROSTERNUM=1, FILL_PCAL003_001_3: “child’s life”
Else, FILL_PCAL_001_3: “children’s lives”
Create ﬁll, FILL_PCAL_001_1
If YOUTHROSTERNUM=1, FILL_PCAL001: “su hijo(a)”
Else, FILL_PCAL001: “sus hijos(as)”

FILLS (SPAN)

Create ﬁll, FILL_PCAL_001_2
If YOUTHROSTERNUM=1, FILL_PCAL001: “el nacimiento”
Else, FILL_PCAL001: “los nacimientos”
Create ﬁll, FILL_PCAL_001_3
If YOUTHROSTERNUM=1, FILL_PCAL003: “la vida de su hijo(a)”
Else, FILL_PCAL003: “la vida de sus hijos(as)“

ENGLISH

SPANISH

Now we would like to find out a little about your life history. In this section we are especially
interested in your marriage and cohabitation history. Since this survey is mainly concerned with your
^{FILL_PCAL_001_01} who will be in our study, we will concentrate on events which have happened
since their ^{FILL_PCAL_001_02}. Later in the survey, there will be more questions specifically about
events in your ^{FILL_PCAL_001_03} such as living arrangements.
Ahora, quisiera saber un poco sobre la historia de su vida. En esta sección, nos interesa especialmente
saber de su historial de matrimonio y de convivencia. Dado que esta encuesta se refiere
principalmente a ^{FILL_PCAL_001_01} en nuestro estudio, nos enfocaremos en los acontecimientos
que han sucedido desde ^{FILL_PCAL_001_02}. Más adelante en la encuesta, habrá más preguntas
específicas sobre los acontecimientos de ^{FILL_PCAL_001_03}, como cuestiones de vivienda.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CAWI, CASI

LEAD-IN
NEXT

PFAM_102
PCAL_002

PCAL_002
ASK

All respondents

QUESTION TYPE

Informational

FILLS (ENG)
FILLS (SPAN)
In order to keep all the dates straight, most people find it easier to use a calendar. We find that people
are often better at recalling the dates of events if they think of them in relation to important
ENGLISH milestones in their lives such as the date of their marriage or the birthdates of their children. You can
access the calendar during this section of the survey by clicking on the calendar icon in the top left of
your screen.
Para tener todas las fechas claras, a la mayoría de las personas les resulta más fácil usar un calendario.
Descubrimos que suelen recordar mejor las fechas de los acontecimientos si piensan en ellos en
SPANISH relación con hitos importantes de su vida, como la fecha de su matrimonio o la del nacimiento de sus
hijos(as). Puede acceder al calendario durante esta sección de la encuesta haciendo clic en el ícono del
calendario ubicado en la parte superior izquierda de su pantalla.
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

DISPLAY CALENDAR

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_001
PCAL_003

PCAL_003
ASK

All respondents

QUESTION TYPE

Informational
Create ﬁll, FILL_PCAL_003
If YOUTHROSTERNUM=1, FILL_PCAL_003: “date of your child who is”
Else, FILL_PCAL_003: “dates of your children who are”

FILLS (ENG)

FILLS (SPAN)

ENGLISH

SPANISH

Create ﬁll, FILL_PCAL_003
If YOUTHROSTERNUM=1, FILL_PCAL_003: “la fecha de nacimiento de su hijo(a)
que participa”
Else, FILL_PCAL_003: “las fechas de nacimiento de sus hijo(a)s que participan”

As you can see, this calendar has months and years across the top and a space listed for events down
the side. Each month of a particular year is represented by a box. If you click on the box for a particular
month, the calendar will expand to show you days. The calendar will automatically display the birth
^{PCAL_003} in the study.
Como puede ver, este calendario tiene los meses y los años en la parte superior y un espacio para los
acontecimientos en el costado. Los meses de cada año concreto están representados por casillas. Si le
hace clic a la casilla de un mes concreto, el calendario se ampliará para mostrarle los días. El
calendario mostrará automáticamente ^{PCAL_003} en el estudio.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

CREATE TEENPARENT=1 IF PCAGE-YOUTHAGE(oldest youth)<18. Else
TEENPARENT=0.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN

PCAL_002

NEXT

PCAL_007

PCAL_007
ASK

All respondents

QUESTION TYPE

Informational

FILLS (ENG)
FILLS (SPAN)
To access the calendar, just click on the calendar icon at the top left of your screen. Feel free to refer
to it as much or as little as you want to help you answer the survey questions. People often find it
especially useful when answering questions about their marriage and cohabitation, residential moves,
ENGLISH
and the schooling and living arrangements of their children. As you provide time periods and dates in
the survey, they will be automatically added to your calendar.

SPANISH

Para acceder al calendario, haga clic en el ícono del calendario ubicado en la parte superior izquierda
de su pantalla. Siéntase libre de consultarlo tanto o tan poco como quiera para responder las
preguntas de la encuesta. Las personas suelen encontrarlo especialmente útil a la hora de responder
preguntas sobre su matrimonio y convivencia, las mudanzas residenciales, y la escolarización y
vivienda de sus hijos(as). A medida que nos dé períodos de tiempo y fechas en la encuesta, se irán
añadiendo automáticamente a su calendario.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_003
PCAL_008

PCAL_008
ASK

All respondents

QUESTION TYPE

Informational

FILLS (ENG)
FILLS (SPAN)
These next questions are about marriages and cohabitating relationships.

ENGLISH

In a legal marriage, spouses may live together in the same household, but there may be times when
married spouses live apart, for example when away for work or on military assignments.
Some couples live together in cohabitating relationships without being legally married. By cohabitating
relationships, we mean romantic or sexual relationships in which partners establish one household
and live together for a period of at least three months.
Las siguientes preguntas son sobre matrimonios y relaciones de convivencia.

SPANISH

En un matrimonio legal, los(as) cónyuges pueden vivir juntos(as) en el mismo hogar, pero puede haber
ocasiones en que quienes están casados(as) vivan separados(as), por ejemplo, cuando trabajan en
otro lugar o tienen asignaciones militares.
Algunas parejas en relaciones de convivencia viven juntas sin estar legalmente casadas. Por
“relaciones de convivencia” nos referimos a las relaciones románticas o sexuales en las que los
miembros de la pareja establecen un hogar y viven juntos durante un período de al menos tres meses.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_007
If PCMART>=1: PCAL_010
Else: PCAL_009

PCAL_009
ASK

PCMART<1

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Have you ever been legally married or lived with someone in a cohabitating relationship?

ENGLISH

By cohabitating relationships, we mean romantic or sexual relationships in which partners establish
one household and live together for a period of at least three months.

1. Yes
0. No
¿Alguna vez has estado legalmente casado(a) o has vivido con alguien en una relación de convivencia?

SPANISH

Por “relaciones de convivencia” nos referimos a las relaciones románticas o sexuales en las que los
miembros de la pareja establecen un hogar y viven juntos durante un período de al menos tres meses.

1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_008
PCAL_009=1: PCAL_010
Else: PCAL_071

PCAL_010
ASK

PCMART>=1 or PCAL_009=1

QUESTION TYPE

Numeric
Create ﬁll, FILL_PCAL_010:
If PCPART>0, FILL_PCAL_010: “Including your current partner, how”
Else, FILL_PCAL_010: “How”

FILLS (ENG)

Create ﬁll, FILL_PCAL_010:
If PCPART>0, FILL_PCAL_010: “Incluyendo a su pareja actual, ¿con cuántas”
Else, FILL_PCAL_010: “¿Con cuántas”

FILLS (SPAN)

^{FILL_PCAL_010} many partners in total have you ever been legally married to or lived with in a
cohabitating relationship?
ENGLISH By cohabitating relationships, we mean romantic or sexual relationships in which partners establish one
household and live together for a period of at least three months.
Enter Number: ________________
^{FILL_PCAL_010} parejas en total ha estado casado(a) legalmente o ha convivido?
SPANISH

Por “relaciones de convivencia” nos referimos a las relaciones románticas o sexuales en las que los
miembros de la pareja establecen un hogar y viven juntos durante un período de al menos tres meses.

RANGE

Ingrese un número: ________________
0-15

LIMITS

2 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

SOFT CHECK IF PCAL_010=0:
“Earlier, you reported having a current spouse or partner or answered that you have been
legally married or lived in a cohabiting relationship..”Please include your current spouse or
cohabiting partner in your number.”
HARD CHECK IF PCAL_010 IS >15: ‘Please enter a number of partners to whom you were
legally married or lived with in a cohabiting relationship between 1 and 15.’
SOFT CHECK IF PCAL_010=0:
“Antes indicó tener un cónyuge o pareja actual o respondió que ha estado casado(a)
legalmente o que ha vivido en una relación de convivencia. Incluya a su cónyuge o pareja
de convivencia actual en su número.” (Return R to PCAL_009)
HARD CHECK IF PCAL_010 IS >15: ‘Ingrese un número de parejas con las que estuvo
casado(a) legalmente o convivió entre el 1 y el 15.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_008, PCAL_009
If PCAL_010=0 or DK or REF: PCAL_071
Else: PCAL_011

f_PCAL_011
PCAL_011NAME_X
ASK

PCMART>=1 or PCAL_009=1
Roster and textbox
QUESTION TYPE
Radio button
Create fill, FILL_PCAL_011:
If PCPART>1, FILL_PCAL_011: “current”
FILLS (ENG)
Else, FILL_PCAL_011: “most recent”
NUMPART: ‘PCAL_010’
Create fill, FILL_PCNUM: ‘PCPARTNUM’
Create fill, FILL_PCAL_011:
If PCPART>1, FILL_PCAL_011: “actual”
FILLS (SPAN)
Else, FILL_PCAL_011: “más reciente”
NUMPART: ‘PCAL_010’
Create ﬁll, FILL_PCNUM: ‘PCPARTNUM’
In order to refer to them in later questions, please provide a unique name or nickname for each of the
partners whom you have ever been legally married to or lived with in a cohabitating relationship.
Please begin with the first partner you ever married or lived with and continue through with your
^{FILL_ PCAL_011} one. List each partner on a separate row in the table below.
[PCAL_011NAME_1]
ENGLISH

[PCAL_011NAME_2]
[PCAL_011NAME_3]
[PCAL_011NAME_4]
[PCAL_011NAME_5]
Para referirme a estas personas en preguntas posteriores, deme un nombre o apodo único de cada
una de las parejas con las que ha estado legalmente casado(a) o con las que vivió en una relación de
convivencia.
Empiece por la primera pareja con la que se casó o vivió y continúe con la ^{FILL_ PCAL_011}. Enumere
a cada pareja en una fila separada de la tabla siguiente.
[PCAL_011NAME_1]

SPANISH

[PCAL_011NAME_2]
[PCAL_011NAME_3]
[PCAL_011NAME_4]
[PCAL_011NAME_5]

RANGE

LIMITS
LOOP MAX

PROGRAM. NOTES

SYSTEM PROVIDE A TABLE FOR THE R TO LIST ALL SPOUSES OR PARTNERS. PLEASE LIST UP
TO 5 RESPONSE BLANKS PER SCREEN AND INCLUDE A BUTTON BELOW THE LIST TO “ADD
MORE PARTNERS” (FOR SPAN: “AÑADIR MÁS PAREJAS”). IF THE BUTTON IS SELECTED,
REPEAT THE PROCESS ON THE NEXT SCREEN TO ALLOW UP TO 15 PARTNERS.
CREATE VAR PCPARTNUM AND SET EQUAL TO NUMBER OF ROWS WITH ENTRIES IN
PCAL_011 (COUNT OF PARTNERS).).

CHECK (ENG)

CHECK (SPAN)

If PCPARTNUM≠PCAL_010, display soft check:
You reported that you have had ^{PCAL_010} partners to whom you were married or
with whom you cohabited, but you listed ^{PCPARTNUM} partners. Please add partners
you may have missed by clicking "Back" or update the number of partners you reported
by clicking here. (EMBED LINK TO RETURN TO PCAL_010 in “clicking here”).
If PCPARTNUM≠PCAL_010, display soft check:
Informó que tuvo ^{PCAL_010} parejas con las que estuvo casado o con las que cohabitó,
pero incluyó ^{PCPARTNUM} parejas. Agregue las parejas que no haya incluido haciendo
clic en "Atrás" o actualice el número de parejas que informó haciendo clic aquí. (EMBED
LINK TO RETURN TO PCAL_010 in “clic aquí”).

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_010
If PCPARTNUM>0: PCAL_011a
If PCPARTNUM=0: PCAL_071

f_PCAL_011a
PCAL_011MAR_X
ASK

PCPARTNUM>0

QUESTION TYPE

Radio button

FILLS (ENG)

Create ﬁll, FILL_ PCAL_011NAME_X: ‘PCAL_011NAME_X’

FILLS (SPAN)
Create ﬁll, FILL_ PCAL_011NAME_X: ‘PCAL_011NAME_X’
For each partner below, please indicate whether you were ever legally married to them or not.
TABLE ROWS:

ENGLISH

1. ^{FILL_PCAL_011NAME_X}
2. ^{FILL_PCAL_011NAME_X}
3. ^{FILL_PCAL_011NAME_X}
4. ^{FILL_PCAL_011NAME_X}
5. ^{FILL_PCAL_011NAME_X}
6. ^{FILL_PCAL_011NAME_X}
7. ^{FILL_PCAL_011NAME_X}
8. ^{FILL_PCAL_011NAME_X}
9. ^{FILL_PCAL_011NAME_X}
10. ^{FILL_PCAL_011NAME_X}
11. ^{FILL_PCAL_011NAME_X}
12. ^{FILL_PCAL_011NAME_X}
13. ^{FILL_PCAL_011NAME_X}
14. ^{FILL_PCAL_011NAME_X}
15. ^{FILL_PCAL_011NAME_X]
TABLE COLUMNS:
1. Yes
0. No
TABLE HEADER:
Ever Legally Married
Indique si alguna vez estuvo casado(a) legalmente con una de las parejas que figuran a continuación.
TABLE ROWS:

SPANISH

1. ^{FILL_PCAL_011NAME_X}
2. ^{FILL_PCAL_011NAME_X}
3. ^{FILL_PCAL_011NAME_X}
4. ^{FILL_PCAL_011NAME_X}
5. ^{FILL_PCAL_011NAME_X}
6. ^{FILL_PCAL_011NAME_X}
7. ^{FILL_PCAL_011NAME_X}
8. ^{FILL_PCAL_011NAME_X}
9. ^{FILL_PCAL_011NAME_X}
10. ^{FILL_PCAL_011NAME_X}

11.
12.
13.
14.
15.

^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X]

TABLE COLUMNS:
1. Sí
0. No
TABLE HEADER:
Casamiento legal alguna vez
RANGE
LIMITS
LOOP MAX
DISPLAY A TABLE OF ALL SPOUSES OR PARTNERS REPORTED IN PCAL_011 AS ROWS (UP TO
15) AND LEGALLY MARRIED YES/NO AS COLUMNS.
DO NOT DISPLAY EMPTY ROWS.
PROGRAM. NOTES

CREATE SPROSTER: ROSTER OF ALL PARTNERS COLLECTED IN PCAL_011. INLCUDE
PCAL_011NAME_X AND PCAL_011MAR_X IN ROSTER ARRAY.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_011
If PCPART>0: PCAL_012
If PCPART=0: PCAL_019

PCAL_012/PCAL_012b
ASK

PCPART>0

QUESTION TYPE

Radio button

FILLS (ENG)

Use FILL_ PCAL_011NAME_X: ‘PCAL_011NAME_X’ from PCAL_011a

FILLS (SPAN)
Use FILL_ PCAL_011NAME_X: ‘PCAL_011NAME_X’ from PCAL_011a
PCAL_012
Please select your current partner from the list of partners you provided:
1.
2.
3.
4.
5.
6.
7.
ENGLISH

^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}

PCAL_012b
8. ^{FILL_PCAL_011NAME_X}
9. ^{FILL_PCAL_011NAME_X}
10. ^{FILL_PCAL_011NAME_X}
11. ^{FILL_PCAL_011NAME_X}
12. ^{FILL_PCAL_011NAME_X}
13. ^{FILL_PCAL_011NAME_X}
14. ^{FILL_PCAL_011NAME_X}
15. ^{FILL_PCAL_011NAME_X]
-8. My current partner is not listed on this screen.

PCAL_012
Seleccione a su pareja actual de la lista de parejas que nos dio:
1.
2.
3.
4.
5.
6.
7.
SPANISH

^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}
^{FILL_PCAL_011NAME_X}

PCAL_012b
8. ^{FILL_PCAL_011NAME_X}
9. ^{FILL_PCAL_011NAME_X}
10. ^{FILL_PCAL_011NAME_X}
11. ^{FILL_PCAL_011NAME_X}
12. ^{FILL_PCAL_011NAME_X}
13. ^{FILL_PCAL_011NAME_X}
14. ^{FILL_PCAL_011NAME_X}
15. ^{FILL_PCAL_011NAME_X]
-8. Mi pareja actual no aparece en esta pantalla.

RANGE
LIMITS
LOOP MAX
CREATE VAR PCPARTCURR AND SET EQUAL TO 1 FOR PARTNER SELECTED. SET EQUAL TO 0
FOR ALL OTHERS ON PARTNER ROSTER.

PROGRAM. NOTES

SORT SPROSTER SO PCPARTCURR = 1 (CURRENT SPOUSE/PARTNER) APPEARS FIRST, THEN
SORT REMAINING ROSTER LINES IN ORDER REPORTED. IF NONE IN PCPARTCURR = 1, SORT
SPROSTER IN REVERSE ORDER OF REPORTED (MOST RECENT FIRST).
PLEASE INCLUDE A BUTTON BELOW THE LIST TO “MY CURRENT PARTNER IS NOT LISTED
ON THIS SCREEN” (FOR SPAN: “MI PAREJA ACTUAL NO APARECE EN ESTA PANTALLA”. IF
THE BUTTON IS SELECTED, DISPLAY RESPONSES 8 through 15. INCLUDE THE BUTTON AT
THE BOTTOM OF THE SCREEN EACH TIME TO ALLOW THE RESPONDENT TO FIND THEIR
PARTNER.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_011a
If PCPART= 2: PCAL_019
Else: PCAL_013

PCAL_013
ASK

PCPART=1 or 3

QUESTION TYPE

Radio button
Create ﬁll, FILL_PCAL_013_1:
If PCPART=1 and PCSPOUSE not missing, FILL_ PCAL_013_1: PCSPOUSE
Else if PCPARTNER not missing, FILL_PCAL_013_1: PCPARTNER
Else FILL_PCAL_013_1: ‘unknown name’

FILLS (ENG)

FILLS (SPAN)

Create ﬁll, FILL_PCAL_013_2:
If PCMART = 1, FILL_PCAL_013: “spouse”
Else, FILL_PCAL_013: “partner”
Create ﬁll, FILL_PCAL_013_1:
If PCPART=1 and PCSPOUSE not missing, FILL_ PCAL_013_1: PCSPOUSE
Else, if PCPARTNER not missing, FILL_PCAL_013_1: PCPARTNER
Else FILL_PCAL_013_1: ‘nombre desconocido’
Create ﬁll, FILL_PCAL_013_2:
If PCMART = 1, FILL_PCAL_013: “cónyuge”
Else, FILL_PCAL_013: “pareja”

Just to confirm, we have ^{FILL_PCAL_013_1} as your current ^{FILL_PCAL_013_2}. living in your
household. Is that correct?
ENGLISH

1. Yes
0. No
Para confirmar, tenemos registrado que ^{FILL_PCAL_013_1} es su ^{FILL_PCAL_013_2} actual,
viviendo en su hogar. ¿Es correcto?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_012
PCAL_013=0: PCAL_014
Else: PCAL_018

PCAL_014
ASK

PCAL_013=0

QUESTION TYPE
FILLS (ENG)

Radio button, special radio
Create ﬁll, FILL_ADULTLIST: Radio button list of HHNAME(s) from ADULTROSTER minus
HHNAME on line 1 (i.e., do not include the informant’s name on the list)

FILLS (SPAN)

Create ﬁll, FILL_ADULTLIST: Radio button list of HHNAME(s) from ADULTROSTER minus
HHNAME on line 1 (i.e., do not include the informant’s name on the list)

Please select your current spouse or partner from the list of household members.
ENGLISH

^{FILL_ADULTLIST}
-9. Not applicable, my current spouse or cohabiting partner is not on this list
Seleccione a su cónyuge o pareja actual de la lista de miembros del hogar.

SPANISH

^{FILL_ADULTLIST}
-9. No corresponde, mi cónyuge o pareja actual no está en esta lista

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Make option -9 an exclusive option.
DISPLAY HH ROSTER IN REVERSE ORDER SO THAT MEMBERS ARE LISTED FROM OLDEST TO
YOUNGEST.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_013
If PCAL_014 = -9: PCAL_015
Else: PCAL_018

PCAL_015
ASK

PCAL_014 = -9

QUESTION TYPE

Textbox

FILLS (ENG)
FILLS (SPAN)
What is the name of your current spouse or cohabiting partner who is missing from the list?
ENGLISH

NAME: ______________________________
¿Cuál es el nombre de su cónyuge o pareja actual con la que convive que no está en la lista?

SPANISH

NOMBRE: ______________________________

RANGE
LIMITS

Max 20 characters

LOOP MAX
PROGRAM. NOTES

UPDATE VARIABLE ‘PCPARTNER’

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_014
PCAL_016

PCAL_016
ASK

PCAL_014 = -9

QUESTION TYPE

Radio button
Create ﬁll, FILL_ PCPARTNER:
FILLS (ENG)
Fill ‘PCPARTNER’
Create ﬁll, FILL_ PCPARTNER:
FILLS (SPAN)
Fill ‘PCPARTNER’
Does ^{FILL_PCPARTNER} currently live with you?
1. Yes
0. No

ENGLISH

¿Vive ^{FILL_PCPARTNER} actualmente con usted?
SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_015
PCAL_017

PCAL_017
ASK

PCAL_014= - 9

QUESTION TYPE

Radio button
Use ﬁll, FILL_PCPARTNER:
FILLS (ENG)
Fill ‘PCPARTNER’
Use ﬁll, FILL_PCPARTNER:
FILLS (SPAN)
Fill ‘PCPARTNER’
Are you currently married to ^{FILL_PCPARTNER}?

ENGLISH

1. Yes
0. No
¿Está casado(a) en este momento con ^{FILL_PCPARTNER}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

IF PCAL_017=1 SET PCSPOUSE=PCPARTNER

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_016
PCAL_018

PCAL_018
ASK

IF PCPART=1 or 3

QUESTION TYPE

Radio button
Create ﬁll, FILL_PCAL_018
If PCSPOUSE≠missing, FILL_PCAL_018: “spouse”
Else, FILL_PCAL_018: “partner”

FILLS (ENG)

FILLS (SPAN)

Create ﬁll, FILL_PCAL_018
If PCSPOUSE≠missing, FILL_PCAL_018: “cónyuge”
Else, FILL_PCAL_018: “pareja”

We have your ^{FILL_PCAL_018} as currently living in your household. Is that correct?
ENGLISH

1. Yes
0. No
Tenemos registrado que su ^{FILL_PCAL_018} vive actualmente en su hogar. ¿Es eso correcto?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_013, PCAL_014, PCAL_017
If PCAL_018=0: PCAL_019
Else: PCAL_022 (Begin PCAL LOOP 1)

PCAL_019
ASK

PCPART=0 or 2 OR (PCPART = 1 or 3 AND PCAL_018 = 0)

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Do you have a spouse or partner who currently lives with you?
ENGLISH

1. Yes
0. No
¿Tiene un cónyuge o pareja que viva actualmente con usted?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_011, PCAL_011a, PCAL_012, PCAL_017, PCAL_018
If PCAL_019=1: PCAL_022 (Begin PCAL LOOP 1)
Else: PCAL_020

PCAL_020
ASK

PCAL_019≠1

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Do you have a spouse who currently does not live with you?
ENGLISH

1. Yes
0. No
¿Tiene un cónyuge que en este momento no viva con usted?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_019
PCAL_022 (Begin PCAL LOOP 1)

PCAL_022_#
ASK

PCPARTNUM>0 (Begin PCAL LOOP 1)

QUESTION TYPE

Informational
Create Fill, FILL_PCAL_SPOUSEPARTNER:
If PCAL_011MAR_X=1 FILL: “spouse”
ELSE FILL “partner”

FILLS (ENG)

Create Fill, FILL_PCAL_SPNAME:
’PCAL_011_X’
Create ﬁll, FILL_PASTCURRENT.
If FILL_PCAL_011NAME_X selected on PCAL_012, FILL_PASTCURRENT: ‘current’
Else FILL_PASTCURRENT: ‘past’
Create Fill, FILL_PCAL_SPOUSEPARTNER:
If PCAL_011MAR_X=1 FILL: “cónyuge”
ELSE FILL“pareja”

FILLS (SPAN)

Create Fill, FILL_PCAL_SPNAME: ’PCAL_011_X’
Create ﬁll, FILL_PASTCURRENT.
If FILL_PCAL_011NAME_X selected on PCAL_012, FILL_PASTCURRENT: ‘actual’
Else FILL_PASTCURRENT: ‘anterior’

ENGLISH

The next questions are about your ^{FILL_PASTCURRENT} ^{FILL_PCAL_SPOUSEPARTNER},
^{FILL_PCAL_SPNAME}.

SPANISH

Las siguientes preguntas son sobre su ^{FILL_PCAL_SPOUSEPARTNER} ^{FILL_PASTCURRENT},
^{FILL_PCAL_SPNAME}.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM
or a maximum of 15 loops is reached

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_018, PCAL_019, PCAL_020
(PCPART=2 or PCAL_020 =1) and PCPARTCURR=1 OR (PCAL_011MAR_X=1 and
PCPARTCURR≠1)]: PCAL_023
Else: PCAL_024

PCAL_023_#
ASK
QUESTION TYPE
FILLS (ENG)

[((PCPART=2 or PCAL_020=1) and PCPARTCURR=1) OR (PCAL_011MAR_X=1 and
PCPARTCURR≠1)] (Continue PCAL LOOP 1)
Radio button
Use ﬁll from PCAL_011: FILL_PCAL_011NAME_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011NAME_X
Did you ever live with ^{FILL_PCAL_011NAME_X}?
ENGLISH

1. Yes
0. No
¿Ha vivido alguna vez con ^{FILL_PCAL_011NAME_X}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM
or maximum loops (15) is reached

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

f_PCAL_022
f_PCAL_024

f_PCAL_024_#
PCAL_024_MO_#/PCAL_024_YR_#
ASK
If PCPARTNUM>0 (Continue PCAL LOOP 1)
PCAL_024_MO: Dropdown
QUESTION TYPE
PCAL_024_YR: Numeric
Create ﬁll, FILL_PCAL_024
If PCAL_023 = 0, FILL_PCAL_024: “marry”
Else, FILL_PCAL_024: “start living with”
FILLS (ENG)
Use ﬁll from PCAL_011: FILL_PCAL_011NAME_X

FILLS (SPAN)

Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
Create ﬁll, FILL_PCAL_024
If PCAL_023 = 0, FILL_PCAL_024: “se casó con”
Else, FILL_PCAL_024: “empezó a vivir con”
Use ﬁll from PCAL_011: FILL_PCAL_011NAME_X’

Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
In what month and year did you ^{FILL_PCAL_024} ^{FILL_PCAL_011NAME_X}} for the first time? Your
best estimate is fine.
ENGLISH

Month: { - Select - } [PCAL_024_MO_#]
Year: _______ [PCAL_024_YR_#]
¿En qué mes y año ^{FILL_PCAL_024} ^{FILL_PCAL_011NAME_X} por primera vez? Proporcione su
mejor estimación.

SPANISH

Mes: { - Seleccione - } [PCAL_024_MO_#]
Año: _______ [PCAL_024_YR_#]
PCAL_024_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCAL_024_YR: 1950-2030
Spanish:

LIMITS

1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”
11 = “Noviembre”
12 = “Diciembre”
PCAL_024_YR: 4 digits

LOOP MAX

15

RANGE

PROGRAM. NOTES

DISPLAY CALENDAR.

CHECK (ENG)
CHECK (SPAN)

Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached.
If PCAL_024_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Please enter a year between 1950 and ^{FILL_INTERVIEWYEAR}
If PCAL_024_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_023, f_PCAL_022
PCAL_025

PCAL_025_#
ASK

If PCPARTNUM>0 (Continue PCAL LOOP 1)

QUESTION TYPE

Numeric
Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (ENG)

Create ﬁll, FILL_PCAL_025
If PCAL_023 = 0, FILL_PCAL_025: “got married”
Else, FILL_PCAL_025: “began living together”
Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)

Create ﬁll, FILL_PCAL_025
If PCAL_023 = 0, FILL_PCAL_025: “se casaron”
Else, FILL_PCAL_025: “empezaron a vivir juntos(as)”
How old was ^{FILL_PCAL_011_X} when you ^{FILL_PCAL_025}?

ENGLISH

Age: ____________
¿Qué edad tenía ^{FILL_PCAL_011_X} cuando ^{FILL_PCAL_025}?

SPANISH

Edad: ____________

RANGE

14-99

LIMITS

2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached
HARD CHECK IF PCAL_025 IS OUT OF RANGE:
Please enter an age for your partner between 14 and 99.
HARD CHECK IF PCAL_025 IS OUT OF RANGE:
Ingrese una edad para su pareja entre 14 y 99 años.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN

f_PCAL_024

NEXT

If PCAL_025=DK or REF: PCAL_026
If PCPARTCURR=1 AND PCAL_011MAR_X=1: f_PCAL_032
If PCPARTCURR=1 AND PCAL_011MAR_X=0: f_PCAL_033
Else: PCAL_027

PCAL_026_#
ASK

PCAL_025=DK (Continue PCAL LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
What is your best guess? Was ^{FILL_PCAL_011_X}...
1.
2.
3.
4.
5.

ENGLISH

Younger than 20 years old?
20 to 24 years old?
25 to 40 years old?
41 to 55 years old?
Older than 55 years old?

¿Podría darme su mejor estimación? Tenía ^{FILL_PCAL_011_X}...

SPANISH

1.
2.
3.
4.
5.

¿Menos de 20 años?
¿De 20 a 24 años?
¿De 25 a 40 años?
¿De 41 a 55 años?
¿Más de 55 años?

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM
or maximum loops (15) is reached

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_025=-2
PCPARTCURR=1 AND PCAL_011MAR_X=1: f_PCAL_032
If PCPARTCURR=1 AND PCAL_011MAR_X=0: f_PCAL_033
Else: PCAL_027

PCAL_027_#
ASK

PCPARTCURR≠1 (Continue PCAL LOOP 1)

QUESTION TYPE

Radio button
Use ﬁll from PCAL_025: FILL_PCAL_025

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X
Use ﬁll from PCAL_025: FILL_PCAL_025

FILLS (SPAN)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

At the time you ^{FILL_PCAL_025} what was the highest educational degree/certificate that
^{FILL_PCAL_011_X} had received?
1. None
2. High school equivalency such as GED (General Education Development) or HiSET (High
School Equivalency Test)
3. High school diploma (Regular 12-year program)
4. Associate’s/Junior College (AA, AS)
5. Bachelor’s degree (BA, BS)
6. Master’s degree (MA, MBA, MS)
7. Doctoral degree (PhD, EdD)
8. Professional degree (MD, DDS, JD)

ENGLISH

En el momento en que ^{FILL_PCAL_025}, ¿cuál era el título educativo/certificado más alto que había
recibido ^{FILL_PCAL_011_X}?

SPANISH

1. Ninguno
2. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de
Educación General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela
Secundaria (HiSET, por sus siglas en inglés)
3. Diploma de escuela secundaria (programa regular de 12 años)
4. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
5. Título de cuatro años (BA, BS, por sus siglas en inglés)
6. Maestría (MA, MBA, MS, por sus siglas en inglés)
7. Doctorado (PhD, EdD, por sus siglas en inglés)
8. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15

Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop
number=PCPARTNUM or maximum loops (15) is reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CAWI, CASI

LEAD-IN
NEXT

PCAL_025, PCAL_026
f_PCAL_028

f_PCAL_028_#
PCAL_028AI_#/PCAL_028AS_#/PCAL_028BL_#/PCAL_028HI_#/PCAL_028ME_#/PCAL_028NH_#/PCAL_028WT_#
ASK
PCPARTCURR≠1 (Continue PCAL LOOP 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
What is ^{FILL_PCAL_011_X}’s race and/or ethnicity? Select all that apply.

ENGLISH

1. American Indian or Alaska Native [PCAL_028AI_#]
2. Asian [PCAL_028AS_#]
3. Black or African American [PCAL_028BL_#]
4. Hispanic or Latino [PCAL_028HI_#]
5. Middle Eastern or North African [PCAL_028ME_#]
6. Native Hawaiian or Pacific Islander [PCAL_028NH_#]
7. White [PCAL_028WT_#]
¿Cuál es la raza y/o el origen étnico de ^{FILL_PCAL_011_X}? Seleccione todas las opciones que
correspondan.

SPANISH

1.
2.
3.
4.
5.
6.
7.

Indígena de las Américas o nativo(a) de Alaska [PCAL_028AI_#]
Asiático(a) [PCAL_028AS_#]
Negro(a) o afroamericano(a) [PCAL_028BL_#]
Hispano(a) o latino(a) [PCAL_028HI_#]
De Medio Oriente o África del norte [PCAL_028ME_#]
Nativo(a) de Hawái o de otras islas del Pacífico [PCAL_028NH_#]
Blanco(a) [PCAL_028WT_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached
Add help text as hover text for each response option.

CHECK (ENG)
CHECK (SPAN)

HELP TEXT (ENG)

DISPLAY HOVER OVER HELP TEXT CORRESPONDING TO EACH RESPONSE OPTION LISTED
BELOW:
1. American Indian or Alaska Native: For example, Navajo Nation, Blackfeet Tribe of the
Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, Aztec, Maya, etc.
2. Asian: For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese,
etc.
3. Black or African American: For example, African American, Jamaican, Haitian,
Nigerian, Ethiopian, Somali, etc.
4. Hispanic or Latino: For example, Mexican, Puerto Rican, Salvadoran, Cuban,
Dominican, Guatemalan, etc.
5. Middle Eastern or North African: For example, Lebanese, Iranian, Egyptian, Syrian,
Iraqi, Israeli, etc.
6. Native Hawaiian or Pacific Islander: For example, Native Hawaiian, Samoan,
Chamorro, Tongan, Fijian, Marshallese, etc.
7. White: For example, English, German, Irish, Italian, Polish, Scottish, etc.

DISPLAY HOVER OVER HELP TEXT CORRESPONDING TO EACH RESPONSE OPTION LISTED
BELOW:
1. Indígena de las Américas o nativo(a) de Alaska: Por ejemplo, de la Nación Navajo,
Tribu Blackfeet de la Reserva Indígena Blackfeet de Montana, Pueblo Nativo del
Gobierno Tradicional Inupiat de Barrow, Comunidad Esquimal Nome, Azteca o Maya.
2. Asiático(a): Por ejemplo, chino(a), indio(a) asiático(a), filipino(a), vietnamita,
coreano(a), japonés(a), etc.
3. Negro(a) o afroamericano(a): Por ejemplo, afroamericano(a), jamaicano(a),
haitiano(a), nigeriano(a), etíope, somalí, etc.
4. Hispano o latino: Por ejemplo, mexicano(a), puertorriqueño(a), salvadoreño(a),
cubano(a), dominicano(a), guatemalteco(a), etc.
5. De Medio Oriente o África del norte: Por ejemplo, libanés(a), iraní, egipcio(a),
sirio(a), iraquí, israelí, etc.
6. Nativo(a) de Hawái o de otras islas del Pacífico: Por ejemplo, nativo(a) hawaiano(a),
samoano(a), chamorro(a), tongano(a), fiyiano(a), marshalés(a), etc.
7. Blanco(a): Por ejemplo, inglés(a), alemán(a), irlandés(a), italiano(a), polaco(a),
escocés(a), etc.

HELP TEXT (SPAN)

MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_027
PCAL_029

PCAL_029_#
ASK

PCPARTCURR≠1 (Continue PCAL LOOP1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
What is ^{FILL_PCAL_011_X}’s sex?
ENGLISH

1.

Male

2. Female

¿Cuál es el sexo de ^{FILL_PCAL_011_X}?
SPANISH

1.
2.

Masculino
Femenino

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_028
If PCAL_011MAR_X=1 and PCAL_023=0: PCAL_030
Else If PCAL_011MAR_X=1: PCAL_032
Else: PCAL_033

PCAL_030_#
ASK

PCAL_011MAR_X = 1 and PCAL_023 = 0 (Continue PCAL LOOP1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
What is your current marital status with ^{FILL_PCAL_011_X}?
1.
2.
3.
4.

ENGLISH

Still married
AnnulmentDivorced
Annulled marriage
Widowed (^{FILL_PCAL_011_X} died)

¿Cuál es su estado civil actual con ^{FILL_PCAL_011_X}?
Obtuvo un divorcio legal o una anulación de ^{FILL_PCAL_011_X}?
SPANISH

1.
2.
3.
4.

Todavía casado(a)
Divorciado(a)
Matrimonio anulado
Viudo(a) (^{FILL_PCAL_011_X} murió)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN

NEXT

PCAL_029
If PCAL_030=31 and PCAL_023=0 AND IF PCAL LOOP 1 NUM PCAL_024_MO_#), display soft check: You previously reported
that you ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X} in ^{PCAL_024_MO_#}
^{PCAL_024_YR_#}. Please review your answer.
If PCAL_031_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

IF PCAL_031_YR_# < PCAL_024_YR_# OR (PCAL_031_YR_# = PCAL_024_YR_# AND
PCAL_031_MO_# > PCAL_024_MO_#), display soft check: Anteriormente informó
que ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X} en ^{PCAL_024_MO_#} de
^{PCAL_024_YR_#}. Por favor, revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_030
IF PCAL LOOP 1 NUM PCAL_024_MO_#), display hard check:
You previously reported that you ^{FILL_PCAL_031_2} ^{FILL_PCAL_011NAME_X} in
^{PCAL_024_MO_#} ^{PCAL_024_YR_#}. Please review your answer.
If PCAL_034_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}
CHECK (SPAN)

IF PCAL_034_YR_# < PCAL_024_YR_# OR (PCAL_034_YR_# = PCAL_024_YR_# AND
PCAL_034_MO_# > PCAL_024_MO_#), display hard check:
Anteriormente informó que ^{FILL_PCAL_031_2} ^{FILL_PCAL_011NAME_X} en
^{PCAL_024_MO_#} de ^{PCAL_024_YR_#}. Por favor, revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_033
PCAL_035

PCAL_035_#
ASK

PCAL_033=0 (Continue PCAL LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
During this time that you were living with ^{FILL_PCAL_011_X} were there any changes in your marital
status?
ENGLISH

1. Yes
0. No
Durante el tiempo que estuvo viviendo con ^{FILL_PCAL_011_X}, ¿hubo algún cambio en su estado
civil?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_034
If PCAL_035=1: PCAL_037
Else: PCAL_043

PCAL_037_#_#
ASK

PCAL_035=1 (Begin PCAL LOOP 1a)

QUESTION TYPE

Radio button
Create Fill, FILL_PCAL_FIRSTNEXT:
FILLS (ENG)
IF LOOPNUMBER=1 FILL: “ﬁrst”;
ELSE FILL: “next”
Create Fill, FILL_PCAL_FIRSTNEXT:
FILLS (SPAN)
IF LOOPNUMBER=1 FILL: “la primera vez”;
ELSE FILL: “la siguiente vez”
What was the ^{FILL_PCAL_FIRSTNEXT} change in marital status? Did you . . .
1.
2.
3.
4.
5.

ENGLISH

Become legally married?
Reunite?
Get a legal separation only?
Get a legal divorce?
Get an annulment?

¿Cuál fue ^{FILL_PCAL_FIRSTNEXT} que hubo un cambio en su estado civil? Cuando...

SPANISH

1.
2.
3.
4.
5.

Se casó legalmente
Volvió con esa persona
Obtuvo solo una separación legal
Obtuvo un divorcio legal
Obtuvo una anulación

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

5
IF PCAL_035 = 1, LOOP THROUGH PCAL LOOP 1A (PCAL_037 – PCAL_041) UNTIL
PCAL_041= 0 OR MAX LOOP NUM (5) REACHED.
IF LOOP NUM = 1 AND IF PCAL_011MAR_X (does not equal) 1 AND PCAL_037_# = 3, 4,
OR 5, DISPLAY SOFT CHECK: You have not previously indicated that you are married to
^{FILL_PCAL_011_X}. Please check your answer.
IF LOOP NUM = 1 AND IF PCAL_011MAR_X (does not equal) 1 AND PCAL_037_# = 3, 4, OR
5, DISPLAY SOFT CHECK: No ha indicado previamente que está casado(a) con
^{FILL_PCAL_011_X}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_035
If PCAL_037=1: PCAL_039
If PCAL_037=3, 4, 5: PCAL_038
Else: PCAL_041

f_PCAL_038_#_#
PCAL_038_MO_#_#/PCAL_038_YR_#_#
ASK
PCAL_037 = 3 or 4 or 5 (Continue PCAL LOOP 1a)
PCAL_038_MO: Dropdown
QUESTION TYPE
PCAL_38_YR: Numeric
Create ﬁll, FILL_PCAL_038:
If PCAL_037 = 3, FILL_PCAL_038: “legal separation”
Else if PCAL_037 = 4, FILL_PCAL_038: “legal divorce”
FILLS (ENG)
Else, if PCAL_037 = 5, FILL_PCAL_038: “annulment

FILLS (SPAN)

Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
Create ﬁll, FILL_PCAL_038:
If PCAL_037 = 3, FILL_PCAL_038: “la separación legal”
Else if PCAL_037 = 4, FILL_PCAL_038: “el divorcio legal”
Else, if PCAL_037 = 5, FILL_PCAL_038: “la anulación”

Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
In what month and year was the ^{FILL_PCAL_038} obtained?
ENGLISH

Month: { - Select - } [PCAL_038_MO_#_#]
Year: _______ [PCAL_038_YR_#_#]
¿En qué mes y año se obtuvo ^{FILL_PCAL_038}?

SPANISH

Mes: { - Seleccione - } [PCAL_038_MO_#_#]
Año: _______ [PCAL_038_YR_#_#]

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

PCAL_038_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCAL_038_YR: 1950-2030
Spanish:
1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”
11 = “Noviembre”
12 = “Diciembre”
PCAL_038_YR: 4 digits
5
DISPLAY CALENDAR.
IF PCAL_035 = 1, LOOP THROUGH PCAL LOOP 1A (PCAL_037 – PCAL_041) UNTIL
PCAL_041= 0 OR MAX LOOP NUM (5) REACHED.
If PCAL_038_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:

Please enter a year between 1950 and ^{FILL_INTERVIEWYEAR}.
IF PCAL_038_YR_# < PCAL_024_YR_# OR (PCAL_038_YR_# = PCAL_024_YR_# AND
PCAL_038_MO_# > PCAL_024_MO_#)), display hard check: You previously reported that
you married ^{FILL_PCAL_011_X} in ^{PCAL_024_MO_#} ^{PCAL_024_YR_#}. Please
review your answer.
If PCAL_038_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.
CHECK (SPAN)

IF PCAL_038_YR_# < PCAL_024_YR_# OR (PCAL_038_YR_# = PCAL_024_YR_# AND
PCAL_038_MO_# > PCAL_024_MO_#)), display hard check: Anteriormente informó que se
casó con ^{FILL_PCAL_011_X} en ^{PCAL_024_MO_#} de ^{PCAL_024_YR_#}. Revise su
respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_037
PCAL_041

f_PCAL_039_#_#
PCAL_039_MO_#_#/PCAL_039_YR_#_#
ASK
PCAL_037 = 1 (Continue PCAL LOOP 1a)
PCAL_039_MO: Dropdown
QUESTION TYPE
PCAL_039_YR: Numeric
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Use ﬁll from PCAL_037: FILL_PCAL_FIRSTNEXT
FILLS (ENG)
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
Use ﬁll from PCAL_034_#: FILL_PCAL_031_2
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Use ﬁll from PCAL_037: FILL_PCAL_FIRSTNEXT
FILLS (SPAN)
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
Use ﬁll from PCAL_034_#: FILL_PCAL_031_2
In what month and year did you ^{FILL_PCAL_FIRSTNEXT} marry ^{FILL_PCAL_011_X}?
ENGLISH

Month: { - Select - } [PCAL_039_MO_#_#]
Year: _______ [PCAL_039_YR_#_#]
¿En qué mes y año fue ^{FILL_PCAL_FIRSTNEXT} que se casó con ^{FILL_PCAL_011_X}?

SPANISH

Mes: { - Seleccione - } [PCAL_039_MO_#_#]
Año: _______ [PCAL_039_YR_#_#]

RANGE

LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)

PCAL_039_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCAL_039_YR: 1950-2030
Spanish:
1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”
11 = “Noviembre”
12 = “Diciembre”
PCAL_039_YR: 4 digits
5
DISPLAY CALENDAR. FOR [DROPDOWN] MONTH PLEASE USE A STANDARD LIST OF
MONTHS FOR PARTICIPANTS TO SELECT WITH TEXT LABELS AND ASSIGNED TO THE
NUMBER OF THE MONTH 1-12.
IF PCAL_035 = 1, LOOP THROUGH PCAL LOOP 1A (PCAL_037 – PCAL_041) UNTIL
PCAL_041= 0 OR MAX LOOP NUM (5) REACHED.
If PCAL_039_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Please enter a year between 1950 and ^{FILL_INTERVIEWYEAR}.

011MAR_X = 1 AND IF PCAL_039_YR_# < PCAL_024_YR_# OR (PCAL_039_YR_# =
PCAL_024_YR_# AND PCAL_039_MO_# > PCAL_024_MO_#):
You previously reported that you ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X} in
^{PCAL_024_MO_#} ^{PCAL_024_YR_#}. Please review your answer.
If PCAL_039_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.
CHECK (SPAN)

IF 011MAR_X = 1 AND IF PCAL_039_YR_# < PCAL_024_YR_# OR (PCAL_039_YR_# =
PCAL_024_YR_# AND PCAL_039_MO_# > PCAL_024_MO_#):
Anteriormente informó que ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X} en
^{PCAL_024_MO_#} de ^{PCAL_024_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_037
PCAL_041

PCAL_041_#_#
ASK

PCAL_035=1 (End PCAL LOOP 1a)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
During this time that you were living with ^{FILL_PCAL_011_X} was there another change in your
marital status?
ENGLISH

1. Yes
0. No
Durante este tiempo que estuvo viviendo con ^{FILL_PCAL_011_X}, ¿hubo algún otro cambio en su
estado civil?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
IF PCAL_035 = 1, LOOP THROUGH PCAL LOOP 1A (PCAL_037 – PCAL_041) UNTIL
PCAL_041= 0 OR MAX LOOP NUM (5) REACHED.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_037, PCAL_038, PCAL_039
If PCAL_041≠0 AND PCAL LOOP 1a<5: PCAL_037
Else: PCAL_043

PCAL_043_#
ASK

PCAL_033 = 0 or PCAL_030=3 (Continue PCAL LOOP 1)

QUESTION TYPE

Radio button
Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (ENG)

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
At the time you first stopped living with ^{FILL_PCAL_011_X}}, what was your legal relationship with
^{FILL_PCAL_011_X}?
0.
1.
2.
3.
4.

ENGLISH

Never legally married
Legally married
Legally separated
Divorced
Widowed

En el momento en que dejó de vivir con ^{FILL_PCAL_011_X}, ¿cuál era su relación legal con
^{FILL_PCAL_011_X}?
SPANISH

0.
1.
2.
3.
4.

No estaban casados(as) legalmente
Estaban casados(as) legalmente
Estaban separados(as) legalmente
Estaban divorciado(as)
Eran viudos(as)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_030, PCAL_035, PCAL_041
If PCAL_043=4: PCAL_069
Else: PCAL_044

PCAL_044_#
ASK

PCAL_033 =0 or PCAL_030=3 (Continue PCAL LOOP 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use fill from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Did you ever live with ^{FILL_PCAL_011_X} again?
ENGLISH

1. Yes
0. No
¿Ha vivido alguna vez con ^{FILL_PCAL_011_X}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCAL LOOP1 (f_PCAL_022 - f_PCAL_069) until loop number=PCPARTNUM or
maximum loops (15) is reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_043
If PCAL_044=1: PCAL_046 (Begin PCAL LOOP 1b)
Else: PCAL_068

f_PCAL_046_#_#
PCAL_046_MO_#_#/PCAL_046_YR_#_#
ASK
PCAL_044=1 (Begin PCAL LOOP 1b)
PCAL_046_MO: Dropdown
QUESTION TYPE
PCAL_046_YR: Numeric
Use ﬁll from PCAL_011: FILL_PCAL_011_X
FILLS (ENG)
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
Use ﬁll from PCAL_031: FILL_PCAL_031_2
Use ﬁll from PCAL_011: FILL_PCAL_011_X
FILLS (SPAN)
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
Use ﬁll from PCAL_031: FILL_PCAL_031_2
When did you next start living with ^{FILL_PCAL_011_X} again?
ENGLISH

Month: { - Select - } [PCAL_046_MO_#]
Year: _______ [PCAL_046_YR_#]
¿Cuándo fue la siguiente vez que volvió a vivir con ^{FILL_PCAL_011_X}?

SPANISH

Mes: { - Seleccione - } [PCAL_046_MO_#]
Año: _______ [PCAL_046_YR_#]
PCAL_046_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCAL_046_YR: 1950-2030
Spanish:

RANGE

LIMITS

1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”
11 = “Noviembre”
12 = “Diciembre”
PCAL_046_YR: 4 digits

LOOP MAX

5
DISPLAY CALENDAR.

PROGRAM. NOTES

LOOP THROUGH PCAL LOOP 1b (PCAL_046 – PCAL_066) UNTIL PCAL_066≠1 OR MAX
LOOPS (5) REACHED.

CHECK (ENG)

If PCAL_046_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Please enter a year between 1950 and ^{FILL_INTERVIEWYEAR}.
PCAL_046_YR_# < PCAL_024_YR_# OR (PCAL_046_YR_# = PCAL_024_YR_# AND
PCAL_046_MO_# > PCAL_024_MO_#) display hard check:

You previously reported that you ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X} in
^{PCAL_024_MO_#} ^{PCAL_024_YR_#}. Please review your answer.
If PCAL_046_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.
CHECK (SPAN)

IF PCAL_046_YR_# < PCAL_024_YR_# OR (PCAL_046_YR_# = PCAL_024_YR_# AND
PCAL_046_MO_# > PCAL_024_MO_#) display hard check:
Anteriormente informó que ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X} en
^{PCAL_024_MO_#} de ^{PCAL_024_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_044=1
PCAL_047

PCAL_047_#_#
ASK

PCAL_044=1 (Continue PCAL LOOP 1b)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Between the time you left and the time you moved back in with ^{FILL_PCAL_011_X} was there any
change in your marital status with ^{FILL_PCAL_011_X}?
ENGLISH

1. Yes
0. No
Entre el momento en que se fue y el momento en que volvió a vivir con ^{FILL_PCAL_011_X}, ¿hubo
algún cambio en su estado civil con ^{FILL_PCAL_011_X}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
LOOP THROUGH PCAL LOOP 1b (PCAL_046 – PCAL_066) UNTIL PCAL_066≠1 OR MAX
LOOPS (5) REACHED.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_046
If PCAL_047=1: PCAL_050 (begin PCAL LOOP 1b_1)
Else: PCAL_056

PCAL_048_#_#
ASK

PCAL_033 = 1 or DK or REF (Continue PCAL LOOP 1b)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Since you started living with ^{FILL_PCAL_011_X} has there been any change in your and
^{FILL_PCAL_011_X}’s marital status?
ENGLISH

1. Yes
0. No
Desde que empezó a vivir con ^{FILL_PCAL_011_X}, ¿ha habido algún cambio en su estado civil y en el
de ^{FILL_PCAL_011_X}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
LOOP THROUGH PCAL LOOP 1b (PCAL_046 – PCAL_066) UNTIL PCAL_066≠1 OR MAX
LOOPS (5) REACHED.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN

NEXT

PCAL_033, PCAL_046
If PCAL_048=1: PCAL_050 (begin PCAL LOOP 1b_1)
Else if PCPARTCURR=0: PCAL_068
Else if PCAL LOOP 1 NUM PCAL_024_MO_#)), display hard check: You previously reported that
you ﬁrst ^{FILL_PCAL_031_2} with ^{FILL_PCAL_011_X} in ^{PCAL_024_MO_#}
^{PCAL_024_YR_#}. Please review your answer.
If PCAL_051_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

IF PCAL_051_YR_# < PCAL_024_YR_# OR (PCAL_051_YR_# = PCAL_024_YR_# AND
PCAL_051_MO_# > PCAL_024_MO_#)), display hard check:
Anteriormente informó que la primera vez que ^{FILL_PCAL_031_2} ^{FILL_PCAL_011_X}
en ^{PCAL_024_MO_#} de ^{PCAL_024_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_050=3, 4, 5
If PCAL_033=1: PCAL_053
Else: PCAL_054

f_PCAL_052_#_#_#
PCAL_052_MO_#_#_#/PCAL_052_YR_#_#_#
ASK
PCAL_050 = 1 (Continue PCAL LOOP 1b_1)
PCAL_052_MO: Dropdown
QUESTION TYPE
PCAL_052_YR: Numeric
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
FILLS (ENG)
Create ﬁll, FILL_PCAL_052.
If PCAL_032=0 and PCAL_033=1, FILL_PCAL_052: ‘ﬁrst’
Else FILL_PCAL_052: ‘next’
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
FILLS (SPAN)

Create ﬁll, FILL_PCAL_052.
If PCAL_032=0 and PCAL_033=1, FILL_PCAL_052: ‘la primera vez’
Else FILL_PCAL_052: ‘la próxima vez’
In what month and year did you ^{FILL_PCAL_052} marry ^{FILL_PCAL_011_X}?

ENGLISH

Month: { - Select - } [PCAL_052_MO_#_#_#]
Year: _______ [PCAL_052_YR_#_#_#]
¿En qué mes y año fue ^{FILL_PCAL_FIRSTNEXT} que se casó con ^{FILL_PCAL_011_X}?

SPANISH

Mes: { - Seleccione - } [PCAL_052_MO_#_#_#]
Año: _______ [PCAL_052_YR_#_#_#]
PCAL_052_MO_#_#_#: List months in order. 1 = “January”, 2 = “February”, … 12 =
“December”
PCAL_052_YR: 1950-2030
Spanish:

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES

1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”
11 = “Noviembre”
12 = “Diciembre”
PCAL_052_YR_#_#_#: 4 digits
5
DISPLAY CALENDAR.

Loop through PCAL LOOP1b_1 (f_PCAL_050 - f_PCAL_054) until PCAL_053=0 or
PCAL_054=0 or MAX LOOPS (5) is REACHED.
If PCAL_052_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Please enter a year between 1950 and ^{FILL_INTERVIEWYEAR}.
CHECK (ENG)

If PCAL_011MAR_X = 1 AND IF PCAL_052_YR_# < PCAL_024_YR_# OR (PCAL_052_YR_# =
PCAL_024_YR_# AND PCAL_052_MO_# > PCAL_024_MO_#):
You previously reported that you married ^{FILL_PCAL_011_X} in ^{PCAL_024_MO_#}
^{PCAL_024_YR_#}. Please review your answer.
If PCAL_052_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

If PCAL_011MAR_X = 1 AND IF PCAL_052_YR_# < PCAL_024_YR_# OR (PCAL_052_YR_# =
PCAL_024_YR_# AND PCAL_052_MO_# > PCAL_024_MO_#):
Anteriormente informó que se casó con ^{FILL_PCAL_011_X} en ^{PCAL_024_MO_#} de
^{PCAL_024_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_050
If PCAL_033=1: PCAL_053
Else: PCAL_054

PCAL_053_#_#_#
ASK

If PCAL_033 = 1 and PCAL_048 = 1 (Continue PCAL LOOP 1b_1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
Was there another change in the marital status between you and ^{FILL_PCAL_011_X}?
ENGLISH

1. Yes
0. No
¿Hubo algún otro cambio en el estado civil entre usted y ^{FILL_PCAL_011_X}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
Loop through PCAL LOOP1b_1 (f_PCAL_050 - f_PCAL_054) until PCAL_053=0 or
PCAL_054=0 or MAX LOOPS (5) is REACHED.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_051, PCAL_050
IF PCAL_053=1 and PCAL Loop 1b_1<5: PCAL_050
IF PCAL_033=1 IF PCAL LOOP 1 NUM PCAL_046_MO_#), display hard check:
You previously reported that you next started living with ^{FILL_PCAL_011NAME_X} in
^{PCAL_046_MO_#} ^{PCAL_046_YR_#}. Please review your answer.

If PCAL_057_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.
CHECK (SPAN)

IF PCAL_057_YR_# < PCAL_046_YR_# OR (PCAL_057_YR_# = PCAL_046_YR_# AND
PCAL_057_MO_# > PCAL_046_MO_#), display hard check:
Anteriormente informó que comenzó a vivir nuevamente con ^{FILL_PCAL_011NAME_X}
en ^{PCAL_046_MO_#} de ^{PCAL_046_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_056
PCAL_058

PCAL_058_#_#
ASK

PCAL_033 = 0 (Continue PCAL LOOP 1b)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
During this time that you were living with ^{FILL_PCAL_011_X}, were there any changes in your marital
status?
ENGLISH

1. Yes
0. No
Durante el tiempo que estuvo viviendo con ^{FILL_PCAL_011_X}, ¿hubo algún cambio en su estado
civil?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
LOOP THROUGH PCAL LOOP 1b (PCAL_046 – PCAL_066) UNTIL PCAL_066≠1 OR MAX
LOOPS (5) REACHED.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_056=1, PCAL_057
If PCAL_058=1: PCAL_060 (Begin PCAL LOOP 1b_2)
Else IF PCAL_056=1 and PCAL LOOP 1 NUM PCAL_046_MO_#)), display hard check: You
previously reported that you started living with ^{FILL_PCAL_011_X} in
^{PCAL_046_MO_#} ^{PCAL_046_YR_#}. Please review your answer.
IF LOOP NUM > 1 AND (IF PCAL_061_YR_# < PCAL_062_YR_# OR (PCAL_061_YR_# =
PCAL_062_YR_# AND PCAL_061_MO_# > PCAL_062_MO_#)), display hard check: You
previously reported that you married ^{FILL_PCAL_011_X} in ^{PCAL_062_MO_#}
^{PCAL_062_YR_#}. Please review your answer.
If PCAL_061_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

IF LOOP NUM = 1 AND (IF PCAL_061_YR_# < PCAL_046_YR_# OR (PCAL_061_YR_# =
PCAL_046_YR_# AND PCAL_061_MO_# > PCAL_046_MO_#)), display hard check:
Anteriormente informó que comenzó a vivir con ^{FILL_PCAL_011_X} en
^{PCAL_046_MO_#} de ^{PCAL_046_YR_#}. Revise su respuesta.
IF LOOP NUM > 1 AND (IF PCAL_061_YR_# < PCAL_062_YR_# OR (PCAL_061_YR_# =
PCAL_062_YR_# AND PCAL_061_MO_# > PCAL_062_MO_#)), display hard check:
Anteriormente informó que se casó con ^{FILL_PCAL_011_X} en ^{PCAL_062_MO_#} de
^{PCAL_062_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_060=3, 4, 5
PCAL_063 (End PCAL LOOP 1b_2)

f_PCAL_062_#_#_#
PCAL_062_MO_#_#_#/PCAL_062_YR_#_#_#
ASK
PCAL_060=1 (Continue PCAL LOOP 1b_2)
PCAL_062_MO_#_#_#: Dropdown
QUESTION TYPE
PCAL_062_YR_#_#_#: Numeric
Use ﬁll from PCAL_011: FILL_PCAL_011_X
FILLS (ENG)
Use ﬁll from PCAL_037: FILL_PCAL_FIRSTNEXT
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
Use ﬁll from PCAL_011: FILL_PCAL_011_X
FILLS (SPAN)
Use ﬁll from PCAL_037: FILL_PCAL_FIRSTNEXT
Use ﬁll from PCAL_024_#: FILL_INTERVIEWYEAR
In what month and year did you ^{FILL_PCAL_FIRSTNEXT} marry ^{FILL_PCAL_011_X}?
ENGLISH

Month: { - Select - } [PCAL_062_MO_#_#_#]
Year: _______ [PCAL_062_YR_#_#_#]
¿En qué mes y año fue ^{FILL_PCAL_FIRSTNEXT} que se casó con ^{FILL_PCAL_011_X}?

SPANISH

Mes: { - Seleccione - } [PCAL_062_MO_#_#_#]
Año: _______ [PCAL_062_YR_#_#_#]
PCAL_062_MO_#_#_#: List months in order. 1 = “January”, 2 = “February”, … 12 =
“December”
PCAL_062_YR: 1950-2030
Spanish:

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

1 = “Enero”
2 = “Febrero”
3 = “Marzo”
4 = “Abril”
5 = “Mayo”
6 = “Junio”
7 = “Julio”
8 = “Agosto”
9 = “Septiembre”
10 = “Octubre”
11 = “Noviembre”
12 = “Diciembre”
PCAL_062_YR_#_#_#: 4 digits
5
DISPLAY CALENDAR.
Loop through PCAL LOOP 1b_2 (PCAL_060-PCAL_063) until PCAL_063≠ 1 or max loops (5)
reached.
If PCAL_062_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Please enter a year between 1950 and ^{FILL_INTERVIEWYEAR}.
If PCAL_011MAR_X = 1 AND IF PCAL_062_YR_# < PCAL_052_YR_# OR (PCAL_062_YR_# =
PCAL_052_YR_# AND PCAL_062_MO_# > PCAL_052_MO_#):

You previously reported that you married ^{FILL_PCAL_011_X} in ^{PCAL_052_MO_#}
^{PCAL_052_YR_#}. Please review your answer.
If PCAL_062_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.
CHECK (SPAN)

If PCAL_011MAR_X = 1 AND IF PCAL_062_YR_# < PCAL_052_YR_# OR (PCAL_062_YR_# =
PCAL_052_YR_# AND PCAL_062_MO_# > PCAL_052_MO_#):
Anteriormente informó que se casó con ^{FILL_PCAL_011_X} en ^{PCAL_052_MO_#} de
^{PCAL_052_YR_#}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_060=1
PCAL_063 (End PCAL LOOP 1b_2)

PCAL_063_#_#_#
ASK

PCAL_058=1 (End PCAL LOOP 1b_2)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCAL_011: FILL_PCAL_011_X

FILLS (SPAN)
Use ﬁll from PCAL_011: FILL_PCAL_011_X
During this time that you were living with ^{FILL_PCAL_011_X} was there another change in your
marital status?
ENGLISH

1. Yes
0. No
Durante este tiempo que estuvo viviendo con ^{FILL_PCAL_011_X}, ¿hubo algún otro cambio en su
estado civil?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
Loop through PCAL LOOP 1b_2 (PCAL_060-PCAL_063) until PCAL_063≠ 1 or max loops (5)
reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_060, PCAL_061, PCAL_062
IF PCAL_063=1 and PCAL LOOP 1b_2<5: PCAL_060
ELSE IF PCAL_033=1 and IF PCAL LOOP 1 NUM PCAL_024_MO_#), display hard check: You previously reported that
you ^{FILL_PCAL_031} ^{FILL_PCAL_011_X} in ^{PCAL_024_MO_#} ^{PCAL_024_YR_#}.
Please review your answer.
If PCAL_069_YR OUT OF RANGE OR IN THE FUTURE ON DOI, DISPLAY HARD CHECK:
Ingrese un año entre 1950 y ^{FILL_INTERVIEWYEAR}.

CHECK (SPAN)

IF PCAL_069_YR_# < PCAL_024_YR_# OR (PCAL_069_YR_# = PCAL_024_YR_# AND
PCAL_069_MO_# > PCAL_024_MO_#), display hard check: Anteriormente informó que
^{FILL_PCAL_031} ^{FILL_PCAL_011_X} en ^{PCAL_024_MO_#} de ^{PCAL_024_YR_#}.
Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI, CASI

NOTES
LEAD-IN
NEXT

PCAL_065, PCAL_068
IF PCAL LOOP 1 NUM 0: PHEA_015; Else: PHEA_019

f_PHEA_015_#
PHEA_015HEIGHTFT_# / PHEA_015HEIGHTIN_#
ASK
If NRPARENTQCOUNT > 0 (Continue PHEA Loop 1)
Numeric: PHEA_015HEIGHTFT_# / PHEA_015HEIGHTIN_#
QUESTION TYPE
Special radio button
CREATE FILL, FILL_NRYOUTHNAMES: FILL ALL YOUTH NAMES ASSOCIATED WITH
NONRESPARENT FROM NONRESROSTER, (NONRES_YOUTH#_NAME), SEPARATED BY
“and”
FILLS (ENG)
CREATE FILL FILL_NONRESNAME: ‘NONRESNAME’
CREATE FILL_WASIS: IF NONRES_DECEASED=1, FILL_WASIS: ‘was’
ELSE, FILL_WASIS: ‘is’
CREATE FILL, FILL_NRYOUTHNAMES: FILL ALL YOUTH NAMES ASSOCIATED WITH
NONRESPARENT FROM NONRESROSTER, (NONRES_YOUTH#_NAME), SEPARATED BY “y”
FILLS (SPAN)
CREATE FILL FILL_NONRESNAME: ‘NONRESNAME’
CREATE FILL_WASIS: IF NONRES_DECEASED=1, FILL_WASIS: ‘era’
ELSE, FILL_WASIS: ‘es’
The next couple of questions are about ^{FILL_NRYOUTHNAMES}'s birth parent,
^{NONRESNAME}.
ENGLISH

Approximately what ^{FILL_WASIS} their height without shoes?
Feet: _____________ [PHEA_015HEIGHTFT_#]
Inches: _____________ [PHEA_015HEIGHTIN_#]
-8. I prefer to report height in centimeters
Las siguientes preguntas son sobre el(la) padre/madre biológico(a) de ^{FILL_NRYOUTHNAMES},
^{NONRESNAME}.

SPANISH

RANGE
LIMITS
LOOP MAX

¿Aproximadamente cuál ^{FILL_WASIS} su altura sin zapatos?
Pies: _____________ [PHEA_015HEIGHTFT_#]
Pulgadas: _____________ [PHEA_015HEIGHTIN_#]
-8. Prefiero ingresar la altura en centímetros
PHEA_015HEIGHTFT_#: RANGE = 2-6
PHEA_015HEIGHTIN_#: RANGE = 0-11
PHEA_015HEIGHTFT_#: LIMIT = 1 digit
PHEA_015HEIGHTIN_#: LIMIT = 2 digits
15
Loop PHEA Loop 1 (f_PHEA_014 through PHEA_019) FOR EACH NON-RESIDENTIAL
PARENT ON NONRESROSTER

PROGRAM. NOTES

CHECK (ENG)

Create variable PHEALOOP1[#].NONRES_PARENT_UID= NONRES_PARENT_UID
INCLUDE SEPARATE NUMBOX FOR FEET AND INCHES ON SAME ROW WITH
CORRESPONDING LABELS; ALSO INCLUDE A SINGLE SELECT OPTION TO REPORT HEIGHT
IN CENTIMETERS DIRECTLY BELOW NUMBOX ENTRIES.
IF PHEA_015HEIGHTFT_# OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
of feet between 2 and 6.
IF PHEA_015HEIGHTIN_# OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
of inches between 0 and 11.

CHECK (SPAN)

IF PHEA_015HEIGHTFT_# OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número de
pies entre 2 y 6.
IF PHEA_015HEIGHTIN_# OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número de
pulgadas entre 0 y 11.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_014
If PHEA_015_#=-8: PHEA_016_#; Else: PHEA_017_#

f_PHEA_016_#
PHEA_016HEIGHTCEN_#
ASK
IF PHEA_015_# = -8 (Continue PHEA Loop 1)
QUESTION TYPE
FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH

Numeric
CREATE FILL_WASIS: IF NRDECEASED=1, FILL_WASIS: ‘was’
ELSE, FILL_WASIS: ‘is’
CREATE FILL_WASIS: IF NRDECEASED=1, FILL_WASIS: ‘era’
ELSE, FILL_WASIS: ‘es’
Approximately what ^{FILL_WASIS} their height without shoes?
Centimeters: _____________ [PHEA_016HEIGHTCEN_#]
¿Aproximadamente cuál ^{FILL_WASIS} su altura sin zapatos?

RANGE

Centímetros: _____________ [PHEA_016HEIGHTCEN_#]
PHEA_016HEIGHTCEN_#: RANGE = 60-213

LIMITS

PHEA_016HEIGHTCEN_#: LIMIT = 3 digits

LOOP MAX

15
Loop PHEA Loop 1 (f_PHEA_014 through PHEA_019) FOR EACH NON-RESIDENTIAL
PARENT ON NONRESROSTER

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

IF PHEA_016HEIGHTCEN_# OUT OF RANGE, DISPLAY HARD CHECK: Please enter a
number of centimeters between 60 and 213.
IF PHEA_016HEIGHTCEN_# OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número de
centímetros entre 60 y 213.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_015_#
PHEA_017_#

f_PHEA_017_#
PHEA_017WEIGHTLB_#
ASK
All respondents (Continue PHEA Loop 1)
Numeric: PHEA_017WEIGHTLB_#
QUESTION TYPE
Checkbox
CREATE FILL_DIDDOES: IF NRDECEASED=1, FILL_DIDDOES: ‘did’
ELSE, FILL_DIDDOES: ‘does’
USE FILL_NONRESNAME FROM PHEA_015
FILLS (ENG)
CREATE FILL_DECEASED: IF NONRES_DECEASED=1, FILL_DECEASED: ‘during their adult
life’
ELSE FILL _DECEASED: ‘’
CREATE FILL_DIDDOES: IF NRDECEASED=1, FILL_DIDDOES:‘pesaba’
ELSE, FILL_DIDDOES: ‘pesa’
USE FILL_NONRESNAME FROM PHEA_015
FILLS (SPAN)
CREATE FILL_DECEASED: IF NONRES_DECEASED=1, FILL_DECEASED: ‘durante su vida
adulta’
ELSE FILL _DECEASED: ‘’
On average, how much ^{FILL_DIDDOES} ^{FILL_NONRESNAME} weigh ^{FILL_DECEASED}?
ENGLISH

Pounds: _____________ [PHEA_017WEIGHTLB_#]
-8. I prefer to report weight in kilograms
En promedio, ¿cuánto ^{FILL_DIDDOES} ^{FILL_NONRESNAME} ^{FILL_DECEASED}?

SPANISH

Libras: _____________ [PHEA_017WEIGHTLB_#]

RANGE

-8. Prefiero informar el peso en kilogramos
PHEA_017WEIGHTLB_#: RANGE = 10-500

LIMITS

PHEA_017WEIGHTLB_#: LIMIT = 3 digits

LOOP MAX

15
Loop PHEA Loop 1 (f_PHEA_014 through PHEA_019) FOR EACH NON-RESIDENTIAL
PARENT ON NONRESROSTER

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

INCLUDE NUMBOX FOR WEIGHT; ALSO INCLUDE A SINGLE SELECT OPTION TO REPORT
WEIGHT IN POUNDS DIRECTLY BELOW NUMBOX ENTRIES.
IF PHEA_017WEIGHTLB_# OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
of pounds between 10 and 500.
IF PHEA_017WEIGHTLB_# OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número de
libras entre 10 y 500.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PHEA_016
If f_PHEA_017=-8: f_PHEA_018; Else: PHEA_019

f_PHEA_018_#
PHEA_0018WEIGHTKILO_#
ASK
IF f_PHEA_017_# = -8 (Continue PHEA Loop 1)
QUESTION TYPE
FILLS (ENG)

FILLS (SPAN)

ENGLISH

Numeric
CREATE FILL_DIDDO: IF NRDECEASED=1, FILL_DIDDO: ‘did’
ELSE, FILL_DIDDO: ‘do’
CREATE FILL_DECEASED: IF NRDECEASED=1, FILL_DECEASED: ‘during their adult life’
ELSE FILL _DECEASED: ‘’
CREATE FILL_DIDDO: IF NRDECEASED=1, FILL_DIDDO: ‘pesó’
ELSE, FILL_DIDDO: ‘pesaba’
CREATE FILL_DECEASED: IF NRDECEASED=1, FILL_DECEASED:‘durante su vida adulta’
ELSE FILL _DECEASED: ‘’
On average, how much ^{FILL_DIDDO} they weigh ^{FILL_DECEASED}?
Kilograms: _____________ [PHEA_018WEIGHTKILO_#]
En promedio, ¿cuánto ^{FILL_DIDDOES} ^{NONRESNAME} ^{FILL_DECEASED}?

SPANISH

Kilogramos: _____________ [PHEA_018WEIGHTKILO_#]

RANGE

PHEA_018WEIGHTKILO_#: RANGE = 4.5-227.0

LIMITS

PHEA_018WEIGHTKILO_#: LIMIT = 3 digits and 1 decimal

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
Loop PHEA Loop 1 (f_PHEA_014 through PHEA_019) FOR EACH NON-RESIDENTIAL
PARENT ON NONRESROSTER
IF PHEA_018WEIGHTKILO_# OUT OF RANGE, DISPLAY HARD CHECK: Please enter a
number of kilograms between 4.5 and 227.
IF PHEA_018WEIGHTKILO_# OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número de
kilogramos entre 4.5 y 227.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PHEA_017
PHEA_019

PHEA_019
ASK

All respondents (End PHEA Loop 1)

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
This is a computer check. Do not display this screen.
Loop PHEA Loop 1 (f_PHEA_015 through PHEA_019) FOR EACH NON-RESIDENTIAL
PARENT ON NONRESROSTER

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PHEA_017 / f_PHEA_018
If PCPART>0: PHEA_020; Else: PHEA_023

PHEA_020
ASK
QUESTION TYPE
FILLS (ENG)

FILLS (SPAN)

ENGLISH

SPANISH

IF SPOUSEIDPCSPOUSEID>0 or PARTNERIDPCPARTNERID>0
Radio button
CREATE FILL_PARTNERNAME:
If PCSPOUSE≠ missing, FILL_PARTNERNAME: ‘^{PCSPOUSE}, ’
ELSE IF PCPARTNER ≠ missing, FILL_PARTNERNAME: ‘^{PCPARTNER}, ’ FROM PRELOAD
ELSE, FILL_PARTNERNAME: Empty
CREATE FILL_PARTNERNAME:
If PCSPOUSE≠ missing, FILL_PARTNERNAME: ‘^{PCSPOUSE}, ’
ELSE IF PCPARTNER ≠ missing, FILL_PARTNERNAME: ‘^{PCPARTNER}, ’ FROM PRELOAD
ELSE, FILL_PARTNERNAME: Empty
The next few questions are about the health of ^{FILL_SPOUSENAME} ^{PARTNERNAME}, your
spouse or partner.
In general, how is their physical health?
5. Excellent
4. Very good
3. Good
2. Fair
1. Poor
Las siguientes preguntas son sobre la salud de ^{FILL_SPOUSENAME} ^{PARTNERNAME}, su
cónyuge o pareja.
En general, ¿cómo es su salud física?
5. Excelente
4. Muy buena
3. Buena
2. Regular
1. Mala

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_019
PHEA_021

PHEA_021
ASK
QUESTION TYPE
FILLS (ENG)

FILLS (SPAN)

ENGLISH

SPANISH

IF PCSPOUSEID>0 or PCPARTNERID>0
Radio button
CREATE FILL_PARTNERNAME1:
If PCSPOUSE≠ missing, FILL_PARTNERNAME1: ‘PCSPOUSE’ from preload
ELSE IF PCPARTNER ≠ missing, FILL_PARTNERNAME1: ‘PCPARTNER’ FROM PRELOAD
ELSE, FILL_PARTNERNAME1: ‘your spouse or partner’
CREATE FILL_PARTNERNAME1:
If PCSPOUSE≠ missing, FILL_PARTNERNAME1: ‘PCSPOUSE’ from preload
ELSE IF PCPARTNER ≠ missing, FILL_PARTNERNAME1: ‘PCPARTNER’ FROM PRELOAD
ELSE, FILL_PARTNERNAME1: ‘su cónyuge o pareja’
In general, how is ^{FILL_SPOUSENAME} ^{PARTNERNAME^{PARTNERNAME1}’s mental or
emotional health?
5. Excellent
4. Very good
3. Good
2. Fair
1. Poor
En general, ¿cómo se encuentra la salud mental o emocional de
^{FILL_SPOUSENAME}^{PARTNERNAME} ^{PARTNERNAME1}?
5.
4.
3.
2.
1.

Excelente
Muy bien
Bien
Regular
Mala

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_020
PHEA_022

PHEA_022
ASK

IF PCSPOUSEID>0 or PCPARTNERID>0

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)

ENGLISH

SPANISH

Use ﬁll FILL_PARTNERNAME1 from PHEA_021
Use ﬁll FILL_PARTNERNAME1 from PHEA_021
Does ^{FILL_SPOUSENAME} ^{PARTNERNAME} have any long-term health problem or condition
that limits the type or amount of employment they can accept?
1. Yes
0. No
¿Tiene ^{FILL_SPOUSENAME} ^{PARTNERNAME} algún problema o afección de salud a largo plazo
que limite el tipo o la cantidad de empleo que puede aceptar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_021
PHEA_023

PHEA_023
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Which of these statements best describes the food eaten in your household in the past 12
months?
ENGLISH

1. Enough of the kinds of food we want to eat
2. Enough but not always the kinds of food we want to eat
3. Sometimes not enough to eat
4. Often not enough to eat
¿Cuál de estas aﬁrmaciones describe mejor los alimentos consumidos en su hogar durante los
últimos 12 meses?

SPANISH

1. Suﬁciente de los tipos de comidas que queremos comer
2. Suﬁciente, pero no siempre el tipo de comidas que queremos comer
3. A veces no hay suﬁciente para comer
4. Con frecuencia no hay suﬁciente para comer

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_019, PHEA_022
f_PHEA_024

f_PHEA_024
PHEA_024a / PHEA_024b / PHEA_024c / PHEA_024d / PHEA_024e / PHEA_024f / PHEA_024g
ASK
All respondents
QUESTION TYPE

Radio button grid

FILLS (ENG)
FILLS (SPAN)
Below is a list of the ways that you might have felt or behaved recently. After each statement,
indicate how often you felt this way during the past week.

ENGLISH

SPANISH

COLUMN HEADERS:
0. Rarely or none of the time (less than 1 day)
1. Some or a little of the time (1-2 days)
2. Occasionally or a moderate amount of the time (3-4 days)
3. Most or all of the time (5-7 days)
ROW ITEMS:
a. I did not feel like eating; my appetite was poor [PHEA_024a]
b. I had trouble keeping my mind on what I was doing [PHEA_024b]
c. I felt depressed [PHEA_024c]
d. I felt that everything I did was an eﬀort [PHEA_024d]
e. My sleep was restless [PHEA_024e]
f. I felt sad [PHEA_024f]
g. I could not get "going" [PHEA_024g]
A continuación, encontrará una lista de las formas en las que podría haberse sentido o
comportado recientemente. Después de cada aﬁrmación, indique con qué frecuencia se sintió así
durante la semana pasada.
COLUMN HEADERS:
0. Rara vez o nunca (menos de 1 día)
1. Algo o pocas veces (1-2 días)
2. Ocasionalmente o una cantidad moderada de tiempo (3-4 días)
3. La mayor parte del tiempo o todo el tiempo (5-7 días)
ROW ITEMS:
a. No tenía ganas de comer; falta de apetito [PHEA_024a]
b. Me costó concentrarme en lo que estaba haciendo [PHEA_024b]
c. Me sentí deprimido(a) [PHEA_024c]
d. Sentí que todo lo que hacía requería mucho esfuerzo [PHEA_024d]
e. Dormí mal [PHEA_024e]
f. Me sentí triste [PHEA_024f]
g. No podía tomar iniciativas [PHEA_024g]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_023
PHEA_025

PHEA_025
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Over the last 2 weeks, how often have you been bothered by feeling nervous, anxious, or on
edge?
ENGLISH

SPANISH

0. Not at all
1. Several days
2. More than half the days
3. Nearly every day
Durante las últimas 2 semanas, ¿con qué frecuencia sintió molestias por nervios, ansiedad o
tensión?

0.
1.
2.
3.

Nunca
Varios días
Más de la mitad de los días
Casi todos los días

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_024
PHEA_026

PHEA_026
ASK

All respondents

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Over the last 2 weeks, how often have you been bothered by not being able to stop or control
worrying?
ENGLISH

SPANISH

0. Not at all
1. Several days
2. More than half the days
3. Nearly every day
Durante las últimas 2 semanas, ¿con qué frecuencia sintió molestias por no poder dejar de
preocuparse o controlar su preocupación?

0.
1.
2.
3.

Nunca
Varios días
Más de la mitad de los días
Casi todos los días

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PHEA_025
PSRF_INTRO

BRIEF2A Placeholder

The Behavioral Rating Inventory of Executive Function®, Second Edition (i.e., BRIEF2 and BRIEF2A) will be
the assessments implemented in the NLSY27 Pretest.
The BRIEF2 and 2A are licensed assessments and not available for public use outside of licensing.
Therefore, this section of the Youth instrument is a placeholder.

Parent-Caregiver Income Module Specs
Preloads:
REFYR: PINF Module
•

This will be set with each round of data collection to be the prior calendar year. For instance, if the survey
occurs in September 2025, this will refer to calendar year 2024. This number will be used throughout that
round of the survey.

PCPART: Indicator for residential partner of selected parent/caregiver from PINF
0. None
1. Married and living with spouse
2. Married, no spouse in household
3. Cohabiting with partner
P
Paradata:
Capture item level timing
Include a time/date stamp at beginning and end of screener
General Notes:
Do not display response option numbers/letters.
• Do not display DK and REF on each screen at loading.
ο If R tries to move forward without providing a response, display DK (‘Don’t know’) and REF (‘Prefer
not to answer’) on screen. (Spanish translation for DK – ‘No lo sé’ and REF ‘Prefiero no contestar’
♣ Unless otherwise noted, include a soft prompt for R to respond or select DK/REF option:
“Your answers are very important. Please consider providing a response. Otherwise, please
select "Don’t know" or "Prefer not to answer.”
♣ Spanish translation: “Sus respuestas son muy importantes. Considere la posibilidad de
seleccionar una respuesta.”
ο If R still tries to move forward without answering, assign REF code to missing response.

PINC_001
ASK

ALL

QUESTION TYPE

Informational

FILLS (ENG)
FILLS (SPAN)
We now have some questions about your household's income. We appreciate that our questions are
ENGLISH difficult to answer and sometimes seem intrusive. As with other questions in this survey, the
information you provide to us is kept confidential.
Ahora tenemos algunas preguntas sobre los ingresos de su hogar. Somos conscientes de que nuestras
SPANISH preguntas son difíciles de responder y, a veces, parecen intrusivas. Al igual que con otras preguntas de
esta encuesta, la información que nos da se mantendrá confidencial.
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Create Var PARPARTNER; IF PCPART=0, SET PARPARTNER=0; Else SET PARPARTNER=1

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PSRF_014
PINC_002

PINC_002
ASK

ALL

QUESTION TYPE

Radio Button
Create fill FILL_REFYR
FILLS (ENG)
FILL FILL_REFYR set in PINF survey module.
Create fill FILL_REFYR
FILLS (SPAN)
FILL FILL_REFYR set in PINF survey module.
Were you married or in a cohabiting relationship at any time during ^{FILL_REFYR}? By cohabitating
relationships, we mean romantic or sexual relationships in which partners establish one household
and live together for a period of at least three months.

ENGLISH

Please include any marriages or cohabiting relationships during ^{FILL_REFYR} that you may have
already reported in this survey.
1. Yes
0. No
¿Estuvo casado(a) o en una relación de convivencia en algún momento durante el año ^{FILL_REFYR}?
Por “relaciones de convivencia” nos referimos a las relaciones románticas o sexuales en las que los
miembros de la pareja establecen un hogar y viven juntos durante un período de al menos tres meses.

SPANISH

Incluya cualquier matrimonio o relación de convivencia durante el ^{FILL_REFYR} que ya haya
comunicado en esta encuesta.
1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

FILL_REFYR: This will be set with each round of data collection to be the prior calendar
year. For instance, if the survey occurs in September 2025, this will refer to calendar
year 2024. This number will be used throughout that round of the survey.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_001
PINC_002=1: PINC_004;
Else PINC_003

PINC_003
ASK

IF PINC_002 ≠1

QUESTION TYPE

Informational

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Now let's go over your earnings and income in the year ^{FILL_REFYR}. Please round to the nearest
ENGLISH dollar for your responses. If you don’t know the exact amount, your best estimate is fine.

SPANISH

Ahora, repasemos sus ganancias e ingresos en el año ^{FILL_REFYR}. Redondee sus respuestas al dólar
más cercano. Si no conoce la cantidad exacta, su mejor estimación es suficiente.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_002
PINC_005

PINC_004
IF PINC_002= 1

ASK
QUESTION TYPE

Informational

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Let's start with some questions about the earnings and income you and your spouse or partner
ENGLISH received during ^{FILL_REFYR}. The first questions will be about your earnings and business income
and then you will be asked about the earnings and business income of your spouse or partner.

SPANISH

Empecemos con algunas preguntas sobre las ganancias e ingresos que usted y su cónyuge o pareja
recibieron durante el año ^{FILL_REFYR}. Las primeras preguntas serán sobre sus ganancias y los
ingresos de su negocio y después responderá preguntas sobre las ganancias y los ingresos del negocio
de su cónyuge o pareja.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_002
PINC_005

PINC_005
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During ^{FILL_REFYR}, did you receive any income from a job such as wages, salary, commissions, or
tips? Please include any income you received from doing odd jobs, temporary or seasonal work, and
ENGLISH service in the military, the military reserves, or the National Guard.

SPANISH

1. Yes
0. No
Durante el año ^{FILL_REFYR}, ¿recibió usted algún ingreso de un trabajo como sueldos, salarios,
comisiones o propinas? Incluya los ingresos que haya recibido por realizar trabajos ocasionales,
trabajo temporal o estacional, y servicio en las fuerzas armadas, las reservas militares o la Guardia
Nacional.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_003, PINC_004
If PINC_005=DK or REF: PINC_006;
If PINC_005=0: PINC_012;
Else PINC_007

PINC_006
ASK

IF PINC_005 = DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During ^{FILL_REFYR}, did you have any income from odd jobs, self-employment, or employee-type
jobs?
ENGLISH
1. Yes
0. No
Durante el ^{FILL_REFYR}, ¿tuvo usted algún ingreso procedente de trabajos ocasionales, trabajo
independiente o trabajo como empleado(a)?
SPANISH
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

IF PINC_005 = DK or REF
If PINC_006=0: PINC_012;
Else PINC_007

PINC_007
ASK

IF PINC_005 ≠0 AND PINC_006 ≠ 0

QUESTION TYPE

Numeric

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During the 52 weeks of ^{FILL_REFYR}, how many weeks did you work at all jobs, either full-time or
ENGLISH part-time? Please include weeks you were on paid leave from a job.

SPANISH

Weeks: _____________
Durante las 52 semanas del año ^{FILL_REFYR}, ¿cuántas semanas trabajó en todos sus empleos, ya
sea a tiempo completo o a tiempo parcial? Incluya las semanas en las que estuvo ausente con licencia
remunerada.

RANGE

Semanas: _____________
0-52

LIMITS

2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HARD CHECK IF PINC_007 IS OUT OF RANGE: ‘Please enter a number of weeks between
0-52.’
HARD CHECK IF PINC_007 IS OUT OF RANGE: ‘Ingrese un número de semanas entre 0-52.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_005; PINC_006
If PINC_007=0: PINC_010;
Else PINC_008

PINC_008
ASK

IF PINC_007 ≠0

QUESTION TYPE

Numeric

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
In the weeks that you worked in ^{FILL_REFYR}, how many hours did you usually work per week?
Please include all hours you worked whether at their normal work site, at home, or in some other
ENGLISH location.

SPANISH

Hours per week: _____________
En las semanas que trabajó en el año ^{FILL_REFYR}, ¿cuántas horas trabajó normalmente a la
semana? Incluya todas las horas trabajadas, ya sea en su lugar de trabajo habitual, en casa o en algún
otro lugar.

RANGE

Horas por semana: _____________
0-120

LIMITS

3 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HARD CHECK IF PINC_008 OUT OF RANGE: ‘Please enter a number of hours per week
between 0-120.’
HARD CHECK IF PINC_008 OUT OF RANGE: ‘Ingrese un número de horas por semana entre
0-120.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_007
PINC_009

PINC_009
ASK

IF PINC_007 ≠0

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
How many of those hours per week did you usually telework or work at home?
ENGLISH
Hours per week: _____________
¿Cuántas de esas horas a la semana suele teletrabajar o trabajar desde casa?
SPANISH
Horas por semana: _____________
RANGE
0-120
LIMITS

3 digits

LOOP MAX
PROGRAM. NOTES
HARD CHECK IF PINC_009 OUT OF RANGE: ‘Please enter a number of hours per week
between 0-120.’
CHECK (ENG)

IF (PINC_009)>(PINC_008) DISPLAY HARD CHECK: ‘You reported that you worked more
hours from home than the hours you worked total per week. Please update your answer
to hours worked from home or click here to update the total number of hours worked per
week.” (Return R to PINC_008)
HARD CHECK IF PINC_009 OUT OF RANGE: ‘Ingrese un número de horas por semana
entre 0-120.’

CHECK (SPAN)

IF (PINC_009)>(PINC_008) DISPLAY HARD CHECK: ‘Usted informó que trabajaba más horas
desde casa que las que trabajaba en total a la semana. Actualice su respuesta a las horas
trabajadas desde casa o haga clic aquí para actualizar el número total de horas trabajadas
por semana.” (Return R to PINC_008)

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_008
PINC_010

PINC_010
ASK

IF PINC_005 ≠0 AND PINC_006 ≠ 0

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC010: ‘PINC_010’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC010: ‘PINC_010’
During ^{FILL_REFYR}, how much income did you receive from wages, salary, commissions, or tips
from all jobs, before deductions for taxes or for anything else? Please round to the nearest dollar for
ENGLISH your responses. If you don’t know the exact amount, your best estimate is fine.

SPANISH

$ ______________ Income
Durante el año ^{FILL_REFYR}, ¿cuántos ingresos recibió de sueldos, salarios, comisiones o propinas de
todos los trabajos, antes de las deducciones por impuestos o u otras? Redondee sus respuestas al
dólar más cercano. Si no conoce la cantidad exacta, su mejor estimación es suficiente.

RANGE

$ ______________ dólares en ingresos
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_010 OUT OF RANGE: (PINC_010=0): ‘You reported earlier that you
had income from a job or self-employment during ^{FILL_REFYR}. Please click here to
update your answer if that is not correct.’ (Return R to PINC_005)
SOFT CHECK IF PINC_010>$500,000: ‘You reported ^{FILL_PINC010} in income from all
jobs in ^{FILL_REFYR}. Please review your answer and correct if needed.’
HARD CHECK IF PINC_010 OUT OF RANGE: (PINC_010=0): ‘Usted informó que tuvo
ingresos de un trabajo independiente o por cuenta propia durante el año ^{FILL_REFYR}.
Si esto no es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to
PINC_005)
SOFT CHECK IF PINC_010>$500,000: ‘Usted informó que recibió ^{FILL_PINC010} dólares
en ingresos de todos los trabajos en el año ^{FILL_REFYR}. Revise su respuesta y corríjala si
es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_006, PINC_009, PINC_007
If PINC_010=DK or REF: PINC_011;
Else PINC_012

PINC_011
ASK

If PINC_010 =DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these categories includes your best estimate of the amount you received in ^{FILL_REFYR} in
wages, salary, commissions, and tips?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
ENGLISH
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000
¿Cuál de estas categorías representa su mejor estimación de la cantidad que recibió en el año
^{FILL_REFYR} en sueldos, salarios, comisiones y propinas?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
SPANISH
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_010 =DK or REF
PINC_012

PINC_012
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Excluding any income you already have mentioned, during ^{FILL_REFYR}, did you receive any money
in income from your own farm, business, partnership, or professional practice?
ENGLISH
1. Yes
0. No
Excluyendo los ingresos ya mencionados, durante el año ^{FILL_REFYR}, ¿recibió dinero en ingresos de
su propia granja, negocio, sociedad o práctica profesional?
SPANISH
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_005=0, PINC_006=0, PINC_010, PINC_011
If PINC_012 = 1: PINC_013
Else PINC_017

PINC_013
ASK

IF PINC_012 =1
PINC_013: Numeric
QUESTION TYPE
Special response radio button
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC013: ‘PINC_013’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC013: ‘PINC_013’
During ^{FILL_REFYR}, how much income did you receive from your own farm, business, partnership,
or professional practice after expenses?
ENGLISH
$ ______________ Income
-9. Does not apply, I lost money on my farm or business last year
Durante el año ^{FILL_REFYR}, ¿cuántos ingresos recibió de su propia granja, negocio, sociedad o
práctica profesional después de los gastos?
SPANISH
$ ______________ dólares en ingresos
-9. No corresponde, perdí dinero en mi granja o negocio el año pasado
RANGE
0-999,999,999
LIMITS

Max 9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
INCLUDE SEPARATE RADIO BUTTON FOR THE (-9) DOES NOT APPLY OPTION WITH A
CORRESPONDING LABEL. THIS RESPONSE SHOULD BE EXCLUSIVE.
HARD CHECK IF PINC_013 OUT OF RANGE (PINC_013=0): ‘You reported earlier that you
had income from a farm or business during ^{FILL_REFYR}. Please click here to update
your answer if that is not correct.’ (Return R to PINC_012)

CHECK (ENG)

SOFT CHECK IF PINC_013>$1,000,000: ‘You reported ^{FILL_PINC013} in income from
your own farm, business, partnership, or professional practice after expenses in
^{FILL_REFYR}. Please review your answer and correct if needed.’
HARD CHECK IF PINC_013 OUT OF RANGE (PINC_013=0): ‘Usted informó que tuvo
ingresos de una granja o negocio durante el año ^{FILL_REFYR}. Si esto no es correcto,
haga clic aquí para actualizar su respuesta.’ (Return R to PINC_012)

CHECK (SPAN)

SOFT CHECK IF PINC_013>$1,000,000: ‘Usted informó que recibió ^{FILL_PINC013}
dólares en ingresos de su propia granja, negocio, sociedad o práctica profesional
después de los gastos en el año ^{FILL_REFYR}. Revise su respuesta y corríjala si es
necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_012=1
IF PINC_013=DK or REF: PINC_014
ELSE IF PINC_013=-9: PINC_015

Else PINC_017
PINC_014
ASK

IF PINC_013 = DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these categories includes the amount of income you received in ^{FILL_REFYR} from your
own farm, business, partnership, or professional practice after expenses?

ENGLISH

1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000
0. Not applicable, I lost money from my farm, business, or practice
¿Cuál de estas categorías incluye la cantidad de ingresos que recibió en el año ^{FILL_REFYR} de su
propia granja, negocio, sociedad o práctica profesional después de los gastos?

SPANISH

1.
2.
3.
4.
5.
6.
7.
0.

$1 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
Más de $250,000 dólares
No aplica, perdí dinero de mi granja, negocio o consultorio.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_013=DK or REF
If PINC_014=0: PINC_015
Else PINC_017

PINC_015
ASK

IF PINC_013 =-9 OR PINC_014=0

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC015: ‘PINC_015’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC015: ‘PINC_015’
During ^{FILL_REFYR}, about how much money did you lose from your own farm, business,
ENGLISH partnership, or professional practice after expenses?

SPANISH

$ ______________ Money lost
Durante el año ^{FILL_REFYR}, ¿aproximadamente cuánto dinero perdió de su propia granja, negocio,
sociedad o práctica profesional después de los gastos?

RANGE

$ ______________ dólares en dinero perdido
0-999,999,999

LIMITS

9 characters

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
SOFT CHECK IF PINC_015>$1,000,000: ‘You reported ^{FILL_PINC015} in losses from your
own farm, business, partnership, or professional practice after expenses in
^{FILL_REFYR}. Please review your answer and correct if needed.’
SOFT CHECK IF PINC_015>$1,000,000: ‘Usted informó que perdió ^{FILL_PINC015}
dólares de su propia granja, negocio, sociedad o práctica profesional después de los
gastos en el año ^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_013=-9, PINC_014=0
If PINC_015=DK or REF: PINC_016
Else PINC_017

PINC_016
ASK

IF PINC_015= DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these categories includes the amount of money you lost in ^{FILL_REFYR} from your own
farm, business, partnership, or professional practice after expenses?

ENGLISH

1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000
¿Cuál de estas categorías incluye la cantidad de dinero que perdió en el año ^{FILL_REFYR} de su
propia granja, negocio, sociedad o práctica profesional después de los gastos?

SPANISH

1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_015=DK or REF
PINC_017

PINC_017
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During ^{FILL_REFYR}, did you receive any income from Worker's Compensation?
Worker’s Compensation is an insurance program that provides cash benefits and medical care,
including temporary and permanent disability benefits, lost wages, rehabilitation, and job retraining if
ENGLISH
a worker becomes injured or sick as a direct result of their job.
1. Yes
0. No
Durante el año ^{FILL_REFYR}, ¿recibió algún ingreso de indemnización para trabajadores?
La indemnización para trabajadores es un programa de seguro que proporciona beneficios en efectivo
y atención médica, incluidos beneficios por discapacidad temporal y permanente, salarios perdidos,
SPANISH rehabilitación y recapacitación laboral si un trabajador se lesiona o enferma como resultado directo de
su trabajo.
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_012, PINC_013, PINC_014, PINC_015, PINC_016
If PINC_017=1: PINC_018;
Else PINC_020

PINC_018
ASK

IF PINC_017=1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC018: ‘PINC_018’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC018: ‘PINC_018’
During ^{FILL_REFYR}, how much income did you receive from Worker's Compensation?
ENGLISH
$ ______________
Durante el año ^{FILL_REFYR}, ¿cuántos ingresos recibió de la indemnización para trabajadores?
SPANISH
$ ______________ dólares
RANGE
0-999,999,999
LIMITS

9 characters

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_018 OUT OF RANGE (PINC_018=0): ‘You reported earlier that you
had income from Worker’s Compensation during ^{FILL_REFYR}. Please click here to
update your answer if that is not correct.’ (Return R to PINC_017)

CHECK (ENG)

SOFT CHECK IF PINC_018>$1,000,000: ‘You reported ^{FILL_PINC018} in income from
Worker’s Compensation in ^{FILL_REFYR}. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_018 OUT OF RANGE (PINC_018=0): ‘Usted informó que tuvo
ingresos por indemnización para trabajadores durante el ^{FILL_REFYR}. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_017)

CHECK (SPAN)

SOFT CHECK IF PINC_018>$1,000,000: ‘Usted declaró que recibió ^{FILL_PINC018}
dólares en ingresos por indemnización para trabajadores en el año ^{FILL_REFYR}. Revise
su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_017=1
If PINC_018=DK or REF: PINC_019
Else PINC_020

PINC_019
ASK

IF PINC_018= DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these ranges includes your best estimate of the amount of income you received in
^{FILL_REFYR} from Worker's Compensation?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
ENGLISH
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estos intervalos incluye su mejor estimación de la cantidad de ingresos que recibió en el año
^{FILL_REFYR} procedentes de la indemnización para trabajadores?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
SPANISH
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. Más de $50,000 dólares
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_018= DK or REF
PINC_020

PINC_020
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During ^{FILL_REFYR}, did you receive any income from Unemployment Insurance?
Unemployment insurance is a joint state-federal program that provides cash benefits to unemployed
ENGLISH workers.
1. Yes
0. No
Durante el ^{FILL_REFYR}, ¿recibió algún ingreso del seguro por desempleo?
El seguro por desempleo es un programa conjunto estatal-federal que da beneficios en efectivo a los
SPANISH trabajadores desempleados.
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_017, PINC_018, PINC_019
If PINC_020=1: PINC_021
Else if PINC_002=1: PINC_023
Else PINC_041

PINC_021
ASK

IF PINC_020 = 1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC021: ‘PINC_021’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC021: ‘PINC_021’
During ^{FILL_REFYR}, how much income did you receive from Unemployment Insurance?
ENGLISH
$ ______________
Durante el año ^{FILL_REFYR}, ¿cuántos ingresos recibió del seguro por desempleo?
SPANISH
$ ______________ dólares
RANGE
0-99,999
LIMITS

5 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_021 OUT OF RANGE (PINC_021=0): ‘You reported earlier that you
had income unemployment insurance during ^{FILL_REFYR}. Please click here to update
your answer if that is not correct.’ (Return R to PINC_020)

CHECK (ENG)

SOFT CHECK IF PINC_021>$25,000: ‘You reported ^{FILL_PINC021} in income from
unemployment insurance in ^{FILL_REFYR}. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_021 OUT OF RANGE (PINC_021=0): ‘Usted informó que tuvo
ingresos del seguro por desempleo durante el año ^{FILL_REFYR}. Si esto no es correcto,
haga clic aquí para actualizar su respuesta’. (Return R to PINC_020)

CHECK (SPAN)

SOFT CHECK IF PINC_021>$25,000: ‘Usted declaró que recibió ^{FILL_PINC021} dólares
en ingresos procedentes del seguro por desempleo en el año ^{FILL_REFYR}. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_020=1
If PINC_021= DK or REF: PINC_022
Else PINC_002= 1: PINC_023
Else PINC_041

PINC_022
ASK

IF PINC_021=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)

Use fill from PINC_002, FILL_REFYR

ENGLISH

Which of these ranges best describes the amount of income you received in ^{FILL_REFYR} from
Unemployment Insurance?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000

SPANISH

¿Cuál de estos intervalos describe mejor la cantidad de ingresos que recibió en el año ^{FILL_REFYR}
del seguro por desempleo?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_021=DK or REF
PINC_002=1: PINC_023;
Else PINC_041

PINC_023
ASK

IF PINC_002 = 1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
The next few questions are about the earnings and business income of your spouse or partner. During
^{FILL_REFYR}, did your spouse or partner receive any income from a job such as wages, salary,
commissions, or tips?
ENGLISH Please include any income your spouse or partner received from doing odd jobs, temporary or
seasonal work, and service in the military, the military reserves, or the National Guard.
1. Yes
0. No
Las siguientes preguntas son sobre las ganancias y los ingresos empresariales de su cónyuge o pareja.
Durante el año ^{FILL_REFYR}, ¿su cónyuge o pareja recibió algún ingreso de un trabajo, como sueldos,
salarios, comisiones o propinas?
SPANISH Incluya los ingresos que su cónyuge o pareja haya recibido por realizar trabajos ocasionales, trabajo
temporal o estacional y servicio en las fuerzas armadas, las reservas militares o la Guardia Nacional.
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_020, PINC_021, PINC_022
If PINC_023=0 or DK: PINC_030
Else PINC_023=REF: PINC_024
Else PINC_025

PINC_024
ASK

IF PINC_023 = -1REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Please remember that the information you provide to us about yourself and your spouse or partner is
kept strictly confidential. Did your spouse or partner have any income from any jobs during
ENGLISH ^{FILL_REFYR}?
1. Yes
0. No
Recuerde que la información que nos da sobre usted y su cónyuge o pareja es estrictamente
confidencial. ¿Tuvo su cónyuge o pareja ingresos de algún trabajo durante el año ^{FILL_REFYR}?
SPANISH
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_023=REF
PINC_024=REF or 1: PINC_025
Else PINC_030

PINC_025
ASK

IF PINC_023 =1 OR PINC_024 = 1 or REF

QUESTION TYPE

Numeric

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During the 52 weeks of ^{FILL_REFYR}, how many weeks did your spouse or partner work at all jobs,
either full-time or part-time? Please include weeks when they were on paid leave from a job.
ENGLISH
_____________ weeks

SPANISH

Durante las 52 semanas del año ^{FILL_REFYR}, ¿cuántas semanas trabajó su cónyuge o pareja en
todos sus empleos, ya sea a tiempo completo o a tiempo parcial? Incluya las semanas que estuvo
ausente con licencia remunerada.

RANGE

_____________ semanas
0-52

LIMITS

2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HARD CHECK IF PINC_025 IS OUT OF RANGE: ‘Please enter a number of weeks between
0-52.’
HARD CHECK IF PINC_025 IS OUT OF RANGE: ‘Ingrese un número de semanas entre 0 y 52.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_023=1, PINC_024=1 or REF
If PINC_025 = 0: PINC_028;
Else PINC_026

PINC_026
ASK

IF PINC_025>0

QUESTION TYPE

Numeric

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
In the weeks that your spouse or partner worked in ^{FILL_REFYR}, how many hours did they usually
work per week? Please include all hours your spouse or partner worked whether at their normal work
ENGLISH site, at home, or in some other location.

SPANISH

_____________ hours per week
En las semanas en las que su cónyuge o pareja trabajó en el año ^{FILL_REFYR}, ¿cuántas horas solía
trabajar por semana? Incluya todas las horas trabajadas por su cónyuge o pareja, ya sea en su lugar de
trabajo habitual, en casa o en algún otro lugar.

RANGE

_____________ horas por semana
0-120

LIMITS

3 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

HARD CHECK IF PINC_026 OUT OF RANGE: ‘Please enter a number of hours per week
between 0-120.’
HARD CHECK IF PINC_026 OUT OF RANGE: ‘Ingrese un número de horas por semana entre
0 y 120.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_025
PINC_027

PINC_027
ASK

IF (PINC_023=1 OR PINC_024=1 or REF) AND PINC_025≠0

QUESTION TYPE

Numeric

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
How many of those hours per week did they usually telework or work at home?
ENGLISH
Hours per week: _____________
¿Cuántas de esas horas a la semana suele teletrabajar o trabajar desde casa?
SPANISH
Horas por semana: _____________
RANGE
0-120
LIMITS

3 digits

LOOP MAX
PROGRAM. NOTES
HARD CHECK IF PINC_027 OUT OF RANGE: ‘Please enter a number of hours per week
between 0-120.’
CHECK (ENG)

CHECK (SPAN)

HARD CHECK IF PINC_027>PINC_026: ‘You reported that youthey worked more hours
from home than the hours youthey worked total per week. Please click here to update
your answer, as appropriate.’
DISPLAY LINK ‘Update total hours worked per week’ that will route R back to PINC_026
HARD CHECK IF PINC_027 OUT OF RANGE: ‘Ingrese un número de horas por semana
entre 0 y 120.’
HARD CHECK IF PINC_027>PINC_026: ‘Usted informó que trabajaban más horas desde
casa que las que trabajaban en total a la semana. Haga clic aquí para actualizar su
respuesta, según corresponda.’
DISPLAY LINK ‘Actualizar el total de horas trabajadas por semana’ that will route R back to
PINC_026

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_026
PINC_028

PINC_028
ASK

IF PINC_023 =1 OR PINC_024 = 1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC028: ‘PINC_028’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC028: ‘PINC_028’
During ^{FILL_REFYR}, how much income did your spouse or partner receive from wages, salary,
commissions, or tips from all jobs, before deductions for taxes or anything else? Please round to the
ENGLISH nearest dollar for your responses. If you don’t know the exact amount, your best estimate is fine.

SPANISH

$ ______________ Income
Durante el año ^{FILL_REFYR}, ¿cuántos ingresos recibió su cónyuge o pareja de sueldos, salarios,
comisiones o propinas de todos los trabajos, antes de las deducciones por impuestos o u otras?
Redondee sus respuestas al dólar más cercano. Si no conoce la cantidad exacta, su mejor estimación
es suficiente.

RANGE

$ ______________ dólares en ingresos
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_028 OUT OF RANGE (PINC_028=0): ‘You reported earlier that your
spouse or partner had income from jobs during ^{FILL_REFYR}. Please click here to
update your answer if that is not correct.’ (Return R to PINC_023)

CHECK (ENG)

CHECK (SPAN)

SOFT CHECK IF PINC_028>$500,000: ‘You reported that your partner had
^{FILL_PINC028} in income from jobs in ^{FILL_REFYR}. Please review your answer and
correct if needed.’
HARD CHECK IF PINC_028 OUT OF RANGE (PINC_028=0): ‘Usted informó que su cónyuge
o pareja tuvo ingresos por trabajos durante el año ^{FILL_REFYR}. Si esto no es correcto,
haga clic aquí para actualizar su respuesta.’ (Return R to PINC_023)
SOFT CHECK IF PINC_028>$500,000: ‘Usted informó que su pareja tenía ingresos de
^{FILL_PINC028} dólares por trabajos en el año ^{FILL_REFYR}. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_025=0, PINC_027
PINC_028=DK or REF: PINC_029
Else PINC_030

PINC_029
ASK

IF PINC_028 =DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these categories includes your best estimate of the amount your spouse or partner received
in ^{FILL_REFYR} in wages, salary, commissions, and tips?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000

ENGLISH

¿Cuál de estas categorías representa su mejor estimación de la cantidad que recibió su cónyuge o
pareja en el año ^{FILL_REFYR} de sueldos, salarios, comisiones y propinas?

SPANISH

1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_028=DK or REF
PINC_030

PINC_030
ASK

IF PINC_002=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Excluding any income you already mentioned, during ^{FILL_REFYR}, did your spouse or partner
receive any money in income from a farm, business, partnership, or professional practice?
ENGLISH
1. Yes
0. No
Excluyendo los ingresos que ya ha mencionado, durante el año ^{FILL_REFYR}, ¿recibió su cónyuge o
pareja dinero como ingresos procedentes de su granja, negocio, sociedad o práctica profesional?
SPANISH
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_023=DK or 0, PINC_024=DK or 0, PINC_028, PINC_029
PINC_030=1: PINC_031
Else PINC_035

PINC_031
ASK

IF PINC_030 =1
PINC_031: Numeric
QUESTION TYPE
Special response radio button
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC031: ‘PINC_031’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC031: ‘PINC_031’
During ^{FILL_REFYR}, how much did your spouse or partner receive from their farm, business,
partnership, or professional practice after expenses?
ENGLISH
$ ______________ Income
-9. Lost money on their farm or business last year
Durante el año ^{FILL_REFYR}, ¿cuánto recibió su cónyuge o pareja de su granja, negocio, sociedad o
práctica profesional después de los gastos?
SPANISH
$ ______________ dólares en ingresos
-9. Perdió dinero en la granja o negocio el año pasado
RANGE
0-999,999,999
LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

INCLUDE SEPARATE RADIO BUTTON FOR THE (-9) DOES NOT APPLY OPTION WITH A
CORRESPONDING LABEL. THIS SPECIAL RESPONSE SHOULD BE EXCLUSIVE.
HARD CHECK IF PINC_031 OUT OF RANGE (PINC_031=0): ‘You reported earlier that your
spouse or partner had income from their farm, business, partnership, or professional
practice during ^{FILL_REFYR}. Please click here to update your answer if that is not
correct.’ (Return R to PINC_030)
SOFT CHECK IF PINC_031>$1,000,000: ‘You reported that your partner had
^{FILL_PINC031} in income from their farm, business, partnership, or professional
practice after expenses in ^{FILL_REFYR}. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_031 OUT OF RANGE (PINC_031=0): ‘Usted informó que su cónyuge
o pareja tenía ingresos procedentes de su su granja, negocio, sociedad o práctica
profesional durante el ^{FILL_REFYR}. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_030)

CHECK (SPAN)

SOFT CHECK IF PINC_031>$1,000,000: ‘Usted informó que su pareja recibió
^{FILL_PINC031} dólares en ingresos de su granja, negocio, sociedad o práctica
profesional después de los gastos en el año ^{FILL_REFYR}. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_030
IF PINC_031=-9: PINC_033;

Else if PINC_031=DK or REF: PINC_032;
Else PINC_035
PINC_032
ASK

IF PINC_031 = DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of the following categories corresponds to the range that includes the amount of income your
spouse or partner received during ^{FILL_REFYR} from their farm, business, partnership, or
professional practice after expenses?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
ENGLISH
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000
0. N/A, They lost or would lose money
¿Cuál de las siguientes categorías corresponde al intervalo que incluye la cantidad de ingresos que su
cónyuge o pareja recibió durante el año ^{FILL_REFYR} de su granja, negocio, sociedad o práctica
profesional después de los gastos?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
SPANISH
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares
0. No corresponde, perdió o perdería dinero
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_031=DK or REF
PINC_032=0: PINC_033;
Else PINC_035

PINC_033
ASK

IF PINC_031 = -9 or PINC_032=0

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill, FILL_PINC033: ‘PINC_033’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill, FILL_PINC033: ‘PINC_033’
During ^{FILL_REFYR}, about how much money did your spouse or partner lose from their farm,
ENGLISH business, partnership, or professional practice after expenses?

SPANISH

$ ______________ Money lost
Durante el año ^{FILL_REFYR}, ¿aproximadamente cuánto dinero perdió su cónyuge o pareja de su
propia granja, negocio, sociedad o práctica profesional después de los gastos?

RANGE

$ ______________ dólares en dinero perdido
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
SOFT CHECK IF PINC_031>$1,000,000: ‘You reported that your partner had
^{FILL_PINC033} in losses from their farm, business, partnership, or professional practice
in ^{FILL_REFYR}. Please review your answer and correct if needed.’
SOFT CHECK IF PINC_031>$1,000,000: ‘Usted informó que su pareja perdió
^{FILL_PINC033} dólares en su granja, negocio, sociedad o práctica profesional en el año
^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_031 = -9 or PINC_032=0
PINC_033= DK or REF: PINC_034
Else PINC_035

PINC_034
ASK

IF PINC_033 =DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these categories corresponds to the range that includes the amount of money your spouse
or partner lost in ^{FILL_REFYR} from their farm, business, partnership, or professional practice after
expenses?

ENGLISH

SPANISH

1.
$1 - $5,000
2.
$5,001 - $10,000
3.
$10,001 - $25,000
4.
$25,001 - $50,000
5.
$50,001 - $100,000
6.
$100,001 - $250,000
7.
More than $250,000
¿Cuál de estas categorías corresponde al intervalo que incluye la cantidad de dinero que su cónyuge o
pareja perdió durante el año ^{FILL_REFYR} de su granja, negocio, sociedad o práctica profesional
después de los gastos?
1.
2.
3.
4.
5.
6.
7.

$1 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_033=DK or REF
PINC_035

PINC_035
ASK

IF PINC_002 =1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During ^{FILL_REFYR}, did your spouse or partner receive any income from Worker's Compensation?
Worker’s Compensation is an insurance program that provides cash benefits and medical care,
including temporary and permanent disability benefits, lost wages, rehabilitation, and job retraining if
ENGLISH
a worker becomes injured or sick as a direct result of their job.
1. Yes
0. No
Durante el año ^{FILL_REFYR}, ¿su cónyuge o pareja recibió algún ingreso de indemnización para
trabajadores?
La indemnización para trabajadores es un programa de seguro que proporciona beneficios en efectivo
y atención médica, incluidos beneficios por discapacidad temporal y permanente, salarios perdidos,
SPANISH
rehabilitación y recapacitación laboral si un trabajador se lesiona o enferma como resultado directo de
su trabajo.
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_030, PINC_031, PINC_032, PINC_033, PINC_034
PINC_035=1: PINC_036
Else PINC_038

PINC_036
ASK

IF PINC_035 = 1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC036: ‘PINC_036’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC036: ‘PINC_036’
During ^{FILL_REFYR}, how much income did your spouse or partner receive from Worker's
ENGLISH Compensation?

SPANISH

$ ______________ Income
Durante el ^{FILL_REFYR}, ¿cuántos ingresos recibió su cónyuge o pareja de la indemnización para
trabajadores?

RANGE

$ ______________ dólares en ingresos
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_036 OUT OF RANGE (PINC_036=0): ‘You reported earlier that your
spouse or partner had income from worker’s compensation during ^{FILL_REFYR}. Please
click here to update your answer if that is not correct.’ (Return R to PINC_035)

CHECK (ENG)

SOFT CHECK IF PINC_036>$1,000,000: ‘You reported that your partner had
^{FILL_PINC036} in income from worker’s compensation in ^{FILL_REFYR}. Please review
your answer and correct if needed.’
HARD CHECK IF PINC_036 OUT OF RANGE (PINC_036=0): ‘Usted informó que su cónyuge
o pareja tuvo ingresos por indemnización para trabajadores durante el ^{FILL_REFYR}. Si
esto no es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_035)

CHECK (SPAN)

SOFT CHECK IF PINC_036>$1,000,000: ‘Usted informó que su pareja tuvo ingresos de
^{FILL_PINC036} dólares por indemnización laboral en el año ^{FILL_REFYR}. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_035=1
PINC_036=DK or REF: PINC_037;
Else PINC_038

PINC_037
ASK

IF PINC_036 =DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these ranges best describes the amount of income your spouse or partner received in
^{FILL_REFYR} from Worker's Compensation?

ENGLISH

1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estos intervalos describe mejor la cantidad de ingresos que recibió su cónyuge o pareja en el
año ^{FILL_REFYR} procedentes de la indemnización para trabajadores?

SPANISH

1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_036=DK or REF
PINC_038

PINC_038
ASK

IF PINC_002 = 1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
During ^{FILL_REFYR}, did your spouse or partner receive any income from Unemployment Insurance?
1. Yes
ENGLISH
0. No
Durante el año ^{FILL_REFYR}, ¿recibió su cónyuge o pareja algún ingreso del seguro por desempleo?
SPANISH
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_035, PINC_036, PINC_037
PINC_038=1: PINC_039
Else PINC_041

PINC_039
ASK

IF PINC_038 =1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill, FILL_PINC039: ‘PINC_039’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill, FILL_PINC039: ‘PINC_039’
During ^[FILL_REFYR], how much income did your spouse or partner receive from Unemployment
ENGLISH Insurance?

SPANISH

$ ______________
Durante el ^[FILL_REFYR], ¿cuántos ingresos recibió su cónyuge o pareja del seguro por desempleo?

RANGE

$ ______________ dólares
0-99,999

LIMITS

5 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_039 OUT OF RANGE (PINC_039=0): ‘You reported earlier that your
spouse or partner had income unemployment insurance during ^{FILL_REFYR}. Please
click here to update your answer if that is not correct.’ (Return R to PINC_038)

CHECK (ENG)

SOFT CHECK IF PINC_039>$25,000: ‘You reported that your partner had ^{FILL_PINC039}
in income from unemployment insurance in ^{FILL_REFYR}. Please review your answer
and correct if needed.’
HARD CHECK IF PINC_039 OUT OF RANGE (PINC_039=0): ‘Usted informó que su cónyuge
o pareja tuvo ingresos por el seguro por desempleo durante el año ^{FILL_REFYR}. Si
esto no es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_038)

CHECK (SPAN)

SOFT CHECK IF PINC_039>$25,000: ‘Usted informó que su pareja recibió ^{FILL_PINC039}
dólares en ingresos del seguro por desempleo en ^{FILL_REFYR}. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_038=1
PINC_039=DK or REF: PINC_040
Else PINC_041

PINC_040
ASK

IF PINC_039=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these ranges includes your best estimate of the amount your spouse or partner received in
^[FILL_REFYR] from Unemployment Insurance?

ENGLISH

1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estos intervalos incluye su mejor estimación de la cantidad que su cónyuge o pareja recibió
en el año ^[FILL_REFYR] del seguro por desempleo?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $1,000
$1,001 a $2,500
$2,501 a $5,000
$5,001 a $10,000
$10,001 a $25,000
$25,001 a $50,000
Más de $50,000

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_039=DK or REF
PINC_041

PINC_041
ASK

ALL

QUESTION TYPE

Informational
Use fill from PINC_002, FILL_REFYR

FILLS (ENG)

Create fill, FILL_PINC_041
IF PINC_002 = 1, FILL_PINC_041: ‘you and your spouse or partner’
ELSE FILL_PINC_041: ‘you’
Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)

ENGLISH
SPANISH

Create fill, FILL_PINC_041S
IF PINC_002 = 1, FILL_PINC_041S: ‘usted y su cónyuge o pareja podrían haber recibido’
ELSE FILL_PINC_041S: ‘usted podría haber recibido’
The next questions are about other sources of income ^{FILL_PINC_041} may have received in
^[FILL_REFYR].
Las siguientes preguntas son sobre otras fuentes de ingresos que ^{FILL_PINC_041} en el año
^[FILL_REFYR].

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_002=0, PINC_038=0, PINC_039, PINC_040, PINC_020=0, PINC_021, PINC_022
PINC_042

PINC_042
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR

FILLS (ENG)

Create fill, FILL_PINC_042
IF PINC_002 = 1, FILL_PINC_042: ‘your or your spouse or partner’s children’
ELSE FILL_PINC_042: ‘your children’
Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)

ENGLISH

SPANISH

Create fill, FILL_PINC_042
IF PINC_002 = 1, FILL_PINC_042: ‘los(as) hijos(as) que son de su cónyuge o pareja’
ELSE FILL_PINC_042: ‘sus hijos(as)’

Have child support payments ever been agreed to or awarded for any of ^{FILL_PINC_042} living with
you?
1. Yes
0. No
¿Alguna vez se han acordado u otorgado pagos de manutención de menores para algunos(as) de
^{FILL_PINC_042} que viven con usted?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_041
PINC_042=1: PINC_043
Else PINC_046

PINC_043
ASK

IF PINC_042 = 1

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR

FILLS (ENG)

Create fill, FILL_PINC_043
IF PINC_002 = 1, FILL_PINC_043: ‘you or your spouse or partner’
ELSE FILL_PINC_043: ‘you’
Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)

ENGLISH

SPANISH

Create fill, FILL_PINC_043S
IF PINC_002 = 1, FILL_PINC_043S: ‘se suponía que usted y su cónyuge o pareja recibirían’
ELSE FILL_PINC_043S: ‘se suponía que usted recibiría’

During ^[FILL_REFYR], were ^{FILL_PINC_043} supposed to receive any child- support payments?
1. Yes
0. No
Durante el año ^[FILL_REFYR], ¿^{FILL_PINC_043S} pagos de manutención de menores?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_042=1
PINC_043=1: PINC_044;
Else PINC_046

PINC_044
ASK

IF PINC_043 = 1

QUESTION TYPE
FILLS (ENG)

Numeric
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_041, FILL_PINC_041
Create fill FILL_PINC044: ‘PINC_044’
Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)

Create fill, FILL_PINC_044S
IF PINC_002 = 1, FILL_PINC_044S: ‘reciben usted y su cónyuge o pareja’
ELSE FILL_PINC_044S: ‘recibe usted’

ENGLISH
SPANISH

Create fill FILL_PINC044: ‘PINC_044’
How much did ^{FILL_PINC_041} receive in child support during ^[FILL_REFYR]?
$ ______________ Child support
¿Cuánto ^{FILL_PINC_044S} en manutención de menores durante el año ^[FILL_REFYR]?

RANGE

$ ______________ dólares en manutención de menores
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
SOFT CHECK IF PINC_044>$1,000,000: ‘You reported that you and/or your partner
received ^{FILL_PINC044} in child support in ^{FILL_REFYR}. Please review your answer
and correct if needed.’
SOFT CHECK IF PINC_044>$1,000,000 AND PINC_002 = 1: ‘Usted informó que usted y/o
su pareja recibieron ^{FILL_PINC044} dólares en manutención de menores en el año
^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’

CHECK (SPAN)

SOFT CHECK IF PINC_044>$1,000,000 AND PINC_002 != 1: ‘Usted informó que recibió
^{FILL_PINC044} dólares en manutención de menores en el año ^{FILL_REFYR}. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_043 = 1
PINC_044= DK or REF: PINC_045
Else PINC_046

PINC_045
ASK

IF PINC_044 = DK or REF

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR

FILLS (ENG)

Create fill, FILL_PINC_045S
IF PINC_002 = 1, FILL_PINC_045S: ‘usted y su cónyuge o pareja recibieron’
ELSE FILL_PINC_045S: ‘usted recibió’

FILLS (SPAN)

Which of these categories includes your best estimate of the amount of income ^{FILL_PINC_041}
received in ^[FILL_REFYR] in child support payments?

ENGLISH

0. $0
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estas categorías incluye su mejor estimación de la cantidad de ingresos que
^{FILL_PINC_045S} en el año ^[FILL_REFYR] de pagos de manutención de menores?

SPANISH

0.
1.
2.
3.
4.
5.
6.
7.

$0 dólares
$1 a $1,000 dólares
$1,001 a $2,500 dólares
$2,501 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_044=DK or REF
PINC_046

PINC_046
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_043, FILL_PINC_043
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_045, FILL_PINC_045S

FILLS (ENG)

Create fill, FILL_PINC_046S
IF PINC_002 = 1, FILL_PINC_046S: ‘recibieron usted y su cónyuge o pareja’
ELSE FILL_PINC_046S: ‘recibió usted’

FILLS (SPAN)

Use fill from PINC_044, FILL_PINC_044S
We have asked about the earnings and business income that ^{FILL_PINC_041} received in
^[^{FILL_REFYR].}. Now, think about other sources of income that ^{FILL_PINC_041} had in that year.
Please round to the nearest dollar for your responses. If you don’t know the exact amount, your best
estimate is fine.
ENGLISH

During ^[^{FILL_REFYR],}, did ^{FILL_PINC_043} receive any interest or dividend income? Interest can come
from interest-earning-checking accounts, savings accounts, money market accounts, bonds, treasury notes,
IRA accounts, or certificates of deposit. Dividends can come from stocks or mutual funds.
1. Yes
0. No
Hemos preguntado acerca de las ganancias e ingresos comerciales que ^{FILL_PINC_045S} en el año
^[FILL_REFYR]. Ahora, piense en otras fuentes de ingresos que ^{FILL_PINC_045S} ese año. Redondee
sus respuestas al dólar más cercano. Si no conoce la cantidad exacta, su mejor estimación es
suficiente.

SPANISH

Durante el ^[FILL_REFYR], ¿^{FILL_PINC_044S} algún ingreso por intereses o dividendos? Los intereses
pueden provenir de cuentas corrientes, cuentas de ahorro, cuentas del mercado monetario, bonos,
pagarés del tesoro, cuentas IRA o certificados de depósito que generen intereses. Los dividendos
pueden provenir de acciones o fondos mutuos.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN
NEXT

PINC_042, PINC_043, PINC_044, PINC_045
PINC_046=1: PINC_047
Else PINC_049

PINC_047
ASK

IF PINC_046 = 1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Create fill FILL_PINC047: ‘PINC_047’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_045, FILL_PINC_045S
Create fill FILL_PINC047: ‘PINC_047’
What was the total amount of interest and dividend income ^{FILL_PINC_041} received during
ENGLISH ^{FILL_REFYR}, including even small amounts and amounts reinvested or credited to the account?

SPANISH

$ ______________ Income
¿Cuál fue la cantidad total de los ingresos por intereses y dividendos que ^{FILL_PINC_045S} durante el
año ^[FILL_REFYR], incluso las pequeñas cantidades y las cantidades reinvertidas o acreditadas en la
cuenta?

RANGE

$ ______________ dólares en ingresos
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_047 OUT OF RANGE (PINC_047=0): ‘You reported earlier that you
and/or your partner had income from interest or dividends during ^{FILL_REFYR}. Please
click here to update your answer if that is not correct.’ (Return R to PINC_046)

CHECK (ENG)

SOFT CHECK IF PINC_047>$1,000,000: ‘You reported that you and/or your partner had
^{FILL_PINC047} in income from interest and dividends in ^{FILL_REFYR}. Please review
your answer and correct if needed.’
HARD CHECK IF PINC_047 OUT OF RANGE (PINC_047=0) AND PINC_002 = 1: ‘Usted
informó que usted y/o su pareja tuvieron ingresos por intereses o dividendos durante el
año ^{FILL_REFYR}. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_046)

CHECK (SPAN)

HARD CHECK IF PINC_047 OUT OF RANGE (PINC_047=0) AND PINC_002 != 1: ‘Usted
informó que tuvo ingresos por intereses o dividendos durante el año ^{FILL_REFYR}. Si
esto no es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_046)
SOFT CHECK IF PINC_047>$1,000,000 AND PINC_002 = 1: ‘Usted informó que usted y/o
su pareja recibieron ^{FILL_PINC047} dólares en ingresos por intereses y dividendos en
el año ^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’
SOFT CHECK IF PINC_047>$1,000,000 AND PINC_002 != 1: ‘Usted informó que recibió
^{FILL_PINC047} dólares en ingresos por intereses y dividendos en el año ^{FILL_REFYR}.
Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)

MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_4300=1
PINC_047=DK or REF: PINC_048
Else PINC_049

PINC_048
ASK

IF PINC_047 =DK or REF

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_045, FILL_PINC_045S
Which of these categories includes your best estimate of the amount of income ^{FILL_PINC_041}
received in ^{FILL_REFYR} in interest and dividend payments?

ENGLISH

1. $1 - $500
2. $501- $1,000
3. $1,001- $2,500
4. $2,501- $5,000
5. $5,001- $7,500
6. $7,501- $10,000
7. More than $10,000
¿Cuál de estas categorías incluye su mejor estimación de la cantidad de ingresos que
^{FILL_PINC_045S} en el año ^[FILL_REFYR] de pagos de intereses y dividendos?

SPANISH

1. $1 a $500 dólares
2. $501 a $1,000 dólares
3. $1,001 a $2,500 dólares
4. $2,501 a $5,000 dólares
5. $5,001 a $7,500 dólares
6. $7,501 a $10,000 dólares
7. Más de $10,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_047 = DK or REF
PINC_049

PINC_049
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_044, FILL_PINC_044S

FILLS (ENG)

FILLS (SPAN)

ENGLISH

SPANISH

Create fill, FILL_PINC_049S
IF PINC_002 = 1, FILL_PINC_049S: ‘tienen usted y su cónyuge o pareja’
ELSE FILL_PINC_049S: ‘tiene usted’

During ^{FILL_REFYR}, did ^{FILL_PINC_041} receive any rental income from any land, business
property, apartments, or houses which ^{FILL_PINC_041} own, or money from any estates, trusts,
annuities or inheritances, or any money as gifts from friends or family?
1. Yes
0. No
Durante el año ^[FILL_REFYR], ¿^{FILL_PINC_044S} algún ingreso por alquiler de algún terreno,
propiedad comercial, apartamentos o casas que ^{FILL_PINC_049S}, o dinero de algún sucesiones,
fideicomisos, anualidades o herencias, o dinero como regalo de amistades o familiares?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_46, PINC_047, PINC_048
PINC_049=1: PINC_050
Else PINC_052

PINC_050
ASK

IF PINC_049=1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Create fill FILL_PINC050: ‘PINC_050’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_045, FILL_PINC_045S
Create fill FILL_PINC050: ‘PINC_050’
What was the total amount of rental income and money from estates or trusts or gifts
ENGLISH ^{FILL_PINC_041} received during ^[FILL_REFYR]?

SPANISH

$ ______________ Income
¿Cuál fue la cantidad total de ingresos por alquiler y dinero procedentes de sucesiones, fideicomisos o
regalos que ^{FILL_PINC_045S} durante el año ^[FILL_REFYR]?

RANGE

$ ______________ dólares en ingresos
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_050 OUT OF RANGE (PINC_050=0): ‘You reported earlier that you
and/or your partner had rental income or received money from estates or trusts or gifts
during ^{FILL_REFYR}. Please click here to update your answer if that is not correct.’
(Return R to PINC_049)
SOFT CHECK IF PINC_050>$1,000,000: ‘You reported that you and/or your partner
received ^{FILL_PINC050} from rental income, estates, trusts or gifts in ^{FILL_REFYR}.
Please review your answer and correct if needed.’
HARD CHECK IF PINC_050 OUT OF RANGE (PINC_050=0) AND PINC_002 = 1: 'Usted
informó que usted y/o su pareja tuvieron ingresos por alquiler o recibieron dinero de
sucesiones, fideicomisos o regalos durante el año ^{FILL_REFYR}. Si esto no es correcto,
haga clic aquí para actualizar su respuesta.’ (Return R to PINC_049)

CHECK (SPAN)

HARD CHECK IF PINC_050 OUT OF RANGE (PINC_050=0) AND PINC_002 != 1: ‘Usted
informó que tuvo ingresos por alquiler o recibió dinero de sucesiones, fideicomisos o
regalos durante el año ^{FILL_REFYR}. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_049)
SOFT CHECK IF PINC_050>$1,000,000 AND PINC_002 = 1: ‘Usted informó que usted y/o
su pareja recibieron ^{FILL_PINC050} dólares en ingresos por alquiler, herencias,
fideicomisos o regalos en el año ^{FILL_REFYR}. Revise su respuesta y corríjala si es
necesario.’
SOFT CHECK IF PINC_050>$1,000,000 AND PINC_002 != 1: ‘Usted informó que recibió
^{FILL_PINC050} dólares en ingresos por alquiler, herencias, fideicomisos o regalos en el
año ^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_049=1
PINC_050: DK or REF: PINC_051
Else PINC_052

PINC_051
ASK

IF PINC_050 = DK or REF

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_045, FILL_PINC_045S

FILLS (ENG)
FILLS (SPAN)

ENGLISH

SPANISH

Which of these categories includes your best estimate of the amount of rental income and money
from estates or trusts and gifts ^{FILL_PINC_041} received in ^{FILL_REFYR}?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estas categorías incluye su mejor estimación de la cantidad de ingresos por alquiler y dinero
procedente de sucesiones, fideicomisos y regalos que ^{FILL_PINC_045S} en el año ^[FILL_REFYR]?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_050= DK or REF
PINC_052

PINC_052
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_044, FILL_PINC_044S
During ^{FILL_REFYR}, did ^{FILL_PINC_041} receive income from government programs such as TANF,
Supplemental Security Income (SSI), Social Security Disability (SSDI), veterans or GI benefits or other
government programs? Please exclude any income from Worker’s Compensation or Unemployment
ENGLISH
Insurance you’ve already told us about.
1. Yes
0. No
Durante el año ^[FILL_REFYR], ¿^{FILL_PINC_044S} ingresos de programas gubernamentales como
TANF, Seguridad de Ingreso Suplementario (SSI), Seguro Social por Discapacidad (SSDI, por sus siglas
en inglés), beneficios para veteranos o GI u otros programas gubernamentales? No incluya los ingresos
SPANISH procedentes del seguro por desempleo o de indemnización para trabajadores que ya nos haya
comunicado.
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_049, PINC_050, PINC_051
PINC_052=1: PINC_053
Else PINC_055

PINC_053
ASK

IF PINC_052 = 1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Create fill FILL_PINC053: ‘PINC_053’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_045, FILL_PINC_045S
Create fill FILL_PINC053: ‘PINC_053’
What was the total amount ^{FILL_PINC_041} received from government programs such as TANF,
Supplemental Security Income (SSI), Social Security Disability (SSDI), veterans or GI benefits or other
ENGLISH government programs during ^{FILL_REFYR}?

SPANISH

$ ______________ Income
¿Cuál fue la cantidad total que ^{FILL_PINC_045S} procedente de programas gubernamentales como
TANF, Seguridad de Ingreso Suplementario (SSI), Seguro Social por Discapacidad (SSDI), beneficios para
veteranos o GI u otros programas gubernamentales durante el año ^[FILL_REFYR]?

RANGE

$ ______________ dólares en ingresos
0-999,999

LIMITS

6 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_053 OUT OF RANGE (PINC_053=0): ‘You reported earlier that you
and/or your partner received money from government programs during ^{FILL_REFYR}.
Please click here to update your answer if that is not correct.’ (Return R to PINC_052)

CHECK (ENG)

SOFT CHECK IF PINC_053>$100,000: ‘You reported that you and/or your partner
received ^{FILL_PINC053} from government programs in ^{FILL_REFYR}. Please review
your answer and correct if needed.’
HARD CHECK IF PINC_053 OUT OF RANGE (PINC_053=0) AND PINC_002 = 1: ‘Usted
informó que usted y/o su pareja recibieron dinero de programas gubernamentales
durante el año ^{FILL_REFYR}. Si esto no es correcto, haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_052)

CHECK (SPAN)

HARD CHECK IF PINC_053 OUT OF RANGE (PINC_053=0) AND PINC_002 != 1: ‘Usted
informó que recibió dinero de programas gubernamentales durante el año
^{FILL_REFYR}. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_052)
SOFT CHECK IF PINC_053>$100,000 AND PINC_002 = 1: ‘Usted informó que usted y/o su
pareja recibieron ^{FILL_PINC053} dólares de programas gubernamentales en el año
^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’
SOFT CHECK IF PINC_053>$100,000 AND PINC_002 != 1: ‘Usted informó que recibió
^{FILL_PINC053} dólares de programas gubernamentales en el año ^{FILL_REFYR}. Revise
su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_052=1
PINC_053=DK or REF: PINC_054
Else PINC_055

PINC_054
ASK

IF PINC_053 = DK or REF

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_045, FILL_PINC_045S
Which of these categories includes your best estimate of the total amount ^{FILL_PINC_041} received
from government programs such as TANF, Supplemental Security Income (SSI), Social Security
Disability (SSDI), veterans or GI benefits or other government programs in ^{FILL_REFYR}?

ENGLISH

1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estas categorías incluye su mejor estimación de la cantidad total que ^{FILL_PINC_045S}
procedente de programas gubernamentales como TANF, Seguridad de Ingreso Suplementario (SSI),
Seguro Social por Discapacidad (SSDI), beneficios para veteranos o GI u otros programas
gubernamentales del año ^[FILL_REFYR]?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $1,000 dólares
$1,001 a $2,500 dólares
$2,501 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_053=DK or REF
PINC_055

PINC_055
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_044, FILL_PINC_044S
During ^{FILL_REFYR}, did ^{FILL_PINC_041} receive income from any other sources, such as pension
or retirement income including survivor's benefits, alimony, payments from life insurance policies or
ENGLISH any other regular or periodic source of income not from a government source?
1. Yes
0. No
Durante el año ^[FILL_REFYR], ^{FILL_PINC_044S} ingresos de otras fuentes, como ingresos de pensión
o jubilación, incluidos beneficios de sobreviviente, pensión alimenticia, pagos de pólizas de seguro de
vida o cualquier otra fuente regular o periódica de ingresos que no provenga de una fuente
SPANISH
gubernamental?
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_052, PINC_053, PINC_054
PINC_055=1: PINC_056
Else PINC_058

PINC_056
ASK

IF PINC_055=1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Use fill from PINC_041, FILL_PINC_041
Create fill FILL_PINC056: ‘PINC_056’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Use fill from PINC_045, FILL_PINC_045S
Create fill FILL_PINC056: ‘PINC_056’
What was the total amount ^{FILL_PINC_041} received from all of these other sources during
ENGLISH ^{FILL_REFYR}?

SPANISH

$ ______________ Income
¿Cuál fue la cantidad total que ^{FILL_PINC_045S} de todas estas otras fuentes durante el
año^[FILL_REFYR]?

RANGE

$ ______________ dólares en ingresos
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_056 OUT OF RANGE (PINC_056=0): ‘You reported earlier that you
and/or your partner had income from other sources during ^{FILL_REFYR}. Please click
here to update your answer if that is not correct.’ (Return R to PINC_055)

CHECK (ENG)

SOFT CHECK IF PINC_056>$1,000,000: ‘You reported that you and/or your partner had
^{FILL_PINC056} in income from other sources in ^{FILL_REFYR}. Please review your
answer and correct if needed.’
HARD CHECK IF PINC_056 OUT OF RANGE (PINC_056=0) AND PINC_002 = 1: ‘Usted
informó que usted y/o su pareja tuvieron ingresos de otras fuentes durante el año
^{FILL_REFYR}. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_055)

CHECK (SPAN)

HARD CHECK IF PINC_056 OUT OF RANGE (PINC_056=0) AND PINC_002 != 1: ‘Usted
informó que tuvo ingresos de otras fuentes durante el ^{FILL_REFYR}. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_055)
SOFT CHECK IF PINC_056>$1,000,000 AND PINC_002 = 1: ‘Usted informó que usted y/o
su pareja recibieron ^{FILL_PINC056} dólares en ingresos de otras fuentes en el año
^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’
SOFT CHECK IF PINC_056>$1,000,000 AND PINC_002 != 1: ‘Usted informó que tenía
^{FILL_PINC056} dólares en ingresos de otras fuentes en el año ^{FILL_REFYR}. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)

MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_055=1
PINC_056=DK or REF: PINC_057
Else PINC_058

PINC_057
ASK

IF PINC_056 = DK or REF

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_041, FILL_PINC_041
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_045, FILL_PINC_045S

FILLS (ENG)
FILLS (SPAN)

Which of these categories includes your best estimate of the total amount ^{FILL_PINC_041} received
from all other sources of income in ^{FILL_REFYR}?

ENGLISH

1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000
¿Cuál de estas categorías incluye su mejor estimación de la cantidad total que ^{FILL_PINC_045S}
procedente de todas las demás fuentes de ingresos en el año ^[FILL_REFYR]?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $1,000 dólares
$1,001 a $2,500 dólares
$2,501 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_056=DK or REF
PINC_058

PINC_058
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_043, FILL_PINC_043
Use fill from PINC_002, FILL_REFYR

FILLS (ENG)

FILLS (SPAN)

ENGLISH

SPANISH

Create fill, FILL_PINC_058S
IF PINC_002 = 1, FILL_PINC_058S: ‘usted o su cónyuge o pareja’
ELSE FILL_PINC_058S: ‘usted’

Did ^{FILL_PINC_043} file a federal income tax return in ^{FILL_REFYR}?
1. Yes
0. No
¿Presentó ^{FILL_PINC_58S} una declaración de impuestos federales en el año ^[FILL_REFYR]?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_055, PINC_056, PINC_057
PINC_058=1: PINC_059
Else PINC_061

PINC_059
ASK

IF PINC_058 = 1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
What was your filing status on your ^{FILL_REFYR} federal income tax return?
1.
A single taxpayer
2.
Married, filing jointly
ENGLISH
3.
Married, filing separately
4.
Unmarried head of household
5.
Qualifying widow(er) with dependent child
¿Cuál fue su estado civil en la declaración de impuestos federales del año ^[FILL_REFYR]?
1.
Un(a) solo(a) contribuyente
2.
Casado(a), declaración conjunta
SPANISH
3.
Casado(a), declaración por separado
4.
Jefe(a) de familia, soltero(a)
5.
Viudo(a) calificado(a) con hijo(a) dependiente
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_058=1
PINC_060

PINC_060
ASK

IF PINC_058 = 1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
What method did you use to prepare your ^{FILL_REFYR} tax return?
1.
Self-prepared manually
Tax software or tax assistance website
ENGLISH 2.
3.
Friend or relative
4.
Professional tax preparer
¿Qué método usó para preparar su declaración de impuestos del año ^[FILL_REFYR]?
1.
Preparado manualmente por su cuenta
SPANISH 2.
Sitio web de software fiscal o de asistencia fiscal
3.
Amigo(a) o familiar
4.
Preparador(a) de impuestos profesional
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_059
PINC_061

PINC_061
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_043, FILL_PINC_043
Create fill FILL_PINC_061.
IF PINC_002 = 1, FILL_PINC_061: ‘your or your spouse or partner’s’
ELSE FILL_PINC_061: ‘your’

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR
Use fill from PINC_058, FILL_PINC_058S

FILLS (SPAN)

Create fill, FILL_PINC_061S
IF PINC_002 = 1, FILL_PINC_061S: ‘su o la’
ELSE FILL_PINC_061S: ‘su’
Create fill, FILL_PINC_061S2
IF PINC_002 = 1, FILL_PINC_061S2: ‘de su cónyuge o pareja’
ELSE FILL_PINC_061S2: EMPTY

The Earned Income Tax Credit (EITC) is a refundable Federal tax credit for eligible individuals and
families who work and have earned income below a certain amount. The EITC reduces the amount of
tax you owe, and it may give you a refund.
ENGLISH

SPANISH

Did ^{FILL_PINC_043} claim, or are ^{FILL_PINC_043} planning to claim, an Earned Income Tax Credit
on ^{FILL_PINC_061} federal income tax return for the year ^{FILL_REFYR}?
1. Yes
0.
No
El Crédito Tributario por Ingreso del Trabajo (EITC, por sus siglas en inglés) es un crédito tributario
federal reembolsable para personas y familias que cumplen los requisitos y que trabajan y tienen
ingresos del trabajo por debajo de cierta cantidad. El EITC reduce la cantidad de impuestos que usted
debe y podría darle un reembolso.
¿Solicitó/solicitaron ^{FILL_PINC_058S} o planea(n) solicitar ^{FILL_PINC_058S} un Crédito Tributario
por Ingreso del Trabajo en ^{FILL_PINC_061S} declaración de impuestos federales ^{FILL_PINC_061S2}
para el año ^[FILL_REFYR]?
1 Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)

MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_058, PINC_060
If PINC_061=0: PINC_062
Else PINC_063

PINC_062
ASK

INC_061=0

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_061, FILL_PINC_061
Use fill from PINC_002, FILL_REFYR
Use fill from PINC_0061, FILL_PINC_061S
Use fill from PINC_0061, FILL_PINC_061S2

FILLS (ENG)
FILLS (SPAN)

ENGLISH

SPANISH

Which of the following best describes why you did not claim or do not plan to claim an Earned Income
Tax Credit on ^{FILL_PINC_061} federal income tax return for the year ^{FILL_REFYR}?
1. Not eligible for an Earned Income Tax Credit
2. Not aware of the Earned Income Tax Credit
3. Another reason
¿Cuál de las siguientes opciones describe mejor por qué no solicitó o planea solicitar un Crédito
Tributario por Ingreso del Trabajo en ^{FILL_PINC_061S} declaración de impuestos federales
^{FILL_PINC_061S2} para el año ^[FILL_REFYR]?
1. No cumplo los requisitos para un Crédito Tributario por Ingreso del Trabajo
2. No conozco lo que es el Crédito Tributario por Ingreso del Trabajo
3. Otra razón

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_061=0
PINC_063

PINC_063
ASK

ALL

QUESTION TYPE

Radio Button
Use fill from PINC_002, FILL_REFYR

FILLS (ENG)

Create fill, FILL_PINC_063
IF PINC_002 = 1, FILL_PINC_063: ‘or any relatives of your spouse or partner’
ELSE FILL_PINC_063: BLANK
Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)

ENGLISH

SPANISH

Create fill, FILL_PINC_063
IF PINC_002 = 1, FILL_PINC_063: ‘o cualquier familiar de su cónyuge o pareja’
ELSE FILL_PINC_063: BLANK
Now please think about any other adult family members you lived with during the calendar year
^{FILL_REFYR}. At any time during the year, did you live with any of your relatives ^{FILL_PINC_063}?
1. Yes
0. No
Piense en cualquier otro miembro adulto de la familia con el que haya vivido durante el año calendario
^[FILL_REFYR]. ¿En algún momento del año, vivió con alguno de sus familiares ^{FILL_PINC_063}?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_061, PINC_062
PINC_063=1: PINC_064
Else PINC_066

PINC_064
ASK

IF PINC_063=1

QUESTION TYPE

Numeric
Use fill from PINC_002, FILL_REFYR
FILLS (ENG)
Create fill FILL_PINC064: ‘PINC_064’
Use fill from PINC_002, FILL_REFYR
FILLS (SPAN)
Create fill FILL_PINC064: ‘PINC_064’
During ^{FILL_REFYR}, what was the combined income of all these family members that you lived with
during that year? Please estimate total income across all of these people rounded to the nearest
$10,000.

ENGLISH

Please include income from any full or part time jobs, temporary or seasonal work and service in the
military, military reserves or the National Guard, a farm, a business or professional partnership, Social
Security, pensions, welfare, interest, gifts or anything else. Please do not include your own income or
the income you've already reported for your spouse or partner.
$ ______________ Income
Durante el año ^[FILL_REFYR], ¿cuál fue el ingreso combinado de todos estos miembros de la familia
con los que vivió durante ese año? Calcule el ingreso total de todas estas personas redondeado a los
$10,000 más cercanos.

SPANISH

Incluya los ingresos de cualquier trabajo de tiempo completo o parcial, trabajo temporal o estacional y
servicio en el ejército, las reservas militares o la Guardia Nacional, una granja, una sociedad comercial
o profesional, el Seguro Social, pensiones, asistencia social, intereses, regalos o cualquier otra cosa. No
incluya sus propios ingresos o los ingresos que ya ha declarado para su cónyuge o pareja.
$ ______________ dólares en ingresos
0-999,999,999

RANGE
LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
SOFT CHECK IF PINC_064>$1,000,000: ‘You reported that the combined income of the
family members who were living with you was ^{FILL_PINC064} in ^{FILL_REFYR}. Please
review your answer and correct if needed.’
SOFT CHECK IF PINC_064>$1,000,000: ‘Usted informó que los ingresos combinados de
los miembros de la familia que vivían con usted fueron de ^{FILL_PINC064} dólares en el
año ^{FILL_REFYR}. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_063=1
PINC_064=DK or REF: PINC_065;
Else PINC_066

PINC_065
ASK

IF PINC_064=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
Which of these categories includes your best estimate of your family members' combined income in
^[FILL_REFYR]?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
ENGLISH
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000
¿Cuál de estas categorías incluye su mejor estimación de los ingresos combinados de los miembros de
su familia en el año ^[FILL_REFYR]?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
SPANISH
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_064=DK or REF
PINC_066

PINC_066
ASK

ALL

QUESTION TYPE

Radio Button
Create fill, FILL_PINC_063
FILLS (ENG)
IF PINC_002 = 1, FILL_PINC_063: ‘you and your current spouse or partner’
ELSE FILL_PINC_063: ‘you’
Create fill, FILL_PINC_066S
IF PINC_002 = 1, FILL_PINC_066S: ‘usted y su actual cónyuge o pareja se sustentan
FILLS (SPAN)
económicamente’
ELSE FILL_PINC_066S: ‘usted se sustenta económicamente’
Overall, which one of the following best describes how well ^{FILL_PINC_066} are managing financially
these days?

ENGLISH

1.
Finding it difficult to get by
2.
Just getting by
3.
Doing okay
4.
Living comfortably
En general, ¿cuál de las siguientes opciones describe mejor qué tan bien ^{FILL_PINC_066S} estos
días?

SPANISH

1.
2.
3.
4.

Tengo/tenemos dificultades para salir adelante
Apenas me/nos alcanza
Me/nos va bien
Vivo/vivimos cómodamente

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_063, PINC_064, PINC_065
PINC_067

PINC_067
ASK

ALL

QUESTION TYPE

informational

FILLS (ENG)
FILLS (SPAN)
ENGLISH

The next questions are about your current housing situation.

SPANISH

Las siguientes preguntas están relacionadas con su situación de vivienda.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_066
PINC_068

PINC_068
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of the following best describes the place where you currently live?
1. Single-family house (including mobile home)
2. Apartment, condo, or townhouse
ENGLISH
3. Farm or ranch
99.
Some other type of housing
¿Cuál de las siguientes opciones describe mejor el lugar donde vive actualmente?
1. Casa unifamiliar (incluida una casa móvil)
SPANISH
2. Apartamento, condominio o casa adosada (townhouse)
3. Granja o rancho
99.
Algún otro tipo de vivienda
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_067
PINC_068=99: PINC_069;
Else PINC_070

PINC_069
ASK

IF PINC_068=99

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of the following best describes the place where you currently live?
4. Dormitory (including a fraternity or sorority) or Military Barracks
5. Hotel, Motel, Rooming or Boarding House
6. Shelter (for homeless or abused) or on street
ENGLISH
7. Jail, Prison, Detention
9. Hospital
10. Group Home or Treatment Center
11. Other Type of Housing
¿Cuál de las siguientes opciones describe mejor el lugar donde vive actualmente?
4. Dormitorio (incluida una fraternidad o hermandad) o cuartel militar
5. Hotel, motel, pensión o casa de huéspedes
6. Refugio (para personas sin hogar o maltratadas) o en la calle
SPANISH
7. Cárcel, prisión, detención
9. Hospital
10. Hogar grupal o centro de tratamiento
11. Otro tipo de vivienda
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_068=99
PINC_083

PINC_070
ASK

IF PINC_068≠99

QUESTION TYPE

Radio Button
Create fill FILL_PARTNER
IF PARPARTNER = 1, FILL_PARTNER: ‘you and/or your spouse or partner’
ELSE FILL_PARTNER: ‘you’

FILLS (ENG)

Create fill FILL_HOMETYPE
IF PINC_068= 1, FILL_HOMETYPE: ‘house or mobile home’
ELSE IF PINC_068= 2, FILL_HOMETYPE: ‘apartment, condo, or townhouse’
ELSE IF PINC_068= 3, FILL_HOMETYPE: ‘farm’
ELSE, FILL_HOMETYPE: ‘home’
Create fill FILL_PARTNER1S
IF PARPARTNER = 1, FILL_PARTNER1S: ‘Usted y/o su cónyuge o pareja son dueños(as) de’
ELSE FILL_PARTNER1S: ‘Usted es dueño(a) de’

FILLS (SPAN)

Create fill FILL_HOMETYPE
IF PINC_068= 1, FILL_HOMETYPE: ‘esta casa o casa móvil’
ELSE IF PINC_068= 2, FILL_HOMETYPE: ‘este apartamento, condominio o casa adosada’
ELSE IF PINC_068= 3, FILL_HOMETYPE: ‘esta granja’
ELSE, FILL_HOMETYPE: ‘esta vivienda’

Do ^{FILL_PARTNER} own this whole ^{FILL_HOMETYPE}, do you own part of it, do you rent it, is it
owned by a business, or something else?
If you are paying off a mortgage on this property, but it corresponds to the whole home, please
respond that you own all of it.

ENGLISH

SPANISH

1.You own all of it
2. You and your spouse or partner jointly own all of it
3.You own part of it
4. You and your spouse or partner jointly own part of it
5. Only your spouse or partner owns all or part of it
6.You rent it
7.You live with your parents, who rent or own this home
8. You live with your spouse or partner’s parent(s), who rent or own this home
9.Something else
¿^{FILL_PARTNER1S} ^{FILL_HOMETYPE}, posee solo una parte, lo(a) alquila, usa la propiedad de una
empresa o hace alguna otra cosa?
Si está pagando una hipoteca sobre esta propiedad, pero corresponde a toda la vivienda, responda
como si fuera(n) propietarios(as) de toda la vivienda.
1. Usted es dueño(a) de todo
2. Usted y su cónyuge o pareja son dueños(as) conjuntos(as) de toda la vivienda
3. Usted es dueño(a) de una parte
4. Usted y su cónyuge o pareja son dueños(as) conjuntos(as) de una parte
5. Solo su cónyuge o pareja es dueño(a) de todo o de parte de la vivienda
6. Usted alquila
7. Usted vive con sus padres/madres, que alquilan esta vivienda o son los(as) propietarios(as)

8. Usted vive con los(as) padres/madres de su cónyuge o pareja, que alquilan o son propietarios(as)
de esta vivienda
9.Otra cosa
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Only display response options 2, 4, 5, and 8 if PARPARTNER = 1

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_068
IF PINC_070=1 or 2 or 3 or 4 or 5: f_PINC_072
ELSE IF PINC_070=6 or 7 or 8: PINC_083
ELSE IF PINC_070=9: PINC_071
Else PINC_075

PINC_071
ASK

IF PINC_070=9

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_002, FILL_REFYR

FILLS (SPAN)
Use fill from PINC_002, FILL_REFYR
What is your housing situation?
1. Your housing is provided as part of your job, for example as a live-in servant, housekeeper,
gardener, or farm laborer
2. Your housing is a gift paid for by someone in the household besides yourself or your spouse
or partner
3. Your housing is a gift paid for by a friend or relative outside of your household
4. Your housing is paid for by a government agency or charitable institution
ENGLISH
5. You have sold your home, but you have not moved out yet
6. You are living in a home that you will inherit, but do not yet own
7. You are living in temporary quarters, like a garage or shed, while your home is under
construction
8. You live in a place without formal arrangements, where you are staying temporarily or squatting
9. You rent your home from a family member
97. Something else
¿Cuál es su situación de vivienda?
1. Su vivienda se le proporciona como parte de su trabajo, por ejemplo, como servidor(a),
amo(a) de llaves, jardinero(a) o trabajador(a) agrícola
2. Su vivienda es un regalo pagado por alguien del hogar además de usted o su cónyuge o pareja
3. Su vivienda es un regalo pagado por un(a) amigo(a) o familiar externo(a) a su hogar
4. Su alojamiento lo paga una agencia gubernamental o una institución benéfica
5. Ha vendido su casa, pero aún no se ha mudado
SPANISH
6. Vive en una casa que heredará, pero de la que aún no es propietario(a)
7. Está viviendo en una vivienda temporal, como un garaje o un cobertizo, mientras su casa está
en construcción
8. Vive en un lugar sin acuerdos formales, donde se aloja temporalmente o que ocupa
9. Alquila su vivienda a un familiar
97. Otra cosa
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_070=9
PINC_083

f_PINC_072
PINC_072MO/PINC_072YR
ASK
IF PINC_070=1 or 2 or 3 or 4 or 5
PINC_072MO: Dropdown
QUESTION TYPE
PINC_072YR: Numeric
Special responses Radio button
Use fill from PINC_070, FILL_PARTNER
FILLS (ENG)
Use fill from PINC_070, FILL_HOMETYPE
Create fill, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
Create fill FILL_PARTNER072S
IF PARPARTNER = 1, FILL_PARTNER072S: ‘usted y/o su cónyuge o pareja compraron’
ELSE FILL_PARTNER072S: ‘usted compró’
FILLS (SPAN)

ENGLISH

SPANISH

Use fill from PINC_070, FILL_HOMETYPE
Create fill, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
What month and year did ^{FILL_PARTNER} purchase this ^{FILL_HOMETYPE}?
Month:
__________ [PINC_072MO]
Year: ___________ [PINC_072YR]
-8. Spouse or partner owned this home before you knew them
-9. You did not purchase this home (for example, you received it as a gift or inheritance)
¿En qué mes y año ^{FILL_PARTNER072S} ^{FILL_HOMETYPE}?
Mes:
__________ [PINC_072MO]
Año: ___________ [PINC_072YR]

RANGE

-8. Su cónyuge o pareja era dueño(a) de esta vivienda antes de que usted lo(a) conociera
-9. No compró esta vivienda (por ejemplo, la recibió como regalo o herencia)
PINC_072YR: 1950-2030

LIMITS
LOOP MAX
PINC_072MO: Please display a dropdown list of the months January through December
PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

Special responses are Radio buttons and should each be exclusive (i.e. if one is selected,
the other should not be able to be selected and nothing should be allowed to be input
for month or year)
HARD CHECK IF PINC_072YR OUT OF RANGE OR IN FUTURE ON DOI: ‘Please enter a year
between 1950 and ^{FILL_INTERVIEWYEAR}.’
HARD CHECK IF PINC_072YR OUT OF RANGE OR IN FUTURE ON DOI: ‘Ingrese un año entre
1950 y ^{FILL_INTERVIEWYEAR}.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_070
PINC_072=-8 or -9: PINC_075 Else PINC_073

PINC_073
ASK

IF (PINC_070=1 or 2 or 3 or 4 or 5) AND (PINC_072≠-8) AND (PINC_072≠-9)

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_HOMETYPE
Create fill FILL_PINC073: ‘PINC_073’
Create fill FILL_PARTNER073S
IF PARPARTNER = 1, FILL_PARTNER073S: ‘usted y/o su cónyuge o pareja compraron
por primera vez’
ELSE FILL_PARTNER073S: ‘usted compró por primera vez’

FILLS (ENG)

FILLS (SPAN)

Use fill from PINC_070, FILL_HOMETYPE
Create fill FILL_PINC073: ‘PINC_073’
When ^{FILL_PARTNER} first bought this ^{FILL_HOMETYPE}, about what was the purchase price?
ENGLISH
$ ______________
Cuando ^{FILL_PARTNER073S} ^{FILL_HOMETYPE}, ¿cuál fue el precio de la compra?
SPANISH
RANGE

$ ______________ dólares
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_073 OUT OF RANGE (PINC_073=0): ‘You reported earlier that you
and/or your partner purchased this home. If you received as a gift or inheritance, please
click here to update your answer.’ (Return R to PINC_072)
SOFT CHECK IF PINC_073>$1,000,000: ‘You reported that this home was purchased for
^{FILL_PINC073}. Please review your answer and correct if needed.’
HARD CHECK IF PINC_073 OUT OF RANGE (PINC_073=0): ‘Usted informó que usted y/o
su pareja compraron esta vivienda. Si la recibió como regalo o herencia, haga clic en aquí
para actualizar su respuesta.’ (Return R to PINC_072)
SOFT CHECK IF PINC_073>$1,000,000: ‘Usted informó que esta vivienda se compró por
^{FILL_PINC073} dólares. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_072
If PINC_073=DK or REF: PINC_074
Else PINC_075

PINC_074
ASK

IF PINC_073=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the purchase price?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
More than $1,000,000

¿Cuál de estas categorías incluye su mejor estimación del precio de compra?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_073=DK or REF
PINC_075

PINC_075
ASK

IF (PINC_070=1 or 2 or 3 or 4 or 5) AND (PINC_072≠ -8)

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_HOMETYPE

FILLS (SPAN)
Use fill from PINC_070, FILL_HOMETYPE
Is there a mortgage on this ^{FILL_HOMETYPE}?
1. Yes
ENGLISH
0. No

SPANISH

¿Hay una hipoteca para ^{FILL_HOMETYPE}?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_073, PINC_070, PINC_072, PINC_074
PINC_075=1: PINC_076
Else PINC_078

PINC_076
ASK

IF PINC_075=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC076: ‘PINC_076’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC076: ‘PINC_076’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_076S
IF PARPARTNER = 1, FILL_PARTNER_076S: ‘deben usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_076S: ‘debe usted’
How much do ^{FILL_PARTNER} owe on this mortgage?

ENGLISH

$ ______________
¿Cuánto ^{FILL_PARTNER} en esta hipoteca?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_076 OUT OF RANGE (PINC_076=0): ‘You reported earlier that there
is a mortgage on this home. If this is not correct, please click here to update your
answer.’ (Return R to PINC_075)
SOFT CHECK IF PINC_076>$1,000,000: ‘You reported that ^{FILL_PINC076} is owed on
this mortgage. Please review your answer and correct if needed.’
HARD CHECK IF PINC_076 OUT OF RANGE (PINC_076=0): ‘Usted informó que hay una
hipoteca para esta vivienda. Si esto no es correcto, haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_075)
SOFT CHECK IF PINC_076>$1,000,000: ‘Usted informó que se deben ^{FILL_PINC076}
dólares de esta hipoteca. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_075=1
PINC_076=DK or REF: PINC_077
Else PINC_078

PINC_077
ASK

IF PINC_076=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the amount owed on the mortgage?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
More than $1,000,000

¿Cuál de estas categorías incluye su mejor estimación de la cantidad adeudada por la hipoteca?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_076 =DK or REF
PINC_078

PINC_078
ASK

IF PINC_070=1 or 2 or 3 or 4 or 5

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Are there any other types of loans that use your property as collateral, including second mortgages,
home equity loans, or any outstanding balances against a home equity line of credit?
1. Yes
ENGLISH
0. No

SPANISH

¿Existen otros tipos de préstamos que usen su propiedad como garantía, lo que incluye segundas
hipotecas, préstamos sobre el capital de la vivienda o cualquier saldo pendiente de una línea de
crédito sobre el capital de la vivienda?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_075=0, PINC_076, PINC_077
PINC_078=1: PINC_079;
Else PINC_081

PINC_079
ASK

IF PINC_078=1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC079: ‘PINC_079’

FILLS (SPAN)
Create fill FILL_PINC079: ‘PINC_079’
How much is still owed on these loans?
ENGLISH

$ ______________
¿Cuánto se debe aún por estos préstamos?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_079 OUT OF RANGE (PINC_079=0): ‘You reported earlier that there
were outstanding loans against your home. If this is not correct, please click here to
update your answer.’ (Return R to PINC_078)
SOFT CHECK IF PINC_079>$1,000,000: ‘You reported that ^{FILL_PINC079} is still owed
on these loans. Please review your answer and correct if needed.’
HARD CHECK IF PINC_079 OUT OF RANGE (PINC_079=0): ‘Usted informó que había
préstamos pendientes para su vivienda. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_078)

CHECK (SPAN)

SOFT CHECK IF PINC_079>$1,000,000: ‘Usted informó que todavía se adeudan
^{FILL_PINC079} dólares por estos préstamos. Revise su respuesta y corríjala si es
necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_078=1
PINC_079=DK or REF: PINC_080
Else PINC_081

PINC_080
ASK

IF PINC_079=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the amount owed on these loans?

ENGLISH

1. $1 - $25,000
2. $25,001 - $50,000
3. $50,001 - $100,000
4. $100,001 - $250,000
5. $250,001 - $500,000
6. $500,001 - $1,000,000
7. More than $1,000,000
¿Cuál de estas categorías incluye su mejor estimación de la cantidad adeudada por estos préstamos?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_079 =DK or REF
PINC_081

PINC_081
ASK

IF PINC_070=1 or 2 or 3 or 4 or 5

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_HOMETYPE
Create fill, FILL_PINC_081
IF PINC_070=3 or 4, FILL_PINC_081: ‘your portion’
IF PINC_070=5, FILL_PINC_081: ‘your spouse or partner’s portion’
Else FILL_PINC_081: ‘it’

FILLS (ENG)

Create fill FILL_PINC_081_2: ‘PINC_081’
Use fill from PINC_070, FILL_HOMETYPE
Create fill, FILL_PINC_081
IF PINC_070=1 or 2, FILL_PINC_081: ‘esta vivienda’
IF PINC_070=3 or 4, FILL_PINC_081: ‘su parte’
IF PINC_070=5, FILL_PINC_081: ‘la parte de su cónyuge o de su pareja’

FILLS (SPAN)

Create fill FILL_PINC081: ‘PINC_081’
What is the present value of this ^{FILL_HOMETYPE} if ^{FILL_PINC_081} were sold today?
ENGLISH

$ ______________
¿Cuál sería el valor actual de ^{FILL_HOMETYPE} si ^{FILL_PINC_081} se vendiera hoy?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_081 OUT OF RANGE (PINC_081=0): ‘Please enter a number for
home value between 1-999,999,999.’
SOFT CHECK IF PINC_081>$1,000,000: ‘You reported that the present value of this home
is ^{FILL_PINC_081_2}. Please review your answer and correct if needed.’
HARD CHECK IF PINC_081 OUT OF RANGE (PINC_081=0): ‘Ingrese un número para el
valor de la vivienda entre 1 y 999,999,999.’

CHECK (SPAN)

SOFT CHECK IF PINC_081>$1,000,000: ‘Usted informó que el valor actual de esta
vivienda es de ^{FILL_PINC081} dólares. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN
NEXT

PINC_078, PINC_079, PINC_080
PINC_081=DK or REF: PINC_082
Else PINC_083

PINC_082
ASK

IF PINC_081=DK or REF

QUESTION TYPE

Radio Button
Create fill, FILL_PINC_082
IF PINC_070=3 or 4, FILL_PINC_082: ‘of your portion’
IF PINC_070=5, FILL_PINC_082: ‘of your spouse or partner’s portion’
ELSE, FILL_PINC_082: Empty

FILLS (ENG)

Use fill from PINC_070, FILL_HOMETYPE
Create fill, FILL_PINC_082
IF PINC_070=1 or 2, FILL_PINC_082: Empty
IF PINC_070=3 or 4, FILL_PINC_082: ‘de su parte’
IF PINC_070=5, FILL_PINC_082: ‘de la parte de su cónyuge o de su pareja’

FILLS (SPAN)

Use fill from PINC_070, FILL_HOMETYPE
Which of these categories includes your best estimate of the value^{FILL_PINC_082} of this
^{FILL_HOMETYPE}?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
More than $1,000,000

¿Cuál de estas categorías incluye su mejor estimación del precio de compra ^{FILL_PINC_082} de
^{FILL_HOMETYPE}?

SPANISH

1.
2.
3.
4.
5.
6.
7.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_081=DK or REF
PINC_083

PINC_083
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

Create fill FILL_PARTNER083S
IF PARPARTNER = 1, FILL_PARTNER083S: ‘Usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER083S: ‘Usted tiene’
The next few questions are about your household savings, other assets, and debts. As with all of the
questions in this survey, the information you provide to us is kept strictly confidential. Please round to
the nearest dollar for your responses. If you don’t know the exact amount, your best estimate is fine.

ENGLISH

Do ^{FILL_PARTNER} have any checking accounts, savings accounts or money market accounts or
funds?
1. Yes
0. No
Las siguientes preguntas son sobre los ahorros de su hogar, otros activos y deudas. Al igual que con
todas las preguntas de esta encuesta, la información que nos da es estrictamente confidencial.
Redondee sus respuestas al dólar más cercano. Si no conoce la cantidad exacta, su mejor estimación
es suficiente.

SPANISH

¿^{FILL_PARTNER083S} cuentas corrientes, cuentas de ahorro o cuentas o fondos del mercado
monetario?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_069, PINC_070=6 or 9 or 10, PINC_071, PINC_081, PINC_082
PINC_083=1: PINC_084
Else PINC_086

PINC_084
ASK

IF PINC_083=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC084: ‘PINC_084’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC084: ‘PINC_084’

FILLS (ENG)

FILLS (SPAN)

ENGLISH

Create fill FILL_PARTNER084S
IF PARPARTNER = 1, FILL_PARTNER084S: ‘usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER084S: ‘usted tiene’
What is the total current balance in all of the checking, savings, and money market accounts
^{FILL_PARTNER} have? (If the amount changes frequently, please report the average balance over the
past month.)
$ ______________

SPANISH

¿Cuál es el saldo actual total en todas las cuentas corrientes, de ahorro y del mercado monetario que
^{FILL_PARTNER084S}? (Si la cantidad cambia con frecuencia, informe del saldo promedio del último
mes)
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_084 OUT OF RANGE (PINC_084=0): ‘You reported earlier that you
and/or your partner have checking, savings, and money market accounts. If this is not
correct, please click here to update your answer.’ (Return R to PINC_083)

CHECK (ENG)

SOFT CHECK IF PINC_084>$1,000,000: ‘You reported that the current balance of these
checking, savings, and money market accounts is ^{FILL_PINC084}. Please review your
answer and correct if needed.’
HARD CHECK IF PINC_084 OUT OF RANGE (PINC_084=0): ‘Usted informó que usted y/o
su pareja tienen cuentas corrientes, de ahorro y del mercado monetario. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_083)

CHECK (SPAN)

SOFT CHECK IF PINC_084>$1,000,000: ‘Usted informó que el saldo actual de estas
cuentas corrientes, de ahorro y del mercado monetario es de ^{FILL_PINC084} dólares.
Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_083=1
PINC_084=DK or REF: PINC_085
Else PINC_086

NEXT
PINC_085
ASK

IF PINC_084= DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the current or average balance over the last
month?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
ENGLISH
5. $10,001 - $25,000
6. $25,001 - $50,000
7. $50,001 - $100,000
8. $100,001 - $250,000
9. More than $250,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación del saldo actual o promedio del último mes?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. $50,001 a $100,000 dólares
8. $100,001 a $250,000 dólares
9. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_084 =DK or REF
PINC_086

PINC_086
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER086S
IF PARPARTNER = 1, FILL_PARTNER086S: ‘usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER086S: ‘usted tiene’
Excluding retirement plan savings, do ^{FILL_PARTNER} have any certificates of deposit (CDs) at
financial institutions, government savings bonds, Treasury bills, or other types of corporate, municipal,
government bonds or bills, including any CDs, bonds, or bills held in investment trusts?
1.
Yes
0.
No
Excluyendo los ahorros del plan de jubilación, ¿^{FILL_PARTNER086S} certificados de depósito (CD)
en instituciones financieras, bonos de ahorro del gobierno, letras del Tesoro u otros tipos de bonos o
letras corporativas, municipales o del gobierno, incluidos los CD, bonos o letras mantenidos en
fideicomisos de inversión?
1.
Sí
0.
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_083, PINC_084, PINC_085
PINC_086=1: PINC_087
Else PINC_089

PINC_087
ASK

IF PINC_086=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC087: ‘PINC_087’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC087: ‘PINC_087’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER087S
IF PARPARTNER = 1, FILL_PARTNER087S: ‘usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER087S: ‘usted tiene’
If you were to cash in all of the CDs, bonds, and bills ^{FILL_PARTNER} have, how much would you get?

ENGLISH

$ ______________
Si cobrara en efectivo todos los CD, bonos y letras que ^{FILL_PARTNER087S}, ¿cuánto obtendría?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_087 OUT OF RANGE (PINC_087=0): ‘You reported earlier that you
and/or your partner have CDs, bonds, or bills. If this is not correct, please click here to
update your answer.’ (Return R to PINC_086)

CHECK (ENG)

SOFT CHECK IF PINC_087>$1,000,000: ‘You reported that the current balance of these
CDs, bonds, and bills is ^{FILL_PINC087}. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_087 OUT OF RANGE (PINC_087=0): ‘Usted informó que usted y/o
su pareja tienen certificados de depósito, bonos o letras. Si esto no es correcto, haga clic
aquí para actualizar su respuesta.’ (Return R to PINC_086)

CHECK (SPAN)

SOFT CHECK IF PINC_087>$1,000,000: ‘Usted informó que el saldo actual de estos CD,
bonos y letras es de ^{FILL_PINC087} dólares. Revise su respuesta y corríjala si es
necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_086=1
PINC_087=DK or REF: PINC_088
Else PINC_089

PINC_088
ASK

IF PINC_087=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the cash value of all your CDs, bond, and
bills?
1.
2.
3.
4.
5.
6.
7.
8.
9.

ENGLISH

$1 - $1,000
$1,001 - $2,500
$2,501 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
More than $250,000

¿Cuál de estas categorías incluye su mejor estimación del valor en efectivo de todos sus CD, bonos y
letras?

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.
9.

$1 a $1,000 dólares
$1,001 a $2,500 dólares
$2,501 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_087
PINC_089

PINC_089
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER089S
IF PARPARTNER = 1, FILL_PARTNER089S: ‘Usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER089S: ‘Usted tiene’
Do ^{FILL_PARTNER} have any shares of stock in publicly held corporations or mutual funds, including
any stock or mutual funds held in investment trusts?
1.
Yes
0.
No
¿^{FILL_PARTNER089S} acciones en compañías de participación pública o fondos de inversión,
incluidas acciones o fondos de inversión en fideicomisos de inversión?
1.
Sí
0.
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_086, PINC_087, PINC_088
PINC_089=1: PINC_090
Else PINC_092

PINC_090
ASK

IF PINC_089=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC090: ‘PINC_090’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC090: ‘PINC_090’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER090S
IF PARPARTNER = 1, FILL_PARTNER090S: ‘usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER090S: ‘usted tiene’
If you sold all of the shares of stock in publicly held corporations ^{FILL_PARTNER} have, including
mutual funds, how much would you get?

ENGLISH
$ ______________
Si vendiera todas las acciones de compañías de participación pública que ^{FILL_PARTNER090S},
incluidos los fondos de inversión, ¿cuánto obtendría?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_090 OUT OF RANGE (PINC_090=0): ‘You reported earlier that you
and/or your partner have stock shares. If this is not correct, please click here to update
your answer.’ (Return R to PINC_089)
SOFT CHECK IF PINC_090>$1,000,000: ‘You reported that the current balance of these
stock shares is ^{FILL_PINC090}. Please review your answer and correct if needed.’
HARD CHECK IF PINC_090 OUT OF RANGE (PINC_090=0): ‘Usted informó que usted y/o
su pareja tienen acciones. Si esto no es correcto, haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_089)
SOFT CHECK IF PINC_090>$1,000,000: ‘Usted informó que el saldo actual de estas
acciones es de ^{FILL_PINC090} dólares. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_089=1
PINC_090=DK or REF: PINC_091
Else PINC_092

PINC_091
ASK

IF PINC_090=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the value of your shares?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
5. $10,001 - $25,000
ENGLISH
6. $25,001 - $50,000
7. $50,001 - $100,000
8. $100,001 - $250,000
9. More than $250,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación del valor de sus acciones?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. $50,001 a $100,000 dólares
8. $100,001 a $250,000 dólares
9. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_090=DK or REF
PINC_092

PINC_092
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

Create fill FILL_PARTNER092S
IF PARPARTNER = 1, FILL_PARTNER092S: ‘usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER092S: ‘usted tiene’
Many employers and unions offer pensions or retirement plans; some provide tax-deferred plans such
as 401(k)'s, profit sharing or stock ownership plans. Other examples include 403(b) plans, 457 plans,
IRA-SEP plans, and IRA-SIMPLE plans. Please do not include Traditional IRAs, Roth IRAs, or education
IRAs as these will be asked about later.

ENGLISH
Do ^{FILL_PARTNER} have any savings in these types of plans?
1. Yes
0. No

SPANISH

Muchos empleadores y sindicatos ofrecen pensiones o planes de jubilación; algunos dan planes con
impuestos diferidos como los 401(k), la participación en los beneficios o los planes de propiedad de
acciones. Otros ejemplos son los planes 403(b), los planes 457, las cuentas individuales de
jubilación IRA-SEP y los planes IRA-SIMPLE. No incluya las cuentas IRA tradicionales, las Roth IRA o
las IRA educativas, ya que responderá preguntas sobre estas más adelante.
¿Se ahorra ^{FILL_PARTNER092S} en este tipo de planes?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_089, PINC_090, PINC_091
PINC_092=1: PINC_093
Else PINC_095

PINC_093
ASK

IF PINC_092=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC093: ‘PINC_093’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC070: ‘PINC_070’

FILLS (ENG)

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER093S
IF PARPARTNER = 1, FILL_PARTNER093S: ‘usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER093S: ‘usted tiene’
What is the total value of all the savings ^{FILL_PARTNER} have in employer-sponsored plans that save
for retirement?
Note that tax-advantaged accounts such as IRA or Keogh plans or accounts for saving for educational
expenses, such as Coverdell IRAs or 529 plans will be collected later.
$ ______________
¿Cuál es el valor total de todos los ahorros que ^{FILL_PARTNER093S} en planes patrocinados por el
empleador que sirven para ahorrar para la jubilación?
Tenga en cuenta que se le preguntará más adelante sobre las cuentas con ventajas fiscales, como los
planes IRA o Keogh, o las cuentas de ahorro para gastos educativos, como las Coverdell IRA o los
planes 529.
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_093 OUT OF RANGE (PINC_093=0): ‘You reported earlier that you
and/or your partner have savings in employer-sponsored savings plans. If this is not
correct, please click here to update your answer.’ (Return R to PINC_092)
SOFT CHECK IF PINC_093>$1,000,000: ‘You reported that the current value of your
savings in employer-sponsored savings plans is ^{FILL_PINC093}. Please review your
answer and correct if needed.’
HARD CHECK IF PINC_093 OUT OF RANGE (PINC_093=0): ‘Usted informó que usted y/o
su pareja tienen ahorros en planes de ahorro patrocinados por el empleador. Si esto no
es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_092)

CHECK (SPAN)

SOFT CHECK IF PINC_093>$1,000,000: ‘Usted informó que el valor actual de sus ahorros
en planes de ahorro patrocinados por el empleador es de ^{FILL_PINC093} dólares.
Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_092=1
If PINC_093=DK or REF: PINC_094; Else PINC_095

PINC_094
ASK

IF PINC_093=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1.
2.
3.
4.
5.
6.
7.
8.

ENGLISH

$1 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
More than $500,000

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.

$1 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_093=DK or REF
PINC_095

PINC_095
ASK

All

QUESTION TYPE

Radio Button
Use fill from PINC_070, FILL_PARTNER

FILLS (ENG)

Create fill, FILL_PINC_095
IF PINC_092 = 1, FILL_PINC_095: ‘Other than the accounts you have through your
employer, do’
ELSE FILL_PINC_095: ‘Do’
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER095S
IF PARPARTNER = 1, FILL_PARTNER095S: ‘usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER095S: ‘usted’
Create fill, FILL_PINC_095
IF PINC_092 = 1, FILL_PINC_095: ‘Aparte de las cuentas que tiene a través de su
empleador, tiene(n)’
ELSE FILL_PINC_095: ‘Tiene(n)’

^{FILL_PINC_095} ^{FILL_PARTNER} have any money in IRAs, Keoghs, variable annuities, 529 plans, or
other tax-advantaged accounts?
1. Yes
0. No
¿^{FILL_PINC_095} ^{FILL_PARTNER095S} dinero en cuentas IRA, Keogh, anualidades variables, planes
529 u otras cuentas con ventajas fiscales?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_092, PINC_093, PINC_094
PINC_095=1: f_PINC_096
Else PINC_125

f_PINC_096
PINC_0961/PINC_0962/PINC_0963/PINC_0964/PINC_0965/PINC_0966/PINC_0967/PINC_0967_SPECIFY
ASK
IF PINC_095=1
PINC_0961: Radio button
PINC_0962: Radio button
PINC_0963: Radio button
PINC_0964: Radio button
QUESTION TYPE
PINC_0965: Radio button
PINC_0966: Radio button
PINC_0967: Radio button
PINC_0967_SPECIFY: Textbox
Create fill FILL_PARTNER_2
FILLS (ENG)
IF PARAPARTNER = 1, FILL_PARTNER_2: ‘you or your spouse or partner’
ELSE FILL_PINC_PARTNER_2: ‘you’
Create fill FILL_PARTNER_2_096S
FILLS (SPAN)
IF PARAPARTNER = 1, FILL_PARTNER_2_096S: ‘tienen usted o su cónyuge o pareja’
ELSE FILL_PINC_PARTNER_2_096S: ‘tiene usted’
Below is a list of different types of tax-advantaged accounts. Please tell us which of these
^{FILL_PARTNER_2} hold. Please respond “Yes” or “No” for each.
COLUMN HEADERS:
1. Yes
0. No

ENGLISH

ROW ITEMS:
Traditional IRA [PINC_0961]
Roth IRA [PINC_0962]
Coverdell IRAs or Education IRAs [PINC_0963]
Keogh Plans [PINC_0964]
Variable Annuities [PINC_0965]
529 Plans (State Sponsored Education Plans) [PINC_0966]
Other (SPECIFY) [PINC_0967] [PINC_0967_SPECIFY]
A continuación, encontrará una lista de los diferentes tipos de cuentas con ventajas fiscales. Díganos
cuál de estas cuentas ^{FILL_PARTNER_2_096S}. Responda “Sí” o “No” para cada opción.
COLUMN HEADERS:
1. Sí
0. No

SPANISH

ROW ITEMS:
IRA tradicional [PINC_0961]
Roth IRA [PINC_0962]
IRA Coverdell o educativa [PINC_0963]
Planes Keogh [PINC_0964]
Anualidades variables [PINC_0965]
Planes 529 (planes educativos patrocinados por el Estado) [PINC_0966]
Otro (ESPECIFIQUE) [PINC_0967] [PINC_0967_SPECIFY]

RANGE
LIMITS

PINC_0967_SPECIFY: 25 Max characters

LOOP MAX
If PINC_0967=1, display text box PINC_0967_SPECIFY with label above the text box:
What other kinds of tax-advantaged accounts do ^{FILL_PARTNER_2} hold?
PROGRAM. NOTES

If PINC_0967=1, display text box PINC_0967_SPECIFY with label above the text box:
¿Qué otros tipos de cuentas con ventajas fiscales tiene ^{FILL_PARTNER_2}?

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

NEXT

PINC_095=1
If PINC_0961=1: PINC_097;
Else if PINC_0962=1: PINC_101;
Else if PINC_0963=1: PINC_105;
Else if PINC_0964=1: PINC_109;
Else if PINC_0965=1: PINC_113;
Else if PINC_0966=1: PINC_117;
Else if PINC_0967=1: PINC_121;
Else PINC_125

PINC_097
ASK

IF PINC_0961=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER0_2_097S
IF PARPARTNER = 1, FILL_PARTNER_2_097S: ‘Usted y/o su cónyuge o pareja han retirado’
ELSE FILL_PARTNER_2_097SS: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from this Traditional IRA that you intend to pay back
or redeposit?
1. Yes
0. No
¿^{FILL_PARTNER_2_097S} dinero de esta cuenta IRA tradicional que tenga intención de devolver o
volver a depositar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096
If PINC_097=1: PINC_098
Else PINC_100

PINC_098
ASK

IF PINC_097=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC098: ‘PINC_098’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC098: ‘PINC_098’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER0_2_098S
IF PARPARTNER = 1, FILL_PARTNER_2_098S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_098SS: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on this
Traditional IRA?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_098S} devolver sobre todos los retiros hechos de esta
cuenta IRA tradicional?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_098 OUT OF RANGE (PINC_098=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from this Traditional IRA that you
intend to pay back or redeposit. If this is not correct, please click here to update your
answer.’ (Return R to PINC_097)
SOFT CHECK IF PINC_098>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC098} to a Traditional IRA. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_098 OUT OF RANGE (PINC_098=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de esta cuenta IRA tradicional que tienen intención de
devolver o de volver a depositar. Si esto no es correcto, haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_097)
SOFT CHECK IF PINC_098>$1,000,000: ‘Usted informó que tiene la intención de devolver
o de volver a depositar ^{FILL_PINC098} dólares en una cuenta IRA tradicional. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_097=1
PINC_098=DK or REF: PINC_099
Else PINC_100

NEXT

PINC_099
ASK

IF PINC_098= DK or REF

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_098 =DK or REF
PINC_100

PINC_100
ASK

IF PINC_0961=1

QUESTION TYPE

Numeric
Create fill PINC_100
IF PINC_097 = 1 AND PARAPARTNER = 1, FILL_PINC_100: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_097 = 1, FILL_PINC_100: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_100: ‘Today, about how much is’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PINC100: ‘PINC_100’
Create fill PINC_100
IF PINC_097 = 1 AND PARAPARTNER = 1, FILL_PINC_100: ‘Si usted y/o su cónyuge o
pareja tuvieran que devolver hoy todos estos reintegros, ¿cuánto habría
aproximadamente’
ELSE IF PINC_097 = 1, FILL_PINC_100: ‘Si usted tuviera que devolver todos estos
reintegros hoy, ¿cuánto habría aproximadamente’
ELSE, FILL_PINC_100: ‘Hoy, ¿cuánto hay aproximadamente’

ENGLISH

Create fill FILL_PINC100: ‘PINC_100’
^{FILL_PINC_100} in this Traditional IRA?
$ ______________

SPANISH

^{FILL_PINC_100} en esta cuenta IRA tradicional?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_100 OUT OF RANGE (PINC_100=0): ‘You reported earlier that you
and/or your partner have money in a Traditional IRA. If this is not correct, please click
here to update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_100>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC100} in a Traditional IRA. Please review your answer and correct if needed.’
HARD CHECK IF PINC_100 OUT OF RANGE (PINC_100=0): ‘Usted informó que usted y/o
su pareja tienen dinero en una cuenta IRA tradicional. Si esto no es correcto, haga clic
aquí para actualizar su respuesta.’ (Return R to PINC_096)

CHECK (SPAN)

SOFT CHECK IF PINC_100>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC100} dólares en una cuenta IRA tradicional. Revise su respuesta y corríjala si
es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

NEXT

PINC_097, PINC_098, PINC_099
If PINC_0962=1: PINC_101
Else if PINC_0963=1: PINC_105
Else if PINC_0964=1: PINC_109
Else if PINC_0965=1: PINC_113
Else if PINC_0966=1: PINC_117
Else if PINC_0967=1: PINC_121
Else PINC_125

PINC_101
ASK

IF PINC_0962=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER0_2_101S
IF PARPARTNER = 1, FILL_PARTNER_2_101S: ‘Usted y/o su cónyuge o pareja retiraron’
ELSE FILL_PARTNER_2_101S: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from this Roth IRA that you intend to pay back or
redeposit?
1. Yes
0. No
¿^{FILL_PARTNER_2_101S} más dinero de esta cuenta Roth IRA que tiene(n) la intención de devolver o
volver a depositar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096, PINC_100
If PINC_101=1: PINC_102;
Else PINC_104

PINC_102
ASK

IF PINC_101=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC102: ‘PINC_102’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC102: ‘PINC_102’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_2_102S
IF PARPARTNER = 1, FILL_PARTNER_2_102S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_102S: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on this Roth
IRA?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_102S} devolver de todos los retiros efectuados en esta
cuenta Roth IRA?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_102 OUT OF RANGE (PINC_102=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from a Roth IRA that you intend to pay
back or redeposit. If this is not correct, please click here to update your answer.’ (Return
R to PINC_101)
SOFT CHECK IF PINC_102>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC102} to a Roth IRA. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_102 OUT OF RANGE (PINC_102=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de esta cuenta Roth IRA que tienen intención de devolver
o de volver a depositar. Si esto no es correcto, haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_101)
SOFT CHECK IF PINC_102>$1,000,000: ‘Usted informó que tiene la intención de devolver
o de volver a depositar ^{FILL_PINC102} dólares en una cuenta Roth IRA. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_101=1
PINC_102=DK or REF: PINC_103
Else PINC_104

NEXT

PINC_103
ASK

IF PINC_102=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_102 =DK or REF
PINC_104

PINC_104
ASK

IF PINC_0962=1

QUESTION TYPE

Numeric
Use Create fill from PINC_100, FILL_PINC_100104_2
IF PINC_101 = 1 AND PARAPARTNER = 1, FILL_PINC_104_2: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_101= 1, FILL_PINC_104_2: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_104_2: ‘Today, about how much is’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PINC104: ‘PINC_104’
Use Create fill from PINC_100, FILL_PINC_100104_2
IF PINC_101 = 1 AND PARAPARTNER = 1, FILL_PINC_104_2: Si usted y/o su cónyuge o
pareja fueran a devolver todos estos retiros hoy, ¿aproximadamente cuanto tendría’
ELSE IF PINC_101= 1, FILL_PINC_104_2: ‘Si fuera a devolver todos estos retiros hoy,
¿aproximadamente cuánto tendría’
ELSE, FILL_PINC_104_2: ‘¿Hoy en día, aproximadamente cuando hay’

ENGLISH

Create fill FILL_PINC104: ‘PINC_104’
^{FILL_PINC_100104_2} in this Roth IRA?
$ ______________

SPANISH

^{FILL_PINC_100} en esta cuenta Roth IRA?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_104 OUT OF RANGE (PINC_104=0): ‘You reported earlier that you
and/or your partner have money in a Roth IRA. If this is not correct, please click here to
update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_104>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC100} in a Roth IRA. Please review your answer and correct if needed.’
HARD CHECK IF PINC_104 OUT OF RANGE (PINC_104=0): ‘Usted informó que usted y/o
su pareja tienen dinero en una cuenta Roth IRA. Si esto no es correcto, haga clic aquí
para actualizar su respuesta.’ (Return R to PINC_096)

CHECK (SPAN)

SOFT CHECK IF PINC_104>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC100} dólares en una cuenta Roth IRA. Revise su respuesta y corríjala si es
necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

NEXT

PINC_101, PINC_102, PINC_103
If PINC_0963=1: PINC_105
Else if PINC_0964=1: PINC_109
Else if PINC_0965=1: PINC_113
Else if PINC_0966=1: PINC_117
Else if PINC_0967=1: PINC_121
Else PINC_125

PINC_105
ASK

IF PINC_0963=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_105S
IF PARPARTNER = 1, FILL_PARTNER_2_105S: ‘Usted y/o su cónyuge o pareja retiraron’
ELSE FILL_PARTNER_2_105S: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from these Coverdell IRAs or Education IRAs that you
intend to pay back or redeposit?
1. Yes
0. No
¿^{FILL_PARTNER_2_105S} algún dinero de estas cuentas Coverdell IRA o IRA educativas que tenga(n)
la intención de devolver o volver a depositar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096, PINC_100, PINC_104
If PINC_105=1: PINC_106;
Else PINC_108

PINC_106
ASK

IF PINC_105=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC106: ‘PINC_106’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC106: ‘PINC_106’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_2_106S
IF PARPARTNER = 1, FILL_PARTNER_2_106S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_106S: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on these
Coverdell IRAs or Education IRAs?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_106S} devolver sobre todos los retiros efectuados de
estas cuentas Coverdell IRA o IRA educativas?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_106 OUT OF RANGE (PINC_106=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from a Coverdell or Education IRA that
you intend to pay back or redeposit. If this is not correct, please click here to update
your answer.’ (Return R to PINC_105)
SOFT CHECK IF PINC_106>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC106} to a Coverdell or Education IRA. Please review your answer
and correct if needed.’
HARD CHECK IF PINC_106 OUT OF RANGE (PINC_106=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de estas cuentas Coverdell IRA o IRA educativas que tienen
la intención de devolver o de volver a depositar. Si esto no es correcto, haga clic aquí
para actualizar su respuesta.’ (Return R to PINC_105)
SOFT CHECK IF PINC_106>$1,000,000: ‘Usted informó que tiene la intención de devolver
o volver a depositar ^{FILL_PINC106} dólares en una cuenta Coverdell o IRA educativa.
Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_105=1
PINC_106=DK or REF: PINC_107
Else PINC_108

NEXT

PINC_107
ASK

IF PINC_106=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_106 =DK or REF
PINC_108

PINC_108
ASK

IF PINC_0963=1

QUESTION TYPE

Numeric
Create fill FILL_PINC_108_2
IF PINC_105 = 1 AND PARAPARTNER = 1, FILL_PINC_108_2: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_105= 1, FILL_PINC_108_2: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_108_2: ‘Today, about how much is’

FILLS (ENG)

Create fill FILL_PINC108: ‘PINC_108’
Create fill FILL_PINC_108_2
IF PINC_105 = 1 AND PARAPARTNER = 1, FILL_PINC_108_2: Si usted y/o su cónyuge o
pareja fueran a devolver todos estos retiros hoy, ¿aproximadamente cuanto tendría’
FILLS (SPAN)
ELSE IF PINC_105= 1, FILL_PINC_108_2: ‘Si fuera a devolver todos estos retiros hoy,
¿aproximadamente cuánto tendría’
ELSE, FILL_PINC_108_2: ‘¿Hoy en día, aproximadamente cuando hay’
Create fill FILL_PINC108: ‘PINC_108’
^{FILL_PINC_100} in these Coverdell IRAs or Education IRAs?
$ ______________
ENGLISH

SPANISH

^{FILL_PINC_100} en estas cuentas Coverdell IRA o IRA educativas?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_108 OUT OF RANGE (PINC_108=0): ‘You reported earlier that you
and/or your partner have money in a Coverdell or Education IRA. If this is not correct,
please click here to update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_108>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC108} in Coverdell or Education IRAs. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_108 OUT OF RANGE (PINC_108=0): ‘Usted informó que usted y/o
su pareja tienen dinero en una cuenta Coverdell IRA o IRA educativa. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_096)

CHECK (SPAN)

SOFT CHECK IF PINC_108>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC108} dólares en cuentas Coverdell IRA o IRA educativas. Revise su respuesta
y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

NEXT

PINC_105, PINC_106, PINC_107
If PINC_0964=1: PINC_109
Else if PINC_0965=1: PINC_113
Else if PINC_0966=1: PINC_117
Else if PINC_0967=1: PINC_121
Else PINC_125

PINC_109
ASK

IF PINC_0964=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_109S
IF PARPARTNER = 1, FILL_PARTNER_2_109S: ‘Usted y/o su cónyuge o pareja retiraron’
ELSE FILL_PARTNER_2_109S: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from these Keogh Plans that you intend to pay back
or redeposit?
1 Yes
0 No
¿^{FILL_PARTNER_2_109S} dinero de estos planes Keogh que planea(n) devolver o volver a depositar?
1 Sí
0 No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096, PINC_100, PINC_104, PINC_108
If PINC_109=1: PINC_110
Else PINC_112

PINC_110
ASK

IF PINC_109=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC110: ‘PINC_110’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC110: ‘PINC_110’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_2_110S
IF PARPARTNER = 1, FILL_PARTNER_2_110S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_110S: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on these
Keogh Plans?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_110S} devolver sobre todos los retiros efectuados en
estos planes Keogh?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_110 OUT OF RANGE (PINC_110=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from a Keogh Plan that you intend to
pay back or redeposit. If this is not correct, please click here to update your answer.’
(Return R to PINC_109)
SOFT CHECK IF PINC_110>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC110} to a Keogh Plan. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_110 OUT OF RANGE (PINC_110=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de este plan Keogh que tienen intención de devolver o de
volver a depositar. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_109)
SOFT CHECK IF PINC_110>$1,000,000: ‘Usted informó que tiene la intención de devolver
o de volver a depositar ^{FILL_PINC110} dólares en un plan Keogh. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN
NEXT

PINC_109=1
PINC_110=DK or REF: PINC_111
Else PINC_112

PINC_111
ASK

IF PINC_110=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000
¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
SPANISH
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_110 =DK or REF
PINC_112

PINC_112
ASK

IF PINC_0964=1

QUESTION TYPE

Numeric
Create fill FILL_PINC_112_2
IF PINC_109 = 1 AND PARAPARTNER = 1, FILL_PINC_112_2: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_109= 1, FILL_PINC_112_2: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_112_2: ‘Today, about how much is’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PINC112: ‘PINC_112’
Create fill FILL_PINC_112_2
IF PINC_109 = 1 AND PARAPARTNER = 1, FILL_PINC_112_2: Si usted y/o su cónyuge o
pareja fueran a devolver todos estos retiros hoy, ¿aproximadamente cuanto tendría’
ELSE IF PINC_109= 1, FILL_PINC_112_2: ‘Si fuera a devolver todos estos retiros hoy,
¿aproximadamente cuánto tendría’
ELSE, FILL_PINC_112_2: ‘¿Hoy en día, aproximadamente cuando hay’

ENGLISH

Create fill FILL_PINC112: ‘PINC_112’
^{FILL_PINC_112_2} in these Keogh Plans?
$ ______________

SPANISH

^{FILL_PINC_100} en estos planes Keogh?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_112 OUT OF RANGE (PINC_112=0): ‘You reported earlier that you
and/or your partner have money in Keogh Plan. If this is not correct, please click here to
update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_112>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC112} in Keogh Plans. Please review your answer and correct if needed.’
HARD CHECK IF PINC_112 OUT OF RANGE (PINC_112=0): ‘Usted informó que usted y/o
su pareja tienen dinero en un plan Keogh. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_113)
SOFT CHECK IF PINC_112>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC112} dólares en planes Keogh. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PINC_097, PINC_097, PINC_099

NEXT

If PINC_0965=1: PINC_113
Else if PINC_0966=1: PINC_117
Else if PINC_0967=1: PINC_121
Else PINC_125

PINC_113
ASK

IF PINC_0965=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_113S
IF PARPARTNER = 1, FILL_PARTNER_2_113S: ‘Usted y/o su cónyuge o pareja retiraron’
ELSE FILL_PARTNER_2_113S: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from these variable annuities that you intend to pay
back or redeposit?
1. Yes
0. No
¿^{FILL_PARTNER_2_113S} dinero de estas anualidades variables que planea(n) devolver o volver a
depositar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096, PINC_100, PINC_104, PINC_108, PINC_112
If PINC_113=1: PINC_114
Else PINC_116

PINC_114
ASK

IF PINC_113=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC114: ‘PINC_114’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC114: ‘PINC_114’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_2_114S
IF PARPARTNER = 1, FILL_PARTNER_2_114S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_114S: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on these
variable annuities?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_114S} devolver sobre todos los retiros efectuados en
estas anualidades variables?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_114 OUT OF RANGE (PINC_114=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from variable annuities that you intend
to pay back or redeposit. If this is not correct, please click here to update your answer.’
(Return R to PINC_113)
SOFT CHECK IF PINC_114>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC114} to variable annuities. Please review your answer and correct
if needed.’
HARD CHECK IF PINC_114 OUT OF RANGE (PINC_114=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de estas anualidades variables que tienen intención de
devolver o de volver a depositar. Si esto no es correcto, haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_113)
SOFT CHECK IF PINC_114>$1,000,000: ‘Usted informó que tiene la intención de devolver
o de volver a depositar ^{FILL_PINC114} dólares en anualidades variables. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_113=1
PINC_114=DK or REF: PINC_115
Else PINC_116

NEXT

PINC_115
ASK

IF PINC_114=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_114 =DK or REF
PINC_116

PINC_116
ASK

IF PINC_0965=1

QUESTION TYPE

Numeric
Create fill FILL_PINC_116_2
IF PINC_113 = 1 AND PARAPARTNER = 1, FILL_PINC_116_2: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_113= 1, FILL_PINC_116_2: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_116_2: ‘Today, about how much is’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PINC116: ‘PINC_116’
Create fill FILL_PINC_116_2
IF PINC_113 = 1 AND PARAPARTNER = 1, FILL_PINC_116_2: Si usted y/o su cónyuge o
pareja fueran a devolver todos estos retiros hoy, ¿aproximadamente cuanto tendría’
ELSE IF PINC_113= 1, FILL_PINC_116_2: ‘Si fuera a devolver todos estos retiros hoy,
¿aproximadamente cuánto tendría’
ELSE, FILL_PINC_116_2: ‘¿Hoy en día, aproximadamente cuando hay’

ENGLISH

Create fill FILL_PINC116: ‘PINC_116’
^{FILL_PINC_100116_2} in these variable annuities?
$ ______________

SPANISH

^{FILL_PINC_100} en estas anualidades variables?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_116 OUT OF RANGE (PINC_116=0): ‘You reported earlier that you
and/or your partner have money in variable annuities. If this is not correct, please click
here to update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_116>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC116} in variable annuities. Please review your answer and correct if needed.’
HARD CHECK IF PINC_116 OUT OF RANGE (PINC_116=0): ‘Usted informó que usted y/o
su pareja tienen dinero en anualidades variables. Si esto no es correcto, haga clic aquí
para actualizar su respuesta.’ (Return R to PINC_096)

CHECK (SPAN)

SOFT CHECK IF PINC_116>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC116} dólares en anualidades variables. Revise su respuesta y corríjala si es
necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN
NEXT

PINC_113, PINC_114, PINC_115
If PINC_0966=1: PINC_117
Else if PINC_0967=1: PINC_121
Else PINC_125

PINC_117
ASK

IF PINC_0966=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_117S
IF PARPARTNER = 1, FILL_PARTNER_2_117S: ‘Usted y/o su cónyuge o pareja han retirado’
ELSE FILL_PARTNER_2_127S: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from these 529 Plans that you intend to pay back or
redeposit?
1. Yes
0. No
¿^{FILL_PARTNER_2_117S} dinero de estos planes 529 que planea(n) devolver o volver a depositar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096, PINC_100, PINC_104, PINC_108, PINC_112, PINC_116
If PINC_117=1: PINC_118
Else PINC_120

PINC_118
ASK

IF PINC_117=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC118: ‘PINC_118’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC118: ‘PINC_118’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_2_118S
IF PARPARTNER = 1, FILL_PARTNER_2_118S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_118S: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on these 529
Plans?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_118S} devolver sobre todos los retiros efectuados en
estos planes 529?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_118 OUT OF RANGE (PINC_118=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from 529 Plans that you intend to pay
back or redeposit. If this is not correct, please click here to update your answer.’ (Return
R to PINC_117)
SOFT CHECK IF PINC_118>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC118} to 529 plans. Please review your answer and correct if
needed.’
HARD CHECK IF PINC_118 OUT OF RANGE (PINC_118=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de estos planes 529 que tienen intención de devolver o de
volver a depositar. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_117)
SOFT CHECK IF PINC_118>$1,000,000: ‘Usted informó que planeaba devolver o volver a
depositar ^{FILL_PINC118} dólares a los planes 529. Revise su respuesta y corríjala si es
necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_117=1
PINC_118=DK or REF: PINC_119
Else PINC_120

NEXT

PINC_119
ASK

IF PINC_118=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_118 =DK or REF
PINC_120

PINC_120
ASK

IF PINC_0966=1

QUESTION TYPE

Numeric
Create fill FILL_PINC_120_2
IF PINC_117 = 1 AND PARAPARTNER = 1, FILL_PINC_120_2: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_117= 1, FILL_PINC_120_2: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_120_2: ‘Today, about how much is’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PINC120: ‘PINC_120’
Create fill FILL_PINC_120_2
IF PINC_117 = 1 AND PARAPARTNER = 1, FILL_PINC_120_2: Si usted y/o su cónyuge o
pareja fueran a devolver todos estos retiros hoy, ¿aproximadamente cuanto tendría’
ELSE IF PINC_117= 1, FILL_PINC_120_2: ‘Si fuera a devolver todos estos retiros hoy,
¿aproximadamente cuánto tendría’
ELSE, FILL_PINC_120_2: ‘¿Hoy en día, aproximadamente cuando hay’

ENGLISH

Create fill FILL_PINC120: ‘PINC_120’
^{FILL_PINC_120_2} in these 529 Plans?
$ ______________

SPANISH

^{FILL_PINC_100} en estos planes 529?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_120 OUT OF RANGE (PINC_120=0): ‘You reported earlier that you
and/or your partner have money in a 529 Plan. If this is not correct, please click here to
update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_120>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC120} in 529 plans. Please review your answer and correct if needed.’
HARD CHECK IF PINC_120 OUT OF RANGE (PINC_120=0): ‘Usted informó que usted y/o
su pareja tienen dinero en un plan 529. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_096)
SOFT CHECK IF PINC_120>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC120} dólares en planes 529. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PINC_117, PINC_118, PINC_119

NEXT

If PINC_0967=1: PINC_121
Else PINC_125

PINC_121
ASK

IF PINC_0967=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_121S
IF PARPARTNER = 1, FILL_PARTNER_2_121S: ‘Usted y/o su cónyuge o pareja han retirado’
ELSE FILL_PARTNER_2_121S: ‘Usted ha retirado’
Have ^{FILL_PARTNER_2} withdrawn any money from these other tax-advantaged accounts that you
intend to pay back or redeposit?
1. Yes
0. No
¿^{FILL_PARTNER_2_121S} dinero de estas otras cuentas con ventajas fiscales que tenga(n) la
intención de devolver o de volver a depositar?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_096, PINC_100, PINC_104, PINC_108, PINC_112, PINC_116, PINC_120
If PINC_121=1: PINC_122
Else PINC_124

PINC_122
ASK

IF PINC_121=1

QUESTION TYPE

Numeric
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC122: ‘PINC_122’
Use fill from PINC_096, FILL_PARTNER_2
Create fill FILL_PINC122: ‘PINC_122’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_2_122S
IF PARPARTNER = 1, FILL_PARTNER_2_122S: ‘usted y/o su cónyuge o pareja tienen la
intención de’
ELSE FILL_PARTNER_2_122S: ‘usted tiene la intención de’
What is the amount that ^{FILL_PARTNER_2} intend to pay back on all withdrawals made on these
other tax-advantaged accounts?

ENGLISH
$ ______________
¿Cuál es la cantidad que ^{FILL_PARTNER_2_122S} devolver sobre todos los retiros efectuados en
estas otras cuentas con ventajas fiscales?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_122 OUT OF RANGE (PINC_122=0): ‘You reported earlier that you
and/or your partner have withdrawn any money from other tax-advantaged accounts
that you intend to pay back or redeposit. If this is not correct, please click here to update
your answer.’ (Return R to PINC_121)
SOFT CHECK IF PINC_122>$1,000,000: ‘You reported that you intend to pay back or
redeposit ^{FILL_PINC122} to other tax-advantaged accounts. Please review your answer
and correct if needed.’
HARD CHECK IF PINC_122 OUT OF RANGE (PINC_122=0): ‘Usted informó que usted y/o
su pareja han retirado dinero de estas otras cuentas con ventajas fiscales que tienen
intención de devolver o de volver a depositar. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_121)
SOFT CHECK IF PINC_122>$1,000,000: ‘Usted informó que tiene la intención de devolver
o volver a depositar ^{FILL_PINC122} dólares en otras cuentas con ventajas fiscales.
Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN

PINC_121=1
PINC_122=DK or REF: PINC_123
Else PINC_124

NEXT

PINC_123
ASK

IF PINC_122=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. $250,001 - $500,000
8. More than $500,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. $250,001 a $500,000 dólares
8. Más de $500,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_122 =DK or REF
PINC_124

PINC_124
ASK

IF PINC_0967=1

QUESTION TYPE

Numeric
Create fill FILL_PINC_124
IF PINC_121 = 1 AND PARAPARTNER = 1, FILL_PINC_124: ‘If you and/or your spouse or
partner were to pay back all of these withdrawals today, about how much would be’
ELSE IF PINC_121= 1, FILL_PINC_124: ‘If you were to pay back all of these withdrawals
today, about how much would be’
ELSE, FILL_PINC_124: ‘Today, about how much is’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PINC124: ‘PINC_124’
Create fill FILL_PINC_124
IF PINC_121 = 1 AND PARAPARTNER = 1, FILL_PINC_124: Si usted y/o su cónyuge o
pareja fueran a devolver todos estos retiros hoy, ¿aproximadamente cuanto tendría’
ELSE IF PINC_121= 1, FILL_PINC_124: ‘Si fuera a devolver todos estos retiros hoy,
¿aproximadamente cuánto tendría’
ELSE, FILL_PINC_124: ‘¿Hoy en día, aproximadamente cuando hay’

ENGLISH

Create fill FILL_PINC124: ‘PINC_124’
^{FILL_PINC_124_2} in these other tax-advantaged accounts?
$ ______________

SPANISH

^{FILL_PINC_100} en estas otras cuentas con ventajas fiscales?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_124 OUT OF RANGE (PINC_124=0): ‘You reported earlier that you
and/or your partner have money in other tax-advantaged accounts. If this is not correct,
please click here to update your answer.’ (Return R to PINC_096)
SOFT CHECK IF PINC_124>$1,000,000: ‘You reported that you and/or your partner have
^{FILL_PINC124} in other tax-advantaged accounts. Please review your answer and
correct if needed.’
HARD CHECK IF PINC_104 OUT OF RANGE (PINC_104=0): ‘Usted informó que usted y/o
su pareja tienen dinero en otras cuentas con ventajas fiscales. Si esto no es correcto,
haga clic aquí para actualizar su respuesta.’ (Return R to PINC_096)

CHECK (SPAN)

SOFT CHECK IF PINC_124>$1,000,000: ‘Usted informó que usted y/o su pareja tienen
^{FILL_PINC124} dólares en otras cuentas con ventajas fiscales. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_121, PINC_122, PINC_123
PINC_125

PINC_125
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

Create fill FILL_PARTNER_125S
IF PARPARTNER = 1, FILL_PARTNER_125S: ‘les debe a usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_125S: ‘le debe a usted’
Does anyone owe ^{FILL_PARTNER} $1,000 or more from personal loans or from any mortgage loans
that you have made to others, even if you are not sure that these people will repay you?

ENGLISH

Please do not include any loans owed to your business or farm as you will asked about them later.
1. Yes
0. No
¿Alguien ^{FILL_PARTNER_125S} $1,000 dólares o más de préstamos personales o de cualquier
préstamo hipotecario que haya(n) hecho a otras personas, aunque no haya garantía de que se los
devuelvan?

SPANISH

No incluya ningún préstamo adeudado a su empresa o granja, ya que responderá preguntas al
respecto más adelante.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_095, PINC_100, PINC_104, PINC_108, PINC_112, PINC_116, PINC_120, PINC_124
PINC_125=1: PINC_126
Else PINC_128

PINC_126
ASK

IF PINC_125=1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC126: ‘PINC_126’

FILLS (SPAN)
Create fill FILL_PINC126: ‘PINC_126’
Altogether, how much are you owed from these loans?
$ ______________
ENGLISH

SPANISH

En total, ¿cuánto se debe de estos préstamos?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_126 OUT OF RANGE (PINC_126=0): ‘You reported earlier that you
and/or your partner are owed money on loans you made to other people. If this is not
correct, please click here to update your answer.’ (Return R to PINC_125)
SOFT CHECK IF PINC_126>$1,000,000: ‘You reported that you and/or your partner are
owed ^{FILL_PINC126} on loans made to other people. This amount should not include
loans owed to your business or farm. Please review your answer and correct if needed.’
HARD CHECK IF PINC_126 OUT OF RANGE (PINC_126=0): ‘Usted informó que a usted y/o
a su pareja se les debe dinero por préstamos que hicieron a otras personas. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_125)

CHECK (SPAN)

SOFT CHECK IF PINC_126>$1,000,000: ‘Usted informó que a usted y/o a su pareja se les
deben ^{FILL_PINC126} dólares por préstamos realizados a otras personas. Esta cantidad
no debe incluir los préstamos adeudados a su empresa o granja. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_125=1
PINC_126=DK or REF: PINC_127
Else PINC_128

PINC_127
ASK

IF PINC_126=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
More than $250,000

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_126 =DK or REF
PINC_128

PINC_128
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

Create fill FILL_PARTNER_128S
IF PARPARTNER = 1, FILL_PARTNER_128S: ‘Usted y/o su cónyuge o pareja son dueños(as)
de’
ELSE FILL_PARTNER_128S: ‘Usted es dueño(a) de’
Do ^{FILL_PARTNER} own any vehicles for personal use such as a car, van, truck, jeep-like vehicle, a
motor home/RV, motorcycle, boat, or airplane?

FILLS (SPAN)

ENGLISH

Please do not include vehicles that you lease or have use of, but do not own. Please do include
vehicles you are still paying for but will own when you finish making payments.
1. Yes
0. No
¿^{FILL_PARTNER_128S} algún vehículo para uso personal como un coche, una furgoneta, un camión,
un vehículo tipo Jeep, una casa rodante/RV, una motocicleta, un barco o un avión?

SPANISH

No incluya los vehículos que alquile o los que use que no sean suyos. Incluya los vehículos que aún
está pagando pero que poseerá cuando termine de realizar los pagos.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_125, PINC_126, PINC_127
PINC_128=1: PINC_129
Else PINC_133

PINC_129
ASK

IF PINC_128=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC129: ‘PINC_129’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC129: ‘PINC_129’

FILLS (ENG)

FILLS (SPAN)

ENGLISH

Create fill FILL_PARTNER_129S
IF PARPARTNER = 1, FILL_PARTNER_129S: ‘tienen usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_129S: ‘tiene usted’
Altogether, what is the current market value of all of the vehicles ^{FILL_PARTNER} own?
$ ______________

SPANISH

En total, ¿cuál es el valor de mercado actual de todos los vehículos que ^{FILL_PARTNER}?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_129 OUT OF RANGE: ‘Please enter a number for the value of your
vehicles between 1-999,999,999. If you do not own any vehicles, please click here to
update your answer’ (Return R to PINC_128)

CHECK (ENG)

SOFT CHECK IF PINC_129>$1,000,000: ‘You reported that ^{FILL_PINC129} is the current
market value of all the vehicles you and/or your partner own for personal use. This
number should not include vehicles owned by a farm or business. Please review your
answer and correct if needed.’
HARD CHECK IF PINC_129 OUT OF RANGE: ‘Ingrese un número para el valor de sus
vehículos entre 1 y 999,999,999. Si no posee ningún vehículo, haga clic en aquí para
actualizar su respuesta’ (Return R to PINC_128)

CHECK (SPAN)

SOFT CHECK IF PINC_129>$1,000,000: ‘Usted informó que ^{FILL_PINC129} dólares es el
valor de mercado actual de todos los vehículos que usted y/o su pareja poseen para uso
personal. Este número no debe incluir los vehículos que son propiedad de una granja o
empresa. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_128=1
PINC_129=DK or REF: PINC_130
Else PINC_131

PINC_130
ASK

IF PINC_129=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the market value of all your vehicles?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
ENGLISH
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000
¿Cuál de estas categorías incluye su mejor estimación del valor de mercado de todos sus vehículos?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
SPANISH
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_129=DK or REF
PINC_131

PINC_131
ASK

IF PINC_128=1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC131: ‘PINC_131’

FILLS (SPAN)
Create fill FILL_PINC131: ‘PINC_131’
How much is still owed on these vehicles?
$ ______________
ENGLISH

SPANISH

¿Cuánto se debe aún por estos vehículos?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
SOFT CHECK IF PINC_131>$1,000,000: ‘You reported that you and/or your partner
currently owe ^{FILL_PINC131} on the vehicles you own. Please review your answer and
correct if needed.’
SOFT CHECK IF PINC_131>$1,000,000: ‘Usted informó que usted y/o su pareja deben
actualmente ^{FILL_PINC131} dólares por los vehículos de su propiedad. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_130, PINC_129
PINC_131=DK or REF: PINC_132
Else PINC_133

PINC_132
ASK

IF PINC_131=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the amount owed on these vehicles?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
More than $250,000

¿Cuál de estas categorías incluye su mejor estimación de la cantidad adeudada por estos vehículos?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_131=DK or REF
PINC_133

PINC_133
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

Create fill FILL_PARTNER_133S
IF PARPARTNER = 1, FILL_PARTNER_133S: ‘Usted y/o su cónyuge o pareja son dueños(as)
de’
ELSE FILL_PARTNER_133S: ‘Usted es dueño(a) de’
Do ^{FILL_PARTNER} own a business, partnership or professional practice, or any part of one?
1. Yes
0. No

FILLS (SPAN)

ENGLISH

SPANISH

¿^{FILL_PARTNER_133S} un negocio, sociedad o práctica profesional, o de parte de alguno?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_128, PINC_131 PINC_132
PINC_133=1: PINC_134;
Else PINC_141

PINC_134
ASK

IF PINC_133=1

QUESTION TYPE

Numeric

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

Create fill FILL_PARTNER_134S
IF PARPARTNER = 1, FILL_PARTNER_134S: ‘tienen usted y/o su cónyuge o pareja en este
momento’
ELSE FILL_PARTNER_134S: ‘tiene usted en este momento’
How many businesses and professional practices do ^{FILL_PARTNER} currently own or are invested
in?
Number of businesses: __________

FILLS (SPAN)

ENGLISH

SPANISH

¿Cuántas empresas y prácticas profesionales ^{FILL_PARTNER_134S} o en cuántas invierte(n)?
Número de empresas: __________

RANGE

0-999

LIMITS

3 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

HARD CHECK IF PINC_134 OUT OF RANGE (PINC_134=0): ‘You reported earlier that you
and/or your partner own a business, partnership or professional practice, or any part of
one. If this is not correct, please click here to update your answer.’ (Return R to
PINC_133)
SOFT CHECK IF PINC_134 > 5: ‘Please check your answer. Do not include publicly traded
stocks in a business in your number.’
HARD CHECK IF PINC_134 OUT OF RANGE (PINC_134=0): ‘Usted informó que usted y/o
su pareja son propietarios de un negocio, sociedad o práctica profesional, o parte de
alguno. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to
PINC_133)
SOFT CHECK IF PINC_134 > 5: ‘Revise su respuesta. No incluya las acciones cotizadas en
bolsa de una empresa en su número.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_133=1
PINC_135

PINC_135
ASK

IF PINC_133=1

QUESTION TYPE

Informational

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

Create fill FILL_PARTNER_135S
IF PARPARTNER = 1, FILL_PARTNER_135S: ‘tienen usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_135S: ‘tiene usted’
Next are some questions about all the businesses or professional practices ^{FILL_PARTNER} are
currently invested in. In answering these questions, please include all of the land, buildings, tools,
equipment, intellectual property, and other assets that ^{FILL_PARTNER} own as part of a business.

ENGLISH

SPANISH

Please round to the nearest dollar for your responses. If you don’t know the exact amount, your best
estimate is fine.

Las siguientes preguntas son sobre todos los negocios o prácticas profesionales en los que
^{FILL_PARTNER} invierte en este momento. Al responder a estas preguntas, incluya todos los
terrenos, edificios, herramientas, equipos, propiedad intelectual y otros activos que
^{FILL_PARTNER_135S} como parte de una empresa.
Redondee sus respuestas al dólar más cercano. Si no conoce la cantidad exacta, su mejor estimación
es suficiente.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_134
PINC_136

PINC_136
ASK

IF PINC_133=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_136S
IF PARPARTNER = 1, FILL_PARTNER_136S: ‘tienen usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_136S: ‘tiene usted’
If you sold all of the businesses or business investments that ^{FILL_PARTNER} own, including any real
estate owned by the business/partnership/professional practice, and paid off any debts, would you
lose money, would you make money, or would you just about break even? Please include only the part
of the business currently owned by ^{FILL_PARTNER}.
1.
Lose money
2.
Make money
3.
Break even
Si vendiera todos los negocios o inversiones empresariales que ^{FILL_PARTNER_136S}, incluyendo los
bienes inmuebles que son propiedad del negocio/sociedad/práctica profesional, y pagara todas sus
deudas, ¿habría pérdidas, habría ganancias o simplemente se alcanzaría un equilibrio? Incluya solo la
parte del negocio que actualmente ^{FILL_PARTNER_136S}.
1.
Habría pérdidas
2.
Habría ganancias
3.
Se alcanzaría un equilibrio

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_135
PINC_136=1: PINC_138
PINC_136=2: PINC_137
Else PINC_141

PINC_137
ASK

IF PINC_136=2

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
FILLS (ENG)
Create fill FILL_PINC137: ‘PINC_137’
Use fill from PINC_070, FILL_PARTNER
FILLS (SPAN)
Create fill FILL_PINC137: ‘PINC_137’
How much money would ^{FILL_PARTNER} make?

ENGLISH

$ ______________
¿Cuánto dinero ganaría ^{FILL_PARTNER}?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_137 OUT OF RANGE (PINC_137=0): ‘You reported earlier that you
and/or your partner would make money if you sold all your businesses or business
investments. If this is not correct, please click here to update your answer.’ (Return R to
PINC_136)
SOFT CHECK IF PINC_137>$1,000,000: ‘You reported that you and/or your partner would
make ^{FILL_PINC137} after selling your businesses or business investments and paying
off any debts. Please review your answer and correct if needed.’
HARD CHECK IF PINC_137 OUT OF RANGE (PINC_137=0): ‘Usted informó que usted y/o
su pareja tendrían ganancias si vendieran todos sus negocios o inversiones
empresariales. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_136)
SOFT CHECK IF PINC_137>$1,000,000: ‘Usted informó que usted y/o su pareja ganarían
^{FILL_PINC137} dólares después de vender sus negocios o inversiones empresariales y
pagar sus deudas. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_136=2
PINC_137=DK or REF: PINC_139
Else PINC_141

PINC_138
ASK

IF PINC_136=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
FILLS (ENG)
Create fill FILL_PINC138: ‘PINC_138’
Use fill from PINC_070, FILL_PARTNER
FILLS (SPAN)
Create fill FILL_PINC138: ‘PINC_138’
How much money would ^{FILL_PARTNER} lose?

ENGLISH

$ ______________
¿Cuánto dinero perdería ^{FILL_PARTNER}?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_138 OUT OF RANGE (PINC_138=0): ‘You reported earlier that you
and/or your partner would lose money if you sold all your businesses or business
investments. If this is not correct, please click here to update your answer.’ (Return R to
PINC_136)
SOFT CHECK IF PINC_138>$1,000,000: ‘You reported that you and/or your partner would
lose ^{FILL_PINC138} after selling your businesses or business investments and paying
off any debts. Please review your answer and correct if needed.’
HARD CHECK IF PINC_138 OUT OF RANGE (PINC_138=0): ‘Usted informó que usted y/o
su pareja tendrían pérdidas si vendieran todos sus negocios o inversiones
empresariales. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_136)
SOFT CHECK IF PINC_138>$1,000,000: ‘Usted informó que usted y/o su pareja perderían
^{FILL_PINC138} dólares después de vender sus negocios o inversiones empresariales y
pagar sus deudas. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_136=1
If PINC_138=DK or REF: PINC_140
Else PINC_141

PINC_139
ASK

IF PINC_137=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of how much money you would make?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
More than $1,000,000

¿Cuál de estas categorías incluye su mejor estimación de cuánto dinero ganaría?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_137=DK or REF
PINC_141

PINC_140
ASK

IF PINC_138=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of how much money you would lose?

ENGLISH

1.
2.
3.
4.
5.
6.
7.

$1 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
More than $1,000,000

¿Cuál de estas categorías incluye su mejor estimación de cuánto dinero perdería?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_138=DK or REF
PINC_141

PINC_141
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_141S
IF PARPARTNER = 1, FILL_PARTNER_141S: ‘Tienen usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_141S: ‘Tiene usted’
Do ^{FILL_PARTNER} have any other real estate, such as a second home, vacation homes or
condominiums (including any weeks in a time-share unit), land, rental real estate, a partnership, or
money owed to you on a land contract or mortgage?
1. Yes
0. No
¿^{FILL_PARTNER_141S} cualquier otro bien inmueble, como una segunda vivienda, casas de
vacaciones o condominios (incluidas las semanas en una unidad de tiempo compartido), terrenos,
bienes inmuebles en alquiler, una sociedad, o dinero que se le(s) deba en un contrato inmobiliario o
una hipoteca?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_133, PINC_136, PINC_137, PINC_138, PINC_139, PINC_140
PINC_141=1: PINC_142
Else PINC_146

PINC_142
ASK

IF PINC_141=1

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_142S
IF PARPARTNER = 1, FILL_PARTNER_142S: ‘tienen usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_142S: ‘tiene usted’
If you sold all of the other real estate that ^{FILL_PARTNER} own and paid off any debts on it, would
you lose money, make money, or break even?
1 Lose money
2 Make money
3 Break even
Si vendiera todos los demás bienes inmuebles que ^{FILL_PARTNER_142S} y pagara las deudas sobre
ellos, ¿habría pérdidas, habría ganancias o simplemente se alcanzaría un equilibrio?
1 Habría pérdidas
2 Habría ganancias
3 Se alcanzaría un equilibrio

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_141=1
IF PINC_142=1: PINC_144
ELSE IF PINC_142=2: PINC_143
Else PINC_146

PINC_143
ASK

IF PINC_142=2

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC143: ‘PINF_143’

FILLS (SPAN)
Create fill FILL_PINC143: ‘PINF_143’
How much would you get?
ENGLISH
$ ______________
¿Cuánto obtendría?
SPANISH
$ ______________ dólares
RANGE
0-999,999,999
LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_143 OUT OF RANGE (PINC_143=0): ‘You reported earlier that you
and/or your partner would make money if you sold other real estate. If this is not
correct, please click here to update your answer.’ (Return R to PINC_142)
SOFT CHECK IF PINC_143>$1,000,000: ‘You reported that you and/or your partner would
make ^{FILL_PINC143} after selling your other real estate and paying off any debts.
Please review your answer and correct if needed.’
HARD CHECK IF PINC_143 OUT OF RANGE (PINC_143=0): ‘Usted informó que usted y/o
su pareja tendrían ganancias si vendieran todos sus negocios o inversiones
empresariales. Si esto no es correcto, haga clic aquí para actualizar su respuesta.’
(Return R to PINC_142)
SOFT CHECK IF PINC_143>$1,000,000: ‘Usted informó que usted y/o su pareja ganarían
^{FILL_PINC143} dólares después de vender sus otros bienes inmuebles y pagar sus
deudas. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_142=2
PINC_143=DK or REF: PINC_145
Else PINC_146

PINC_144
ASK

IF PINC_142 = 1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC144: ‘PINC_144’

FILLS (SPAN)
Create fill FILL_PINC144: ‘PINC_144’
How much would you owe?
ENGLISH
$ ______________
¿Cuánto debería?
SPANISH
$ ______________ dólares
RANGE
0-999,999,999
LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_144 OUT OF RANGE (PINC_144=0): ‘You reported earlier that you
and/or your partner would lose money if you sold other real estate. If this is not correct,
please click here to update your answer.’ (Return R to PINC_142)
SOFT CHECK IF PINC_144>$1,000,000: ‘You reported that you and/or your partner would
owe ^{FILL_PINC144} after selling your other real estate and paying off any debts. Please
review your answer and correct if needed.’
HARD CHECK IF PINC_144 OUT OF RANGE (PINC_144=0): ‘Usted informó que usted y/o
su pareja tendrían pérdidas si vendieran sus otros bienes inmuebles. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_142)

CHECK (SPAN)

SOFT CHECK IF PINC_144>$1,000,000: ‘Usted informó que usted y/o su pareja deberían
^{FILL_PINC144} dólares tras vender sus otros bienes inmuebles y pagar sus deudas.
Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_142=1
PINC_144=DK or REF: PINC_145
Else PINC_146

PINC_145
ASK

IF (PINC_143=DK or REF) OR (PINC_144=DK or REF)

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $25,000
2. $25,001 - $50,000
3. $50,001 - $100,000
4. $100,001 - $250,000
ENGLISH
5. $250,001 - $500,000
6. $500,001 - $1,000,000
7. More than $1,000,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $25,000 dólares
2. $25,001 a $50,000 dólares
3. $50,001 a $100,000 dólares
4. $100,001 a $250,000 dólares
5. $250,001 a $500,000 dólares
6. $500,001 a $1,000,000 dólares
7. Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_144=DK or REF, PINC_143=DK or REF
PINC_146

PINC_146
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

Create fill FILL_PARTNER_146S
IF PARPARTNER = 1, FILL_PARTNER_146S: ‘usted y/o su cónyuge o pareja recibirían’
ELSE FILL_PARTNER_146S: ‘usted recibiría’
What is your best estimate of how much money ^{FILL_PARTNER} would get if you sold all of your
personal household furnishings such as furniture, major appliances, and home electronics?
0. $0
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000

ENGLISH

¿Cuál es su mejor estimación de cuánto dinero ^{FILL_PARTNER_146S} si vendiera todo el mobiliario
personal de su hogar, como muebles, electrodomésticos grandes y aparatos electrónicos?

SPANISH

0. $0 dólares
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_141, PINC_142, PINC_143, PINC_144, PINC_145
PINC_147

PINC_147
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_147S
IF PARPARTNER = 1, FILL_PARTNER_147S: ‘Tienen usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_147S: ‘Tiene usted’
Do ^{FILL_PARTNER} have any other savings or substantial assets that we haven't already discussed -for example assets in a trust, annuity, or managed investment account, artwork, precious metals,
antiques, oil and gas leases, futures contracts, royalties, or something else?
1. Yes
0. No
¿^{FILL_PARTNER_147S} algún otro ahorro o activo importante del que no hayamos hablado, por
ejemplo, activos en un fideicomiso, anualidades o cuentas de inversión gestionadas, obras de arte,
metales preciosos, antigüedades, licitaciones de petróleo y gas, contratos de futuros, regalías o algo
más?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_146
PINC_147=1: PINC_148
Else PINC_150

PINC_148
ASK

IF PINC_147=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
FILLS (ENG)
Create fill FILL_PINC148: ‘PINC_148’
Use fill from PINC_070, FILL_PARTNER
FILLS (SPAN)
Create fill FILL_PINC148: ‘PINC_148’
If you sold all of the other assets ^{FILL_PARTNER} own, how much would you get?

ENGLISH

$ ______________
Si vendiera todos los demás activos que posee ^{FILL_PARTNER}, ¿cuánto obtendría?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_148 OUT OF RANGE (PINC_148=0): ‘You reported earlier that you
and/or your partner have other savings or substantial assets that we haven’t already
discussed. If this is not correct, please click here to update your answer.’ (Return R to
PINC_147)
SOFT CHECK IF PINC_148>$10,000,000: ‘You reported that you and/or your partner
would get ^{FILL_PINC148} after selling off your other assets. Please review your answer
and correct if needed.’
HARD CHECK IF PINC_148 OUT OF RANGE (PINC_148=0): ‘Usted informó que usted y/o
su pareja tienen otros ahorros o activos importantes de los que aún no hemos hablado.
Si esto no es correcto, haga clic aquí para actualizar su respuesta.’ (Return R to
PINC_147)
SOFT CHECK IF PINC_148>$10,000,000: ‘Usted informó que usted y/o su pareja
obtendrían ^{FILL_PINC148} dólares tras vender sus otros bienes. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_147=1
PINC_148=DK or REF: PINC_149
Else PINC_150

PINC_149
ASK

IF PINC_148=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
4. $25,001 - $50,000
ENGLISH
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_148 =DK or REF
PINC_150

PINC_150
ASK

ALL

QUESTION TYPE

Informational

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

FILLS (SPAN)

ENGLISH

Create fill FILL_PARTNER_150S
IF PARPARTNER = 1, FILL_PARTNER_150S: ‘podrían tener usted y/o su cónyuge o pareja’
ELSE FILL_PARTNER_150S: ‘podría tener usted’
Next are a few questions about any debts ^{FILL_PARTNER} might have other than mortgages and
other real estate loans, business debts, and auto loans.

SPANISH

Las siguientes preguntas son sobre cualquier deuda que ^{FILL_PARTNER_150S} además de hipotecas
y otros préstamos inmobiliarios, deudas comerciales y préstamos para la compra de automóviles.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_147, PINC_148, PINC_149
PINC_151

PINC_151
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_070, FILL_PARTNER
Use fill from PINC_070, FILL_PARTNER

Create fill FILL_PARTNER_151S
IF PARPARTNER = 1, FILL_PARTNER_151S: ‘¿Están usted y/o su cónyuge o pareja pagando
todavía’
ELSE FILL_PARTNER_151S: ‘¿Está usted pagando todavía’
Are ^{FILL_PARTNER} still paying off any educational loans from family, friends or government
sources?
1. Yes
0. No

FILLS (SPAN)

ENGLISH

SPANISH

^{FILL_PARTNER_151S} préstamos educativos de familiares, amistades o fuentes gubernamentales?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_150
PINC_151=1: PINC_152
Else PINC_154

PINC_152
ASK

IF PINC_151=1

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC152: ‘PINC_152’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC152: ‘PINC_152’

FILLS (ENG)

FILLS (SPAN)

Create fill FILL_PARTNER_152S
IF PARPARTNER = 1, FILL_PARTNER_152S: ‘usted y/o su cónyuge o pareja deben’
ELSE FILL_PARTNER_152S: ‘usted debe’
What is the total amount that ^{FILL_PARTNER} owe altogether for educational loans given by family
or friends and from government-subsidized or other types of loans to attend school or college?

ENGLISH
$ ______________

SPANISH

¿Cuál es la cantidad total que ^{FILL_PARTNER_152S} en total en préstamos educativos dados por
familiares o amistades y en préstamos subvencionados por el gobierno o de otro tipo para asistir a la
escuela o universidad?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_152 OUT OF RANGE (PINC_152=0): ‘You reported earlier that you
and/or your partner owe money on educational loans. If this is not correct, please click
here to update your answer.’ (Return R to PINC_151)
SOFT CHECK IF PINC_152>$1,000,000: ‘You reported that you and/or your partner owe
^{FILL_PINC152} altogether for educational loans. Please review your answer and correct
if needed.’
HARD CHECK IF PINC_152 OUT OF RANGE (PINC_152=0): ‘Usted informó que usted y/o
su pareja deben dinero por préstamos educativos. Si esto no es correcto, haga clic aquí
para actualizar su respuesta.’ (Return R to PINC_151)

CHECK (SPAN)

SOFT CHECK IF PINC_152>$1,000,000: ‘Usted informó que usted y/o su pareja deben
^{FILL_PINC152} dólares en total en préstamos educativos. Revise su respuesta y
corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PINC_151=1

NEXT

PINC_152=DK or REF: PINC_153
Else PINC_154

PINC_153
ASK

IF PINC_152 =DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the total amount owed for educational
loans?
1. $1 - $5,000
2. $5,001 - $10,000
3. $10,001 - $25,000
ENGLISH
4. $25,001 - $50,000
5. $50,001 - $100,000
6. $100,001 - $250,000
7. More than $250,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de la cantidad total adeudada en préstamos
educativos?
1. $1 a $5,000 dólares
2. $5,001 a $10,000 dólares
3. $10,001 a $25,000 dólares
4. $25,001 a $50,000 dólares
5. $50,001 a $100,000 dólares
6. $100,001 a $250,000 dólares
7. Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_152 =DK or REF
PINC_154

PINC_154
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_154S
IF PARPARTNER = 1, FILL_PARTNER_2_154S: ‘Usted y/o su cónyuge o pareja deben’
ELSE FILL_PARTNER_2_154S: ‘Usted debe’
Do ^{FILL_PARTNER_2} owe any relatives $1,000 or more not counting any money someone loaned
^{FILL_PARTNER_2} for education expenses or for the purchase or remodeling of your home?
1. Yes
0. No
¿^{FILL_PARTNER_2_154S} a algún familiar $1,000 dólares o más sin contar el dinero que le hayan
prestado a ^{FILL_PARTNER_2} para gastos de educación o para la compra o remodelación de su casa?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_151, PINC_152, PINC_153
PINC_154=1: PINC_155
Else PINC_157

PINC_155
ASK

IF PINC_154=1
PINC_155: Numeric
Specialty response radio button
Create fill FILL_PINC155: ‘PINC_155’

QUESTION TYPE
FILLS (ENG)

FILLS (SPAN)
Create fill FILL_PINC155: ‘PINC_155’
Altogether, how much is still owed on this/these loan(s)?
ENGLISH

$ ______________
-9. Nothing, loan(s) have been paid back
En total, ¿cuánto se debe aún de este/estos préstamo(s)?

SPANISH
RANGE

$ ______________ dólares
-9. Nada, los préstamos se pagaron
0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_155 OUT OF RANGE (PINC_155=0): ‘You reported earlier that you
and/or your partner owe money to relatives. If this is not correct, please select “Nothing,
loan(s) have been paid back” or click here to update your answer.’ (Return R to
PINC_154)
SOFT CHECK IF PINC_155>$1,000,000: ‘You reported that you and/or your partner owe
^{FILL_PINC155} to relatives. Please review your answer and correct if needed.’
Special response radio button should be exclusive
HARD CHECK IF PINC_155 OUT OF RANGE (PINC_155=0): ‘Usted informó que usted y/o
su pareja deben dinero a familiares por préstamos educativos. Si no es correcto,
seleccione “Nada, los préstamos se pagaron” o haga clic aquí para actualizar su
respuesta.’ (Return R to PINC_154)
SOFT CHECK IF PINC_155>$1,000,000: ‘Usted informó que usted y/o su pareja deben
^{FILL_PINC155} dólares a familiares. Revise su respuesta y corríjala si es necesario.’
Special response radio button should be exclusive

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_154=1
PINC_155=DK or REF: PINC_156
Else PINC_157

PINC_156
ASK

IF PINC_155=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of how much is owed in these loans?
1.
2.
3.
4.
5.
6.
7.
8.
9.

ENGLISH

$1 - $1,000
$1,001 - $2,500
$2,501 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
More than $250,000

¿Cuál de estas categorías incluye su mejor estimación de cuánto se debe en estos préstamos?

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.
9.

$1 a $1,000 dólares
$1,001 a $2,500 dólares
$2,501 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
Más de $250,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_155=DK or REF
PINC_157

PINC_157
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_157S
IF PARPARTNER = 1, FILL_PARTNER_157S: ‘¿Usted y/o su cónyuge o pareja tienen’
ELSE FILL_PARTNER_157S: ‘¿Usted tiene’
Do ^{FILL_PARTNER_2} have any credit cards, such as Visa, American Express, or credit cards for
specific stores, such as department stores or gas stations?
1. Yes
0. No
^{FILL_PARTNER_2_157S} alguna tarjeta de crédito, como Visa, American Express, o tarjetas de
crédito para tiendas específicas, como tiendas departamentales o estaciones de servicio?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_154, PINC_155, PINC_156
PINC_157=1: PINC_158
Else PINC_161

PINC_158
ASK

IF PINC_157=1

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Thinking of your most recent credit card statements, did you or will you pay off all your balances in full
by the statement due date?
1. Yes
ENGLISH
0. No

SPANISH

Pensando en los estados financieros más recientes de su tarjeta de crédito, ¿pagó o pagará todos los
saldos en su totalidad antes de la fecha de vencimiento?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_157=1
PINC_158=0: PINC_159
Else PINC_161

PINC_159
ASK

IF PINC_158=0

QUESTION TYPE

Numeric
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC159: ‘PINC_159’
Use fill from PINC_070, FILL_PARTNER
Create fill FILL_PINC159: ‘PINC_159’

FILLS (ENG)

FILLS (SPAN)

ENGLISH

Create fill FILL_PARTNER_159S
IF PARPARTNER = 1, FILL_PARTNER_159S: ‘usted y/o su cónyuge o pareja hayan hecho’
ELSE FILL_PARTNER_159S: ‘usted haya hecho’
Again, thinking of your most recent credit card bills, roughly what is the total balance you carried over
or will carry over across all of these accounts after ^{FILL_PARTNER} have made your planned
payments for this month on these credit cards?
$ ______________

SPANISH

De nuevo, pensando en las facturas de sus tarjetas de crédito más recientes, ¿cuál es
aproximadamente el saldo total que tiene o que se transferirá al siguiente mes en todas estas cuentas
después de que ^{FILL_PARTNER_159S} los pagos planeados para este mes en estas tarjetas de
crédito?
$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_159 OUT OF RANGE (PINC_159=0): ‘You reported earlier that you
and/or your partner carried over or will carry over a balance on credit card accounts. If
this is not correct, please click here to update your answer.’ (Return R to PINC_158)

CHECK (ENG)

SOFT CHECK IF PINC_159>$1,000,000: ‘You reported that you and/or your partner
carried over or will carry over ^{FILL_PINC159} on credit card accounts. Please review
your answer and correct if needed.’
’
HARD CHECK IF PINC_159 OUT OF RANGE (PINC_159=0): ‘Usted informó que usted y/o
su pareja tenían un saldo o que se transferiría un saldo al siguiente mes en cuentas de
tarjetas de crédito. Si esto no es correcto, haga clic aquí para actualizar su respuesta’
(Return R to PINC_158)

CHECK (SPAN)

’
HELP TEXT (ENG)
HELP TEXT (SPAN)

SOFT CHECK IF PINC_159>$1,000,000: ‘Usted informó que usted y/o su pareja tenían un
saldo o que se transferiría un saldo que se transferiría al siguiente mes de
^{FILL_PINC159} dólares en cuentas de tarjetas de crédito. Revise su respuesta y corríjala
si es necesario.’

MODE

CASI/CAWI

NOTES
LEAD-IN

PINC_158=0
PINC_159=DK or REF: PINC_160
Else PINC_161

NEXT

PINC_160
ASK

IF PINC_159=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the amount carried over on credit cards?
1.
2.
3.
4.
5.
6.
7.
8.

ENGLISH

$1 - $1,000
$1,001 - $2,500
$2,501 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $100,000
More than $100,000

¿Cuál de estas categorías incluye su mejor estimación de la cantidad que se transferiría en las cuentas
de tarjetas de crédito?

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.

$1 a $1,000 dólares
$1,001 a $2,500 dólares
$2,501 a $5,000 dólares
$5,001 a $10,000 dólares
$10,001 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
Más de $100,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_159=DK or REF
PINC_161

PINC_161
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

FILLS (SPAN)

ENGLISH

SPANISH

Create fill FILL_PARTNER_2_161S
IF PARPARTNER = 1, FILL_PARTNER_2_161S: ‘Usted y/o su cónyuge o pareja deben’
ELSE FILL_PARTNER_2_161S: ‘Usted debe’
Do ^{FILL_PARTNER_2} owe any money on any credit card accounts that you no longer have, such as
Visa, American Express, or credit cards for specific stores, such as department stores or gas stations?
1. Yes
0. No
¿^{FILL_PARTNER_2_161S} dinero de alguna cuenta de tarjeta de crédito que ya no tenga, como Visa,
American Express o tarjetas de crédito de tiendas específicas, como tiendas departamentales o
estaciones de servicio?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_157, PINC_158, PINC_159, PINC_160
PINC_161=1: PINC_162
Else PINC_164

PINC_162
ASK

IF PINC_161=1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC162: ‘PINC_162’

FILLS (SPAN)
Create fill FILL_PINC162: ‘PINC_162’
After the most recent payment, roughly what was the balance still owed on all of these accounts
together?
ENGLISH
$ ______________
Después del pago más reciente, ¿cuál era aproximadamente el saldo que aún se debía en todas estas
cuentas juntas?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_162 OUT OF RANGE (PINC_162=0): ‘You reported earlier that you
and/or your partner owe money on closed credit card accounts. If this is not correct,
please click here to update your answer.’ (Return R to PINC_161)

CHECK (ENG)

SOFT CHECK IF PINC_162>$1,000,000: ‘You reported that you and/or your partner owe
^{FILL_PINC162} on closed credit card accounts. Please review your answer and correct
if needed.’
’
HARD CHECK IF PINC_162 OUT OF RANGE (PINC_162=0): ‘Usted informó que usted y/o
su pareja tienen deudas en cuentas de tarjetas de crédito cerradas. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_161)

CHECK (SPAN)

’

SOFT CHECK IF PINC_162>$1,000,000: ‘Usted informó que usted y/o su pareja deben
^{FILL_PINC162} dólares en cuentas de tarjetas de crédito cerradas. Revise su respuesta
y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_161=1
PINC_162=DK or REF: PINC_163
Else PINC_164

PINC_163
ASK

IF PINC_162=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the amount still owed on closed credit cards?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
ENGLISH
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de la cantidad que aún debe en tarjetas de
crédito cerradas?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_162=DK or REF
PINC_164

PINC_164
ASK

ALL

QUESTION TYPE

Radio Button

FILLS (ENG)

Use fill from PINC_096, FILL_PARTNER_2
Use fill from PINC_096, FILL_PARTNER_2

Create fill FILL_PARTNER_2_164S
IF PARPARTNER = 1, FILL_PARTNER_2_164S: ‘deben en este momento usted y/o su
cónyuge o pareja’
ELSE FILL_PARTNER_2_164S: ‘debe usted en este momento’
Aside from the accounts you have already been asked about, do ^{FILL_PARTNER_2} currently owe
money to any other businesses, such as stores, doctor's offices, hospitals, or banks? Please include any
installment plans, rent-to-own accounts, or any other business that you owe money to.
1. Yes
0. No

FILLS (SPAN)

ENGLISH

SPANISH

Aparte de las cuentas por las que ya le han preguntado, ¿^{FILL_PARTNER_2_164S} dinero a alguna
otra empresa, como tiendas, consultorios del doctor, hospitales o bancos? Incluya cualquier plan de
pago a plazos, cuentas de alquiler con opción a compra o cualquier otra empresa a la que le deba
dinero.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_161, PINC_162, PINC_163
PINC_164=1: PINC_165
ELSE, IF PARPARTNER=1: PINC_167
Else PCCL_001

PINC_165
ASK

IF PINC_164=1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC165: ‘PINC_165’

FILLS (SPAN)
Create fill FILL_PINC165: ‘PINC_165’
After the most recent payments were made on these accounts, what was the balance still owed?
ENGLISH

$ ______________
Después de realizar los pagos más recientes en estas cuentas, ¿cuál era el saldo que aún se debía?

SPANISH

$ ______________ dólares

RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_165 OUT OF RANGE (PINC_165=0): ‘You reported earlier that you
and/or your partner owe money to other businesses. If this is not correct, please click
here to update your answer.’ (Return R to PINC_164)
SOFT CHECK IF PINC_165>$1,000,000: ‘You reported that you and/or your partner owe
^{FILL_PINC165} to other businesses. Please review your answer and correct if needed.’
HARD CHECK IF PINC_165 OUT OF RANGE (PINC_165=0): ‘Usted informó que usted y/o
su pareja deben dinero a otras empresas. Si esto no es correcto, haga clic aquí para
actualizar su respuesta.’ (Return R to PINC_164)
SOFT CHECK IF PINC_165>$1,000,000: ‘Usted informó que usted y/o su pareja deben
^{FILL_PINC165} a otras empresas. Revise su respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_164=1
PINC_165=DK or REF: PINC_166
PARPARTNER=1: PINC_167
Else PCCL_001

PINC_166
ASK

IF PINC_165 =DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of the amount owed to other businesses?
1. $1 - $1,000
2. $1,001 - $2,500
3. $2,501 - $5,000
4. $5,001 - $10,000
ENGLISH
5. $10,001 - $25,000
6. $25,001 - $50,000
7. More than $50,000

SPANISH

¿Cuál de estas categorías incluye su mejor estimación de la cantidad adeudada a otras empresas?
1. $1 a $1,000 dólares
2. $1,001 a $2,500 dólares
3. $2,501 a $5,000 dólares
4. $5,001 a $10,000 dólares
5. $10,001 a $25,000 dólares
6. $25,001 a $50,000 dólares
7. Más de $50,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_165 =DK or REF
IF PARPARTNER=1: PINC_167
Else PCCL_001

PINC_167
ASK

IF PARPARTNER=1

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
We understand that some couples have savings, investments, and businesses that are owned by only
one person in the couple and that other couples own most assets jointly. Does your spouse or partner
ENGLISH have any savings, investments, businesses, or own any assets that you do not share any interest in?
1. Yes
0. No
Entendemos que algunas parejas tienen ahorros, inversiones y negocios que son propiedad de una
sola persona de la pareja, y que otras parejas poseen la mayoría de los bienes de forma conjunta.
¿Tiene su cónyuge o pareja ahorros, inversiones, negocios o posee algún bien en los cuales usted no
SPANISH
tenga participación?
1. Sí
0. No
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_166, PINC_164, PINC_165
PINC_167=1: PINC_168
Else PCCL_001

PINC_168
ASK

IF PINC_167=1

QUESTION TYPE

Numeric

FILLS (ENG)

Create fill FILL_PINC168: ‘PINC_168’

FILLS (SPAN)
Create fill FILL_PINC168: ‘PINC_168’
If your spouse or partner sold or cashed in all of the savings, investments, businesses, and assets they
own that you do not have an interest in, how much would your spouse or partner receive?
ENGLISH
$ ______________
Si su cónyuge o pareja vendiera o cobrara en efectivo todos los ahorros, inversiones, negocios y bienes
que posee y que no están compartidos con usted, ¿cuánto recibiría su cónyuge o pareja?
SPANISH
$ ______________ dólares
RANGE

0-999,999,999

LIMITS

9 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Please automatically add commas every 3 digits when inputting numbers above 999.
HARD CHECK IF PINC_168 OUT OF RANGE (PINC_168=0): ‘You reported earlier that your
spouse or partner has additional assets that you don’t have an interest in. If this is not
correct, please click here to update your answer.’ (Return R to PINC_167)
SOFT CHECK IF PINC_168>$1,000,000: ‘You reported that your spouse or partner would
receive ^{FILL_PINC168} if they cashed in their assets that you don’t have an interest in.
Please review your answer and correct if needed.’
HARD CHECK IF PINC_168 OUT OF RANGE (PINC_168=0): ‘Usted informó que su cónyuge
o pareja tiene bienes adicionales en los cuales usted no tiene participación. Si esto no es
correcto, haga clic aquí para actualizar su respuesta.’ (Return R to PINC_167)

CHECK (SPAN)

SOFT CHECK IF PINC_168>$1,000,000: ‘Usted informó que su cónyuge o pareja recibiría
^{FILL_PINC168} si cobraba sus bienes en los que usted no tiene participación. Revise su
respuesta y corríjala si es necesario.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_167=1
PINC_168=DK or REF: PINC_169
Else PCCL_001

PINC_169
ASK

IF PINC_168=DK or REF

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
Which of these categories includes your best estimate of that amount?
1.
2.
3.
4.
5.
6.
7.

ENGLISH

$1 - $25,000
$25,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
More than $1,000,000

¿Cuál de estas categorías incluye su mejor estimación de esa cantidad?

SPANISH

1.
2.
3.
4.
5.
6.
7.

$1 a $25,000 dólares
$25,001 a $50,000 dólares
$50,001 a $100,000 dólares
$100,001 a $250,000 dólares
$250,001 a $500,000 dólares
$500,001 a $1,000,000 dólares
Más de $1,000,000 dólares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_168=DK or REF
PCCL_001

NLSY27 Specifications Formatting
Parent/Caregiver Survey, Child Calendar
PRELOADS:
YOUTH_NAME: Name of the eligible youth, copied from HHNAME, ES/HHS
PCSEX: Sex of selected parent/caregiver respondent, HHS090-SELECTION PROTOCOL
YOUTH_MOTHER: Indicator from HHS for whether biological mother of youth was reported in the
household
YOUTH_FATHER: Indicator from HHS for whether biological father of youth was reported in the
household
YOUTH_RPCPLG: Indicator on youth roster, for relationship between responding P/C and focal youth,
from Parent Information
1= bio parent
2= step-parent
3= adoptive parent
4= foster parent
5= legal guardian
6= grandparent
8=other relative
9=other non-relative
YOUTH_CURRENTAGE: From Eligibility and Household screener, Calculated age of youth on the day of
the interview
YOUTHROSTERNUM: HHS
YOUTHROSTERNUM: HHS

CREATE THE FOLLOWING LIST FOR DROPDOWN QUESTIONS:
MONTHLIST

RESPONSE OPTIONS ENGLISH
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
RESPONSE OPTIONS SPANISH
1. Enero
2. Febrero
3. Marzo
4. Abril
5. Mayo
6. Junio
7. Julio
8. Agosto
9. Septiembre
10. Octubre
11. Noviembre
12. Diciembre
STATENOTUS
1. Alabama
2. Alaska
4. Arizona
5. Arkansas
6. California
8. Colorado
9. Connecticut
10. Delaware
11. District of Columbia
12. Florida
13. Georgia
15. Hawaii
16. Idaho
17. Illinois
18. Indiana
19. Iowa
20. Kansas

21. Kentucky
22. Louisiana
23. Maine
24. Maryland
25. Massachusetts
26. Michigan
27. Minnesota
28. Mississippi
29. Missouri
30. Montana
31. Nebraska
32. Nevada
33. New Hampshire
34. New Jersey
35. New Mexico
36. New York
37. North Carolina
38. North Dakota
39. Ohio
40. Oklahoma
41. Oregon
42. Pennsylvania
44. Rhode Island
45. South Carolina
46. South Dakota
47. Tennessee
48. Texas
49. Utah
50. Vermont
51. Virginia
53. Washington
54. West Virginia
55. Wisconsin
56. Wyoming
57. American Samoa
58. Guam
59. Northern Mariana Islands
60. Puerto Rico
61. US Virgin Islands
62. American Indian Reservation
63. Overseas U.S. Military Base
64. Not in the US
STATEPLUS
1. Alabama
2. Alaska
3. Arizona

4. Arkansas
5. California
6. Colorado
7. Connecticut
8. Delaware
9. District of Columbia
10. Florida
11. Georgia
12. Hawaii
13. Idaho
14. Illinois
15. Indiana
16. Iowa
17. Kansas
18. Kentucky
19. Louisiana
20. Maine
21. Maryland
22. Massachusetts
23. Michigan
24. Minnesota
25. Mississippi
26. Missouri
27. Montana
28. Nebraska
29. Nevada
30. New Hampshire
31. New Jersey
32. New Mexico
33. New York
34. North Carolina
35. North Dakota
36. Ohio
37. Oklahoma
38. Oregon
39. Pennsylvania
40. Rhode Island
41. South Carolina
42. South Dakota
43. Tennessee
44. Texas
45. Utah
46. Vermont
47. Virginia

48.
49.
50.
51.
60.
61.
62.

Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Another U.S. Territory
A tribal nation

GENERAL PROGRAMMING NOTES:
ALL ITEMS ARE REQUIRED.
•
•

Do not display response option numbers/letters.
Do not display DK and REF on each screen at loading.
o If R tries to move forward without providing a response, display DK (‘Don’t know’) and REF
(‘Prefer not to answer’) on screen.
• In Spanish: display DK (‘No lo sé’) and REF (‘Prefiero no contestar’) on
screen.
 Unless otherwise noted, include a soft prompt for R to respond or select DK/REF
option: “Your answers are very important. Please consider selecting a response.”
• In Spanish: “Sus respuestas son muy importantes. Considere la posibilidad
de seleccionar una respuesta.”
o If R still tries to move forward without answering, assign REF code to missing response.

CAPTURE ITEM LEVEL TIMING.
INCLUDE A TIME/DATE STAMP AT BEGINNING AND END OF MODULE.

PCCL_001_#
ASK

All respondents (Begin PCCL Loop 1)

QUESTION TYPE

Informational

FILLS (ENG)

Create ﬁll, FILL_YOUTHNAME: Fill ‘YOUTH_NAME’ from preload

FILLS (SPAN)
Create ﬁll, FILL_YOUTHNAME: Fill ‘YOUTH_NAME’ from preload
Next are some questions about some of the important events in the life of ^{FILL_YOUTHNAME}.
ENGLISH
SPANISH

Las siguientes preguntas son sobre algunos de los acontecimientos importantes de la vida de
^{FILL_YOUTHNAME}.

RANGE
LIMITS
LOOP MAX

15
UPDATE YOUTH_CURRENTAGE: IF YOUTHDOB NOT MISSING, THEN CALCULATE
YOUTH_CURRENTAGE BY SUBTRACTING YOUTHDOB FROM TODAY’S DATE/365.
Else set YOUTH_CURRENTAGE=YOUTH_AGE

PROGRAM. NOTES

Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Create variable PCCLLOOP1[#].YOUTH_UID=YOUTH_UID_#

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PINC_164, PINC_165, PINC_166, PINC_167, PINC_168
If LOOPNUMBER =1: PCCL_003
Else PCCL_004

PCCL_003_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Informational

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
These questions will ask about ^{FILL_YOUTHNAME}’s family and any family changes they may have
experienced. We will also be asking questions about ^{FILL_YOUTHNAME}'s schooling, work
experience, activities, general health, and what you think ^{FILL_YOUTHNAME} will be doing in the
future.
ENGLISH

As in previous sections dealing with past events, you may find the calendar helpful in answering some
of these questions. Event dates that you provide will be added to the calendar for your reference in
answering future questions. Remember that you can access the calendar any time by clicking on the
calendar icon at the top left of your screen.
Estas preguntas son sobre la familia de ^{FILL_YOUTHNAME} y los cambios familiares que haya podido
experimentar. También le haremos preguntas sobre la escolarización de ^{FILL_YOUTHNAME}, su
experiencia laboral, sus actividades, su salud en general y lo que cree que ^{FILL_YOUTHNAME} hará
en el futuro.

SPANISH

Al igual que en las secciones anteriores sobre los acontecimientos pasados, el calendario puede
resultarle útil para responder algunas de estas preguntas. Las fechas de los acontecimientos que nos
dé se añadirán al calendario para que pueda consultarlas cuando responde futuras preguntas.
Recuerde que puede acceder al calendario en cualquier momento haciendo clic en el ícono del
calendario ubicado en la parte superior izquierda de su pantalla.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_001
PCCL_004

PCCL_004_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} always lived with you since their birth?
ENGLISH

1. Yes
0. No
¿Ha vivido ^{FILL_YOUTHNAME} siempre con usted desde su nacimiento?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_003
If PCCL_004 = 1: PCCL_007
Else: PCCL_005

PCCL_005_#
ASK

PCCL_004 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did ^{FILL_YOUTHNAME} live with you immediately after their birth?
ENGLISH

1. Yes
0. No
¿Vivió ^{FILL_YOUTHNAME} con usted inmediatamente después de su nacimiento?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_004
If PCCL_005 = 1: PCCL_007
Else: PCCL_006

f_PCCL_006_#
PCCL_006_MO_# / PCCL_006_YR_#
ASK
PCCL_005 ≠ 1 (Continue PCCL Loop 1)
Dropdown: PCCL_006_MO_#
QUESTION TYPE
Dropdown: PCCL_006_YR_#
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Create ﬁll, FILL_INTERVIEWYEAR: ‘DOI_YEAR’
In what month and year did ^{FILL_YOUTHNAME} first come to live with you?
ENGLISH

Month: { - Select - } [PCCL_006_MO_#]
Year: _______ [PCCL_006_YR_#]
¿En qué mes y año vino ^{FILL_YOUTHNAME} a vivir con usted por primera vez?

SPANISH

Mes: { - Seleccione - } [PCCL_006_MO_#]
Año: _______ [PCCL_006_YR_#]
PCCL_006_MO: List months in order. 1 = “January”, 2 = “February”,… 12 = “December”
PCCL_006_YR: 2009-2030

RANGE

RESPONSE OPTIONS SPANISH
1. Enero
2. Febrero
3. Marzo
4. Abril
5. Mayo
6. Junio
7. Julio
8. Agosto
9. Septiembre
10. Octubre
11. Noviembre
12. Diciembre
PCCL_006_YR: List years 2009-2030 in reverse chronological order (i.e., 2030, 2029,
2028, etc.) starting with DOI year (i.e., if DOI year is 2025, do not include 2026-2030)

LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PCCL_005

NEXT

PCCL_007

PCCL_007_#
ASK

All respondents (continue PCCL Loop 1)

QUESTION TYPE

Informational

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Next there are some questions about the people who have lived with ^{FILL_YOUTHNAME} at
ENGLISH different points in their life.
SPANISH

Las siguientes preguntas son sobre las personas que han vivido con ^{FILL_YOUTHNAME} en diferentes
momentos de su vida.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PCCL_004, PCCL_005, PCCL_006

NEXT

PCCL_008

PCCL_008_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Numeric
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_008: If PCCL_004=1 or PCCL_005 = 1, FILL_PCCL_008: “Including
FILLS (ENG)
you, how”
Else, FILL_PCCL_008: “How”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_008: If PCCL_004=1 or PCCL_005 = 1, FILL_PCCL_008: “Incluido(a)
FILLS (SPAN)
usted, ¿con cuántos”
Else, FILL_PCCL_008: “¿Con cuántos”
^{FILL_PCCL_008} many adults or parent-figures was ^{FILL_YOUTHNAME} living with immediately
following their birth? Please include ^{FILL_YOUTHNAME}’s parents and all people aged 18 or older
who usually stayed at the same address as ^{FILL_YOUTHNAME}.
ENGLISH
____________ adults

SPANISH

^{FILL_PCCL_008} adultos o figuras parentales vivió ^{FILL_YOUTHNAME} inmediatamente después de
su nacimiento? Incluya a los padres/madres de ^{FILL_YOUTHNAME} y a todas las personas mayores
de 18 años que vivían habitualmente en la misma dirección que ^{FILL_YOUTHNAME}.
____________ adultos

RANGE

1-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_007
PCCL_009

f_PCCL_009_#
PCCL_009A_# / PCCL_009B_# / PCCL_009C_# / PCCL_009D_# / PCCL_009E_# / PCCL_009F_# / PCCL_009G_# /
PCCL_009H_# / PCCL_009I_# / PCCL_009J_# / PCCL_009K_# / PCCL_009L_# / PCCL_009M_# / PCCL_009N_# /
PCCLL_009O_# / PCCL_009O_SPECIFY_#
ASK
All respondents (Continue PCCL Loop 1)
Checkbox: PCCL_009A, PCCL_009B, PCCL_009C, PCCL_009D, PCCL_009E, PCCL_009F,
PCCL_009G, PCCL_009H, PCCL_009I, PCCL_009J, PCCL_009K, PCCL_009L,
QUESTION TYPE
PCCL_009M, PCCL_009N, PCCL_009O
Textbox: PCCL_009O_SPECIFY
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_009: If PCCL_004=1 or PCCL_005 = 1, FILL_PCCL_009: “Including
FILLS (ENG)
you, who”
Else, FILL_PCCL_009: “Who”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_009: If PCCL_004=1 or PCCL_005 = 1, FILL_PCCL_009: “Incluido(a)
FILLS (SPAN)
usted, ¿quiénes”
Else, FILL_PCCL_009: “¿Quiénes”
^{FILL_PCCL_009} were the adults that ^{FILL_YOUTHNAME} lived with immediately following their
birth? Please select all that apply. Please enter yourself if you were living with the child at that time
and one relationship for any other adults that ^{FILL_YOUTHNAME} was living with at that time. Only
select one relationship per adult.

ENGLISH

0. Yourself [PCCL_009A_#]
1. Biological mother [PCCL_009B_#]
2. Biological father [PCCL_009C_#]
3. Step-mother [PCCL_009D_#]
4. Step-father [PCCL_009E_#]
5. Adoptive mother [PCCL_009F_#]
6. Adoptive father [PCCL_009G_#]
7. Unmarried partner of a parent [PCCL_009H_#]
8. Grandmother [PCCL_009I_#]
9. Grandfather [PCCL_009J_#]
10. Sibling (full, half, or step) [PCCL_009K_#]
11. Other relative(s) [PCCL_009L_#]
14. Court-appointed foster/temporary parent(s) [PCCL_009M_#]
15. Other non-relative(s) [PCCL_009N_#]
16. Other (please specify:___________________________________________) [PCCL_009O_#]
[PCCL_009O_SPECIFY_#]
^{FILL_PCCL_009} fueron los adultos con los que vivió ^{FILL_YOUTHNAME} inmediatamente
después de su nacimiento? Seleccione todas las opciones que correspondan. Por favor, indíquese usted
mismo si vivía con el niño en ese momento y una relación para cualquier otro adulto con el que
^{FILL_YOUTHNAME} vivía en ese momento. Seleccione solo una relación por adulto.

SPANISH

0.
1.
2.
3.
4.
5.
6.
7.

Usted mismo(a) [PCCL_009A_#]
Madre biológica [PCCL_009B_#]
Padre biológico [PCCL_009C_#]
Madrastra [PCCL_009D_#]
Padrastro [PCCL_009E_#]
Madre adoptiva [PCCL_009F_#]
Padre adoptivo [PCCL_009G_#]
Pareja de hecho de un padre/madre [PCCL_009H_#]

8. Abuela [PCCL_009I_#]
9. Abuelo [PCCL_009J_#]
10. Hermano(a) de sangre, medio(a) hermano(a) o hermanastro(a) [PCCL_009K_#]
11. Otro(as) familiar(es) [PCCL_009L_#]
14. Padre/madre(s) de acogida/temporal(es) designados(as) por el tribunal [PCCL_009M_#]
15. Otra(s) persona(s) que no son familiar(es) [PCCL_009N_#]
16. Otros (especifique:___________________________________________) [PCCL_009O_#]
[PCCL_009O_SPECIFY_#]
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

PCCL_009O_SPECIFY: 100 characters
15
Code variable as 1 if checked, 0 if not.
If response 16 selected, display text box PCCL_009O_SPECIFY
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If number of items selected is > PCCL_008, display hard check: “You reported that
^{FILLYOUTHNAME} was living with {PCCL_008} adults. Please only select one
relationship per adult.”
If number of items selected is > PCCL_008, display hard check: “Usted informó que
^{FILLYOUTHNAME} vivía con {PCCL_008} adulto(s). Seleccione solo una relación por
adulto.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_008
If PCCL_009 = DK or REF: PCCL_012
Else: PCCL_010

PCCL_010_#
ASK

PCCL_009 ≠ DK or REF

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
Computer check, do not display

PROGRAM. NOTES

Computer select ﬁrst 2 relationships reported in PCCL_009, store as PCCL_010_#_1 AND
PCCL_010_#_2.
0 Respondent
1 Biological mother
2 Biological father
3 Adoptive mother
4 Adoptive father
5 Stepmother
6 Stepfather
Loop through PCCL LOOP 1a (PCCL_011_#_#): Loop through max 2 parent ﬁgures identiﬁed
in PCCL_010

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_009
PCCL_011 (Begin PCCL LOOP 1a)

PCCL_011_#_#
ASK
QUESTION TYPE

FILLS (ENG)

PCCL_009 ≠ DK or REF
(Begin/End PCCL LOOP 1a)
Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_011: If PCCL_010_#_# = 0, FILL_PCCL_011: “Were you”
Else if PCCL_010_#_# = 1, FILL_PCCL_011: “Was ^{FILL_YOUTHNAME}’s biological
mother”
Else if PCCL_010_#_# = 2, FILL_PCCL_011: “Was ^{FILL_YOUTHNAME}’s biological
father"
Else if PCCL_010_#_# = 3, FILL_PCCL_011: “Was ^{FILL_YOUTHNAME}’s adoptive
mother”
Else if PCCL_010_#_# = 4, FILL_PCCL_011: “Was ^{FILL_YOUTHNAME}’s adoptive
father”
Else if PCCL_010_#_# = 5, FILL_PCCL_011: “Was ^{FILL_YOUTHNAME}’s step-mother”
Else if PCCL_010_#_# = 6, FILL_PCCL_011: “Was ^{FILL_YOUTHNAME}’s step-father”
Create ﬁll, FILL_YOUTHEY.
If PCCL_010_#_# = 0, FILL_YOUTHEY: “you”
Else FILL_YOUTHEY: “they”
Create ﬁll, FILL_YOURTHEIR.
If PCCL_010_#_# = 0, FILL_YOURTHEIR: “your”
Else FILL_YOURTHEIR: “their”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_011: If PCCL_010_#_# = 0, FILL_PCCL_011: “Usted”
Else if PCCL_010_#_# = 1, FILL_PCCL_011: “La madre biológica de
^{FILL_YOUTHNAME}”
Else if PCCL_010_#_# = 2, FILL_PCCL_011: “El padre biológico de
^{FILL_YOUTHNAME}"
Else if PCCL_010_#_# = 3, FILL_PCCL_011: “La madre adoptiva de
^{FILL_YOUTHNAME}”
Else if PCCL_010_#_# = 4, FILL_PCCL_011: “El padre adoptivo de
^{FILL_YOUTHNAME}”
Else if PCCL_010_#_# = 5, FILL_PCCL_011: “La madrastra de ^{FILL_YOUTHNAME}”
Else if PCCL_010_#_# = 6, FILL_PCCL_011: “El padrastro de ^{FILL_YOUTHNAME}”

FILLS (SPAN)

Create ﬁll, FILL_YOUTHEY.
If PCCL_010_#_# = 0, FILL_YOUTHEY: “usted no trabajó”
Else FILL_YOUTHEY: “no trabajó”
Create ﬁll, FILL_YOURTHEIR.
If PCCL_010_#_# = 0, FILL_YOURTHEIR: “su”
Else FILL_YOURTHEIR: “su”

ENGLISH

^{FILL_PCCL_011} working full-time, part-time, or not at all around the time of ^{FILL_YOUTHNAME}’s
birth? If ^{FILL_YOUTHEY} were on temporary leave due to ^{FILL_YOUTHNAME}’s birth, please
respond based on ^{FILL_YOURTHEIR} normal work schedule after returning to work.
1.
2.

Full-time
Part-time

0.

SPANISH

Not at all

¿^{FILL_PCCL_011} trabajaba a tiempo completo, a tiempo parcial o no trabajaba en absoluto en la
época del nacimiento de ^{FILL_YOUTHNAME}? Si ^{FILL_YOUTHEY} por un tiempo debido al
nacimiento de ^{FILL_YOUTHNAME}, responda con base en ^{FILL_YOURTHEIR} jornada laboral una vez
que regresó al trabajo.
1.
2.
0.

Tiempo completo
Tiempo parcial
No trabajaba

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

2
Loop through PCCL LOOP 1a (PCCL_011_#_#): Loop through max 2 parent ﬁgures identiﬁed
in PCCL_010

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_010
If LOOPNUMBER_1a = 1 and PCCL_010_#_2 not missing: Loop again (PCCL_011_#_#)
Else: PCCL_012

PCCL_012_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
How many children was ^{FILL_YOUTHNAME} living with immediately following their birth?
ENGLISH

_______________ children
¿Con cuántos niños(as) vivía ^{FILL_YOUTHNAME} inmediatamente después de su nacimiento?

SPANISH

_______________ niños(as)

RANGE

0-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_011, PCCL_009
If PCCL_012 > 0: PCCL_013
Else: PCCL_014

f_PCCL_013_#
PCCL_013A_# / PCCL_013B_# / PCCL_013C_# / PCCL_013D_# / PCCL_013E_# / PCCL_013F_# / PCCL_013G_#
ASK
PCCL_012 > 0 (Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Who were the children that ^{FILL_YOUTHNAME} was living with immediately following their birth?
Please select all that apply.
1.
2.
3.
4.
5.
6.
7.

ENGLISH

Full siblings [PCCL_013A_#]
Half or step siblings [PCCL_013B_#]
Adoptive siblings [PCCL_013C_#]
Other relatives [PCCL_013D_#]
Children of mother’s partner/boyfriend/girlfriend [PCCL_013E_#]
Children of father’s partner/boyfriend/girlfriend [PCCL_013F_#]
Other unrelated children [PCCL_013G_#]

¿Quiénes eran los(as) niños(as) con los que vivió ^{FILL_YOUTHNAME} inmediatamente después de su
nacimiento? Seleccione todas las que correspondan.

SPANISH

0.
1.
2.
3.
4.
5.
6.

Hermanos(as) de sangre [PCCL_013A_#]
Medios(as) hermanos(as) o hermanastros(as) [PCCL_013B_#]
Hermanos(as) adoptivos(as) [PCCL_013C_#]
Otros(as) familiares [PCCL_013D_#]
Hijos(as) de la pareja/novio(a) de la madre [PCCL_013E_#]
Hijos(as) de la pareja/novio(a) del padre [PCCL_013F_#]
Otros(as) hijos(as) sin parentesco [PCCL_013G_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)

HELP TEXT (ENG)

•
•
•

Los hermanos(as) de sangre comparten ambos(as) padres/madres
biológicos(as)”
• Los medios(as) hermanos(as) comparten un(a) padre/madre biológico(a) y los(as)
hermanastros(as) se convirtieron en hermanos(as) a través del matrimonio
• Hermanos(as) adoptivos(as) que no comparten ninguno(a) de sus padres/madres
biológicos(as)
CASI/CAWI
•

HELP TEXT (SPAN)

MODE

Full siblings share both biological parents
Half siblings share one biological parent and step-siblings became siblings
through marriage
Adoptive siblings who share neither biological parent

NOTES
LEAD-IN
NEXT

PCCL_012
PCCL_014

f_PCCL_014_#
PCCL_014_CT_# / PCCL_014_ST_#
ASK
All respondents (Continue PCCL Loop 1)
Textbox: PCCL_014_CT
QUESTION TYPE
Dropdown: PCCL_014_ST
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what city and state was ^{FILL_YOUTHNAME} living immediately following their birth?
ENGLISH

City: _______________ [PCCL_014_CT_#]
State: { - State - } [PCCL_014_ST_#]
¿En qué ciudad y estado vivió ^{FILL_YOUTHNAME} inmediatamente después de su nacimiento?

SPANISH

Ciudad: _______________ [PCCL_014_CT_#]
Estado: { - Estado - } [PCCL_014_ST_#]

RANGE

PCCL_014_ST: List states from STATENOTUS list

LIMITS

PCCL_014_CT: Max 100 characters

LOOP MAX

15

PROGRAM. NOTES

Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_012, PCCL_013
IF PCCL_008 or PCCL_009=DK, RF or missing: PCCL_016
Else: PCCL_015

PCCL_015_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL008: Fill numeric response to PCCL_008
Create ﬁll, FILL_PCCL015: If PCCL_008=1, FILL_PCCL015: ‘one adult’
Else FILL_PCCL015: ‘^{FILL_PCCL008} adults’

FILLS (ENG)

Create ﬁll, FILL_PCCL_009: Fill all responses collected in f_PCCL_009. If more than one
selected, separate each by “and”:
If PCCL_009A_# = 1 (selected), ﬁll “yourself”
If PCCL_009B_# = 1 (selected), ﬁll “a biological mother”
If PCCL_009C_# = 1 (selected), ﬁll “a biological father”
If PCCL_009D_# = 1 (selected), ﬁll “a step-mother”
If PCCL_009E_# = 1 (selected), ﬁll “a step-father”
If PCCL_009F_# = 1 (selected), ﬁll “an adoptive mother”
If PCCL_009G_# = 1 (selected), ﬁll “an adoptive father”
If PCCL_009H_# = 1 (selected), ﬁll “an unmarried partner of a parent”
If PCCL_009I_# = 1 (selected), ﬁll “a grandmother”
If PCCL_009J_# = 1 (selected), ﬁll “a grandfather”
If PCCL_009K_# = 1 (selected), ﬁll “a sibling (full, half, or step)”
If PCCL_009L_# = 1 (selected), ﬁll “other relative(s)”
If PCCL_009M_# = 1 (selected), ﬁll “court-appointed foster/temporary parent(s)”
If PCCL_009N_# = 1 (selected), ﬁll “other non-relative(s)”
If PCCL_009P_# = 1 (selected) and PCCL_009P_SPECIFY_# is MISSING, ﬁll “others”
If PCCL_009P_# = 1 (selected) and PCCL_009P_SPECIFY_# is NOT MISSING, ﬁll
text response to PCCL_009P_SPECIFY_#
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL008: Fill numeric response to PCCL_008
Create ﬁll, FILL_PCCL015: If PCCL_008=1, FILL_PCCL015: ‘un(a) adulto(a)’
Else FILL_PCCL015: ‘^{FILL_PCCL008} adults’

FILLS (SPAN)

Create ﬁll, FILL_PCCL_009: Fill all responses collected in f_PCCL_009. If more than one
selected, separate each by “y”:
If PCCL_009A_# = 1 (selected), ﬁll “usted”
If PCCL_009B_# = 1 (selected), ﬁll “una madre biológica”
If PCCL_009C_# = 1 (selected), ﬁll “un padre biológico”
If PCCL_009D_# = 1 (selected), ﬁll “una madrastra”
If PCCL_009E_# = 1 (selected), ﬁll “un padrastro”
If PCCL_009F_# = 1 (selected), ﬁll “una madre adoptiva”
If PCCL_009G_# = 1 (selected), ﬁll “un padre adoptivo”PCCL_009H_# = 1
(selected), ﬁll “una pareja de hecho de un(a) padre/madre”
If PCCL_009I_# = 1 (selected), ﬁll “una abuela”
If PCCL_009J_# = 1 (selected), ﬁll “un abuelo”
If PCCL_009K_# = 1 (selected), ﬁll “un(a) hermano(a) de sangre, medio(a)
hermano(a) o hermanastro(a)”
If PCCL_009L_# = 1 (selected), ﬁll “otros(as) familiar(es)”
If PCCL_009M_# = 1 (selected), ﬁll “padre/madre(s) de acogida/temporal(es)
designados(as) por el tribunal”
If PCCL_009N_# = 1 (selected), ﬁll “otra(s) persona(s) que no son familiar(es)”

If PCCL_009P_# = 1 (selected) and PCCL_009P_SPECIFY_# is MISSING, ﬁll
“otros(as)”
If PCCL_009P_# = 1 (selected) and PCCL_009P_SPECIFY_# is NOT MISSING, ﬁll
text response to PCCL_009P_SPECIFY_#
You reported that immediately following birth, ^{FILL_YOUTHNAME} was living with ^{FILL_PCCL_015},
including ^{FILL_PCCL_009}. Was ^{FILL_YOUTHNAME} living with these same adults, and no other
adults, on their 2nd birthday?
ENGLISH
1. Yes
0. No

SPANISH

Usted informó que, inmediatamente después del nacimiento, ^{FILL_YOUTHNAME} vivía con
^{FILL_PCCL_015}, lo que incluía a ^{FILL_PCCL_009}. ¿^{FILL_YOUTHNAME} vivía con estos(as)
mismos(as) adultos(as) cuando cumplió los 2 años?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
IF PCCL_015 = 1, set PCCL_016 = PCCL_008 and set PCCL_017 = PCCL_009.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_014
If PCCL_015 = 1: PCCL_018
Else: PCCL_016

PCCL_016_#
ASK

PCCL_015 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Including you if you were living with ^{FILL_YOUTHNAME}, how many adults or parent-figures was
^{FILL_YOUTHNAME} living with on their 2nd birthday? Please include ^{FILL_YOUTHNAME}’s parents
and all people aged 18 or older who usually stayed at the same address as ^{FILL_YOUTHNAME}.
ENGLISH
_______________ adults or parent figures

SPANISH

Incluido(a) usted, si es que vivía con ^{FILL_YOUTHNAME}, ¿con cuántos adultos o figuras parentales
vivía ^{FILL_YOUTHNAME} cuando cumplió los 2 años? Incluya a los padres/madres de
^{FILL_YOUTHNAME} y a todas las personas mayores de 18 años que vivían habitualmente en la misma
dirección que ^{FILL_YOUTHNAME}.
_______________ adultos o figuras parentales

RANGE

1-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_015
PCCL_017

f_PCCL_017_#
PCCL_017A_# / PCCL_017B_# / PCCL_017C_# / PCCL_017D_# / PCCL_017E_# / PCCL_017F_# / PCCL_017G_# /
PCCL_017H_# / PCCL_017I_# / PCCL_017J_# / PCCL_017K_# / PCCL_017L_# / PCCL_017M_# / PCCL_017N_# /
PCCL_017O_# / PCCL_017O_SPECIFY_#
ASK
PCCL_015 ≠ 1 (Continue PCCL Loop 1)
Checkbox: PCCL_017A, PCCL_017B, PCCL_017C, PCCL_017D, PCCL_017E, PCCL_017F,
PCCL_017G, PCCL_017H, PCCL_017I, PCCL_017J, PCCL_017K, PCCL_017L,
QUESTION TYPE
PCCL_017M, PCCL_017N, PCCL_017O
Textbox: PCCL_017O_SPECIFY
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Including you if you were living with ^{FILL_YOUTHNAME}, who were the adults that
^{FILL_YOUTHNAME} lived with on their 2nd birthday? Please select all that apply. Please enter
yourself if you were living with the child at that time and one relationship for any other adults that
^{FILL_YOUTHNAME} was living with at that time. Only select one relationship per adult.

ENGLISH

0. Yourself [PCCL_017A_#]
1. Biological mother [PCCL_017B_#]
2. Biological father [PCCL_017C_#]
3. Step-mother [PCCL_017D_#]
4. Step-father [PCCL_017E_#]
5. Adoptive mother [PCCL_017F_#]
6. Adoptive father [PCCL_017G_#]
7. Unmarried partner of a parent [PCCL_017H_#]
8. Grandmother [PCCL_017I_#]
9. Grandfather [PCCL_017J_#]
10. Sibling (full, half, or step) [PCCL_017K_#]
11. Other relative(s) [PCCL_017L_#]
14. Court-appointed foster/temporary parent(s) [PCCL_017M_#]
15. Other non-relative(s) [PCCL_017N_#]
16. Other (please specify:___________________________________________) [PCCL_017O_#]
[PCCL_017O_SPECIFY_#]
Incluido(a) usted, si es que vivía con ^{FILL_YOUTHNAME}, ¿quiénes eran los adultos con los que vivía
^{FILL_YOUTHNAME} cuando cumplió los 2 años? Seleccione todas las que correspondan. Por favor,
indíquese usted mismo si vivía con el niño en ese momento y una relación para cualquier otro adulto
con el que ^{FILL_YOUTHNAME} vivía en ese momento. Seleccione solo una relación por adulto.

SPANISH

0. Usted [PCCL_017A_#]
1. Madre biológica [PCCL_017B_#]
2. Padre biológico [PCCL_017C_#]
3. Madrastra [PCCL_017D_#]
4. Padrastro [PCCL_017E_#]
5. Madre adoptiva [PCCL_017F_#]
6. Padre adoptivo [PCCL_017G_#]
7. Pareja de hecho de un(a) padre/madre [PCCL_017H_#]
8. Abuela [PCCL_017I_#]
9. Abuelo [PCCL_017J_#]
10. Hermano(a) de sangre, medio(a) hermano(a) o hermanastro(a) [PCCL_017K_#]
11. Otro(as) familiar(es) [PCCL_017L_#]
14. Padre/madre(s) de acogida/temporal(es) designados(as) por el tribunal [PCCL_017M_#]

15. Otra(s) persona(s) que no son familiar(es) [PCCL_017N_#]
16. Otros (especifique:___________________________________________) [PCCL_017O_#]
[PCCL_017O_SPECIFY_#]
RANGE
LIMITS

PCCL_017O_SPECIFY: 100 characters

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

Code variable as 1 if checked, 0 if not.
If response 16 selected, display text box PCCL_017O_SPECIFY
If number of items selected is > PCCL_016, display hard check: “You reported that
^{FILLYOUTHNAME} was living with {PCCL_016} adults. Please only select one
relationship per adult.”
If number of items selected is > PCCL_016, display hard check: “Usted informó que
^{FILLYOUTHNAME} vivía con {PCCL_016} adulto(s). Seleccione solo una relación por
adulto.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_016
If PCCL_017= DK or REF: PCCL_021
Else, PCCL_018

PCCL_018_#
ASK

PCCL_017_# ≠ DK or REF

QUESTION TYPE

Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

2
Computer check, do not display.
Computer select ﬁrst 2 relationships reported in AGE2_ADULTREL_#, store as
PCCL_018_#_1 and PCCL_018_#_2.
0 Respondent
1 Biological mother
2 Biological father
3 Adoptive mother
4 Adoptive father
5 Stepmother

6 Stepfather
Loop through PCCL LOOP 1b (PCCL_019_#_# - PCCL_020_LOOP_END_#_#): Loop through
max 2 parent ﬁgures identiﬁed in PCCL_018
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_017, PCCL_015=1
PCCL_019 (Begin PCCL Loop 1b)

PCCL_019_#_#
ASK

PCCL_017_# ≠ DK or REF (Begin PCCL Loop 1b)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_019: If PCCL_018 = 0, FILL_PCCL_019: “Were you”
Else if PCCL_018 = 1, FILL_PCCL_019: “Was ^{FILL_YOUTHNAME}’s biological mother”
Else if PCCL_018 = 2, FILL_PCCL_019: “Was ^{FILL_YOUTHNAME}’s biological father"
FILLS (ENG)
Else if PCCL_018 = 3, FILL_PCCL_019: “Was ^{FILL_YOUTHNAME}’s adoptive mother”
Else if PCCL_018 = 4, FILL_PCCL_019: “Was ^{FILL_YOUTHNAME}’s adoptive father”
Else if PCCL_018 = 5, FILL_PCCL_019: “Was ^{FILL_YOUTHNAME}’s step-mother”
Else if PCCL_018 = 6, FILL_PCCL_019: “Was ^{FILL_YOUTHNAME}’s step-father”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_019: If PCCL_018 = 0, FILL_PCCL_019: “Usted”
Else if PCCL_018 = 1, FILL_PCCL_019: “La madre biológica de ^{FILL_YOUTHNAME}”
Else if PCCL_018 = 2, FILL_PCCL_019: “El padre biológico de ^{FILL_YOUTHNAME}"
FILLS (SPAN)
Else if PCCL_018 = 3, FILL_PCCL_019: “La madre adoptiva de ^{FILL_YOUTHNAME}”
Else if PCCL_018 = 4, FILL_PCCL_019: “El padre adoptivo de ^{FILL_YOUTHNAME}”
Else if PCCL_018 = 5, FILL_PCCL_019: “La madrastra de ^{FILL_YOUTHNAME}”
Else if PCCL_018 = 6, FILL_PCCL_019: “El padrastro de ^{FILL_YOUTHNAME}”
^{FILL_PCCL_019} working full-time, part-time, or not at all at the time that ^{FILL_YOUTHNAME}
turned 2 years old?

ENGLISH

1. Full-time
2. Part-time
0. Not at all
¿^{FILL_PCCL_019} trabajaba a tiempo completo, a tiempo parcial o no trabajaba en absoluto cuando
^{FILL_YOUTHNAME} cumplió los 2 años?

SPANISH

1.

Tiempo completo

0.

No trabajaba

2. Tiempo parcial
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

2
Loop through PCCL LOOP 1b (PCCL_019_#_# - PCCL_020_LOOP_END_#_#): Loop through
max 2 parent ﬁgures identiﬁed in PCCL_018

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_018
PCCL_020_LOOP_END_#_#

PCCL_020_LOOP_END_#_#
ASK

PCCL_017_# ≠ DK or REF (End PCCL Loop 1b)

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

2
Computer check, do not display.
Loop through PCCL LOOP 1b (PCCL_019_#_# - PCCL_020_LOOP_END_#_#): Loop through
max 2 parent ﬁgures identiﬁed in PCCL_018

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_019
If LOOPNUMBER_1b = 1 and PCCL_018_#_2 not missing: Loop again (PCCL_019_#_#)
Else, if PCCL_012 > 0: PCCL_021
Else: PCCL_022

PCCL_021_#
ASK

If PCCL_012 > 0 (Continue Loop PCCL 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_012: ‘PCCL_012’
Create ﬁll, FILL_PCCL_021: If PCCL_012=1, FILL_PCCL_021: ‘one other child’
Else FILL_PCCL_021: ‘^{FILL_PCCL_012} other children’
Create ﬁll, FILL_PCCL_013: Fill all responses collected in f_PCCL_013. If more than one
collected, separate each by “and”:
If PCCL_013A = 1 (selected), ﬁll “full siblings”
If PCCL_013B = 1 (selected), ﬁll “half or step siblings”
If PCCL_013C = 1 (selected), ﬁll “adoptive siblings”
If PCCL_013D = 1 (selected), ﬁll “other relatives”
If PCCL_013E = 1 (selected), ﬁll “children of mother’s
partner/boyfriend/girlfriend”
If PCCL_013F = 1 (selected), ﬁll “children of father’s partner/boyfriend/girlfriend”
If PCCL_013G = 1 (selected), ﬁll “other unrelated children”

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_012: ‘PCCL_012’
Create ﬁll, FILL_PCCL_021: If PCCL_012=1, FILL_PCCL_021: ‘otro(a) hijo(a)’
Else FILL_PCCL_021: ‘^{FILL_PCCL_012} otros(as) hijos(as)
Create ﬁll, FILL_PCCL_013: Fill all responses collected in f_PCCL_013. If more than one
collected, separate each by “y”:
If PCCL_013A = 1 (selected), ﬁll “hermanos(as) de sangre”
If PCCL_013B = 1 (selected), ﬁll “medios(as) hermanos(as) o hermanastros(as)”
If PCCL_013C = 1 (selected), ﬁll “hermanos(as) adoptivos(as)”
If PCCL_013D = 1 (selected), ﬁll “otros(as) familiar(es)”
If PCCL_013E = 1 (selected), ﬁll “hijos(as) de la pareja/novio(a) de la madre”
If PCCL_013F = 1 (selected), ﬁll “hijos(as) de la pareja/novio(a) del padre”
If PCCL_013G = 1 (selected), ﬁll “otros(as) hijos(as) sin parentesco”

FILLS (SPAN)

You reported that immediately following birth, ^{FILL_YOUTHNAME} was living with ^{FILL_PCCL_021},
including ^{FILL_PCCL_013}. Were they living with these same children on their 2nd birthday?
ENGLISH

SPANISH

RANGE
LIMITS

1.
0.

Yes, living with the same number and relationships with children
No, living with fewer, different, or additional children

Usted informó que, inmediatamente después del nacimiento, ^{FILL_YOUTHNAME} vivía con
^{FILL_PCCL_021}, lo que incluía a ^{FILL_PCCL_013}. ¿Vivía con estos(as) mismos(as) niños(as) cuando
cumplió los 2 años?
1.
1.

Sí, vivía con el mismo número de niños(as), con los mismos parentescos
No, vivía con menos niños(as), otros(as) o más

LOOP MAX

15
If PCCL_021 = 1, set PCCL_022 = 1 and set PCCL_023 = PCCL_012 and set PCCL_024 =
PCCL_013

PROGRAM. NOTES

Loop through PCCLPCCL Loop 1 (PCCLPCCL_001 through PCCL_139_LOOP_END) for each
youth on YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached
(15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PCCL_020_LOOP_END_#_#
If PCCL_021 = 1: and PCCL_014CT != (DK, REF) and PCLC_014ST != (DK, REF): PCCL_025a
Else if PCCL_021 = 1: f_PCCL_025
Else: PCCL_022

NEXT

PCCL_022_#
ASK

PCCL_012 < 1 OR PCCL_021 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Was ^{FILL_YOUTHNAME} living with any children on their 2nd birthday?
1. Yes
0. No

ENGLISH

¿Vivía ^{FILL_YOUTHNAME} con algún(a) otro(a) niño(a) cuando cumplió los 2 años?
SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

CASI/CAWI

LEAD-IN
NEXT

PCCL_021, PCCL_020_LOOP_END_#_#
If PCCL_022 = 0: and PCCL_014CT != (DK, REF) and PCLC_014ST != (DK, REF): PCCL_025a
Else if PCCL_022 = 0: f_PCCL_025
Else: PCCL_023

PCCL_023_#
ASK

PCCL_022 ≠ 0 (Continue Loop PCCL 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
How many children was ^{FILL_YOUTHNAME} living with on their 2nd birthday?
ENGLISH

______________ children
¿Con cuántos niños(as) vivía ^{FILL_YOUTHNAME} cuando cumplió los 2 años?

SPANISH

______________ niños(as)

RANGE

0-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_022
If PCCL_023 ≠ 0: f_PCCL_024
Else if PCCL_014CT != (DK, REF) and PCLC_014ST != (DK, REF): PCCL_025a
Else: f_PCCL_025

f_PCCL_024_#
PCCL_024A_#/PCCL_024B_#/PCCL_024C_#/PCCL_024D_#/PCCL_024E_#/PCCL_024F_#/PCCL_024G_#
ASK
PCCL_023 ≠ 0 (Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Who were the children that ^{FILL_YOUTHNAME} was living with on their 2nd birthday? Please select
all that apply.
1.
2.
3.
4.
5.
6.
7.

ENGLISH

Full siblings [PCCL_024A_#]
Half or step siblings [PCCL_024B_#]
Adoptive siblings [PCCL_024C_#]
Other relatives [PCCL_024D_#]
Children of mother’s partner/boyfriend/girlfriend [PCCL_024E_#]
Children of father’s partner/boyfriend/girlfriend [PCCL_024F_#]
Other unrelated children [PCCL_024G_#]

¿Quiénes eran los niños(as) con los que vivía ^{FILL_YOUTHNAME} cuando cumplió los 2 años?
Seleccione todas las que correspondan.

SPANISH

1.
2.
3.
4.
5.
6.
7.

Hermanos(as) de sangre [PCCL_024A_#]
Medios(as) hermanos(as) o hermanastros(as) [PCCL_024B_#]
Hermanos(as) adoptivos(as) [PCCL_024C_#]
Otros(as) familiar(es) [PCCL_024D_#]
Hijos(as) de la pareja/novio(a) de la madre [PCCL_024E_#]
Hijos(as) de la pareja/novio(a) del padre [PCCL_024F_#]
Otros(as) hijos(as) sin parentesco [PCCL_024G_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

HELP TEXT (SPAN)

MODE

Full siblings share both biological parents
Half siblings share one biological parent and step-siblings became siblings
through marriage”
• Adoptive siblings who share neither biological parent”
•
“Los hermanos(as) de sangre comparten ambos(as) padres/madres
biológicos(as)”
•
“Los medios(as) hermanos(as) comparten un(a) padre/madre biológico(a) y
los(as) hermanastros(as) se convirtieron en hermanos(as) a través del
matrimonio”
•
“Hermanos(as) adoptivos(as) que no comparten ninguno(a) de sus
padres/madres biológicos(as)”
CASI/CAWI
•
•

NOTES
LEAD-IN
NEXT

PCCL_023
If PCCL_014CT != (DK, REF) and PCLC_014ST != (DK, REF): PCCL_025a
Else: PCCL_025

PCCL_025a_#
ASK

If PCCL_014CT != (DK, REF) and PCCL_014ST != (DK, REF) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (ENG)

Create ﬁll, FILL_PCCL_014CT: ‘PCCL_014_CT’
Create ﬁll, FILL_PCCL_014ST: ‘PCCL_014_ST’
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)

Create ﬁll, FILL_PCCL_014CT: ‘PCCL_014_CT’
Create ﬁll, FILL_PCCL_014ST: ‘PCCL_014_ST’

On their 2nd birthday, was ^{FILL_YOUTHNAME} still living in ^{FILL_PCCL_014CT }, ^{FILL_
PCCL_014ST}?
ENGLISH

1. Yes
0. No
En su segundo cumpleaños, ¿^{FILL_YOUTHNAME} todavía vivía en ^{FILL_PCCL_014CT }, ^{FILL_
PCCL_014ST }?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If “yes” (1) to PCCL_025a then set PCCL_025_CT to the value of PCCL_014_CT, and set
PCCL_025_ST to the value of PCCL_014_ST.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_024, PCCL_023, PCCL_022, PCCL_021
If PCCL_025a=0: PCCL_025
Else if PCCL_016 > 0: PCCL_026
Else: PCCL_027

f_PCCL_025_#
PCCL_025_CT_#/PCCL_025_ST_#
ASK
If PCCL_025a ≠ 1 (Continue PCCL Loop 1)
Textbox: PCCL_025_CT
QUESTION TYPE
Dropdown: PCCL_025_ST
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what city and state was ^{FILL_YOUTHNAME} living on their 2nd birthday?
ENGLISH

City: _______________ [PCCL_025_CT_#]
State: { - Select - } [PCCL_025_ST_#]
¿En qué ciudad y estado vivía ^{FILL_YOUTHNAME} cuando cumplió los 2 años?

SPANISH

Ciudad: _______________ [PCCL_025_CT_#]
Estado: { - Seleccione - } [PCCL_025_ST_#]

RANGE

PCCL_025_ST: List states on STATENOTUS list

LIMITS

PCCL_025_CT: Max 100 characters

LOOP MAX

15

PROGRAM. NOTES

Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_025a
If PCCL_016 > 0: PCCL_026
Else: PCCL_027

PCCL_026_#
ASK

PCCL_016 > 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL016: Fill numeric response to PCCL_016
Create ﬁll, FILL_PCCL026: If PCCL_016=1, FILL_PCCL026: ‘one adult’
Else FILL_PCCL026: ‘^{FILL_PCCL016} adults’

FILLS (ENG)

Create ﬁll, FILL_PCCL_017: Fill all responses collected in f_PCCL_017. If more than one
selected, separate each by “and”:
If PCCL_017A = 1 (selected), ﬁll “yourself”
If PCCL_017B = 1 (selected), ﬁll “a biological mother”
If PCCL_017C = 1 (selected), ﬁll “a biological father”
If PCCL_017D = 1 (selected), ﬁll “a step-mother”
If PCCL_017E = 1 (selected), ﬁll “a step-father”
If PCCL_017F = 1 (selected), ﬁll “an adoptive mother”
If PCCL_017G = 1 (selected), ﬁll “an adoptive father”
If PCCL_017H = 1 (selected), ﬁll “an unmarried partner of a parent”
If PCCL_017I = 1 (selected), ﬁll “a grandmother”
If PCCL_017J = 1 (selected), ﬁll “a grandfather”
If PCCL_017K = 1 (selected), ﬁll “a sibling (full, half, or step)”
If PCCL_017L = 1 (selected), ﬁll “other relative(s)”
If PCCL_017M = 1 (selected), ﬁll “court-appointed foster/temporary parent(s)”
If PCCL_017N = 1 (selected), ﬁll “other non-relative(s)”
If PCCL_017P = 1 (selected) and PCCL_017P_SPECIFY is MISSING, ﬁll “others”
If PCCL_017P = 1 (selected) and PCCL_017P_SPECIFY is NOT MISSING, ﬁll text
response to PCCL_017P_SPECIFY
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL016: Fill numeric response to PCCL_016
Create ﬁll, FILL_PCCL026: If PCCL_016=1, FILL_PCCL026: ‘un(a) adulto(a)’
Else FILL_PCCL026: ‘^{FILL_PCCL016} adultos(as)’

FILLS (SPAN)

Create ﬁll, FILL_PCCL_017: Fill all responses collected in f_PCCL_017. If more than one
selected, separate each by “y”:
If PCCL_017A = 1 (selected), ﬁll “usted”
If PCCL_017B = 1 (selected), ﬁll “una madre biológica”
If PCCL_017C = 1 (selected), ﬁll “un padre biológico”
If PCCL_017D = 1 (selected), ﬁll "una madrastra”
If PCCL_017E = 1 (selected), ﬁll “un padrastro”
If PCCL_017F = 1 (selected), ﬁll “una madre adoptiva”
If PCCL_017G = 1 (selected), ﬁll “un padre adoptivo”
If PCCL_017H = 1 (selected), ﬁll “una pareja de hecho de un(a) padre/madre”
If PCCL_017I = 1 (selected), ﬁll “una abuela”
If PCCL_017J = 1 (selected), ﬁll “un abuelo”
If PCCL_017K = 1 (selected), ﬁll “un(a) hermano(a) de sangre, medio(a)
hermano(a) o hermanastro(a)”
If PCCL_017L = 1 (selected), ﬁll “otros(as) familiar(es)”
If PCCL_017M = 1 (selected), ﬁll “padre/madre(s) de acogida/temporal(es)
designados(as) por el tribunal”
If PCCL_017N = 1 (selected), ﬁll “otra(s) persona(s) que no son familiar(es)”
If PCCL_017P = 1 (selected) and PCCL_017P_SPECIFY is MISSING, ﬁll “otros(as)”

If PCCL_017P = 1 (selected) and PCCL_017P_SPECIFY is NOT MISSING, ﬁll text
response to PCCL_017P_SPECIFY

ENGLISH

SPANISH

You reported that on their 2nd birthday, ^{FILL_YOUTHNAME} was living with ^{FILL_PCCL026}
including ^{FILL_PCCL_017}. Was ^{FILL_YOUTHNAME} living with these same adults, and no other
adults, on their 6th birthday?
1. Yes
0. No
Usted informó que, cuando cumplió los 2 años, ^{FILL_YOUTHNAME} vivía con ^{FILL_PCCL026}, lo que
incluía a ^{FILL_PCCL_017}. ¿Vivía ^{FILL_YOUTHNAME} con estos(as) mismos(as) adultos(as), y ningún
otro(as) adulto(as), cuando cumplió los 6 años?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
If PCCL_026 = 1, set PCCL_027 = PCCL_016 and set PCCL_028 = PCCL_017
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_025a, PCCL_025
If PCCL_026 = 1: PCCL_029
Else: PCCL_027

PCCL_027_#
ASK

PCCL_026 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Including you if you were living with ^{FILL_YOUTHNAME}, how many adults or parent-figures was
^{FILL_YOUTHNAME} living with on their 6th birthday? Please include ^{FILL_YOUTHNAME}’s parents
and all people aged 18 or older who usually stayed at the same address as ^{FILL_YOUTHNAME}.
ENGLISH
_____________adults

SPANISH

Incluido(a) usted, si es que vivía con ^{FILL_YOUTHNAME}, ¿con cuántos adultos o figuras parentales
vivía ^{FILL_YOUTHNAME} cuando cumplió los 6 años? Incluya a los padres/madres de
^{FILL_YOUTHNAME} y a todas las personas mayores de 18 años que vivían habitualmente en la misma
dirección que ^{FILL_YOUTHNAME}.
_____________adulto(s)

RANGE

1-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_025a, f_PCCL_025, PCCL_026 ≠ 1
f_PCCL_028

f_PCCL_028_#
PCCL_028A_# / PCCL_028B_# / PCCL_028C_# / PCCL_028D_# / PCCL_028E_# / PCCL_028F_# / PCCL_028G_# /
PCCL_028H_# / PCCL_028I_# / PCCL_028J_# / PCCL_028K_# / PCCL_028L_# / PCCL_028M_# / PCCL_028N_# /
PCCL_028O_# / PCCL_028O_SPECIFY_#
ASK
PCCL_026 ≠ 1 (Continue PCCL Loop 1)
Checkbox: PCCL_028A, PCCL_028B, PCCL_028C, PCCL_028D, PCCL_028E, PCCL_028F,
PCCL_028G, PCCL_028H, PCCL_028I, PCCL_028J, PCCL_028K, PCCL_028L,
QUESTION TYPE
PCCL_028M, PCCL_028N, PCCL_028P
Textbox: PCCL_028P_SPECIFY
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Including you if you were living with ^{FILL_YOUTHNAME}, who were the adults that
^{FILL_YOUTHNAME} lived with on their 6th birthday? Please select all that apply. Please enter
yourself if you were living with the child at that time and one relationship for any other adults that
^{FILL_YOUTHNAME} was living with at that time. Only select one relationship per adult.

ENGLISH

SPANISH

0. Yourself [PCCL_028A_#]
1. Biological mother [PCCL_028B_#]
2. Biological father [PCCL_028C_#]
3. Step-mother [PCCL_028D_#]
4. Step-father [PCCL_028E_#]
5. Adoptive mother [PCCL_028F_#]
6. Adoptive father [PCCL_028G_#]
7. Unmarried partner of a parent [PCCL_028H_#]
8. Grandmother [PCCL_028I_#]
9. Grandfather [PCCL_028J_#]
10. Sibling (full, half, or step) [PCCL_028K_#]
11. Other relative(s) [PCCL_028L_#]
14. Court-appointed foster/temporary parent(s) [PCCL_028M_#]
15. Other non-relative(s) [PCCL_028N_#]
16. Other (please specify:___________________________________________) [PCCL_028O_#]
[PCCL_028O_SPECIFY_#]
Incluido(a) usted, si es que vivía con ^{FILL_YOUTHNAME}, ¿quiénes eran los adultos con los que vivía
^{FILL_YOUTHNAME} cuando cumplió los 6 años? Seleccione todas las que correspondan. Por favor,
indíquese usted mismo si vivía con el niño en ese momento y una relación para cualquier otro adulto
con el que ^{FILL_YOUTHNAME} vivía en ese momento. Seleccione solo una relación por adulto.
0. Usted [PCCL_028A_#]
1. Madre biológica [PCCL_028B_#]
2. Padre biológico [PCCL_028C_#]
3. Madrastra [PCCL_028D_#]
4. Padrastro [PCCL_028E_#]
5. Madre adoptiva [PCCL_028F_#]
6. Padre adoptivo [PCCL_028G_#]
7. Pareja de hecho de un(a) padre/madre [PCCL_028H_#]
8. Abuela [PCCL_028I_#]
9. Abuelo [PCCL_028J_#]
10. Hermano(a) de sangre, medio(a) hermano(a) o hermanastro(a) [PCCL_028K_#]
11. Otro(as) familiar(es) [PCCL_028L_#]
14. Padre/madre(s) de acogida/temporal(es) designados(as) por el tribunal [PCCL_028M_#]
15. Otra(s) persona(s) que no son familiar(es) [PCCL_028N_#]

16. Otros (especifique:___________________________________________) [PCCL_028O_#]
[PCCL_028O_SPECIFY_#]
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

PCCL_028O_SPECIFY: 100 characters
15
Code variable as 1 if checked, 0 if not.
If response 16 selected, display text box PCCL_028O_SPECIFY
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If number of items selected is > PCCL_027, display hard check: “You reported that
^{FILLYOUTHNAME} was living with {PCCL_027} adults. Please only select one
relationship per adult.”
If number of items selected is > PCCL_027, display hard check: “Usted informó que
^{FILLYOUTHNAME} vivía con {PCCL_027} adulto(s). Seleccione solo una relación por
adulto.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_027
If PCCL_028 ≠ DK or REF: PCCL_029
Else If PCCL_023 > 0: PCCL_032
Else: PCCL_033

PCCL_029_#
ASK

PCCL_028 ≠ DK or REF

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

2
Computer check, do not display.
Computer select 2 relationships reported in PCCL_028, selected in hierarchical order as
follows, store as PCCL_029_#_1 and PCCL_029_#_2
0 Respondent
1 Biological mother
2 Biological father
3 Adoptive mother
4 Adoptive father
5 Stepmother
6 Stepfather
Begin PCCL LOOP 1c (PCCL_030_#_# through PCCL_031_LOOP_END_#_#): Loop through
max 2 parent ﬁgures identiﬁed in PCCL_029

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_028
PCCL_030 (Begin PCCL LOOP 1c)

PCCL_030_#_#
ASK

PCCL_028 ≠ DK or REF (Begin PCCL LOOP 1c)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_030: If PCCL_029_#_# = 0, FILL_PCCL_030: “Were you”
Else if PCCL_029_#_# = 1, FILL_PCCL_030: “Was ^{FILL_YOUTHNAME}’s biological
mother”
Else if PCCL_029_#_# = 2, FILL_PCCL_030: “Was ^{FILL_YOUTHNAME}’s biological
father"
FILLS (ENG)
Else if PCCL_029_#_# = 3, FILL_PCCL_030: “Was ^{FILL_YOUTHNAME}’s adoptive
mother”
Else if PCCL_029_#_# = 4, FILL_PCCL_030: “Was ^{FILL_YOUTHNAME}’s adoptive
father”
Else if PCCL_029_#_# = 5, FILL_PCCL_030: “Was ^{FILL_YOUTHNAME}’s step-mother”
Else if PCCL_029_#_# = 6, FILL_PCCL_030: “Was ^{FILL_YOUTHNAME}’s step-father”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_030: If PCCL_029_#_# = 0, FILL_PCCL_030: “Usted”
Else if PCCL_029_#_# = 1, FILL_PCCL_030: “La madre biológica de
^{FILL_YOUTHNAME}”
Else if PCCL_029_#_# = 2, FILL_PCCL_030: “El padre biológico de
^{FILL_YOUTHNAME}"
FILLS (SPAN)
Else if PCCL_029_#_# = 3, FILL_PCCL_030: “La madre adoptiva de
^{FILL_YOUTHNAME}”
Else if PCCL_029_#_# = 4, FILL_PCCL_030: “El padre adoptivo de
^{FILL_YOUTHNAME}”
Else if PCCL_029_#_# = 5, FILL_PCCL_030: “La madrastra de ^{FILL_YOUTHNAME}”
Else if PCCL_029_#_# = 6, FILL_PCCL_030: “El padrastro de ^{FILL_YOUTHNAME}”
^{FILL_PCCL_030} working full-time, part-time, or not at all at the time ^{FILL_YOUTHNAME} turned 6
years old?

ENGLISH

1.
2.
0.

Full-time
Part-time
Not at all

¿^{FILL_PCCL_030} trabajaba a tiempo completo, a tiempo parcial o no trabajaba en absoluto cuando
^{FILL_YOUTHNAME} cumplió los 6 años?
SPANISH

1.
2.
0.

Tiempo completo
Tiempo parcial
No trabajaba

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

2
Loop through PCCL LOOP 1c (PCCL_030_#_# through PCCL_031_LOOP_END_#_#) for
each relationship identiﬁed in PCCL_029

HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_029
PCCL_031_LOOP_END

PCCL_031_LOOP_END_#_#
ASK

All respondents (End PCCL LOOP 1c)

QUESTION TYPE

Computer Check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

2
Computer check, do not display.
Loop through PCCL LOOP 1c (PCCL_030_#_# through PCCL_031_LOOP_END_#_#) for each
relationship identiﬁed in PCCL_029

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_030
If LOOPNUMBER_1c = 1 and PCCL_029_#_2 not missing: Loop again (PCCL_030_#_#)
Else, if PCCL_023 >0: PCCL_033
Else: PCCL_032

PCCL_032_#
ASK

PCCL_023 > 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_023: ‘PCCL_023’
Create ﬁll, FILL_PCCL_032.
If PCCL_023=1, FILL_PCCL_032: ‘one other child’
Else FILL_PCCL_032: ‘^{FILL_PCCL_023} other children’
Create ﬁll, FILL_PCCL_024: Fill all responses collected in f_PCCL_024. If more than one
collected, separate each by “and”:
If PCCL_024A = 1 (selected), ﬁll “full siblings”
If PCCL_024B = 1 (selected), ﬁll “half or step siblings”
If PCCL_024C = 1 (selected), ﬁll “adoptive siblings”
If PCCL_024D = 1 (selected), ﬁll “other relatives”
If PCCL_024E = 1 (selected), ﬁll “children of mother’s
partner/boyfriend/girlfriend”
If PCCL_024F = 1 (selected), ﬁll “children of father’s partner/boyfriend/girlfriend”
If PCCL_024G = 1 (selected), ﬁll “other unrelated children”

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_023: ‘PCCL_023’
Create ﬁll, FILL_PCCL_032.
If PCCL_023=1, FILL_PCCL_032: ‘otro(a) hijo(a)’
Else FILL_PCCL_032: ‘^{FILL_PCCL_023} otros(as) hijos(as)’
Create ﬁll, FILL_PCCL_024: Fill all responses collected in f_PCCL_024. If more than one
collected, separate each by“y”:
If PCCL_024A = 1 (selected), ﬁll “hermanos(as) de sangre”
If PCCL_024B = 1 (selected), ﬁll “medios(as) hermanos(as) o hermanastros(as)”
If PCCL_024C = 1 (selected), ﬁll “hermanos(as) adoptivos(as)”
If PCCL_024D = 1 (selected), ﬁll “otros(as) familiar(es)”
If PCCL_024E = 1 (selected), ﬁll “hijos(as) de la pareja/novio(a) de la madre”
If PCCL_024F = 1 (selected), ﬁll “hijos(as) de la pareja/novio(a) del padre”
If PCCL_024G = 1 (selected), ﬁll “otros(as) hijos(as) sin parentesco”

FILLS (SPAN)

You reported that on their 2nd birthday, ^{FILL_YOUTHNAME} was living with ^{FILL_PCCL_032},
including ^{FILL_PCCL_024}. Were they living with these same children on their 6th birthday?
ENGLISH

1.
0.

Yes, living with the same number and relationships with children
No, living with fewer, different, or additional children

Usted informó que, cuando cumplió los 2 años, ^{FILL_YOUTHNAME} vivía con ^{FILL_PCCL_032}, lo
que incluía a ^{FILL_PCCL_024}. ¿Vivía con estos(as) mismos(as) niños(as) cuando cumplió los 6 años?
SPANISH

RANGE
LIMITS

1.
0.

Sí, vivía con el mismo número de niños(as), con los mismos parentescos
No, vivía con menos niños(as), otros(as) o más

LOOP MAX

PROGRAM. NOTES

15
If PCCL_032 = 1, set PCCL_033 = 1 and set PCCL_034 = PCCL_023 and set PCCL_035 =
PCCL_024
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

PCCL_028, PCCL_031
If PCCL_032 = 1 and PCCL_025CT != (DK, REF) and PCCL_025ST != (DK, REF): PCCL_036a
Else if PCCL_032 = 1: f_PCCL_036
Else: PCCL_033

NEXT

PCCL_033_#
ASK

PCCL_023 >0 OR PCCL_032 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Was ^{FILL_YOUTHNAME} living with any children on their 6th birthday?
1. Yes
0. No

ENGLISH

¿Vivía ^{FILL_YOUTHNAME} con algún(a) otro(a) niño(a) cuando cumplió los 6 años?
SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_031_LOOP_END, PCCL_032, f_PCCL_028
If PCCL_033 = 0: and PCCL_025CT != (DK, REF) and PCCL_025ST != (DK, REF): PCCL_036a
Else if PCCL_033 = 0: f_PCCL_036
Else: PCCL_034

PCCL_034_#
ASK

PCCL_033 ≠ 0 (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
How many children was ^{FILL_YOUTHNAME} living with on their 6th birthday?
ENGLISH

_______________children
¿Con cuántos niños(as) vivía ^{FILL_YOUTHNAME} cuando cumplió los 6 años?

SPANISH

_______________niños(as)

RANGE

0-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_033
If PCCL_034 = 0: and PCCL_025CT != (DK, REF) and PCCL_025ST != (DK, REF): PCCL_036a
Else if PCCL_034 = 0: f_PCCL_036
Else: f_PCCL_035

f_PCCL_035_#
PCCL_035_# / PCCL_035B_# / PCCL_035C_# / PCCL_035D_# / PCCL_035E_# / PCCL_035F_# / PCCL_035G_#
ASK
PCCL_034 ≠ 0 (Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Who were the children that ^{FILL_YOUTHNAME} was living with on their 6th birthday? Please select
all that apply.
1.
2.
3.
4.
5.
6.
7.

ENGLISH

Full siblings [PCCL_035A_#]
Half or step siblings [PCCL_035B_#]
Adoptive siblings [PCCL_035C_#]
Other relatives [PCCL_035D_#]
Children of mother’s partner/boyfriend/girlfriend [PCCL_035E_#]
Children of father’s partner/boyfriend/girlfriend [PCCL_035F_#]
Other unrelated children [PCCL_035G_#]

¿Quiénes eran los niños(as) con los que vivía ^{FILL_YOUTHNAME} cuando cumplió los 6 años?
Seleccione todas las que correspondan.

SPANISH

0.
1.
2.
3.
4.
5.
6.

Hermanos(as) de sangre [PCCL_035A_#]
Medios(as) hermanos(as) o hermanastros(as) [PCCL_035B_#]
Hermanos(as) adoptivos(as) [PCCL_035C_#]
Otros(as) familiar(es) [PCCL_035D_#]
Hijos(as) de la pareja/novio(a) de la madre [PCCL_035E_#]
Hijos(as) de la pareja/novio(a) del padre [PCCL_035F_#]
Otros(as) hijos(as) sin parentesco [PCCL_035G_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

HELP TEXT (SPAN)

MODE
NOTES

Full siblings share both biological parents
Half siblings share one biological parent and step-siblings became siblings
through marriage
• Adoptive siblings who share neither biological parent
•
Los hermanos(as) de sangre comparten ambos(as) padres/madres biológicos(as)
•
Los medios(as) hermanos(as) comparten un(a) padre/madre biológico(a) y
los(as) hermanastros(as) se convirtieron en hermanos(as) a través del
matrimonio
Hermanos(as) adoptivos(as) que no comparten ninguno(a) de sus
•
padres/madres biológicos(as)
CASI/CAWI
•
•

LEAD-IN
NEXT

PCCL_034
If PCCL_025CT != (DK, REF) and PCCL_025ST != (DK, REF): PCCL_036a
Else: f_PCCL_036

PCCL_036a_#
ASK

If PCCL_025CT != (DK, REF) and PCCL_025ST != (DK, REF) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (ENG)

Create ﬁll, FILL_PCCL_025CT: ‘PCCL_025_CT’
Create ﬁll, FILL_PCCL_025ST: ‘PCCL_025_ST’
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)

Create ﬁll, FILL_PCCL_025CT: ‘PCCL_025_CT’
Create ﬁll, FILL_PCCL_025ST: ‘PCCL_025_ST’

On their 6th birthday, was ^{FILL_YOUTHNAME} still living in ^{FILL_PCCL_025CT },^{FILL_
PCCL_025ST }?
ENGLISH

1. Yes
0. No
En su sexto cumpleaños, ¿^{FILL_YOUTHNAME} todavía vivía en ^{FILL_PCCL_025CT }, ^{FILL_
PCCL_025ST}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If “yes” (1) to PCCL_036a then set PCCL_036_CT to the value of PCCL_025_CT, and set
PCCL_036_ST to the value of PCCL_025_ST.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_032 = 1, PCCL_033 = 0, PCCL_034, PCCL_035
If PCCL_036a≠ 1: PCCL_036
Else if PCCL_027 > 0: PCCL_037
Else: PCCL_038

f_PCCL_036_#
PCCL_036_CT_#/PCCL_036_ST_#
ASK
If PCCL_036a ≠ 1(Continue PCCL Loop 1)
Textbox: PCCL_036_CT
QUESTION TYPE
Dropdown: PCCL_036_ST
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what city and state was ^{FILL_YOUTHNAME} living on their 6th birthday?
ENGLISH

City: _______________ [PCCL_036_CT_#]
State: { - Select - } [PCCL_036_ST_#]
¿En qué ciudad y estado vivía ^{FILL_YOUTHNAME} cuando cumplió los 6 años?

SPANISH

Ciudad: _______________ [PCCL_036_CT_#]
Estado: { - Seleccione - } [PCCL_036_ST_#]

RANGE

PCCL_036_ST: List states on STATENOTUS

LIMITS

PCCL_036_CT: Max 100 characters

LOOP MAX
PROGRAM. NOTES

15
Please use the list of response options from question STATEEXPAND but only allow 1
response for variable PCCL_036_ST
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_036a
If PCCL_027 > 0: PCCL_037
Else: PCCL_038

PCCL_037_#
ASK

PCCL_027 > 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_027: Fill numeric response to PCCL_027
Create ﬁll, FILL_PCCL_037: If PCCL_027=1, FILL_PCCL_037: ‘one adult’
Else FILL_PCCL_037: ‘^{FILL_PCCL_027} adults’

FILLS (ENG)

Create ﬁll, FILL_PCCL_028: Fill all responses collected in PCCL_028. If more than one
selected, separate each by “and”:
If PCCL_028A = 1 (selected), ﬁll “yourself”
If PCCL_028B = 1 (selected), ﬁll “a biological mother”
If PCCL_028C = 1 (selected), ﬁll “a biological father”
If PCCL_028D = 1 (selected), ﬁll “a step-mother”
If PCCL_028E = 1 (selected), ﬁll “a step-father”
If PCCL_028F = 1 (selected), ﬁll “an adoptive mother”
If PCCL_028G = 1 (selected), ﬁll “an adoptive father”
If PCCL_028H = 1 (selected), ﬁll “an unmarried partner of a parent”
If PCCL_028I = 1 (selected), ﬁll “a grandmother”
If PCCL_028J = 1 (selected), ﬁll “a grandfather”
If PCCL_028K = 1 (selected), ﬁll “a sibling (full, half, or step)”
If PCCL_028L = 1 (selected), ﬁll “other relative(s)”
If PCCL_028M = 1 (selected), ﬁll “court-appointed foster/temporary parent(s)”
If PCCL_028N = 1 (selected), ﬁll “other non-relative(s)”
If PCCL_028P = 1 (selected) and PCCL_028P_SPECIFY is MISSING, ﬁll “others”
If PCCL_028P = 1 (selected) and PCCL_028P_SPECIFY is NOT MISSING, ﬁll text
response to PCCL_028P_SPECIFY
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_027: Fill numeric response to PCCL_027
Create ﬁll, FILL_PCCL_037: If PCCL_027=1, FILL_PCCL_037: ‘un(a) adulto(a)’
Else FILL_PCCL_037: ‘^{FILL_PCCL_027} adultos(as)’

FILLS (SPAN)

Create ﬁll, FILL_PCCL_028: Fill all responses collected in PCCL_028. If more than one
selected, separate each by “y”:
If PCCL_028A = 1 (selected), ﬁll “usted”
If PCCL_028B = 1 (selected), ﬁll “una madre biológica”
If PCCL_028C = 1 (selected), ﬁll “un padre biológico”
If PCCL_028D = 1 (selected), ﬁll "una madrastra”
If PCCL_028E = 1 (selected), ﬁll “un padrastro”
If PCCL_028F = 1 (selected), ﬁll “una madre adoptiva”
If PCCL_028G = 1 (selected), ﬁll “un padre adoptivo”
If PCCL_028H = 1 (selected), ﬁll “una pareja de hecho de un(a) padre/madre”
If PCCL_028I = 1 (selected), ﬁll “una abuela”
If PCCL_028J = 1 (selected), ﬁll “un abuelo”
If PCCL_028K = 1 (selected), ﬁll “un(a) hermano(a) de sangre, medio(a)
hermano(a) o hermanastro(a)”
If PCCL_028L = 1 (selected), ﬁll “otros(as) familiar(es)”
If PCCL_028M = 1 (selected), ﬁll “padre/madre(s) de acogida/temporal(es)
designados(as) por el tribunal”

If PCCL_028N = 1 (selected), ﬁll “otra(s) persona(s) que no son familiar(es)”
If PCCL_028P = 1 (selected) and PCCL_028P_SPECIFY is MISSING, ﬁll “otros(as)”
If PCCL_028P = 1 (selected) and PCCL_028P_SPECIFY is NOT MISSING, ﬁll text
response to PCCL_028P_SPECIFY

ENGLISH

SPANISH

You reported that on their 6th birthday, ^{FILL_YOUTHNAME} was living with ^{FILL_PCCL_037}
including ^{FILL_PCCL_028}. Was ^{FILL_YOUTHNAME} living with these same adults, and no other
adults, on their 11th birthday?
1. Yes
0. No
Usted informó que, cuando cumplió los 6 años, ^{FILL_YOUTHNAME} vivía con ^{FILL_PCCL_037}, lo
que incluía a ^{FILL_PCCL_028}. ¿Vivía ^{FILL_YOUTHNAME} con estos(as) mismos(as) adultos(as), y
ningún otro(as) adulto(as), cuando cumplió los 11 años?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
If PCCL_037 = 1, set PCCL_038 = PCCL_027 and set PCCL_039 = PCCL_028
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_036a, PCCL_036
If PCCL_037 = 1: PCCL_040
Else: PCCL_038

PCCL_038_#
ASK

PCCL_037 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Including you if you were living with ^{FILL_YOUTHNAME}, how many adults or parent-figures was
^{FILL_YOUTHNAME} living with on their 11th birthday? Please include ^{FILL_YOUTHNAME}’s parents
and all people aged 18 or older who usually stayed at the same address as ^{FILL_YOUTHNAME}.
ENGLISH
_____________adults

SPANISH

Incluido(a) usted, si es que vivía con ^{FILL_YOUTHNAME}, ¿con cuántos adultos o figuras parentales
vivía ^{FILL_YOUTHNAME} cuando cumplió los 11 años? Incluya a los padres/madres de
^{FILL_YOUTHNAME} y a todas las personas mayores de 18 años que vivían habitualmente en la misma
dirección que ^{FILL_YOUTHNAME}.
_____________adultos

RANGE

1-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_036a, PCCL_036, PCCL_037 ≠ 1
PCCL_039

f_PCCL_039_#
PCCL_039A_# / PCCL_039B_# / PCCL_039C_# / PCCL_039D_# / PCCL_039E_# / PCCL_039F_# / PCCL_039G_# /
PCCL_039H_# / PCCL_039I_# / PCCL_039J_# / PCCL_039K_# / PCCL_039L_# / PCCL_039M_# / PCCL_039N_# /
PCCL_039O_# / PCCL_039O_SPECIFY_#
ASK
PCCL_037 ≠ 1 (Continue PCCL Loop 1)
Checkbox: PCCL_039A, PCCL_039B, PCCL_039C, PCCL_039D, PCCL_039E, PCCL_039F,
PCCL_039G, PCCL_039H, PCCL_039I, PCCL_039J, PCCL_039K, PCCL_039L,
QUESTION TYPE
PCCL_039M, PCCL_039N, PCCL_039O
Textbox: PCCL_039O_SPECIFY
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Including you if you were living with ^{FILL_YOUTHNAME}, who were the adults that
^{FILL_YOUTHNAME} lived with on their 11th birthday? Please select all that apply. Please enter
yourself if you were living with the child at that time and one relationship for any other adults that
[youth name] was living with at that time. Only select one relationship per adult.

ENGLISH

0. Yourself [PCCL_039A_#]
1. Biological mother [PCCL_039B_#]
2. Biological father [PCCL_039C_#]
3. Step-mother [PCCL_039D_#]
4. Step-father [PCCL_039E_#]
5. Adoptive mother [PCCL_039F_#]
6. Adoptive father [PCCL_039G_#]
7. Unmarried partner of a parent [PCCL_039H_#]
8. Grandmother [PCCL_039I_#]
9. Grandfather [PCCL_039J_#]
10. Sibling (full, half, or step) [PCCL_039K_#]
11. Other relative(s) [PCCL_039L_#]
14. Court-appointed foster/temporary parent(s) [PCCL_039M_#]
15. Other non-relative(s) [PCCL_039N_#]
16. Other (please specify:___________________________________________) [PCCL_039O_#]
[PCCL_039O_SPECIFY_#]
Incluido(a) usted, si es que vivía con ^{FILL_YOUTHNAME}, ¿quiénes eran los adultos con los que vivía
^{FILL_YOUTHNAME} cuando cumplió los 11 años? Seleccione todas las que correspondan. Por favor,
indíquese usted mismo si vivía con el niño en ese momento y una relación para cualquier otro adulto
con el que ^{FILL_YOUTHNAME} vivía en ese momento. Seleccione solo una relación por adulto.

SPANISH

0. Usted [PCCL_039A_#]
1. Madre biológica [PCCL_039B_#]
2. Padre biológico [PCCL_039C_#]
3. Madrastra [PCCL_039D_#]
4. Padrastro [PCCL_039E_#]
5. Madre adoptiva [PCCL_039F_#]
6. Padre adoptivo [PCCL_039G_#]
7. Pareja de hecho de un(a) padre/madre [PCCL_039H_#]
8. Abuela [PCCL_039I_#]
9. Abuelo [PCCL_039J_#]
10. Hermano(a) de sangre, medio(a) hermano(a) o hermanastro(a) [PCCL_039K_#]
11. Otros(as) familiar(es) [PCCL_039L_#]
14. Padre/madre(s) de acogida/temporal(es) designados(as) por el tribunal [PCCL_039M_#]

15. Otra(s) persona(s) que no son familiar(es) [PCCL_039N_#]
16. Otros (especifique:___________________________________________) [PCCL_028O_#]
[PCCL_028O_SPECIFY_#]
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

PCCL_039O_SPECIFY: 100 characters
15
Code variable as 1 if checked, 0 if not.
If response 16 selected, display text box PCCL_039O_SPECIFY
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If number of items selected is > PCCL_038, display hard check: “You reported that
^{FILLYOUTHNAME} was living with {PCCL_038} adults. Please only select one
relationship per adult.”
If number of items selected is > PCCL_038, display hard check: “Usted informó que
^{FILLYOUTHNAME} vivía con {PCCL_038} adulto(s). Seleccione solo una relación por
adulto.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_038
If PCCL_039 ≠ -DK or REF: PCCL_040
Else if PCCL_034 > 0: PCCL_044
Else: PCCL_045

PCCL_040_#
ASK

PCCL_039 ≠ DK or REF

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

2
Computer check, do not display.
Computer select first 2 relationships reported in PCCL_039, store as PCCL_040_#_1 and
PCCL_040_#_2
0 Respondent
1 Biological mother
2 Biological father
3 Adoptive mother
4 Adoptive father
5 Stepmother
6 Stepfather
Loop though PCCL Loop 1d (PCCL_041_#_# through PCCL_043_LOOP_END_#_#) for max 2
parent figures identified in PCCL_040

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_039
PCCL_041 (Begin PCCL Loop 1d)

PCCL_041_#_#
ASK

All respondents (Begin PCCL LOOP 1d)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_041: If PCCL_040 = 0, FILL_PCCL_041: “Were you”
Else if PCCL_040 = 1, FILL_PCCL_041: “Was ^{FILL_YOUTHNAME}’s biological mother”
Else if PCCL_040 = 2, FILL_PCCL_041: “Was ^{FILL_YOUTHNAME}’s biological father"
FILLS (ENG)
Else if PCCL_040 = 3, FILL_PCCL_041: “Was ^{FILL_YOUTHNAME}’s adoptive mother”
Else if PCCL_040 = 4, FILL_PCCL_041: “Was ^{FILL_YOUTHNAME}’s adoptive father”
Else if PCCL_040 = 5, FILL_PCCL_041: “Was ^{FILL_YOUTHNAME}’s step-mother”
Else if PCCL_040 = 6, FILL_PCCL_041: “Was ^{FILL_YOUTHNAME}’s step-father”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_041: If PCCL_040 = 0, FILL_PCCL_041: “Usted”
Else if PCCL_040 = 1, FILL_PCCL_041: “La madre biológica de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 2, FILL_PCCL_041: “El padre biológico de ^{FILL_YOUTHNAME}"
FILLS (SPAN)
Else if PCCL_040 = 3, FILL_PCCL_041: “La madre adoptiva de^{FILL_YOUTHNAME}”
Else if PCCL_040 = 4, FILL_PCCL_041: “El padre adoptivo de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 5, FILL_PCCL_041: “La madrastra de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 6, FILL_PCCL_041: “El padrastro de ^{FILL_YOUTHNAME}”
^{FILL_PCCL_041} working full-time, part-time, or not at all at the time that ^{FILL_YOUTHNAME}
turned 11 years old?

ENGLISH

1.
2.
0.

Full-time
Part-time
Not at all

¿^{FILL_PCCL_041} trabajaba a tiempo completo, a tiempo parcial o no trabajaba en absoluto cuando
^{FILL_YOUTHNAME} cumplió los 11 años?
SPANISH

1.
2.
0.

Tiempo completo
Tiempo parcial
No trabajaba

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

2
Loop though PCCL Loop 1d (PCCL_041_#_# through PCCL_043_LOOP_END_#_#) for max 2
parent figures identified in PCCL_040

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_040
If PCCL_041 = 1 or 2: PCCL_042
Else: PCCL_043_LOOP_END

f_PCCL_042_#_#
PCCL_042_#_# / PCCL_042_SPECIFY_#_#
If PCCL_041 = 1 or 2
ASK
(Continue PCCL LOOP 1d)
Radio button: PCCL_042
QUESTION TYPE
Textbox: PCCL_042_SPECIFY
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_042: If PCCL_040 = 0, FILL_PCCL_042: “were you”
Else if PCCL_040 = 1, FILL_PCCL_042: “was ^{FILL_YOUTHNAME}’s biological mother”
Else if PCCL_040 = 2, FILL_PCCL_042: “was ^{FILL_YOUTHNAME}’s biological father"
FILLS (ENG)
Else if PCCL_040 = 3, FILL_PCCL_042: “was ^{FILL_YOUTHNAME}’s adoptive mother”
Else if PCCL_040 = 4, FILL_PCCL_042: “was ^{FILL_YOUTHNAME}’s adoptive father”
Else if PCCL_040 = 5, FILL_PCCL_042: “was ^{FILL_YOUTHNAME}’s step-mother”
Else if PCCL_040 = 6, FILL_PCCL_042: “was ^{FILL_YOUTHNAME}’s step-father”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_042: If PCCL_040 = 0, FILL_PCCL_042: “usted”
Else if PCCL_040 = 1, FILL_PCCL_042: “la madre biológica de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 2, FILL_PCCL_042: “el padre biológico de ^{FILL_YOUTHNAME}"
FILLS (SPAN)
Else if PCCL_040 = 3, FILL_PCCL_042: “la madre adoptiva de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 4, FILL_PCCL_042: “el padre adoptivo de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 5, FILL_PCCL_042: “la madrastra de ^{FILL_YOUTHNAME}”
Else if PCCL_040 = 6, FILL_PCCL_042: “el padrastro de ^{FILL_YOUTHNAME}”
What kind of work ^{FILL_PCCL_042} doing at the time that ^{FILL_YOUTHNAME} turned 11?

ENGLISH

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.

Management
Business or Financial Operations
Computer or Mathematical Services
Architecture or Engineering
Life Sciences, Physical Sciences, or Social Sciences
Community or Social Services
Legal Services
Education, Instruction or Library services
Arts, Design, Entertainment, Sports, or Media
Healthcare or related Technical Services
Healthcare Support Services
Security and safety services (including police and fire)
Food Preparation or Service-Related Work
Building and Grounds Cleaning or Maintenance
Personal Care or Services
Sales or Related Services
Office or Administrative Support
Farming, Fishing, or Forestry
Construction or Extraction Services
Installation, Maintenance, or Repair
Manufacturing, Assembly, or Production
Transportation or Material Moving
Other (please specify: ________________________) [PCCL_042_SPECIFY_#_#]

¿Qué tipo de trabajo realizaba ^{FILL_PCCL_042} en el momento en que ^{FILL_YOUTHNAME} cumplió
los 11 años?
1.

Gerencia

2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.

Operaciones comerciales o financieras
Servicios informáticos o matemáticos
Arquitectura o ingeniería
Ciencias de la vida, ciencias físicas o ciencias sociales
Servicios comunitarios o sociales
Servicios legales
Servicios de educación, instrucción o biblioteca
Artes, diseño, entretenimiento, deportes o medios de comunicación
Servicios técnicos de salud o afines
Servicios de apoyo de salud
Servicios de seguridad y protección (incluidos policía y bomberos)
Preparación de alimentos o trabajos relacionados con los servicios
Limpieza o mantenimiento de edificios y terrenos
Cuidados o servicios personales
Ventas o servicios relacionados
Apoyo administrativo o de oficina
Agricultura, pesca o silvicultura
Servicios de construcción o extracción
Instalación, mantenimiento o reparación
Fabricación, montaje o producción
Transporte o movimiento de materiales
Otros (especifique: ________________________) [PCCL_042_SPECIFY_#_#]

RANGE
LIMITS

PCCL_042_SPECIFY: Max 100 characters

LOOP MAX

2
If response 23 is selected, display text box PCCL_042_SPECIFY_#_#. Loop though PCCL
Loop 1d (PCCL_041_#_# through PCCL_043_LOOP_END_#_#) for max 2 parent ﬁgures
identiﬁed in PCCL_040.
If PCCL_042_SPECIFY left empty, display default soft check.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

If PCCL_042_SPECIFY left empty, display default soft check.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_041
PCCL_043_LOOP_END

PCCL_043_LOOP_END_#_#
All respondents
ASK
(End PCCL LOOP 1d)
QUESTION TYPE
Computer check
FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

2
Computer check, do not display.
Loop though PCCL Loop 1d (PCCL_041_#_# through PCCL_043_LOOP_END_#_#) for max 2
parent figures identified in PCCL_040

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_041, PCCL_042
Else if LOOPNUMBER_1d = 1 and PCCL_040_#_2 not missing: Loop again (PCCL_041_#_#)
Else if PCCL_034 >0: PCCL_044
Else: PCCL_045

PCCL_044_#
ASK

PCCL_034 > 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_034: ‘PCCL_034’
Create ﬁll, FILL_PCCL_044: If PCCL_034=1, FILL_PCCL_044: ‘one other child’
Else FILL_PCCL_044: ‘^{FILL_PCCL_034} other children’
Create ﬁll, FILL_PCCL_035: Fill all responses collected in f_PCCL_035. If more than one
selected, separate each by “and”:
If PCCL_035A = 1 (selected), ﬁll “full siblings”
If PCCL_035B = 1 (selected), ﬁll “half or step siblings”
If PCCL_035C = 1 (selected), ﬁll “adoptive siblings”
If PCCL_035D = 1 (selected), ﬁll “other relatives”
If PCCL_035E = 1 (selected), ﬁll “children of mother’s
partner/boyfriend/girlfriend”
If PCCL_035F = 1 (selected), ﬁll “children of father’s partner/boyfriend/girlfriend”
If PCCL_035G = 1 (selected), ﬁll “other unrelated children”

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_034: ‘PCCL_034’
Create ﬁll, FILL_PCCL_044: If PCCL_034=1, FILL_PCCL_044: ‘otro(a) niño(a)’
Else FILL_PCCL_044: ‘^{FILL_PCCL_034} otros(as) niño (as)’
Create ﬁll, FILL_PCCL_035: Fill all responses collected in f_PCCL_035. If more than one
selected, separate each by “y”:
If PCCL_035A = 1 (selected), ﬁll “hermanos(as) de sangre”
If PCCL_035B = 1 (selected), ﬁll “medios(as) hermanos(as) o hermanastros(as)”
If PCCL_035C = 1 (selected), ﬁll “hermanos(as) adoptivos(as)”
If PCCL_035D = 1 (selected), ﬁll “otros(as) familiar(es)”
If PCCL_035E = 1 (selected), ﬁll “hijos(as) de la pareja/novio(a) de la madre”
If PCCL_035F = 1 (selected), ﬁll “hijos(as) de la pareja/novio(a) del padre”
If PCCL_035G = 1 (selected), ﬁll “otros(as) hijos(as) sin parentesco”

FILLS (SPAN)

ENGLISH

SPANISH

RANGE
LIMITS

You reported that on their 6th birthday, ^{FILL_YOUTHNAME} was living with ^{FILL_PCCL_044},
including ^{FILL_PCCL_035}. Was ^{FILL_YOUTHNAME} living with these same children on their 11th
birthday?
1.
0.

Yes, living with the same number and relationships with children
No, living with fewer, different, or additional children

Usted informó que, cuando cumplió los 6 años, ^{FILL_YOUTHNAME} vivía con ^{FILL_PCCL_044}, lo
que incluía a ^{FILL_PCCL_035}. ¿Vivía ^{FILL_YOUTHNAME} con estos mismos niños(as) cuando
cumplió los 11 años?
1.
0.

Sí, vivía con el mismo número de niños(as), con los mismos parentescos
No, vivía con menos niños(as), otros(as) o más

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_043_LOOP_END, PCCL_039
If PCCL_044 = 1: and PCCL_036CT != (DK, REF) and PCCL_036ST != (DK, REF): PCCL_048a
Else if PCCL_044 = 1: f_PCCL_048
Else: PCCL_045

PCCL_045_#
ASK

PCCL_044 ≠ 1 OR PCCL_034 < 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Was ^{FILL_YOUTHNAME} living with any children on their 11th birthday?
ENGLISH

1.
0.

Yes
No

¿Vivía ^{FILL_YOUTHNAME} con algún(a) otro(a) niño(a) cuando cumplió los 11 años?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_043_LOOP_END, PCCL_044, PCCL_039
If PCCL_045 = 0: and PCCL_036CT != (DK, REF) and PCCL_036ST != (DK, REF): PCCL_048a
Else if PCCL_045 = 0: f_PCCL_048
Else: PCCL_046

PCCL_046_#
ASK

PCCL_045 ≠ 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
How many children was ^{FILL_YOUTHNAME} living with on their 11th birthday?
ENGLISH

_______________ children
¿Con cuántos niños(as) vivía ^{FILL_YOUTHNAME} cuando cumplió los 11 años?

SPANISH

_______________ niños(as)

RANGE

0-20

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_045
If PCCL_046 = 0: and PCCL_036CT != (DK, REF) and PCCL_036ST != (DK, REF): PCCL_048a
Else if PCCL_046 = 0: f_PCCL_048
Else: f_PCCL_047

f_PCCL_047_#
PCCL_047A_# / PCCL_047B_# / PCCL_047C_# / PCCL_047D_# / PCCL_047E_# / PCCL_047F_# / PCCL_047G_#
ASK
PCCL_046 ≠ 0(Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Who were the children that ^{FILL_YOUTHNAME} was living with on their 11th birthday? Please select
all that apply.
1.
2.
3.
4.
5.
6.
7.

ENGLISH

Full siblings [PCCL_047A_#]
Half or step siblings [PCCL_047B_#]
Adoptive siblings [PCCL_047C_#]
Other relatives [PCCL_047D_#]
Children of mother’s partner/boyfriend/girlfriend [PCCL_047E_#]
Children of father’s partner/boyfriend/girlfriend [PCCL_047F_#]
Other unrelated children [PCCL_047G_#]

¿Quiénes eran los niños(as) con los que vivía ^{FILL_YOUTHNAME} cuando cumplió los 11 años?
Seleccione todas las que correspondan.

SPANISH

1.
2.
3.
4.
5.
6.
7.

Hermanos(as) de sangre [PCCL_047A_#]
Medios(as) hermanos(as) o hermanastros(as) [PCCL_047B_#]
Hermanos(as) adoptivos(as) [PCCL_047C_#]
Otros(as) familiares [PCCL_047D_#]
Hijos(as) de la pareja/novio(a) de la madre [PCCL_047E_#]
Hijos(as) de la pareja/novio(a) del padre [PCCL_047F_#]
Otros(as) hijos(as) sin parentesco [PCCL_047G_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

HELP TEXT (SPAN)

MODE
NOTES

Full siblings share both biological parents
Half siblings share one biological parent and step-siblings became siblings through
marriage
Adoptive siblings who share neither biological parent
Los hermanos(as) de sangre comparten ambos(as) padres/madres biológicos(as)
Los medios(as) hermanos(as) comparten un(a) padre/madre biológico(a) y los(as)
hermanastros(as) se convirtieron en hermanos(as) a través del matrimonio
Hermanos(as) adoptivos(as) que no comparten ninguno de sus padres/madres
biológicos(as)
CASI/CAWI

LEAD-IN
NEXT

PCCL_046
If PCCL_036CT != (DK, REF) and PCCL_036ST != (DK, REF): PCCL_048a
Else: f_PCCL_048

PCCL_048a_#
ASK

If PCCL_036CT != (DK, REF) and PCCL_036ST != (DK, REF) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (ENG)

Create ﬁll, FILL_PCCL_036CT: ‘PCCL_036_CT’
Create ﬁll, FILL_PCCL_036ST: ‘PCCL_036_ST’
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)

Create ﬁll, FILL_PCCL_036CT: ‘PCCL_036_CT’
Create ﬁll, FILL_PCCL_036ST: ‘PCCL_036_ST’

On their 11th birthday, was ^{FILL_YOUTHNAME} still living in ^{FILL_PCCL_036CT },^{FILL_
PCCL_036ST }?
ENGLISH

1. Yes
0. No
En su undécimo cumpleaños, ¿^{FILL_YOUTHNAME} todavía vivía en ^{FILL_PCCL_036CT }, ^{FILL_
PCCL_036ST}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If “yes” (1) to PCCL_048a then set PCCL_048_CT to the value of PCCL_036_CT, and set
PCCL_048_ST to the value of PCCL_036_ST.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_047, PCCL_045 = 0, PCCL_044 = 1, PCCL_046 = 0
If PCCL_048a=1: PCCL_049
Else: PCCL_048

f_PCCL_048_#
PCCL_048_CT_#/PCCL_048_ST_#
ASK
If PCCL_048a ≠ 1 (Continue PCCL Loop 1)
Textbox: PCCL_048_CT
QUESTION TYPE
Dropdown: PCCL_048_ST
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what city and state was ^{FILL_YOUTHNAME} living on their 11th birthday?
ENGLISH

City: ________________ [PCCL_048_CT_#]
State: { - Select - } [PCCL_048_ST_#]
¿En qué ciudad y estado vivía ^{FILL_YOUTHNAME} cuando cumplió los 11 años?

SPANISH

Ciudad: ________________ [PCCL_048_CT_#]
Estado: { - Seleccione - } [PCCL_048_ST_#]

RANGE

PCCL_048_ST: List states on STATENOTUS list

LIMITS

PCCL_048_CT: Max 100 characters

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_048a
PCCL_049

PCCL_049_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Next, I would like you to think about the places ^{FILL_YOUTHNAME} has lived. By places we mean a
house, apartment, or other type of residence.

ENGLISH

How many different places or addresses total, did ^{FILL_YOUTHNAME} live at, from birth until their
11th birthday?
__________________different places

Ahora, quisiera que pensara en los lugares en los que ha vivido ^{FILL_YOUTHNAME}. Por “lugares”,
entendemos una casa, apartamento u otro tipo de residencia.

SPANISH

¿En cuántos lugares o direcciones diferentes, en total, vivió ^{FILL_YOUTHNAME}, desde su nacimiento
hasta que cumplió los 11 años?
__________________lugares diferentes

RANGE

1-99

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_049_# OUT OF RANGE (=0) DISPLAY HARD CHECK: ‘Please enter a number
between 1 and 99 for the number of places that ^{FILL_YOUTHNAME} lived. If they have
always lived at the same place, please enter ‘1.’’
If PCCL_049_# OUT OF RANGE (=0) DISPLAY HARD CHECK: ‘Ingrese un número entre el 1 y
el 99 para indicar el número de lugares en los que vivió ^{FILL_YOUTHNAME}. Si siempre
han vivido en el mismo lugar, ingrese ‘1’.’

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_048a, PCCL_048
f_PCCL_050

f_PCCL_050_#
PCCL_050A_# / PCCL_050B_# / PCCL_050C_# / PCCL_050D_# / PCCL_050E_# / PCCL_050F_# / PCCL_050G_# /
PCCL_050H_# / PCCL_050H_SPECIFY_#
ASK
All respondents (Continue PCCL Loop 1)
Radio grid: PCCL_050A, PCCL_050B, PCCL_050C, PCCL_050D, PCCL_050E, PCCL_050F,
QUESTION TYPE
PCCL_050G, PCCL_050H
Textbox: PCCL_050H_SPECIFY
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Sometimes parents and children live apart from their families. Children might live at boarding school,
in a hospital, or in a group home.
Did ^{FILL_YOUTHNAME} ever live away from their parents in any of these type of places for a month
or more? Please respond “Yes” or “No” for each.
COLUMN HEADERS:
1. Yes
0. No
ENGLISH

ROW ITEMS:
a. Military base [PCCL_050A_#]
b. Boarding school or college [PCCL_050B_#]
c. Correctional facility or jail [PCCL_050C_#]
d. Hospital or mental health treatment facility [PCCL_050D_#]
e. Summer camp/resort [PCCL_050E_#]
f. Group home or shelter [PCCL_050F_#]
g. Orphanage, children's home, or refugee camp [PCCL_050G_#]
h. Other (please specify: __________________________) [PCCL_050H_#]
[PCCL_050H_SPECIFY_#]
A veces, los padres, las madres y los(as) hijos(as) viven separados de sus familias. Los(as) niños(as)
pueden vivir en un internado, en un hospital o en un hogar grupal.
¿Ha vivido ^{FILL_YOUTHNAME} alguna vez lejos de sus padres/madres en alguno de estos tipos de
lugares durante un mes o más? Responda “sí” o “no” para cada opción.
COLUMN HEADERS:
1. Sí
0. No

SPANISH

ROW ITEMS:
a. Base militar [PCCL_050A_#]
b. Internado o instituto superior [PCCL_050B_#]
c. Correccional o cárcel [PCCL_050C_#]
d. Hospital o centro de tratamiento de salud mental [PCCL_050D_#]
e. Campamento de verano/centro vacacional [PCCL_050E_#]
f. Hogar grupal o refugio [PCCL_050F_#]
g. Orfanato, hogar para niños o campo de refugiados [PCCL_050G_#]
h. Otros (especifique: __________________________) [PCCL_050H_#]
[PCCL_050H_SPECIFY_#]

RANGE
LIMITS

PCCL_050H_SPECIFY: 100 characters

LOOP MAX

15
If PCCL_050H is selected, display text box PCCL_050H_SPECIFY

PROGRAM. NOTES

Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_049
PCCL_051

PCCL_051_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did ^{FILL_YOUTHNAME} ever live in state-sponsored foster care? This includes settings such as a
family foster home, a relative foster home, a group home, institution, or supervised independent
living.
ENGLISH
1. Yes
0. No

SPANISH

¿Vivió ^{FILL_YOUTHNAME} alguna vez en un centro de cuidado de crianza patrocinado por el estado?
Esto incluye entornos como un hogar de cuidado de crianza de una familia o de parientes, un hogar
grupal, una institución o la vida independiente supervisada.
1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_050
If PCCL_051 = 1: PCCL_052
Else if YOUTH_RPCPLG = 3: PCCL_061
Else: PCCL_055

PCCL_052_#
ASK

PCCL_051 = 1 (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In how many different foster care settings or locations did ^{FILL_YOUTHNAME} live?
ENGLISH

_________________ settings or locations
¿En cuántos entornos o lugares diferentes de cuidado de crianza vivió ^{FILL_YOUTHNAME} ?

SPANISH

_________________ entornos o lugares

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_051 = 1
PCCL_053

PCCL_053_#
ASK

PCCL_051 = 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Approximately how much time did ^{FILL_YOUTHNAME} spend in foster care total during their life?
1.
2.
3.
4.
5.
9.

ENGLISH

Less than six months
At least six months, but less than a year
At least a year but less than two years
At least two years but less than three years
Three years or more
Don't know

Aproximadamente, ¿cuánto tiempo pasó ^{FILL_YOUTHNAME} en total en cuidado de crianza durante
su vida?

SPANISH

1.
2.
3.
4.
5.
9.

Menos de seis meses
Al menos seis meses, pero menos de un año
Al menos un año pero menos de dos
Al menos dos años pero menos de tres
Cinco años o más
No sé

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_052
PCCL_054

PCCL_054_#
ASK
QUESTION TYPE
FILLS (ENG)

PCCL_051 = 1 (Continue PCCL Loop 1)
Numeric
Radio button special answer option
Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
The last time ^{FILL_YOUTHNAME} left foster care, how old were they?
ENGLISH

Age in years: _________
-9. They were less than one year old when they left foster care.
La última vez que ^{FILL_YOUTHNAME} salió del cuidado de crianza, ¿qué edad tenía?

SPANISH

Edad en años: _________

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

-9. Tenía menos de un año cuando salió del cuidado de crianza
1-19
Max 2 digits
15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_053
If YOUTH_RPCPLG = 3: PCCL_061
Else: PCCL_055

PCCL_055_#
ASK

YOUTH_RPCPLG ≠ 3 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
The next few questions are about legal documents indicating who is responsible for
^{FILL_YOUTHNAME}. First, who is listed as a parent on ^{FILL_YOUTHNAME}'s birth certificate? Are
two parents listed, or is only the birth mother listed?
ENGLISH
1.
2.

SPANISH

Two parents
Birth mother only

Las siguientes preguntas son sobre los documentos legales que indican quién es el responsable de
^{FILL_YOUTHNAME}. En primer lugar, ¿quién figura como padre/madre en el certificado de
nacimiento de ^{FILL_YOUTHNAME}? ¿Están los dos padres/madres enumerados, o solo la madre
biológica?
1.
2.

Los dos padres/madres
Solo la madre biológica

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_051, PCCL_054
If PCCL_055 = 2: PCCL_056
Else: PCCL_061

PCCL_056_#
ASK

PCCL_055 = 2 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_056A: If YOUTH_RPCPLG=1 and PCSEX=1, FILL_PCCL_056A: “Have
you”
FILLS (ENG)
Else FILL_PCCL_056A: “Has ^{FILL_YOUTHNAME}’s biological father”
Create ﬁll, FILL_PCCL_056B: If YOUTH_RPCPLG=1 and PCSEX=1, FILL_PCCL_056B: “your”
Else FILL_PCCL_056B: “his”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_056A: If YOUTH_RPCPLG=1 and PCSEX=1, FILL_PCCL_056A: “Usted”
FILLS (SPAN)
Else FILL_PCCL_056A: “El padre biológico de ^{FILL_YOUTHNAME}”
Create ﬁll, FILL_PCCL_056B: If YOUTH_RPCPLG=1 and PCSEX=1, FILL_PCCL_056B: “su”
Else FILL_PCCL_056B: “su”
^{FILL_PCCL_056A} done any of the following things...

ENGLISH

Signed ^{FILL_PCCL_056B} own name on the application for ^{FILL_YOUTHNAME}’s birth certificate?
1. Yes
0. No

¿^{FILL_PCCL_056A} hizo alguna de las siguientes cosas?
SPANISH

¿Firmó con ^{FILL_PCCL_056B} propio nombre en la solicitud del certificado de nacimiento de
^{FILL_YOUTHNAME}?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_055 = 2
If PCCL_056 = 1: PCCL_061
Else: PCCL_057

PCCL_057_#
ASK

PCCL_056 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_057: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_057: “Have
FILLS (ENG)
you”
Else FILL_PCCL_057: “Has ^{FILL_YOUTHNAME}’s biological father”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_057: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_057: “¿Se le
FILLS (SPAN)
ha identiﬁcado a usted”
Else FILL_PCCL_057: “¿Se ha identiﬁcado al padre biológico de ^{FILL_YOUTHNAME}”
^{FILL_PCCL_057}

ENGLISH

...been legally identified as the child's father by a blood test or other genetic test?
1.
0.

Yes
No

^{FILL_PCCL_057}
SPANISH

...legalmente como padre del(a) niño(a) mediante un análisis de sangre u otra prueba genética?
1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_056
If PCCL_057 = 1: PCCL_061
Else: PCCL_058

PCCL_058_#
ASK

PCCL_057 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_058: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_058: “Have
FILLS (ENG)
you”
Else FILL_PCCL_058: “Has ^{FILL_YOUTHNAME}’s biological father”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_058: If YOUTHPLG = 1 and PCSEX = 1, FILL_PCCL_058: “¿Se le ha
FILLS (SPAN)
identiﬁcado a usted”
Else FILL_PCCL_058: “¿Se ha identiﬁcado al padre biológico de ^{FILL_YOUTHNAME}”
^{FILL_PCCL_058}...
... been legally identified as the child's father in a court ruling?

ENGLISH
1.
0.

Yes
No

^{FILL_PCCL_058}...

SPANISH

...legalmente como padre del(a) niño(a) en una sentencia judicial?
1 Sí
0 No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_057
If PCCL_058 = 1: PCCL_061
Else: PCCL_059

PCCL_059_#
ASK

PCCL_058 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_059A: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_059A:
“Have you”
Else FILL_PCCL_059A: “Has ^{FILL_YOUTHNAME}’s biological father”

FILLS (ENG)

Create ﬁll, FILL_PCCL_059B: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_059B: “you
are”
Else FILL_PCCL_059B: “he is”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_059A: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_059A:
“¿Usted”
Else FILL_PCCL_059A: “¿El padre biológico de ^{FILL_YOUTHNAME}”

FILLS (SPAN)

Create ﬁll, FILL_PCCL_059B: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_059B:
“usted”
Else FILL_PCCL_059B: “él”
^{FILL_PCCL_059A}...
... signed a statement that legally specifies that ^{FILL_PCCL_059B} the child's father?
ENGLISH

1
0.

Yes
No

^{FILL_PCCL_059A}...
SPANISH

...firmó una declaración que especifica legalmente que ^{FILL_PCCL_059B} es el padre del(a)
niño(a)?
1.
0

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_058
If PCCL_059 = 1: PCCL_061
Else: PCCL_060

PCCL_060_#
ASK

PCCL_059 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button
Use ﬁll from PCCL_059: FILL_PCCL_059A
FILLS (ENG)
Create ﬁll, FILL_PCCL_060: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_060: “you”
Else, FILL_PCCL_060: “him”
Use ﬁll from PCCL_059: FILL_PCCL_059A
FILLS (SPAN)
Create ﬁll, FILL_PCCL_060: If YOUTH_RPCPLG = 1 and PCSEX = 1, FILL_PCCL_060: “usted”
Else, FILL_PCCL_060: “él”
^{FILL_PCCL_059A}...

ENGLISH

... signed any other papers (for example, insurance forms, a personal letter or card) that would identify
^{FILL_PCCL_060} as the child's father?
1.
0.

Yes
No

^{FILL_PCCL_059A}...

SPANISH

...firmó algún otro documento (por ejemplo, formularios del seguro, una carta personal o una tarjeta)
que lo(a) identificara a ^{FILL_PCCL_060} como padre de este(a) niño(a)?
1.
0

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_059
PCCL_061

PCCL_061_#
ASK

All respondents (continue PCCL Loop 1)

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Computer check, do not display.
PCCL_061 Computer check:
If YOUTH_MOTHER = 1 and YOUTH_FATHER = 1 (youth living with both biological
parents): code PCCL_061 = 1
Else: code PCCL_061 = 0
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth
on YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_051, PCCL_054, PCCL_055, PCCL_056 = 1, PCCL_057 = 1, PCCL_058 = 1,
PCCL_059 = 1, PCCL_060
If PCCL_061 = 1: PCCL_070
Else: PCCL_062

PCCL_062_#
ASK

PCCL_061 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever been legally adopted?
ENGLISH

1.
0.

Yes
No

¿Ha sido ^{FILL_YOUTHNAME} adoptado(a) legalmente?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_061
If PCCL_062 = 1: PCCL_063
Else: PCCL_064

PCCL_063_#
ASK

PCCL_062 = 1 (Continue PCCL Loop 1)

QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
ENGLISH

SPANISH
RANGE

Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what year was the adoption made final?
Year: { - Select - }
¿En qué año se hizo definitiva la adopción?
Año: { - Seleccione - }
PCCL_063: List years 2030-2010 in reverse chronological order: 2030, 2029, 2028, 2027,
2026, 2025, 2024, 2023…

LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

15
Do not display years that are in the future on DOI.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_063_# before YOUTH_DOBYEAR, display hard check:
Year that adoption was ﬁnalized should be after ^{FILL_YOUTHNAME} was born. Please
review your answer.
If PCCL_063_# before YOUTHDOB, display hard check:
El año en que se ﬁnalizó la adopción debe ser posterior al nacimiento de
^{FILL_YOUTHNAME}. Revise su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_062 = 1
PCCL_064

PCCL_064_#
ASK

PCCL_061 ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has legal responsibility for ^{FILL_YOUTHNAME} ever been specified in a custody award or
agreement?
ENGLISH

1.
0.

Yes
No

¿Se ha especificado alguna vez la responsabilidad legal de ^{FILL_YOUTHNAME} en una sentencia o
acuerdo de custodia?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_062, PCCL_063
If PCCL_064 = 1: PCCL_065_LOOP_BEGIN
Else: PCCL_070

PCCL_065_LOOP_BEGIN_#_#
ASK

PCCL_064 = 1 (Begin PCCL LOOP 1e)

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

8
Computer check, do not display.
Loop through PCCL Loop 1e (PCCL_065_LOOP_BEGIN – PCCL_069_LOOP_END) until
PCCL_068=0 or until max loops reached (8.)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_064 = 1
f_PCCL_066

f_PCCL_066_#_#
PCCL_066_MO_#_# / PCCL_066_YR_#_#
PCCL_064 = 1
ASK
(Continue PCCL LOOP 1e)
PCCL_066_MO: Dropdown
QUESTION TYPE
PCCL_066_YR: Dropdown
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_066: If LOOPNUMBER_1e = 1, FILL_PCCL_066: “ﬁrst speciﬁed”
FILLS (ENG)
Else if LOOPNUMBER_1e = 2, FILL_PCCL_066: “ﬁrst changed”
Else FILL_PCCL_066: “next changed”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_066: If LOOPNUMBER_1e = 1, FILL_PCCL_066: “se especiﬁcó por
FILLS (SPAN)
primera vez”
Else if LOOPNUMBER_1e = 2, FILL_PCCL_066: “se cambió por primera vez”
Else FILL_PCCL_066: “se cambió la siguiente vez”
In what month and year was custody for ^{FILL_YOUTHNAME} ^{FILL_PCCL_066}?
ENGLISH

SPANISH

RANGE

Month: { - Select - } [PCCL_066_MO_#_#]
Year: { - Select - } [PCCL_066_YR_#_#]
¿En qué mes y año ^{FILL_PCCL_066} la custodia para ^{FILL_YOUTHNAME}?
Mes: { - Seleccione - } [PCCL_066_MO_#_#]
Año: { - Seleccione - } [PCCL_066_YR_#_#]
PCCL_066_MO: List months in order. 1 = “January”, 2 = “February”,… 12 = “December”
PCCL_066_YR: List years 2030-2010 in reverse chronological order: 2030, 2029, 2028,
2027…

LIMITS
LOOP MAX
PROGRAM. NOTES

8
Do not display years that are in the future on DOI
Loop through PCCL Loop 1e (PCCL_065_LOOP_BEGIN – PCCL_069_LOOP_END) until
PCCL_068=0 or until max loops reached (88.)
If PCCL_066_YR_#_# before YOUTH_DOBYEAR, display hard check:
Date of custody determination should be after ^{FILL_YOUTHNAME} was born. Please
review your answer.
If PCCL_066_#_# after DOI, display hard check:
Please enter a date that is in the past.

CHECK (ENG)

CHECK (SPAN)

If month/year entered in PCCL_066_# loops 2-8 is before a date entered on loop 1 for
the same child, display hard check: “You previously reported that custody for
^{FILL_YOUTHNAME} was ﬁrst speciﬁed in ^{FILL_PCCL_066_MO_#_#}
^{FILL_PCCL_066_YR_#_#}. Please review your answers.”
If month/year entered in PCCL_066_# in loops 3-8 is before a date entered on any prior
loop for the same child (e.g., date entered in loop 4 is before date entered in loop 3),
display hard check: “You previously reported that custody for ^{FILL_YOUTHNAME} was
last changed in ^{FILL_PCCL_066_MO_#_#} & ^{FILL_PCCL_066_YR_#_#}. Please review
your answers.”
If PCCL_066_YR_#_# before YOUTH_DOBYEAR, display hard check:
La fecha de determinación de la custodia debe ser posterior al nacimiento de
^{FILL_YOUTHNAME}. Revise su respuesta.

If month/year entered in PCCL_066_# loops 2-8 is before a date entered on loop 1 for
the same child, display hard check: “Anteriormente informó que la custodia de
^{FILL_YOUTHNAME} se especiﬁcó por primera vez en ^{FILL_PCCL_066_MO_#_#} de
^{FILL_PCCL_066_YR_#_#}. Revise su respuesta.”
If month/year entered in PCCL_066_# in loops 3-8 is before a date entered on any prior
loop for the same child (e.g., date entered in loop 4 is before date entered in loop 3),
display hard check: “Anteriormente informó que la custodia de ^{FILL_YOUTHNAME} se
modiﬁcó por última vez en ^{FILL_PCCL_066_MO_#_#} de ^{FILL_PCCL_066_YR_#_#}.
Revise su respuesta.”
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_065_LOOP_BEGIN
PCCL_067

PCCL_067_#_#

QUESTION TYPE

PCCL_064 = 1
(Continue PCCL LOOP 1e)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did you receive legal custody of ^{FILL_YOUTHNAME} in this agreement?
ENGLISH

1.
0.

Yes
No

¿Recibió la custodia legal de ^{FILL_YOUTHNAME} en este acuerdo?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

8
Loop through PCCL Loop 1e (PCCL_065_LOOP_BEGIN – PCCL_069_LOOP_END) until
PCCL_068=0 or until max loops reached (8.)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_066
PCCL_068

PCCL_068_#_#

QUESTION TYPE

PCCL_064 = 1
(Continue PCCL LOOP 1e)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has the legal custody status of ^{FILL_YOUTHNAME} changed since then?
ENGLISH

1.
0.

Yes
No

¿Ha cambiado la situación de la custodia legal de ^{FILL_YOUTHNAME} desde entonces?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

8
Loop through PCCL Loop 1e (PCCL_065_LOOP_BEGIN – PCCL_069_LOOP_END) until
PCCL_068=0 or until max loops reached (8.)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_067
PCCL_069_LOOP_END

PCCL_069_LOOP_END_#_#
PCCL_064 = 1
ASK
(End PCCL LOOP 1e)
QUESTION TYPE
Loop Logic
FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

8
Loop logic, do not display.
Loop through PCCL Loop 1e (PCCL_065_LOOP_BEGIN – PCCL_069_LOOP_END) until
PCCL_068=0 or until max loops reached (8.)

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_068
If PCCL_068 = 1 and LOOPNUMBER_1e <8: Loop again (f_PCCL_066_#_#)
Else: f_PCCL_070

f_PCCL_070_1#
PCCL_070A_# / PCCL_070B_# / PCCL_070C_# / PCCL_070D_#
ASK
All respondents (continue PCCL Loop 1)
QUESTION TYPE

Radio grid

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
The next set of questions are about events that may have happened during ^{FILL_YOUTHNAME}’s life.
These things can happen in any family, but some people may feel uncomfortable with these questions.
You may skip any questions you do not want to answer.
Since ^{FILL_YOUTHNAME} was born….

ENGLISH

COLUMN HEADERS:
1. Yes
0. No
9. Don’t know
ROW ITEMS:
a. Have they ever been the victim of violence or witnessed violence in their
neighborhood? [PCCL_070A_#]
b. Have they been separated from a parent or guardian because the parent or
guardian was in jail, prison, or a detention center? [PCCL_070B_#]
c. Have they ever lived with someone who was mentally ill or severely depressed?
[PCCL_070C_#]
d. Have they ever lived with someone who was having a problem with alcohol or
drug use? [PCCL_070D_#]
Las siguientes preguntas son sobre acontecimientos que pudieron haber ocurrido durante la vida de
^{FILL_YOUTHNAME}. Estas cosas pueden ocurrir en cualquier familia, pero algunas personas pueden
sentirse incómodas con estas preguntas. Puede omitir las preguntas que no desee responder.
Desde que nació ^{FILL_YOUTHNAME}…

SPANISH

RANGE
LIMITS

COLUMN HEADERS:
1. Sí
0. No
9. No sé
ROW ITEMS:
a. ¿Alguna vez fue víctima de violencia o presenció actos violentos en su
vecindario? [PCCL_070A_#]
b. ¿Fue separado(a) de un(a) padre/madre o tutor(a) por estar el(la) padre/madre o
tutor(a) en una cárcel, prisión o centro de detención? [PCCL_070B_#]
c. ¿Ha vivido alguna vez con alguien que padeciera una enfermedad mental o una
depresión grave? [PCCL_070C_#]
d. ¿Ha vivido alguna vez con alguien que tuviera problemas con el alcohol o el
consumo de drogas? [PCCL_070D_#]

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_069_LOOP_END#, PCCL_061 = 1, PCCL_064
f_PCCL_070_2

f_PCCL_070_2#
PCCL_070E_# / PCCL_070F_# / PCCL_070G_# / PCCL_070H_# / PCCL_070I_#
ASK
All respondents (continue PCCL Loop 1)
QUESTION TYPE

Radio grid

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Since ^{FILL_YOUTHNAME} was born….
COLUMN HEADERS:
1. Yes
0. No
9. Don’t know
ENGLISH

ROW ITEMS:
e. Have they ever had a parent or guardian die? [PCCL_070E_#]
f. Have they ever had a parent or guardian divorce or separate? [PCCL_070F_#]
g. Have they ever lived with a parent or adult who frequently swore at them,
insulted them, or put them down? [PCCL_070G_#]
h. Has there ever been a time when their basic needs were NOT met, such as having
enough to eat, being able to go to a doctor when they were sick, or having a safe
place to stay? [PCCL_070H_#]
i. Have they ever been homeless, lived in a shelter or motel, or had NO regular place
to sleep at night? [PCCL_070I_#]
Las siguientes preguntas son sobre acontecimientos que pudieron haber ocurrido durante la vida de
^{FILL_YOUTHNAME}. Estas cosas pueden ocurrir en cualquier familia, pero algunas personas pueden
sentirse incómodas con estas preguntas. Puede omitir las preguntas que no desee responder.

SPANISH

Desde que nació ^{FILL_YOUTHNAME}…
COLUMN HEADERS:
1. Sí
1. No
9. No sé

ROW ITEMS:
e. ¿Ha experimentado alguna vez la muerte de un padre/madre o tutor(a)?
[PCCL_070E_#]
f. ¿Ha experimentado alguna vez el divorcio o la separación de su padre/madre o
tutor(a)? [PCCL_070F_#]
g. ¿Ha vivido alguna vez con un padre/madre o adulto que le dijera malas palabras o
insultos, o que lo(a) menospreciara? [PCCL_070G_#]
h. ¿Hubo alguna época en la que sus necesidades básicas NO estuvieran cubiertas,
como tener suﬁciente para comer, poder ir al doctor cuando estaba enfermo(a) o
tener un lugar seguro donde quedarse? [PCCL_070H_#]
i. ¿Alguna vez estuvo sin hogar, vivió en un refugio o motel o NO tuvo un lugar ﬁjo
donde dormir por la noche? [PCCL_070I_#]
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_070_1
PCCL_071

PCCL_071_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Next, there are some questions about childcare and schooling.
We'll start with childcare. We define childcare as any care given by someone other than a parent.
Childcare includes care by relatives, babysitters, and nannies. It also includes time when the child
attends daycare centers or preschools.
ENGLISH

During ^{FILL_YOUTHNAME}'s first year of life, did they ever spend twenty or more hours a week in
childcare?
1.
0.

Yes
No

Las siguientes preguntas son sobre el cuidado infantil y la escolarización.
Empezaremos por el cuidado infantil. Definimos el cuidado infantil como el cuidado prestado por
alguien que no sea el padre o la madre. El cuidado infantil incluye el cuidado por parte de familiares y
niñeros(as). También incluye el tiempo que el(la) niño(a) asiste a guarderías o centros preescolares.
SPANISH

Durante el primer año de vida de ^{FILL_YOUTHNAME}, ¿pasó alguna vez veinte o más horas a la
semana en una guardería?
1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_070
If PCCL_071 = 1: f_PCCL_072
Else: PCCL_073

f_PCCL_072_#
PCCL_072A_# / PCCL_072B_# / PCCL_072C_# / PCCL_072D_# / PCCL_072E_# / PCCL_072F_# /
PCCL_072F_SPECIFY_#
ASK
PCCL_071 = 1 (Continue PCCL Loop 1)
QUESTION TYPE

Radio grid and textbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
During ^{FILL_YOUTHNAME}’s first year of life, what regular sources of childcare were used for them?
Was ^{FILL_YOUTHNAME} regularly cared for by….
COLUMN HEADERS:
1. Yes
0. No
ROW ITEMS:
a. An in-home childcare provider? [PCCL_072A_#]
b. A childcare center? [PCCL_072B_#]
c. The child’s grandparent(s) or other relative(s)? [PCCL_072C_#]
d. A baby-sitter, nanny, friend, or neighbor? [PCCL_072D_#]
e. A parent who stayed home some or all days of the week? [PCCL_072E_#}
f. Some other arrangement? (Please specify:
____________________________________) [PCCL_072F_#]
[PCCL_072F_SPECIFY_#]

ENGLISH

Durante el primer año de vida de ^{FILL_YOUTHNAME}, ¿qué fuentes regulares de cuidado infantil se
usaron?
¿^{FILL_YOUTHNAME} recibió cuidado regularmente por parte de…
COLUMN HEADERS:
1. Sí
0. No
SPANISH

ROW ITEMS:
a. Un proveedor de cuidado infantil a domicilio? [PCCL_072A_#]
b. Una guardería infantil? [PCCL_072B_#]
c. Abuelos(as) u otros familiares del(a) niño(a)? [PCCL_072C_#]
d. Un niñero(a), amigo(a) o vecino(a)? [PCCL_072D_#]
e. Un padre/madre que se quedaba en casa algunos o todos los días de la semana?
[PCCL_072E_#}
f. De alguna otra forma (Especiﬁque: ____________________________________)
[PCCL_072F_#] [PCCL_072F_SPECIFY_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

PCCL_072F_SPECIFY: 100 characters
15
If PCCL_072F=1 (option selected), display text box PCCL_072F_SPECIFY
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_071 = 1
PCCL_073

PCCL_073_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
From ages 1 - 5, did ^{FILL_YOUTHNAME} ever spend twenty or more hours a week in childcare?
ENGLISH

1.
0.

Yes
No

Del primer al quinto año, ¿pasó ^{FILL_YOUTHNAME} alguna vez veinte horas o más a la semana en
cuidado infantil?
SPANISH

1.
0.

Sí
No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through Loop 1 (_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_071; PCCL_072
If PCCL_073 = 1: f_PCCL_074
Else: f_PCCL_075

f_PCCL_074_#
PCCL_074A_# /PCCL_074B_# / PCCL_074C_# / PCCL_074D_# / PCCL_074E_# / PCCL_074F_#
ASK
PCCL_073 = 1 (continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
At which ages did ^{FILL_YOUTHNAME} spend twenty or more hours a week in childcare? Select all
that apply.
1.
2.
3.
4.
5.
0.

ENGLISH

1 year old [PCCL_074A_#]
2 years old [PCCL_074B_#]
3 years old [PCCL_074C_#]
4 years old [PCCL_074D_#]
5 years old (including kindergarten) [PCCL_074E_#]
None [PCCL_074F_#]

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando pasaba veinte horas o más a la semana en cuidado
infantil? Seleccione todas las opciones que correspondan.

SPANISH

1.
2.
3.
4.
5.
0.

1 año [PCCL_074A_#]
2 años [PCCL_074B_#]
3 años [PCCL_074C_#]
4 años [PCCL_074D_#]
5 años (incluido el kínder) [PCCL_074E_#]
Ninguna [PCCL_074F_#]

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Do not allow other options to be selected if PCCL_074F = 1 (should be exclusive)
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_073 = 1
f_PCCL_075

f_PCCL_075_#
PCCL_075A_# / PCCL_075B_# / PCCL_075C_# / PCCL_075D_# / PCCL_075E_# / PCCL_075F_# / PCCL_075G_#
ASK
All respondents (Continue PCCL Loop 1)
QUESTION TYPE

Radio grid

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
From ages 1-5, what regular sources of childcare were used for ^{FILL_YOUTHNAME}? Was
^{FILL_YOUTHNAME} regularly cared for by….
COLUMN HEADERS:
1. Yes
0. No
ROW ITEMS:
a. An in-home childcare provider? [PCCL_075A_#]
b. A childcare center? [PCCL_075B_#]
c. A pre-school or pre-K program? [PCCL_075C_#]
d. The child’s grandparent(s) or other relative(s)? [PCCL_075D_#]
e. A baby-sitter, nanny, friend, or neighbor? [PCCL_075E_#]
f. A parent who stayed home some or all days of the week? [PCCL_075F_#]
g. Kindergarten? [PCCL_075G_#]

ENGLISH

Del primer al quinto año, ¿qué fuentes regulares de cuidado infantil se usaron para
^{FILL_YOUTHNAME}? ¿^{FILL_YOUTHNAME} recibió cuidado regularmente por parte de…
COLUMN HEADERS:
1. Sí
0. No
SPANISH

ROW ITEMS:
a. Un proveedor de cuidado infantil a domicilio? [PCCL_075A_#]
b. Una guardería infantil? [PCCL_075B_#]
c. Un programa preescolar o de prekínder? [PCCL_075C_#]
d. Abuelos(as) u otros familiares del(a) niño(a)? [PCCL_075D_#]
e. Un niñero(a), amigo(a) o vecino(a)? [PCCL_075E_#]
f. Un padre/madre que se quedaba en casa algunos o todos los días de la semana?
[PCCL_075F_#]
g. El kínder? [PCCL_075G_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_074, PCCL_073
PCCL_076

PCCL_076_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did ^{FILL_YOUTHNAME} ever attend an official, government sponsored Head Start or Early Head Start
program?
ENGLISH

1. Yes
0. No
¿Ha asistido ^{FILL_YOUTHNAME} alguna vez a un programa oficial de Head Start o Early Head Start
patrocinado por el gobierno?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

Head Start is a federally supported preschool program for low-income families.

HELP TEXT (SPAN)

Head Start es un programa preescolar con apoyo federal para familias de bajos ingresos.

MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_075
If PCCL_076 = 1: f_PCCL_077
Else: PCCL_079

f_PCCL_077_#
PCCL_077A_# / PCCL_077B_# / PCCL_077C_# / PCCL_077D_# / PCCL_077E_# / PCCL_077F_# / PCCL_077G_# /
PCCL_077H_# / PCCL_077I_# / PCCL_077J_# / PCCL_077K_#
ASK
PCCL_076 = 1 (Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
At which ages did ^{FILL_YOUTHNAME} attend Head Start or Early Head Start? Please select all that
apply.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
0.

ENGLISH

Less than one year old [PCCL_077A_#]
1 year old [PCCL_077B_#]
2 years old [PCCL_077C_#]
3 years old [PCCL_077D_#]
4 years old [PCCL_077E_#]
5 years old [PCCL_077F_#]
6 years old [PCCL_077G_#]
7 years old [PCCL_077H_#]
8 years old [PCCL_077I_#]
9 years old [PCCL_077J_#]
None [PCCL_077K_#]

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando asistió a Head Start o Early Head Start? Seleccione todas
las que correspondan.

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
0.

Menos de un año [PCCL_077A_#]
1 año [PCCL_077B_#]
2 años [PCCL_077C_#]
3 años [PCCL_077D_#]
4 años [PCCL_077E_#]
5 años [PCCL_077F_#]
6 años [PCCL_077G_#]
7 años [PCCL_077H_#]
8 años [PCCL_077I_#]
9 años [PCCL_077J_#]
Ninguna [PCCL_077K_#]

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)

15
Code variable as 1 if checked, 0 if not.
Do not allow other options to be selected if PCCL_077K = 1 (should be exclusive)
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_076 = 1
f_PCCL_078

f_PCCL_078_#
PCCL_078A_# / PCCL_078B_# / PCCL_078C_# / PCCL_078D_#
ASK
PCCL_076 = 1 (Continue PCCL Loop 1)
QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what state or states did ^{FILL_YOUTHNAME} attend Head Start? If ^{FILL_YOUTHNAME} attended
Head Start in more than state, please tell us all the states where they attended.
First state: { - Select - } [PCCL_078A_#]
ENGLISH

Second state: { - Select - } [PCCL_078B_#]
Third state: { - Select - } [PCCL_078C_#]
Fourth state: { - Select - } [PCCL_078D_#]
¿En qué estado o estados asistió ^{FILL_YOUTHNAME} a Head Start? Si ^{FILL_YOUTHNAME} asistió a
Head Start en más de un estado, díganos todos los estados en los que asistió.
Primer estado: { - Seleccione - } [PCCL_078A_#]

SPANISH

Segundo estado: { - Seleccione - } [PCCL_078B_#]
Tercer estado: { - Seleccione - } [PCCL_078C_#]

RANGE

Cuarto estado: { - Seleccione - } [PCCL_078D_#]
Use list STATEPLUS for dropdowns

LIMITS
LOOP MAX
PROGRAM. NOTES

15
All PCCL_078b, PCCL_078C and PCCL_078D to be left blank without prompting
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_077
PCCL_079

PCCL_079_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did ^{FILL_YOUTHNAME} ever attend a state-sponsored or local-government-sponsored Preschool or
Pre-K program?
ENGLISH

1. Yes
0. No
¿Ha asistido ^{FILL_YOUTHNAME} alguna vez a un programa preescolar o prekínder patrocinado por el
estado o por el gobierno local?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_076; f_PCCL_078
If PCCL_079 = 1: PCCL_080
Else: PCCL_082

f_PCCL_080_#
PCCL_080A_# / PCCL_080B_# / PCCL_080C_# / PCCL_080D_# / PCCL_080E_# / PCCL_080F_# / PCCL_080G_#
ASK
PCCL_079 = 1 (continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
At which ages did ^{FILL_YOUTHNAME} attend a state-sponsored or local-government-sponsored
Preschool or Pre-K Program? Please select all that apply.
1. Less than one year old [PCCL_080A_#]
2. 1 year old [PCCL_080B_#]
3. 2 years old [PCCL_080C_#]
4. 3 years old [PCCL_080D_#]
5. 4 years old [PCCL_080E_#]
6. 5 years old [PCCL_080F_#]
7. 6 years old [PCCL_080G_#]

ENGLISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando asistió a un programa preescolar o prekínder
patrocinado por el estado o por el gobierno local? Seleccione todas las que correspondan.

SPANISH

1. Menos de un año [PCCL_080A_#]
2. 1 año [PCCL_080B_#]
3. 2 años [PCCL_080C_#]
4. 3 años [PCCL_080D_#]
5. 4 años [PCCL_080E_#]
6. 5 años [PCCL_080F_#]
7. 6 años [PCCL_080G_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_079
f_PCCL_081

f_PCCL_081_#
PCCL_081A_# / PCCL_081B_# / PCCL_081C_# / PCCL_081D_#
ASK
PCCL_079 = 1 (Continue PCCL Loop 1)
QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what state or states did ^{FILL_YOUTHNAME} attend a state-sponsored or local-governmentsponsored Preschool or Pre-K Program? If ^{FILL_YOUTHNAME} attended these programs in more than
state, please tell us all the states where they attended.
First state: { - Select - } [PCCL_081A_#]
ENGLISH

Second state: { - Select - } [PCCL_081B_#]
Third state: { - Select - } [PCCL_081C_#]
Fourth state: { - Select - } [PCCL_081D_#]
¿En qué estado o estados asistió ^{FILL_YOUTHNAME} a un programa preescolar o prekínder
patrocinado por el estado o por el gobierno local? Si ^{FILL_YOUTHNAME} asistió a estos programas en
más de un estado, indíquenos todos los estados en los que asistió.
Primer estado: { - Seleccione - } [PCCL_081A_#]

SPANISH

Segundo estado: { - Seleccione - } [PCCL_081B_#]
Tercer estado: { - Seleccione - } [PCCL_081C_#]
Cuarto estado: { - Seleccione - } [PCCL_081D_#]

RANGE

Use list STATEPLUS for dropdown

LIMITS
LOOP MAX
PROGRAM. NOTES

15
All PCCL_081A, PCCL_081C and PCCL_081D to be left blank without prompting
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_080
PCCL_082

PCCL_082_#
ASK

All respondents (Continue PCCL Loop 1)

QUESTION TYPE

Numeric, Radio special response

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
At what age did ^{FILL_YOUTHNAME} enter the first grade? Include home schooling if child was homeschooled for kindergarten or higher grade.
ENGLISH

Age in Years: ________________________
-8. Not applicable, this child never had any formal schooling
-9. Not applicable, this child skipped first grade
¿A qué edad entró ^{FILL_YOUTHNAME} en el primer grado? Incluya la educación en casa si el(la)
niño(a) recibió educación en casa para el kínder o un grado superior.

SPANISH

Edad en años: ________________________
-8. No corresponde, este(a) niño(a) nunca tuvo una escolarización formal
-9. No corresponde, este(a) niño(a) se saltó el primer grado

RANGE

PCCL_082 (numeric): 5-10

LIMITS

PCCL_082 (numeric): Max 2 digits

LOOP MAX

15
Responses -8 and -9 should be radio buttons. Do not allow other options to be selected if
either -8 or -9 is selected (should be exclusive)
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_079, f_PCCL_081
If PCCL_082 = -8: PCCL_139_LOOP_END
Else if PCCL_082= -9: PCCL_083
Else if PCCL_082= DK or RF: PCCL_085
DK or RFElse: PCCL_084

PCCL_083_#
ASK

PCCL_082 = -9 (Continue PCCL Loop 1)

QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
At what age did ^{FILL_YOUTHNAME} enter the second grade?
ENGLISH

Age in Years: ________________________
¿A qué edad entró ^{FILL_YOUTHNAME} en el segundo grado?

SPANISH

Edad en años: ________________________

RANGE

6-11

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_082 = -9
PCCL_084

PCCL_084_#
ASK

If PCCL_082 ≠ (-1 or -2 or -8) (Continue PCCL Loop 1)

QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what year was that?
ENGLISH

Year: { - Select - }
¿En qué año ocurrió?

SPANISH

Año: { - Seleccione - }

RANGE

List years 2030-2010 in reverse chronological order: 2030, 2029, 2029, 2027, 2026, 2025,
2024, 2023…

LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

15
Do not display years that are in the future on DOI.
DISPLAY CALENDAR
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_084_# before YOUTHDOB, display hard check:
Year that ^{FILL_YOUTHNAME} entered school should be after they were born. Please
review your answer.
If PCCL_084_# after DOI, display hard check:
Please enter a date that is in the past.
If PCCL_084_# before YOUTHDOB, display hard check:
El año en que ^{FILL_YOUTHNAME} entró en la escuela debe ser posterior a su
nacimiento. Revise su respuesta.
If PCCL_084_# after DOI, display hard check:
Ingrese una fecha que está en el pasado.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_082, PCCL_083
PCCL_085

PCCL_085_#
ASK

If PCCL_082 ≠ -8 (Continue PCCL Loop 1)

QUESTION TYPE

Informational

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
This section asks about ^{FILL_YOUTHNAME}’s school experiences during the coronavirus (COVID-19)
ENGLISH pandemic. Please answer these questions as best you can.
SPANISH

En esta sección, se hacen preguntas sobre las experiencias escolares de ^{FILL_YOUTHNAME} durante
la pandemia de coronavirus (COVID-19). Responda estas preguntas lo mejor que pueda.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_084, PCCL_082 = -1 or -2
PCCL_086

PCCL_086_#
ASK

If PCCL_082 ≠ -8 (continue PCCL Loop 1)

QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What grade of school was ^{FILL_YOUTHNAME} enrolled in during the 2020 – 2021 school year?
ENGLISH

Grade: { - Select - }
¿En qué grado escolar estaba matriculo(a) ^{FILL_YOUTHNAME} durante el año escolar 2020-2021?

SPANISH

RANGE

Grado: { - Seleccione - }
0. None
93. Pre-kindergarten
94. Kindergarten
1. 1st grade
2. 2nd grade
3. 3rd grade
4. 4th grade
5. 5th grade
6. 6th grade
7. 7th grade
8. 8th grade
9. 9th grade
10. 10th grade
11. 11th grade
12. 12th grade
13. In post-secondary vocational or technical training
14. In 2 yr. college
15. In 4 yr. college
16. In graduate/professional school
95. Ungraded
SPANISH:
0. Ninguna
93. Prekínder
94. Kínder
1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado
13. En capacitación profesional o técnica postsecundaria

14.
15.
16.
95.

En la universidad de 2 años
En la universidad de 4 años
En la escuela de posgrado/profesional
Sin grado

LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_085
If PCCL_086=0: PCCL_091
Else PCCL_087

PCCL_087_#
ASK

If PCCL_082 ≠ -8 and PCCL_086 ≠ 0 (continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What type of instruction did ^{FILL_YOUTHNAME} receive for most of the 2020-2021 school year, that
is, the first full school year during the COVID-19 pandemic?
ENGLISH

1. Distance learning such as online, remote, or virtual learning
2. In-person
3. Mix of distance learning and in-person such as hybrid learning
¿Qué tipo de instrucción recibió ^{FILL_YOUTHNAME} durante la mayor parte del año escolar 20202021, es decir, el primer año escolar completo durante la pandemia COVID-19?

SPANISH

1. Aprendizaje a distancia, como por internet, remoto o virtual
2. En persona
3. Mezcla de aprendizaje a distancia y en persona, como el aprendizaje híbrido

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_086
PCCL_088

PCCL_088_#
ASK

If PCCL_082 ≠ -8 and PCCL_086 ≠ 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
During the 2020-2021 school year, when ^{FILL_YOUTHNAME} needed help with schoolwork, how
often were parents or other adults available to help?
1. Almost never
2. Rarely
3. Sometimes
4. Very Often
5. Extremely Often

ENGLISH

Durante el año escolar 2020-2021, cuando ^{FILL_YOUTHNAME} necesitó ayuda con las tareas
escolares, ¿con qué frecuencia estuvieron los padres/madres u otros adultos disponibles para ayudar?
SPANISH

1. Casi nunca
2. Rara vez
3. A veces
4. Con frecuencia
5. Con mucha frecuencia

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_087
PCCL_089

PCCL_089_#
ASK

If PCCL_082 ≠ -8 and PCCL_086 ≠ 0 (continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What type of instruction did ^{FILL_YOUTHNAME} receive for most of the 2021-2022 school year, that
is, the second full school year of the COVID-19 pandemic?
ENGLISH

1. Distance learning such as online, remote, or virtual learning
2. In-person
3. Mix of distance learning and in-person such as hybrid learning
¿Qué tipo de instrucción recibió ^{FILL_YOUTHNAME} durante la mayor parte del año escolar 20212022, es decir, el segundo año escolar completo durante la pandemia COVID-19?

SPANISH

1. Aprendizaje a distancia, como por internet, remoto o virtual
2. En persona
3. Mezcla de aprendizaje a distancia y en persona, como el aprendizaje híbrido

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_088
PCCL_090

PCCL_090_#
ASK

If PCCL_082 ≠ -8 and PCCL_086 ≠ 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
During the 2021-2022 school year, when ^{FILL_YOUTHNAME} needed help with schoolwork, how
often were parents or other adults available to help?
1. Almost never
2. Rarely
3. Sometimes
4. Very Often
5. Extremely Often

ENGLISH

Durante el año escolar 2021-2022, cuando ^{FILL_YOUTHNAME} necesitó ayuda con las tareas
escolares, ¿con qué frecuencia estuvieron los padres/madres u otros adultos disponibles para ayudar?
SPANISH

1. Casi nunca
2. Rara vez
3. A veces
4. Con frecuencia
5. Con mucha frecuencia

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_089
PCCL_091

PCCL_091_#
ASK

If PCCL_082 ≠ -8 (Continue PCCL Loop 1)

QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What grade of school is ^{FILL_YOUTHNAME} currently enrolled in? If ^{FILL_YOUTHNAME} is currently
on summer break, please select the grade that they are going into in the fall.
ENGLISH
Grade: { - Select - }
¿En qué año escolar está matriculado(a) en este momento ^{FILL_YOUTHNAME}?
SPANISH

RANGE

Grado: { - Seleccione - }
0. Not enrolled
93. Pre-kindergarten
94. Kindergarten
1. 1st grade
2. 2nd grade
3. 3rd grade
4. 4th grade
5. 5th grade
6. 6th grade
7. 7th grade
8. 8th grade
9. 9th grade
10. 10th grade
11. 11th grade
12. 12th grade
50. GED
51. Business/Trade School
13. 1st Year College
14. 2nd Year College
15. 3rd Year College
16. 4th Year College
17. 1st Year Grad School
18. 2nd Year Grad School
19. 3rd Year Grad School
20. 4th Year Grad School
21. 5th + Year Grade School
95. Ungraded
SPANISH:

0. No está matriculado(a)
93. Prekínder
94. Kínder
1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado
50. Diploma de Desarrollo de Educación General (GED, por sus siglas en inglés)
51. Escuela de negocios/oﬁcios
13. 1.º año de universidad
14. 2.º año de universidad
15. 3.º año de universidad
16. 4.º año de universidad
17. 1.º año de posgrado
18. 2.º año de posgrado
19. 3.º año de posgrado
20. 4.º año de posgrado
21. 5.º+ año de posgrado
95. Sin grado
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_086, PCCL_090
If PCCL_091 = 95 and YOUTH_CURRENTAGE >= 13: PCCL_091a
Else if PCCL_091 in (1:8) or in (93:95): PCCL_117
Else if PCCL_091 = 0: PCCL_092
Else: f_PCCL_093

PCCL_091a_#
ASK

If PCCL_091=95, and YOUTH_CURRENTAGE>=13 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
You said ^{FILL_YOUTH_NAME} is in an ungraded program. Has ^{FILL_YOUTHNAME} ever attended
any high school (or the equivalent)?
ENGLISH

1. Yes
0. No
Dijo que ^{FILL_YOUTH_NAME} está en una escuela sin grados. ¿^{FILL_YOUTHNAME} ha asistido
alguna vez a alguna escuela secundaria (o equivalente)?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_091
If PCCL_091a=1: PCCL_093
Else: PCCL_117

PCCL_092_#
ASK

PCCL_091 = 0 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did ^{FILL_YOUTHNAME} ever receive a high school diploma, or high school equivalency, such as the
GED or HiSET?
ENGLISH

SPANISH

1. Yes
0. No
¿Recibió ^{FILL_YOUTHNAME} alguna vez un diploma de escuela secundaria/preparatoria, o un
equivalente de escuela secundaria, como el del GED o de la Prueba de Equivalencia de Escuela
Secundaria (HiSET, por sus siglas en inglés)?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_091 = 0
f_PCCL_093

f_PCCL_093_#
PCCL_093_MO_# / PCCL_093_YR_#
ASK
If (PCCL_091 NOT in (1:8) AND NOT in (93:)94)) or If PCCL_091a=1 (continue PCCL Loop 1)
Dropdown: PCCL_093_MO
QUESTION TYPE
Dropdown: PCCL_093_YR
Radio special response
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what month and year did ^{FILL_YOUTHNAME} enter the ninth grade? (or equivalent)? If
^{FILL_YOUTHNAME} has not yet started the ninth grade (or equivalent), please select the “Not
applicable” option below.
ENGLISH

Month: { - Select - } [PCCL_093_MO_#]
Year: ___________ [PCCL_093_YR_#]
-9. Not applicable, this child had not yet entered 9th grade
¿En qué mes y año entró ^{FILL_YOUTHNAME} en el noveno grado (o equivalente)? Si
^{FILL_YOUTHNAME} aún no ha comenzado el noveno grado (o equivalente), seleccione la opción “No
aplicable” a continuación.

SPANISH

Mes: { - Seleccione - } [PCCL_093_MO_#]
Año: ___________ [PCCL_093_YR_#]
-9. No corresponde, este(a) niño(a) aún no había entrado en el 9.º grado.
PCCL_093_MO: List months in order. 1 = “January”, 2 = “February”,… 12 = “December”
PCCL_093_YR: 2015-2030

RANGE

SPANISH:
1. Enero
2. Febrero
3. Marzo
4. Abril
5. Mayo
6. Junio
7. Julio
8. Agosto
9. Septiembre
10. Octubre
11. Noviembre
12. Diciembre
PCCL_093_YR: List years 2015-2030 in reverse chronological order (i.e., 2030, 2029,
2028, etc.) starting with DOI year (i.e., if DOI year is 2025, do not include 2026-2030)

LIMITS
LOOP MAX

PROGRAM. NOTES

15
Response -9 should be a radio button. Do not allow other ﬁelds to be populated if
selected (should be exclusive).
DISPLAY CALENDAR.

CHECK (ENG)

CHECK (SPAN)

Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_093_# before YOUTHDOB, display hard check:
Date ^{FILL_YOUTHNAME} entered 9th grade should be after they were born. Please
review your answer.
If PCCL_093_# after DOI, display hard check:
Please enter a date that is in the past.
If PCCL_093_# before YOUTHDOB, display hard check:
La fecha en que ^{FILL_YOUTHNAME} entró en el 9.º grado debe ser posterior a su
nacimiento. Revise su respuesta.
If PCCL_093_# after DOI, display hard check:
Ingrese una fecha que está en el pasado.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_091a, PCCL_092
If PCCL_093 = -9: PCCL_117
Else: PCCL_094

PCCL_094_#

QUESTION TYPE

If PCCL_091 NOT in (1:8) AND NOT in (93:95) AND f_PCCL_093 ≠ -9 (Continue PCCL Loop
1)
Informational

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Now let's talk about the schools ^{FILL_YOUTHNAME} has attended since they entered the ninth
ENGLISH grade. (or equivalent).
SPANISH

Hablemos ahora de las escuelas a las que ^{FILL_YOUTHNAME} ha asistido desde que entró en el
noveno grado (o equivalente).

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_093
PCCL_095_LOOP_BEGIN

PCCL_095_LOOP_BEGIN_#_#
If f_PCCL_093 ≠ -9 and PCCL_091 not in (1:8) or in (93:95)
ASK
(Begin PCCL LOOP 1f)
QUESTION TYPE
Computer check
FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Computer check, do not display.
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_094
f_PCCL_096

f_PCCL_096_#_#
PCCL_096_#_# / PCCL_096_SPECIFY_#_#
If f_PCCL_093 ≠ -9 and PCCL_091 not in (1:8) or in (93:95)
ASK
(Continue PCCL LOOP 1f)
PCCL_096_#_#: Radio button
QUESTION TYPE
PCCL_096_SPECIFY_#_#: Text box
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_096: If LOOPNUMBER_1f = 1, FILL_PCCL_096: “Starting with the
FILLS (ENG)
ﬁrst”
Else, FILL_PCCL_096: “Thinking of the next”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_096: If LOOPNUMBER_1f = 1, FILL_PCCL_096: “Pensando en la
FILLS (SPAN)
primera”
Else, FILL_PCCL_096: “Pensando en la siguiente”
^{FILL_PCCL_096} school ^{FILL_YOUTHNAME} attended since entering the ninth grade, (or
equivalent), what type of school was this?
2. Middle school/intermediate school/junior high school
3. High school
4. Home school
5. Two-year college, community college, or junior college
6. Four-year college or university
7. Other (please specify: ______________________________________)
[PCCL_096_SPECIFY_#_#]

ENGLISH

^{FILL_PCCL_096} escuela a la que asistió ^{FILL_YOUTHNAME} desde que entró en el noveno grado,
¿qué tipo de escuela era?

SPANISH

1. Escuela primaria
2. Escuela intermedia
3. Escuela secundaria/preparatoria
4. Escolaridad en el hogar
5. Escuela terciaria o de estudios semisuperiores de dos años
6. Facultad o universidad de cuatro años

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN

CASI/CAWI
Dropped response option #1 Elementary school, so responses start with #2.
Display PCCL_096_SPECIFY_#_# if PCCL_096 = 7.
PCCL_095_LOOP_BEGIN

NEXT

PCCL_097

PCCL_097_#_#
If PCCL_093 ≠ -9 and PCCL_091 not in (1:8) or in (93:95)
(Continue PCCL LOOP 1f)
QUESTION TYPE
Dropdown
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Use ﬁll from PCCL_096_#_#, FILL_PCCL_096
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_096_#_#, FILL_PCCL_096
^{FILL_PCCL_096} school ^{FILL_YOUTHNAME} attended since entering the ninth grade, (or
equivalent), in which state was their school located?
ENGLISH
State: { - Select from STATENOTUS - }
ASK

SPANISH

^{FILL_PCCL_096} escuela a la que asistió ^{FILL_YOUTHNAME} desde que entró en el noveno grado,
(o equivalente), ¿en qué estado estaba ubicada su escuela?
Estado: { - Seleccione from STATENOTUS - }

RANGE

Use list STATENOTUS for dropdown

LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_096
If PCCL_097 = DK or REF: PCCL_101A
PCCL_097 = 64: PCCL_101B
Else: PCCL_098

PCCL_098_#_#
ASK
QUESTION TYPE

If PCCL_097 ≠ DK or REF or 64
(Continue PCCL LOOP 1f)
Textbox

FILLS (ENG)
FILLS (SPAN)
In what city was this school located?
ENGLISH

City: _________________________________
¿En qué ciudad estaba ubicada esta escuela?

SPANISH

Ciudad: _________________________________

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Max 100 characters
15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_097
If PCCL_096 = 4: PCCL_102
Else if PCCL_098 = DK or REF: PCCL_101A
Else: f_PCCL_099

f_PCCL_099_#_#
PCCL_099 _#_# / PCCL_099NL_#_#
If (PCCL_096 ≠ 4) AND (PCCL_097 ≠ DK or REF or 64)
ASK
(Continue PCCL LOOP 1f)
PCCL_099: Directory lookup
QUESTION TYPE
PCCL_099NL: Radio button
FILLS (ENG)
FILLS (SPAN)
What is the name of this school?
ENGLISH

_________{ - Text entry and lookup - }_________
-8 This school is not listed [PCCL_099NL_#_#]
¿Cuál es el nombre de esta escuela?

SPANISH

_________{ - Text entry and lookup - }_________
-8 Esta escuela no está en la lista [PCCL_099NL_#_#]

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Open text entry and lookup
If school selected from lookup list, store school data as variables:
SCHOOLPIN_#_#: School pin number
SCHOOLNAME_#_#: School name
SCHOOLADDRESS_#_#: Address line location
SCHOOLCITY_#_#: City location
SCHOOLSTATE_#_#: State location
Do not allow text entry into PCCL_099 and selection of PCCL_099NL.

CHECK (ENG)
CHECK (SPAN)

Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END)
until PCCL_112=0 or max loops reached (15).
If text entered into PCCL_099 and PCCL_099NL is selected, display hard check: “Either
select the school name from the lookup list or select “This school is not listed.” Do not
enter both.”
If text entered into PCCL_099 and PCCL_099NL is selected, display hard check: “Seleccione
el nombre de la escuela en la lista de búsqueda o seleccione "Esta escuela no está en la
lista". No ingrese ambos.”

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_098
If PCCL_099 = (-8, DK, or REF:): f_PCCL_101A
Else: PCCL_100

PCCL_100_#_#
ASK
QUESTION TYPE

FILLS (ENG)

FILLS (SPAN)

If PCCL_099 ≠ -1 or -2
(Continue PCCL LOOP 1f)
Radio Button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_100#: If LOOPNUMBER_1f = 1, FILL_PCCL_100#: “ﬁrst”
Else, FILL_PCCL_100#: “next”
Create ﬁll, FILL_SCHOOLPIN#: Fill SCHOOLPIN_#_# from lookup entry in PCCL_099#
Create ﬁll, FILL_SCHOOLNAME#: Fill SCHOOLNAME_#_# from lookup entry in PCCL_099#
Create ﬁll, FILL_SCHOOLADDRESS#: Fill SCHOOLADDRESS_#_#from lookup entry in
PCCL_099#
Create ﬁll, FILL_SCHOOLCITY#: Fill SCHOOLCITY_#_# from lookup entry in PCCL_099#
Create ﬁll, FILL_SCHOOLSTATE#: Fill SCHOOLSTATE_#_# from lookup entry in PCCL_099#
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_PCCL_100#: If LOOPNUMBER_1f = 1, FILL_PCCL_100#: “la primera”
Else, FILL_PCCL_100#: “la siguiente”
Create ﬁll, FILL_SCHOOLPIN#: Fill SCHOOLPIN_#_# from lookup entry in PCCL_099#
Create ﬁll, FILL_SCHOOLNAME#: Fill SCHOOLNAME_#_# from lookup entry in PCCL_099#
Create ﬁll, FILL_SCHOOLADDRESS#: Fill SCHOOLADDRESS_#_#from lookup entry in
PCCL_099#
Create ﬁll, FILL_SCHOOLCITY#: Fill SCHOOLCITY_#_# from lookup entry in PCCL_099#
Create ﬁll, FILL_SCHOOLSTATE#: Fill SCHOOLSTATE_#_# from lookup entry in PCCL_099#

You have selected the following school as the ^{FILL_PCCL_100#} school that ^{FILL_YOUTHNAME}
attended since entering the ninth grade (or equivalent). Is this correct?
1. Yes
0. No
ENGLISH

Pin Number: ^{FILL_SCHOOLPIN#}
School Name: ^{FILL_SCHOOLNAME#}
Address: ^{FILL_SCHOOLADDRESS#}
City: ^{FILL_SCHOOLCITY#}
State: ^{FILL_SCHOOLSTATE#}
Ha seleccionado la siguiente escuela como ^{FILL_PCCL_100#} escuela a la que ^{FILL_YOUTHNAME}
asistió desde que entró en el noveno grado (o equivalente). ¿Es esto correcto?
1. Sí
0. No

SPANISH

RANGE
LIMITS

Número de PIN: ^{FILL_SCHOOLPIN#}
Nombre de la escuela: ^{FILL_SCHOOLNAME#}
Dirección: ^{FILL_SCHOOLADDRESS#}
Ciudad: ^{FILL_SCHOOLCITY#}
Estado: ^{FILL_SCHOOLSTATE#}

LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_099
If PCCL_100 = 0: f_PCCL_101A
Else: PCCL_102

f_PCCL_101A_#_#
PCCL_101A_NAME_#_# / PCCL_101A_ADDRESS_#_# / PCCL_101A_CITY_#_# / PCCL_101A_STATE_#_# /
PCCL_101A_ZIP_#_#
If PCCL_096 ≠ 4 AND PCCL_097 ≠ 64 AND (PCCL_099 = (-8, DK, or REF) OR PCCL_100 = 0)
ASK
(Continue PCCL LOOP 1f)
Textbox: PCCL_101A_NAME, PCCL_101A_ADDRESS, PCCL_101A_CITY
QUESTION TYPE
Dropdown: PCCL_101A_STATE
Numeric: PCCL_101A_ZIP
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Create ﬁll, FILL_PCCL_101A: If LOOPNUMBER_1f = 1, FILL_PCCL_101A: “ﬁrst”
Else, FILL_PCCL_101A: “next”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Create ﬁll, FILL_PCCL_101A: If LOOPNUMBER_1f = 1, FILL_PCCL_101A: “la primera”
Else, FILL_PCCL_101A: “la siguiente”
What is the name and address of the ^{FILL_PCCL_101A} school that ^{FILL_YOUTHNAME} attended
since entering the ninth grade (or equivalent)? Please fill in as much as you are able in the fields below.
ENGLISH

Name: _____________________ [PCCL_101A_NAME_#_#]
Street: _____________________ [PCCL_101A_ADDRESS_#_#]
City: _____________________ [PCCL_101A_CITY_#_#]
State: { - Select - } [PCCL_101A_STATE_#_#]
Zip: _____________________ [PCCL_101A_ZIP_#_#]
¿Cuál es el nombre y la dirección de ^{FILL_PCCL_101A} escuela a la que ^{FILL_YOUTHNAME} asistió
desde que entró en el noveno grado (o equivalente)? Complete todo lo que pueda en los siguientes
campos.

SPANISH

Nombre: _____________________ [PCCL_101A_NAME_#_#]
Calle: _____________________ [PCCL_101A_ADDRESS_#_#]
Ciudad: _____________________ [PCCL_101A_CITY_#_#]
Estado: { - Seleccione - } [PCCL_101A_STATE_#_#]
Código postal: _____________________ [PCCL_101A_ZIP_#_#]

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

PCCL_101A_STATE: List states on STATENOTUS list
PCCL_101A_NAME: 100 characters
PCCL_101A_ADDRESS: 100 characters
PCCL_101A_CITY: 100 characters
PCCL_101A_ZIP: 5 digits
15
Store school data as variables:
PCCL_101A_NAME_# as SCHOOLNAME_#
PCCL_101A_ADDRESS_# as SCHOOLADDRESS_#
PCCL_101A_CITY_# as SCHOOLCITY_#
PCCL_101A_STATE_# as SCHOOL STATE_#
PCCL_101A_ZIP_# as SCHOOLZIP_#
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END)
until PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_098, PCCL_099, PCCL_100 = 0
PCCL_102

PCCL_101B_#_#
If PCCL_097 = 64
(Continue PCCL LOOP 1f)
QUESTION TYPE
Text box
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Create ﬁll, FILL_PCCL_101#: If LOOPNUMBER_1f = 1, FILL_PCCL_101B: “ﬁrst”
Else, FILL_PCCL_101B: “next”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Create ﬁll, FILL_PCCL_101#: If LOOPNUMBER_1f = 1, FILL_PCCL_101B: “la primera”
Else, FILL_PCCL_101B: “la siguiente”
What is the name of the school that ^{FILL_YOUTHNAME} ^{FILL_PCCL_101B#} attended since
entering ninth grade (or equivalent)?
ENGLISH
Name: __________________________
ASK

SPANISH

¿Cuál es el nombre de ^{FILL_PCCL_101B#} escuela a la que ^{FILL_YOUTHNAME} asistió desde que
entró en el noveno grado (o equivalente)?
Nombre: __________________________

RANGE
LIMITS

Max 100 characters

LOOP MAX

15
Store school data as variables:
PCCL_101B_# as SCHOOLNAME_#

PROGRAM. NOTES

Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_097 = 64
PCCL_102

PCCL_102_#_#

QUESTION TYPE

If f_PCCL_093 ≠ -9
(Continue PCCL LOOP 1f)
Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What grade was ^{FILL_YOUTHNAME} in when they started at this school?
ENGLISH

Grade: { - Select - }
¿En qué grado estaba ^{FILL_YOUTHNAME} cuando empezó en esta escuela?

SPANISH

RANGE

Grado: { - Seleccione - }
93. Pre-Kindergarten
94. Kindergarten
1. 1st grade
2. 2nd grade
3. 3rd grade
4. 4th grade
5. 5th grade
6. 6th grade
7. 7th grade
8. 8th grade
9. 9th grade
10. 10th grade
11. 11th grade
12. 12th grade
50. GED
51. Business/Trade School
13. 1st Year College
14. 2nd Year College
15. 3rd Year College
16. 4th Year College
17. 1st Year Grad School
18. 2nd Year Grad School
19. 3rd Year Grad School
20. 4th Year Grad School
SPANISH:
93. Prekínder
94. Kínder
1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado

11. 11.º grado
12. 12.º grado
50. GED
51. Escuela de negocios/oficios
13. 1.º año de universidad
14. 2.º año de universidad
15. 3.º año de universidad
16. 4.º año de universidad
17. 1.º año de posgrado
18. 2.º año de posgrado
19. 3.º año de posgrado
20. 4.º año de posgrado
95. Sin grados
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_098, PCCL_100, PCCL_101A, PCCL_101B,
PCCL_103

PCCL_103_#_#

QUESTION TYPE

If f_PCCL_093 ≠ -9
(Continue PCCL LOOP 1f)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Is this the school that ^{FILL_YOUTHNAME} currently attends or most recently attended?
ENGLISH

1. Yes
0. No
¿Es esta la escuela a la que ^{FILL_YOUTHNAME} asiste en este momento o a la que ha asistido más
recientemente?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_102
PCCL_104

PCCL_104_#_#
If f_PCCL_093 ≠ -9
(Continue PCCL LOOP 1f)
QUESTION TYPE
Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_SCHOOLNAME: Fill SCHOOLNAME variable collected in either PCCL_099#
FILLS (ENG)
(lookup), PCCL_101A (manual U.S.), or PCCL_101B (manual non-U.S.)
Else if SCHOOLNAME is empty, FILL_SCHOOLNAME: “their school”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Create ﬁll, FILL_SCHOOLNAME: Fill SCHOOLNAME variable collected in either PCCL_099#
FILLS (SPAN)
(lookup), PCCL_101A (manual U.S.), or PCCL_101B (manual non-U.S.)
Else if SCHOOLNAME is empty, FILL_SCHOOLNAME: “su escuela”
Since the ninth grade, (or equivalent), other than school vacations, did ^{FILL_YOUTHNAME} ever miss
more than one full month of school while they were enrolled in that school?
ASK

ENGLISH

SPANISH

1. Yes
0. No
Desde el noveno grado, (o equivalente), aparte de las vacaciones escolares, ¿faltó
^{FILL_YOUTHNAME} alguna vez más de un mes completo a la escuela mientras estuvo matriculado(a)
en esa escuela?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_103
PCCL_104 = 1: PCCL_106
Else if LOOPNUMBER_1f = 1: PCCL_111
Else: PCCL_112

PCCL_106_#_#_#
PCCL_104 = 1
(Begin PCCL LOOP 1f_1)
QUESTION TYPE
Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Create ﬁll, FILL_PCCL_106: If LOOPNUMBER_1f_1 = 1, FILL_PCCL_106: “ﬁrst”
Else, FILL_PCCL_106: “next”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Create ﬁll, FILL_PCCL_106: If LOOPNUMBER_1f_1 = 1, FILL_PCCL_106: “la primera”
Else, FILL_PCCL_106: “la siguiente”
What grade was ^{FILL_YOUTHNAME} in when this ^{FILL_PCCL_106#_#} happened?
ASK

9. 9th grade
10. 10th grade
11. 11th grade
12. 12th grade
0. None
95. Ungraded

ENGLISH

¿En qué grado estaba ^{FILL_YOUTHNAME} cuando ocurrió esto ^{FILL_PCCL_106#_#} vez?

SPANISH

9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado
0. Ninguna
95. Sin grados

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

10
Loop through PCCL Loop 1f_1 (PCCL_106 _#_#_# - PCCL_109_#_#_#) until
PCCL_109_#_#_#=0 or until max loops reached (10).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_104_#_# = 1
PCCL_107_#_#_#

PCCL_107_#_#_#

QUESTION TYPE

PCCL_104 = 1
(Continue PCCL LOOP 1f_1)
Numeric

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
How many months of school did ^{FILL_YOUTHNAME} miss that time?
ENGLISH

_____________ months
¿Cuántos meses de escuela perdió ^{FILL_YOUTHNAME} durante ese tiempo?

SPANISH

_____________ meses

RANGE

0-50

LIMITS

Max 2 digits

LOOP MAX
PROGRAM. NOTES

10
Loop through PCCL Loop 1f_1 (PCCL_106 _#_#_# - PCCL_109_#_#_#) until
PCCL_109_#_#_#=0 or until max loops reached (10).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_106_#_#_#
PCCL_108_#_#_#

f_PCCL_108_#_#_#
PCCL_108_#_#_# / PCCL_108_SPECIFY_#_#_#
PCCL_104 = 1
ASK
(Continue PCCL LOOP 1f_1)
Radio button: PCCL_108_#_#_#
QUESTION TYPE
Textbox: PCCL_108_SPECIFY_#_#_#
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What was the main reason that ^{FILL_YOUTHNAME} missed school?

ENGLISH

1. Received degree, completed course work
2. Physical health problem(s)
3. Mental health problems
4. Problems with drugs or alcohol
5. Moved away from school
6. Sent to jail or correctional facility
7. Pregnant [ONLY IF YOUTHSEX = 2/Female]
8. Became the father/mother of a baby
9. Got married
10. Childcare responsibilities
11. Home responsibilities
12. Financial difficulties, couldn't afford to go
13. Expelled/suspended
14. Poor grades
15. Did not like school
16. School was too dangerous
17. Didn't get along with other students
18. Friends had dropped out of school
19. Wanted to look for a job
20. Offered a job
21. Entered the military
22. Military duty
23. Other (please specify: ______________________________________)
[PCCL_108_SPECIFY_#_#_#]
¿Cuál fue la razón principal por la que ^{FILL_YOUTHNAME} faltó a la escuela?

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Recibió el título, completó el trabajo del curso
Problema(s) de salud física
Problemas de salud mental
Problemas con las drogas o el alcohol
Se mudó lejos de la escuela
Fue a la cárcel o a un correccional
Quedó embarazada [ONLY IF YOUTHSEX = 2/Female]
Se convirtió en padre/madre de un bebé
Se casó
Responsabilidades de cuidado infantil
Responsabilidades domésticas
Dificultades financieras, no podía permitirse ir
Lo(a) expulsaron/suspendieron
Malas calificaciones
No le gustaba la escuela

16. La escuela era demasiado peligrosa
17. No se llevaba bien con los otros estudiantes
18. Las amistades habían dejado la escuela
19. Quería buscar trabajo
20. Le ofrecieron un trabajo
21. Ingresó en el ejército
22. Servicio militar
23. Otra razón (especifique: ______________________________________)
[PCCL_108_SPECIFY_#_#_#]
RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

10
Only allow response 7 to be selected if YOUTHSEX = 2 (Female)
If response 23 selected, display text box PCCL_108_SPECIFY_#_#_#
Loop through PCCL Loop 1f_1 (PCCL_106 _#_#_# - PCCL_109_#_#_#) until
PCCL_109_#_#_#=0 or until max loops reached (10).
If PCCL_108_SPECIFY left empty, display default soft check.
If PCCL_108_SPECIFY left empty, display default soft check.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_107_#_#_#
PCCL_109_#_#_#

PCCL_109_#_#_#
PCCL_104 = 1
(End PCCL Loop 1f_1)
QUESTION TYPE
Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Use ﬁll from PCCL_104#: FILL_SCHOOLNAME
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_104#: FILL_SCHOOLNAME
Since the ninth grade, (or equivalent), has ^{FILL_YOUTHNAME} missed a month or more of school
another time while they were enrolled at ^{FILL_SCHOOLNAME}?
ASK

ENGLISH

1. Yes
0. No
Desde el noveno grado, (o equivalente), ¿ha faltado ^{FILL_YOUTHNAME} un mes o más a la escuela
en otra ocasión mientras estaba matriculado(a) en ^{FILL_SCHOOLNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

10
Loop through PCCL Loop 1f_1 (PCCL_106 _#_#_# - PCCL_109_#_#_#) until
PCCL_109_#_#_#=0 or until max loops reached (10).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_108
If PCCL_109_#_#_# = 1: Loop again (PCCL_106_#_#_#)
Else if LOOPNUMBER_1f = 1: PCCL_111_#_#
Else: PCCL_112_#_#

PCCL_111_#_#

QUESTION TYPE

If LOOPNUMBER_1f = 1
(Continue PCCL Loop 1f)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Since first entering ninth grade, (or equivalent), has ^{FILL_YOUTHNAME} ever changed schools,
including changes for advancement (for example, middle school to high school or high school to
college), changes prompted by a residential move, or changes to a new type of school (for example,
home schooling to attending a formal institution)?
ENGLISH
1. Yes
0. No

SPANISH

Desde que entró por primera vez en noveno grado, (o equivalente), ¿ha cambiado
^{FILL_YOUTHNAME} alguna vez de escuela, incluidos los cambios por motivos de promoción (por
ejemplo, de la escuela secundaria a la preparatoria), los cambios motivados por una mudanza o los
cambios a un nuevo tipo de escuela (por ejemplo, de la educación en casa a una institución oficial)?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_104, PCCL_109
If PCCL_111 = 1: PCCL_113
Else: PCCL_115_LOOP_END

PCCL_112_#_#

QUESTION TYPE

If LOOPNUMBER_1f ≠ 1
(Continue PCCL LOOP 1f)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Did ^{FILL_YOUTHNAME} ever change schools again since entering ninth grade (or equivalent)?
ENGLISH

1. Yes
0. No
¿Volvió a cambiar de escuela ^{FILL_YOUTHNAME} desde que entró en el noveno grado (o
equivalente)?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_104, PCCL_109
If PCCL_112 = 1: PCCL_113
PCCL_115_LOOP_END

PCCL_113_#_#
If PCCL_111_#_#= 1 or PCCL_112_#_#=1
(Continue PCCL LOOP 1f)
QUESTION TYPE
Dropdown
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Create ﬁll, FILL_PCCL_113#: If LOOPNUMBER_1f = 1, FILL_PCCL_113#: “ﬁrst”
Else, FILL_PCCL_113#: “next”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Create ﬁll, FILL_PCCL_113#: If LOOPNUMBER_1f = 1, FILL_PCCL_113#: “la primera”
Else, FILL_PCCL_113#: “la siguiente”
In what year did ^{FILL_YOUTHNAME} ^{FILL_PCCL_113#} change schools since entering ninth grade
(or equivalent)?
ENGLISH
Year: _______________
ASK

SPANISH

¿En qué año fue ^{FILL_PCCL_113#} vez que ^{FILL_YOUTHNAME} cambió de escuela desde que entró
en el noveno grado (o equivalente)?
Año: _______________

RANGE

List years 2015-2030 in reverse chronological order (i.e., 2030, 2029, 2028, etc.) starting
with DOI year (i.e., if DOI year is 2025, do not include 2026-2030)

LIMITS
LOOP MAX
PROGRAM. NOTES

15
Display calendar.
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END)
until PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_111 = 1, PCCL_112 = 1
PCCL_114

PCCL_114_#_#

QUESTION TYPE

If PCCL_111_#_#= 1 or PCCL_112_#_#=1
(Continue PCCL LOOP 1f)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What grade was ^{FILL_YOUTHNAME} in, or had ^{FILL_YOUTHNAME} just finished, when they left the
old school?
9. 9th grade
10. 10th grade
11. 11th grade
12. 12th grade
51. Business/Trade School
13. 1st Year College
14. 2nd Year College
15. 3rd Year College
16. 4th Year College
17. 1st Year Grad School
18. 2nd Year Grad School
19. 3rd Year Grad School
20. 4th Year Grad School
21. 5th + Year Grad School
95. Ungraded

ENGLISH

¿En qué grado estaba ^{FILL_YOUTHNAME} o qué grado acababa de terminar ^{FILL_YOUTHNAME}
cuando dejó su anterior escuela?
9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado

SPANISH

51. Escuela de negocios/oficios
13. 1.º año de universidad
14. 2.º año de universidad
15. 3.º año de universidad
16. 4.º año de universidad
17. 1.º año de posgrado
18. 2.º año de posgrado
19. 3.º año de posgrado
20. 4.º año de posgrado
21. 5.º+ año de posgrado
95. Sin grado

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_113
If LOOPNUMBER=15: PCCL_115_LOOP_END
Else: Loop again (PCCL_095_LOOP_BEGIN)

PCCL_115_LOOP_END_#_#
If f_PCCL_093 ≠ -9
ASK
(End PCCL Loop 1f)
QUESTION TYPE
Computer check
FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Computer check, do not display.
Loop through PCCL Loop 1f (PCCL_095_LOOP_BEGIN through PCCL_115_LOOP_END) until
PCCL_112=0 OR PCCL_111=0 or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_111, PCCL_112, PCCL_114
If every reported school type for PCCL_096 = 4 (homeschool): f_PCCL_136
Else if PCCL_091 = 0: PCCL_116
Else: PCCL_117

PCCL_116_#

QUESTION TYPE

If any value for PCCL_096 ≠ 4 (home school) AND PCCL_091 = 0
(Continue PCCL Loop 1)
Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what year did ^{FILL_YOUTHNAME} stop attending their last school?
ENGLISH

Year: _______________
¿En qué año ^{FILL_YOUTHNAME} dejó de asistir a su última escuela?

SPANISH

Año: _______________

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

List years 2015-2030 in reverse chronological order (i.e., 2030, 2029, 2028, etc.) starting
with DOI year (i.e., if DOI year is 2025, do not include 2026-2030)
Max 4 digits
15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_115_LOOP_END
PCCL_117

PCCL_117_#
ASK

If PCCL_082 ≠ -8 AND any value for PCCL_096# ≠ 4 (home school) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Next are some general questions about ^{FILL_YOUTHNAME}'s schooling. Please think about
^{FILL_YOUTHNAME}'s entire school history, not just what they did at any particular school. Has
^{FILL_YOUTHNAME} ever repeated any grade?
ENGLISH
1. Yes
0. No

SPANISH

Las siguientes preguntas son, en general, sobre la escolarización de ^{FILL_YOUTHNAME}. Piense en
todo el historial escolar de ^{FILL_YOUTHNAME}, no solo en lo que hizo en una escuela en particular.
¿Ha ^{FILL_YOUTHNAME} repetido alguna vez algún grado?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_091 in (1:8) or in (93:95), PCCL_093 = -9, PCCL_116, PCCL_115_LOOP_END
If PCCL_117 = 1: f_PCCL_118
Else: PCCL_120

f_PCCL_118_#
PCCL_118PK_# / PCCL_118K1_# / PCCL_118K2_# / PCCL_118A_# / PCCL_118B_# / PCCL_118C_# / PCCL_118D_# /
PCCL_118E_# / PCCL_118F_# / PCCL_118G_# / PCCL_118H_# / PCCL_118I_# / PCCL_118J_# / PCCL_118K_# /
PCCL_118L_# / PCCL_118M_#
ASK
If PCCL_117 = 1 (Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Which grade(s) did ^{FILL_YOUTHNAME} repeat? Please select all that apply.
90. Prekindergarten [PCCL_118PK_#]
91. Kindergarten (first year or 4K) [PCCL_118K1_#]
92. Kindergarten (second year or 5K) [PCCL_118K2_#]
1. 1st grade [PCCL_118A_#]
2. 2nd grade [PCCL_118B_#]
3. 3rd grade [PCCL_118C_#]
4. 4th grade [PCCL_118D_#]
5. 5th grade [PCCL_118E_#]
6. 6th grade [PCCL_118F_#]
7. 7th grade [PCCL_118G_#]
8. 8th grade [PCCL_118H_#]
9. 9th grade [PCCL_118I_#]
10. 10th grade [PCCL_118J_#]
11. 11th grade [PCCL_118K_#]
12. 12th grade [PCCL_118L_#]
0. None [PCCL_118M_#]

ENGLISH

¿Qué grado(s) repitió ^{FILL_YOUTHNAME}? Seleccione todas las que correspondan.

SPANISH

90.
91.
92.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
0.

Prekínder [PCCL_118PK_#]
Kínder (primer año o 4K) [PCCL_118K1_#]
Kínder (segundo año o 5K) [PCCL_118K2_#]
1.º grado [PCCL_118A_#]
2.º grado [PCCL_118B_#]
3.º grado [PCCL_118C_#]
4.º grado [PCCL_118D_#]
5.º grado [PCCL_118E_#]
6.º grado [PCCL_118F_#]
7.º grado [PCCL_118G_#]
8.º grado [PCCL_118H_#]
9.º grado [PCCL_118I_#]
10.º grado [PCCL_118J_#]
11.º grado [PCCL_118K_#]
12.º grado [PCCL_118L_#]
Ninguno [PCCL_118M_#]

RANGE
LIMITS
LOOP MAX

15

PROGRAM. NOTES

Code variable as 1 if checked, 0 if not.

Do not allow other options to be selected if PCCL_118M = 1 (should be exclusive)
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_117 = 1
If PCCL_118M_# = 1: PCCL_120
Else: PCCL_119

PCCL_119_#
ASK

If PCCL_117 = 1 AND PCCL_118M ≠ 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever repeated a grade more than once?
ENGLISH

1. Yes
0. No
¿Alguna vez ha repetido ^{FILL_YOUTHNAME} un grado más de una vez?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_118
PCCL_120

PCCL_120_#
ASK

If PCCL_082 ≠ -8 AND any value for PCCL_096 ≠ 4 (home school) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever skipped ahead a grade?
ENGLISH

1. Yes
0. No
¿Alguna vez ^{FILL_YOUTHNAME} se saltó un grado?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_119, PCCL_117
If PCCL_120 = 1: PCCL_122 (Begin PCCL Loop_1g)
Else if PCCL_091 = 0: PCCL_126
Else : PCCL_127

PCCL_122_#_#
If PCCL_120 = 1
(Begin PCCL LOOP 1g)
QUESTION TYPE
Radio button
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (ENG)
Create ﬁll, FILL_PCCL_122#: If LOOPNUMBER_1g = 1, FILL_PCCL_122#: “ﬁrst”
Else, FILL_PCCL_122#: “next”
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Create ﬁll, FILL_PCCL_122#: If LOOPNUMBER_1g = 1, FILL_PCCL_122#: “la primera”
Else, FILL_PCCL_122#: “la siguiente”
Tell us about the ^{FILL_PCCL_122#} time ^{FILL_YOUTHNAME} skipped a grade. Which grade were
they in before the skip?
ASK

ENGLISH

90.
91.
92.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Prekindergarten
Kindergarten (first year or 4K)
Kindergarten (second year or 5K)
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade

Háblenos de ^{FILL_PCCL_122#} vez que ^{FILL_YOUTHNAME} se saltó un grado. ¿En qué grado
estaban antes de omitir un grado?

SPANISH

RANGE

90. Prekínder
91. Kínder (primer año o 4K)
92. Kínder (segundo año o 5K)
1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado
10

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)

5
Loop through PCCL Loop 1g (PCCL_122_#_# - PCCL_124_#_#) until PCCL_124_#_#=0 or
until max loops reached (5).
If PCCL_122 grade > PCCL_091 grade, display hard check: “You previously reported that
^{FILL_YOUTHNAME} is currently in ^{FILL_PCCL_091}. Please review your answer.”
Do not compare against PCCL_091 if PCCL_091 = 0 or 95.
If PCCL_122 grade > PCCL_091 grade, display hard check: “Anteriormente informó que
^{FILL_YOUTHNAME} está actualmente en ^{FILL_PCCL_091}. Revise su respuesta.”
Do not compare against PCCL_091 if PCCL_091 = 0 or 95.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_120=1
PCCL_123

PCCL_123_#_#

QUESTION TYPE

If PCCL_120 = 1
(Continue PCCL LOOP 1g)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Which grade was ^{FILL_YOUTHNAME} skipped into?
1. 1st grade
2. 2nd grade
3. 3rd grade
4. 4th grade
5. 5th grade
6. 6th grade
7. 7th grade
8. 8th grade
9. 9th grade
10. 10th grade
11. 11th grade
12. 12th grade

ENGLISH

¿A qué grado pasó ^{FILL_YOUTHNAME} cuando se saltó un grado?

SPANISH

1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)

5
Loop through PCCL Loop 1g (PCCL_122_#_# - PCCL_124_#_#) until PCCL_124_#_#=0 or
until max loops reached (5).
If PCCL_123 grade <= PCCL_122 grade, display hard check: “You previously reported that
^{FILL_YOUTHNAME} was in ^{FILL_PCCL_122} before the skip. Please review your
answer.”
If PCCL_123 grade > PCCL_122 grade, display hard check: “Anteriormente informó que
^{FILL_YOUTHNAME} estaba en ^{FILL_PCCL_091} antes del salto. Revise su respuesta.”

HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_122
PCCL_124

PCCL_124_#_#

QUESTION TYPE

If PCCL_120 = 1
(End PCCL LOOP 1g)
Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

ASK

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Was ^{FILL_YOUTHNAME} ever skipped ahead again?
ENGLISH

1. Yes
0. No
¿^{FILL_YOUTHNAME} ha vuelto a saltar un grado?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

5
Loop through PCCL Loop 1g (PCCL_122_#_# - PCCL_124_#_#) until PCCL_124_#_#=0 or
until max loops reached (5).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_123#
If PCCL_124# = 1 and LOOPNUMBER_1g < 10: Loop again (PCCL_122_#_#)
Else if PCCL_091 = 0: PCCL_126
Else: PCCL_127

PCCL_126_#
ASK

If PCCL_091=0 (Continue PCCL Loop 1)

QUESTION TYPE

Dropdown

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

What is the highest grade of school that ^{FILL_YOUTHNAME} has ever attended?
ENGLISH

Grade: { - Select - }
¿Cuál es el grado más alto de la escuela al que asistió ^{FILL_YOUTHNAME}?

SPANISH

RANGE

Grado: { - Seleccione - }
0.
93.
94.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
95.

None
Pre-kindergarten
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Post-secondary vocational or technical training
2-year college
In 4-year college
Graduate/professional school
Ungraded school

SPANISH:
0. Ninguno
93. Prekínder
94. Kínder
1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado
11. 11.º grado

12.
13.
14.
15.
16.
95.

12.º grado
Capacitación profesional o técnica postsecundaria
Universidad de dos años
Universidad de 4 años
Escuela de posgrado/profesional
Escuela de grado

LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_120, PCCL_124
PCCL_127

PCCL_127_#
ASK

If PCCL_082 ≠ -8 AND any value for PCCL_096# ≠ 4 (home school) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever had a special education or early intervention plan? Children receiving
these services often have an Individualized Family Service Plan (IFSP) or Individualized Education Plan
(IEP).
ENGLISH
1. Yes
0. No

SPANISH

¿Ha tenido ^{FILL_YOUTHNAME} alguna vez un plan de educación especial o de intervención
temprana? Los(as) niños(as) que reciben estos servicios suelen tener un plan de servicios familiares
individualizado (IFSP, por sus siglas en inglés) o un plan de educación individualizado (IEP, por sus
siglas en inglés).
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)

HELP TEXT (ENG)

HELP TEXT (SPAN)

Individualized Education Program (IEP): A written statement for each student with a
disability that sets goals for the student in school, says how progress will be measured,
describes the special education and related services the school will provide, how much
the student will be in the regular class with students without disabilities, and lists
accommodations or modiﬁcations needed to measure what the student knows through
tests.
Instructional/Individual Services Plan (ISP): A plan paid for by a local school district for
students with disabilities who attend private schools. It spells out the special education
and related services that will be made available to a student. Services may be oﬀered
through a private school or a local education agency (LEA).]
Programa de educación individualizado (IEP): una declaración escrita para cada estudiante
con discapacidad que establece objetivos para el estudiante en la escuela, indica cómo se
medirá el progreso, describe la educación especial y los servicios relacionados que
proporcionará la escuela, cuánto estará el estudiante en la clase regular con estudiantes
sin discapacidad y enumera las adaptaciones o modiﬁcaciones necesarias para medir lo
que el estudiante sabe mediante pruebas.
Plan de instrucción/servicios individuales (ISP): un plan pagado por un distrito escolar
local para estudiantes con discapacidades que asisten a escuelas privadas. En este se
detallan la educación especial y los servicios relacionados que se pondrán a disposición

MODE

del estudiante. Los servicios pueden ofrecerse a través de una escuela privada o de una
agencia de educación local (LEA, por sus siglas en inglés).]
CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_120, PCCL_124, PCCL_126
If PCCL_127 = 1: f_PCCL_128
Else: PCCL_130

f_PCCL_128_#
PCCL_128_MO_# / PCCL_128_YR_#
ASK
If PCCL_127 = 1 (Continue PCCL Loop 1)
Dropdown: PCCL_128_MO
QUESTION TYPE
Dropdown: PCCL_128_YR
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what month and year did ^{FILL_YOUTHNAME} receive the first plan?
ENGLISH

Month: { - Select - } [PCCL_128_MO_#]
Year: ___________ [PCCL_128_YR_#]
¿En qué mes y año recibió ^{FILL_YOUTHNAME} el primer plan?

SPANISH

Mes: { - Seleccione - } [PCCL_128_MO_#]
Año: ___________ [PCCL_128_YR_#]
PCCL_128_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCCL_128_YR: 2010-2030

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

RESPONSE OPTIONS SPANISH
1. Enero
2. Febrero
3. Marzo
4. Abril
5. Mayo
6. Junio
7. Julio
8. Agosto
9. Septiembre
10. Octubre
11. Noviembre
12. Diciembre

PCCL_128_YR: List years 2010-2030 in reverse chronological order (i.e., 2030, 2029,
2028, etc.) starting with DOI year (i.e., if DOI year is 2025, do not include 2026-2030)
PCCL_128_YR: Allow 4 digits
15
Display calendar.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_128_# before YOUTHDOB, display hard check:
Date ^{FILL_YOUTHNAME} received ﬁrst plan should be after they were born. Please
review your answer.
If PCCL_128_# after DOI, display hard check:
Please enter a date that is in the past.
If PCCL_128_# before YOUTHDOB, display hard check:

La fecha en que ^{FILL_YOUTHNAME} recibió el primer plan debe ser posterior a su
nacimiento. Revise su respuesta.
If PCCL_128_# after DOI, display hard check:
Ingrese una fecha que está en el pasado.
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_127 = 1
PCCL_129

PCCL_129_#
ASK

If PCCL_127 = 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Is ^{FILL_YOUTHNAME} currently receiving services under one of these plans?
ENGLISH

1. Yes
0. No
¿Recibe ^{FILL_YOUTHNAME} actualmente servicios de alguno de estos planes?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_128
PCCL_130

PCCL_130_#
ASK

If PCCL_082 ≠ -8 AND any value for PCCL_096# ≠ 4 (home school) (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever received special services to meet their developmental needs? Special
services can include therapies such as speech, occupational, physical, or behavioral or other services
received to meet developmental needs.
ENGLISH
1. Yes
0. No

SPANISH

¿Ha recibido ^{FILL_YOUTHNAME} alguna vez servicios especiales para cubrir sus necesidades de
desarrollo? Los servicios especiales pueden incluir terapias como la terapia del habla, ocupacional,
física o conductual u otros servicios recibidos para cubrir las necesidades de desarrollo.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_127, PCCL_129
If PCCL_130 = 1: f_PCCL_131
Else: PCCL_133

f_PCCL_131_#
PCCL_131_MO_# / PCCL_131_YR_#
ASK
If PCCL_130 = 1 (Continue PCCL Loop 1)
Dropdown: PCCL_131_MO
QUESTION TYPE
Dropdown: PCCL_131_YR
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what month and year did ^{FILL_YOUTHNAME} begin receiving these special services? Your best
estimate is fine.
ENGLISH

Month: { - Select - } [PCCL_131_MO_#]
Year: ___________ [PCCL_131_YR_#]
¿En qué mes y año comenzó ^{FILL_YOUTHNAME} a recibir estos servicios especiales? Proporcione su
mejor estimación.

SPANISH

Mes: { - Seleccione - } [PCCL_131_MO_#]
Año: ___________ [PCCL_131_YR_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

PCCL_131_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCCL_131_YR: List years 2010-2030 in reverse chronological order (i.e., 2030, 2029,
2028, etc.) starting with DOI year (i.e., if DOI year is 2025, do not include 2026-2030)
PCCL_131_YR: Allow 4 digits
15
Display calendar.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_131_# before YOUTHDOB, display hard check:
Date ^{FILL_YOUTHNAME} began receiving services should be after they were born.
Please review your answer.
If PCCL_131_# after DOI, display hard check:
Please enter a date that is in the past.
If PCCL_131_# before YOUTHDOB, display hard check:
La fecha en que ^{FILL_YOUTHNAME} comenzó a recibir servicios debe ser posterior a su
nacimiento. Revise su respuesta.
If PCCL_131_# after DOI, display hard check:
Ingrese una fecha que está en el pasado.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_130 = 1
PCCL_132

PCCL_132_#
ASK

If PCCL_130 = 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Is ^{FILL_YOUTHNAME} currently receiving these special services?
ENGLISH

1. Yes
0. No
¿Está ^{FILL_YOUTHNAME} recibiendo en este momento estos servicios especiales?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

f_PCCL_131
PCCL_133

PCCL_133_#
ASK

If PCCL_082 ≠ -8 AND any value for PCCL_096# ≠ 4 (continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever been enrolled in a program for English Language Learners (ELLs) such as
English as a Second Language (ESL), English immersion, or bilingual education?
ENGLISH

SPANISH

1. Yes
0. No
¿Alguna vez ^{FILL_YOUTHNAME} se matriculó en un programa para estudiantes del idioma inglés
(ELL, por sus siglas en inglés), como inglés como segundo idioma (ESL, por sus siglas en inglés),
inmersión en inglés o educación bilingüe?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

NEXT

PCCL_130, PCCL_132
If PCCL_133 = 1: PCCL_134
Else If PCCL_092 = 1: PCCL_137
Else if PCCL_102091 in (9:12): f_PCCL_135
Else if PCCL_091 = 0 AND PCCL_126 in (9:13): f_PCCL_136
Else if YOUTH_CURRENTAGE < 15: PCCL_139_LOOP_END_#
Else: PCCL_137

PCCL_134_#
ASK

If PCCL_133 = 1 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
What was the last grade in which ^{FILL_YOUTHNAME} was enrolled in a program for English Language
Learners (ELLs)?
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.

ENGLISH

1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Still enrolled

¿Cuál fue el último grado en el que ^{FILL_YOUTHNAME} estuvo matriculado(a) en un programa para
estudiantes del idioma inglés (ELL)?

SPANISH

1. 1.º grado
2. 2.º grado
3. 3.º grado
4. 4.º grado
5. 5.º grado
6. 6.º grado
7. 7.º grado
8. 8.º grado
9. 9.º grado
10. 10.º grado
11. 11.º grado
12. 12.º grado
13. Todavía está matriculado(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
If PCCL_134 grade > PCCL_091 grade, display hard check: “You previously reported that
^{FILL_YOUTHNAME} is currently in ^{FILL_PCCL_091}. Please review your answer.”
Do not check against PCCL_091 grade if PCCL_134 = 13 or PCCL_091 = 0 or PCCL_091 =
95

CHECK (SPAN)

If PCCL_134 grade > PCCL_091 grade, display hard check: “Anteriormente informó que
^{FILL_YOUTHNAME} está actualmente en ^{FILL_PCCL_091}. Revise su respuesta.”
Do not check against PCCL_091 grade if PCCL_134 = 13 or PCCL_091 = 0 or PCCL_091 = 95

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN

NEXT

PCCL_133 = 1
If PCCL_092 = 1: PCCL_137
Else if PCCL_102091 in (9:12): f_PCCL_135
Else if PCCL_091 = 0 and PCCL_126 in (9:13): f_PCCL_136
Else If YOUTH_CURRENTAGE < 15: PCCL_139_LOOP_END_#
Else: PCCL_137

f_PCCL_135_#
PCCL_135_MO_# / PCCL_135_YR_#
ASK
If PCCL_091 in (9:12) (Continue PCCL Loop 1)
Dropdown: PCCL_135_MO
QUESTION TYPE
Dropdown: PCCL_135_YR
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
If ^{FILL_YOUTHNAME} does not go to summer school or take extra courses and passes all the courses
they take, including those they are taking now, when would ^{FILL_YOUTHNAME} graduate from high
school -- what month and year?
ENGLISH
Month: { - Select - } [PCCL_135_MO_#]
Year: ___________ [PCCL_135_YR_#]

SPANISH

Si ^{FILL_YOUTHNAME} no va a la escuela de verano ni toma cursos adicionales y aprueba todos los
cursos que toma, incluidos los que está tomando ahora, ¿cuándo se graduaría ^{FILL_YOUTHNAME} de
la escuela secundaria (en qué mes y año)?
Mes: { - Seleccione - } [PCCL_135_MO_#]
Año: ___________ [PCCL_135_YR_#]
PCCL_135_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCCL_135_YR: List years 2026-2040

RANGE

RESPONSE OPTIONS SPANISH
1. Enero
2. Febrero
3. Marzo
4. Abril
5. Mayo
6. Junio
7. Julio
8. Agosto
9. Septiembre
10. Octubre
11. Noviembre
12. Diciembre
in reverse chronological order (i.e., 2040, 2039, 2038, etc.). Do not list past years.

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
Display calendar.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Reported month/year combination must be in the future. If reported date is not in the
future display hard check:
Please report a date in the future.
Reported month/year combination must be in the future. If reported date is not in the
future display hard check:
Proporcione una fecha que está en el futuro.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_133, PCCL_134
Else If YOUTH_CURRENTAGE < 15: PCCL_139_LOOP_END_#
Else: PCCL_137

f_PCCL_136_#
PCCL_136_MO_# / PCCL_136_YR_#
ASK
If PCCL_091 = 0 and PCCL_126 in (9:13) (Continue PCCL Loop 1)
Dropdown: PCCL_136_MO
QUESTION TYPE
Dropdown: PCCL_136_YR
FILLS (ENG)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
If ^{FILL_YOUTHNAME} went back to school next fall, and didn't go to summer school or take extra
courses and ^{FILL_YOUTHNAME} passed all the courses they took, when would ^{FILL_YOUTHNAME}
graduate from high school -- what month and year?
ENGLISH
Month: { - Select - } [PCCL_136_MO_#]
Year: ___________ [PCCL_136_YR_#]

SPANISH

Si ^{FILL_YOUTHNAME} volviera a la escuela el próximo otoño, y no fuera a la escuela de verano ni
tomara cursos adicionales y ^{FILL_YOUTHNAME} aprobara todos los cursos que toma, ¿cuándo se
graduaría ^{FILL_YOUTHNAME} de la escuela secundaria (en qué mes y año)?
Mes: { - Seleccione - } [PCCL_136_MO_#]
Año: ___________ [PCCL_136_YR_#]

RANGE

PCCL_136_MO: List months in order. 1 = “January”, 2 = “February”, … 12 = “December”
PCCL_136_YR: List years 2026-2040 in reverse chronological order (i.e., 2040, 2039,
2038, etc.) Do not list past years.

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

15
Display calendar.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Reported month/year combination must be in the future. If reported date is not in the
future display hard check:
Please report a date in the future.
Reported month/year combination must be in the future. If reported date is not in the
future display hard check:
Proporcione una fecha que está en el futuro.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_115_LOOP_END#, PCCL_133, PCCL_134
Else If YOUTH_CURRENTAGE < 15: PCCL_139_LOOP_END_#
Else: PCCL_137

PCCL_137_#
ASK

If YOUTH_CURRENTAGE >= 15 and PCCL_082 ≠ -8 (Continue PCCL Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
Has ^{FILL_YOUTHNAME} ever taken and received credit for any college courses?
ENGLISH

1. Yes
0. No
¿^{FILL_YOUTHNAME} ha tomado y recibido créditos por algún curso universitario?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_133, PCCL_134, f_PCCL_135, f_PCCL_136
If PCCL_137 = 0: PCCL_139_LOOP_END_#
Else: f_PCCL_138

f_PCCL_138_#
PCCL_138A_# / PCCL_138B_# / PCCL_138C_# / PCCL_138D_# / PCCL_138_#E / PCCL_138F_# / PCCL_138G_# /
PCCL_138H_# / PCCL_138I_#
ASK
If PCCL_138 ≠ 1 (Continue PCCL Loop 1)
QUESTION TYPE

Checkbox

FILLS (ENG)

Use ﬁll from PCCL_001: FILL_YOUTHNAME

FILLS (SPAN)
Use ﬁll from PCCL_001: FILL_YOUTHNAME
In what years did ^{FILL_YOUTHNAME} take college courses? Please select all that apply.
1.
2.
3.
4.
5.
6.
7.
8.
9.

ENGLISH

2020 [PCCL_138A_#]
2021 [PCCL_138B_#]
2022 [PCCL_138C_#]
2023 [PCCL_138D_#]
2024 [PCCL_138E_#]
2025 [PCCL_138F_#]
2026 [PCCL_138G_#]
2027 [PCCL_138H_#]
2028 [PCCL_138I_#]

¿En qué años tomó ^{FILL_YOUTHNAME} los cursos universitarios? Seleccione todas las que
correspondan.

SPANISH

1.
2.
3.
4.
5.
6.
7.
8.
9.

2020 [PCCL_138A_#]
2021 [PCCL_138B_#]
2022 [PCCL_138C_#]
2023 [PCCL_138D_#]
2024 [PCCL_138E_#]
2025 [PCCL_138F_#]
2026 [PCCL_138G_#]
2027 [PCCL_138H_#]
2028 [PCCL_138I_#]

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Code variable as 1 if checked, 0 if not.
Do not display answer options for years after DOI.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_137 = 1
PCCL_139_LOOP_END_#

PCCL_139_LOOP_END_#
ASK

All respondents (End PCCL Loop 1)

QUESTION TYPE

Computer check

FILLS (ENG)
FILLS (SPAN)
ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Computer check, do not display.
Loop through PCCL Loop 1 (PCCL_001 through PCCL_139_LOOP_END) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI/CAWI

NOTES
LEAD-IN
NEXT

PCCL_137 = 1
LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15): PCHE_001
Else: Loop again (PCCL_001_#)

7. Child Health (PCHE)
PRELOADS:
PRELOADS:
YOUTHROSTER: HHS
o YOUTH_UID: Unique ID for each eligible youth in the household
o YOUTH_NAME: Name of the eligible youth
o YOUTH_AGE: Age (in years) of the eligible youth
o YOUTH_DOB: Date of birth for the eligible youth
o YOUTH_DOBYEAR: Year of birth for the eligible youth
o YOUTH_PLGUID1: ID number of youth’s 1st parent or guardian
o YOUTH_SEX: Sex (male/female) of the eligible youth
o YOUTH_RACE: Race/ethnicity of the eligible youth
o YOUTH_RESIDENCE: Flag if the youth lives in the household full-time or part-time
YOUTHROSTERNUM: HHSSTATEPROGRAM1: Sample preload
STATEPROGRAM2: Sample preload
GENERAL PROGRAMMING NOTES:
CAPTURE ITEM LEVEL TIMING.
INCLUDE A TIME/DATE STAMP AT BEGINNING AND END OF MODULE.
•
•

Do not display response option numbers/letters.
Do not display DK and REF on each screen at loading.
o If R tries to move forward without providing a response, display DK (‘Don’t know’) and REF (‘Prefer
not to answer’) on screen.
 Unless otherwise noted, include a soft prompt for R to respond or select DK/REF option:
“Your answers are very important. Please consider selecting a response.”
o If R still tries to move forward without answering, assign REF code to missing response.

1

PCHE_001_#
ASK

All (Begin PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Create ﬁll, FILL_YOUTHNAME: Fill ‘YOUTHNAME’ from preload

FILLS (SPAN)
Create ﬁll, FILL_YOUTHNAME: Fill ‘YOUTHNAME’ from preload
The next few questions are about ^{FILL_YOUTHNAME}’s health.
In general, how is their physical health?
ENGLISH

5.
4.
3.
2.
1.

Excellent
Very good
Good
Fair
Poor

Las siguientes preguntas son sobre la salud de ^{FILL_YOUTHNAME}.
En general, ¿cómo es su salud física?
SPANISH

5.
4.
3.
2.
1.

Excelente
Muy buena
Buena
Regular
Mala

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Create variable PCHELOOP1[#].YOUTH_UID=YOUTH_UID_#

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCCL_082=-8, PCCL_133, PCCL_134, PCCL_135, PCCL_136, PCCL_137, PCCL_138
PCHE_002

2

PCHE_002_# 
ASK

All (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
In general, how is their mental or emotional health?

ENGLISH

5.
4.
3.
2.
1.

Excellent
Very good
Good
Fair
Poor

En general, ¿cómo está su estado de salud mental o emocional?

SPANISH

5.
4.
3.
2.
1.

Excelente
Muy bien
Bien
Regular
Mal

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_001
PCHE_003

3

PCHE_003_# 
ASK

All (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Was ^{FILL_YOUTHNAME} born more than 3 weeks before their due date?
ENGLISH

1. Yes
0. No
¿Nació ^{FILL_YOUTHNAME} más de 3 semanas antes de la fecha prevista de parto?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_002
PCHE_004

4

f_PCHE_004_# 
PCHE_004_WEIGHTLB_#/PCHE_004_WEIGHTOZ_#
ASK
QUESTION TYPE
FILLS (ENG)

All (Continue PCHE Loop 1)
PCHE_004_WEIGHTLB: Numeric
PCHE_004_WEIGHTOZ: Numeric
Radio
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much did ^{FILL_YOUTHNAME} weigh when they were born? Your best estimate is fine.
Pounds: _____________ [PCHE_004_WEIGHTLB_#]
ENGLISH

Ounces: _____________ [PCHE_004-_WEIGHTOZ_#]
-9. I prefer to report in kilograms and grams
¿Cuánto pesaba ^{FILL_YOUTHNAME} cuando nació? Proporcione su mejor estimación.
Libras: _____________ [PCHE_004_WEIGHTLB_#]

SPANISH

Onzas: _____________ [PCHE_004-_WEIGHTOZ_#]
-9. Prefiero ingresar el peso en kilogramos y gramos.

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

PCHE_004_WEIGHTLB: RANGE = 1-13
PCHE_004_WEIGHTOZ: RANGE = 0-15
PCHE_004_WEIGHTLB: Max 2 digit
PCHE_004_WEIGHTOZ: Max 2 digits
15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR POUNDS AND OUNCES ON SAME ROW WITH
CORRESPONDING LABELS; ALSO INCLUDE A SINGLE SELECT OPTION WITH VALUE (-9) TO
REPORT WEIGHT IN KILOGRAMS AND GRAMS DIRECTLY BELOW NUMBOX ENTRIES
IF OUT OF RANGE DISPLAY A HARD CHECK:
PCHE_004-WEIGHTLB: Please enter a number of pounds between 1-13.
PCHE_004- WEIGHTOZ: Please enter a number of ounces between 0-15.
IF OUT OF RANGE DISPLAY A HARD CHECK:
PCHE_004-WEIGHTLB: Ingrese un número de libras entre 1-13.
PCHE_004- WEIGHTOZ: Ingrese un número de onzas entre 0-15.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_003
IF PCHE_004=-9: PCHE_005
Else if (PCHE_004_WEIGHTLB=DK or REF) and (PCHE_004_WEIGHTOZ=DK or REF):
PCHE_006
Else if PCHE_004_WEIGHTLB = 5 and PCHE_004_WEIGHTOZ = (DK or REF): PCHE_006

5

Else PCHE_007

6

f_PCHE_005_#
PCHE_005_WEIGHTKL_#/PCHE_005_WEIGHTGR_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_004=-9 (Continue PCHE Loop 1)
PCHE_005_WEIGHTKG: Numeric
PCHE_005_WEIGHTGR: Numeric
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much did ^{FILL_YOUTHNAME} weigh when they were born? Your best estimate is fine.
ENGLISH

Kilograms: __________ [PCHE_005_WEIGHTKG_#]
Grams: __________ [PCHE_005_WEIGHTGR_#]
¿Cuánto pesaba ^{FILL_YOUTHNAME} cuando nació? Proporcione su mejor estimación.

SPANISH

Kilogramos: __________ [PCHE_005_WEIGHTKG_#]
Gramos: __________ [PCHE_005_WEIGHTGR_#]

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

PCHE_005_WEIGHTKG: RANGE = 1-6
PCHE_005_WEIGHTGR: RANGE = 0-999
PCHE_005_WEIGHTKG: Max 1 digit
PCHE_005_WEIGHTGR: Max 3 digits
15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR KILOGRAMS AND GRAMS ON SAME ROW WITH
CORRESPONDING LABELS
IF OUT OF RANGE, DISPLAY A HARD CHECK:
PCHE_005_WEIGHTKG: Please enter a number of kilograms between 1-6.
PCHE_005_WEIGHTGR: Please enter a number of grams between 0-999.
IF OUT OF RANGE, DISPLAY A HARD CHECK:
PCHE_005_WEIGHTKG: Ingrese un número de kilogramos entre 1-6.
PCHE_005_WEIGHTGR: Ingrese un número de gramos entre 0-999.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
f_PCHE_004
IF (PCHE_005_WEIGHTKG=DK or REF) and (PCHE_005_WEIGHTGR=DK or REF): PCHE_006
Else if (PCHE_WEIGHTKG = 2 and PCHE_005_WEIGHTGR = (DK or REF): PCHE_006
Else PCHE_007

7

PCHE_006_#

QUESTION TYPE

IF ((PCHE_005_WEIGHTKG=DK or REF) and (PCHE_005_WEIGHTGR=DK or REF)) OR
((PCHE_004_WEIGHTLB=DK or REF) and (PCHE_004_WEIGHTOZ=DK or REF)) OR
(PCHE_004_WEIGHTLB = 5 and (PCHE_004_WEIGHTOZ = (DK or REF)) OR
(PCHE_005_WEIGHTKG = 2 and (PCHE_005_WEIGHTGR = (DK or REF) (Continue PCHE
Loop 1)
Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

ASK

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
When ^{FILL_YOUTHNAME} was born, did they weigh at least 5.5 pounds or 2,500 grams?
ENGLISH

1. Yes
0. No
Cuando ^{FILL_YOUTHNAME} nació, ¿pesaba al menos 5.5 libras o 2,500 gramos?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_004, f_PCHE_005
PCHE_007

8

PCHE_007_#
ASK
QUESTION TYPE

All (Continue PCHE Loop 1)
Radio

Create fill, FILL_YOUTHSEX from the YOUTHROSTER:
IF YOUTH_SEX= 1, FILL_YOUTHSEX: ‘Does’
FILLS (ENG)
ELSE IF YOUTH_SEX= 2, FILL_YOUTHSEX: ‘Excluding pregnancy, does’
ELSE, FILL_YOUTHSEX: ‘Does’
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Create fill, FILL_YOUTHSEX from the YOUTHROSTER:
IF YOUTH_SEX= 1, FILL_YOUTHSEX: ‘¿Tiene’
FILLS (SPAN)
ELSE IF YOUTH_SEX= 2, FILL_YOUTHSEX: ‘Excluyendo el embarazo, ¿tiene’
ELSE, FILL_YOUTHSEX: ‘¿Tiene’
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
^{FILL_YOUTHSEX } ^{FILL_YOUTHNAME} have or have they ever had any physical, emotional, or
mental condition that limits or has limited their ability to attend school regularly, do regular
schoolwork, or work at a job for pay?
ENGLISH
1. Yes
0. No

SPANISH

^{FILL_YOUTHSEX } ^{FILL_YOUTHNAME} o ha tenido alguna vez alguna afección física, emocional o
mental que limite o haya limitado su capacidad para asistir a la escuela con regularidad, realizar las
tareas escolares habituales o trabajar en un empleo pago?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_004, f_PCHE_005, PCHE_006
PCHE_008

9

PCHE_008_#
ASK
QUESTION TYPE
FILLS (ENG)

All(Continue PCHE Loop 1)
Radio
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does ^{FILL_YOUTHNAME} now have or have they ever had a learning or emotional problem that
limits or has limited the kind of schoolwork or other daily activities they can perform, the amount of
time they can spend on these activities, or their performance in these activities?
ENGLISH
1. Yes
0. No

SPANISH

¿Tiene ^{FILL_YOUTHNAME} ahora o ha tenido alguna vez un problema de aprendizaje o emocional
que limite o haya limitado el tipo de trabajo escolar u otras actividades diarias que puede realizar, la
cantidad de tiempo que puede dedicar a estas actividades o su rendimiento en estas actividades?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_007
If PCHE_007=1 or PCHE_008=1: f_PCHE_009; Else PCHE_028

10

f_PCHE_009_#
PCHE_009a_#, PCHE_009b_#, PCHE_009c_#, PCHE_009d_#, PCHE_009e_#, PCHE_009f_#, PCHE_009_OTHER_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_007=1(yes) or PCHE_008=1(yes) (Continue PCHE Loop 1)
PCHE_009a, PCHE_009b, PCHE_009c, PCHE_009d, PCHE_009e, PCHE_009f : Checkbox
PCHE_009_OTHER: Text box
Use ﬁll FILL_YOUTHNAME from PCHE_001

FILLS (SPAN)
Use ﬁll FILL_YOUTHNAME from PCHE_001
What are the conditions? Select all that apply.

ENGLISH

1.   Learning disability (such as dyslexia) or attention disorder [PCHE_009a_#]
2.   Emotional, mental problem or behavior problem [PCHE_009b_#]
3.   Eating disorder (such as anorexia or bulimia) [PCHE_009c_#]
4.   Cognitive delay or cognitive disability [PCHE_009d_#]
5.   Physical problem [PCHE_009e_#]
6.   Some other condition [PCHE_009f_#] (Please describe: _____________________________)
[PCHE_009_OTHER_#]
¿Cuáles son estas afecciones? Seleccione todas las opciones que correspondan.

SPANISH

1.  Discapacidad de aprendizaje (como la dislexia) o trastorno de atención [PCHE_009a_#]
2.   Problema emocional, mental o de comportamiento [PCHE_009b_#]
3.  Trastorno alimentario (como anorexia o bulimia) [PCHE_009c_#]
4.   Retraso cognitivo o discapacidad cognitiva [PCHE_009d_#]
5.  Problema físico [PCHE_009e_#]
6.   Alguna otra afección [PCHE_009f_#] (Describa: _____________________________)
[PCHE_009_OTHER_#]

RANGE
LIMITS

PCHE_009_OTHER: Set max 100 characters

LOOP MAX

15

PROGRAM. NOTES

If option 6 is selected, display PCHE_009_OTHER text box
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
IF NO OPTIONS ARE CHECKED, DISPLAY: You responded on a previous question that
^{FILL_YOUTHNAME} has or had a physical, mental or emotional condition or a learning
or emotional problem. If the condition that ^{FILL_YOUTHNAME} has or had is not listed
here, please select “Some other condition”. If ^{FILL_YOUTHNAME} has not had a
condition or problem, please click “Back” to update your answer.
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
IF NO OPTIONS ARE CHECKED, DISPLAY: Usted respondió en una pregunta anterior que
^{FILL_YOUTHNAME} tiene o ha tenido una afección física, mental o emocional o un
problema de aprendizaje o emocional. Si la afección que tiene o tuvo
^{FILL_YOUTHNAME} no aparece en esta lista, seleccione “Alguna otra afección”. Si
^{FILL_YOUTHNAME} no ha tenido ninguna afección o problema, haga clic en “Back”
(Atrás) para actualizar su respuesta.

CHECK (ENG)

CHECK (SPAN)

HELP TEXT (ENG)
HELP TEXT (SPAN)

11

MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_008
If PCHE_009a=1: PCHE_010; Else if PCHE_009b=1: PCHE_013; Else if PCHE_009c=1:
PCHE_016; Else if PCHE_009d=1: PCHE_019; Else if PCHE_009e=1: PCHE_022; Else
PCHE_025

12

PCHE_010_#
ASK

IF PCHE_009a=1 (Continue PCHE Loop 1)
Numeric
QUESTION TYPE
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
FILLS (ENG)
Create ﬁll, FILL_YOUTHAGE: ‘YOUTH_AGE’ from preloads
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
FILLS (SPAN)
Create ﬁll, FILL_YOUTHAGE: ‘YOUTH_AGE’ from preloads
How old was ^{FILL_YOUTHNAME} when the learning disability or attention disorder was first
noticed?
ENGLISH

_______ years
-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la discapacidad de
aprendizaje o el trastorno de atención?

SPANISH

_______ años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE},YOUTH_AGE, DISPLAY A HARD
CHECK: Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_009
PCHE_011

13

PCHE_011_#
ASK

IF PCHE_009a=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Does the learning disability or attention disorder currently limit them?
ENGLISH

1. Yes
0. No
¿Lo(a) limita en este momento la discapacidad de aprendizaje o el trastorno de atención?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_010
IF PCHE_011=1: PCHE_012; Else if PCHE_009b=1: PCHE_013; Else if PCHE_009c=1:
PCHE_016; Else if PCHE_009d=1: PCHE_019; Else if PCHE_009e=1: PCHE_022; Else if
PCHE_009f=1: PCHE_025; Else PCHE_028

14

PCHE_012_#
ASK

IF PCHE_011=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
How much does this learning disability or attention disorder limit them?
1.   Limits a little
ENGLISH
2.   Limits a lot

SPANISH

¿Cuánto lo(a) limita esta discapacidad de aprendizaje o trastorno de atención?
1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_011=1
If PCHE_009b=1: PCHE_013; Else if PCHE_009c=1: PCHE_016; Else if PCHE_009d=1:
PCHE_019; Else if PCHE_009e=1: PCHE_022; Else if PCHE_009f=1: PCHE_025; Else
PCHE_028

15

PCHE_013_#
ASK

FILLS (ENG)

IF PCHE_009b=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

QUESTION TYPE

How old was ^{FILL_YOUTHNAME} when the emotional, mental or behavioral problem was first
noticed?
ENGLISH

________years
-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el problema emocional,
mental o de comportamiento?

SPANISH

________años
-9. No corresponde, tiene la afección desde su nacimiento

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_009, PCHE_011, PCHE_012
PCHE_014

16

PCHE_014_#
ASK

IF PCHE_009b=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Does the emotional, mental or behavioral problem currently limit them?
ENGLISH

1. Yes
0. No
¿El problema emocional, mental o de comportamiento lo(a) limita en este momento?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_013
IF PCHE_014=1: PCHE_015; Else if PCHE_009c=1: PCHE_016; Else if PCHE_009d=1:
PCHE_019; Else if PCHE_009e=1: PCHE_022; Else if PCHE_009f=1: PCHE_025; Else
PCHE_028

17

PCHE_015_#
ASK

PCHE_014=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
How much does this emotional, mental or behavioral problem limit them?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto lo(a) limita este problema emocional, mental o de comportamiento?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_014=1
IF PCHE_009c=1: PCHE_016; Else if PCHE_009d=1: PCHE_019; Else if PCHE_009e=1:
PCHE_022; Else if PCHE_009f=1: PCHE_025; Else PCHE_028

18

PCHE_016_#
ASK

PCHE_009c=1 (Continue PCHE Loop 1)

QUESTION TYPE

Numeric
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
FILLS (ENG)
Create ﬁll, FILL_YOUTHAGE, from PINF_002
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
FILLS (SPAN)
Create ﬁll, FILL_YOUTHAGE, from PINF_002
How old was ^{FILL_YOUTHNAME} when the eating disorder was first noticed?
ENGLISH _________years

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el trastorno alimentario?
_________años

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_009, PCHE_011, PCHE_012, PCHE_014, PCHE_015
PCHE_017

19

PCHE_017_#
ASK

PCHE_009c=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Does the eating disorder currently limit them?
ENGLISH

1. Yes
0. No
¿Lo(a) limita en este momento el trastorno alimentario?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
f_PCHE_009, PCHE_016
IF PCHE_017=1: PCHE_018; Else if PCHE_009d=1: PCHE_019; Else if PCHE_009e=1:
PCHE_022; Else if PCHE_009f=1: PCHE_025; Else PCHE_028

20

PCHE_018_#
ASK

PCHE_017=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
How much does this eating disorder limit them?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto lo(a) limita este trastorno alimentario?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_017=1
If PCHE_009d=1: PCHE_019; Else if PCHE_009e=1: PCHE_022; Else if PCHE_009f=1:
PCHE_025; Else PCHE_028

21

PCHE_019_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_009d=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the cognitive delay or disability was first noticed?
________years
ENGLISH
-9. Does not apply, they have had the condition since birth

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el retraso cognitivo o la
discapacidad?
________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_009, PCHE_011, PCHE_012, PCHE_014, PCHE_015, PCHE_017, PCHE_018
PCHE_020

22

PCHE_020_#
ASK

PCHE_009d=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Does the cognitive delay or disability currently limit them?
ENGLISH

1. Yes
0. No
¿Lo(a) limita en este momento el retraso cognitivo o la discapacidad?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_019
IF PCHE_020=1: PCHE_021; Else if PCHE_009e=1: PCHE_022; Else if PCHE_009f=1:
PCHE_025; Else PCHE_028

23

PCHE_021_#
ASK

PCHE_020=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
How much does this cognitive delay or disability limit them?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto lo(a) limita este retraso cognitivo o discapacidad?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_020=1
IF PCHE_009e=1: PCHE_022; Else if PCHE_009f=1: PCHE_025; Else PCHE_028

24

PCHE_022_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_009e=1 (Continue PCHE Loop 1)
Numeric
Radio special answer
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the physical problem was first noticed?
ENGLISH

_____years
-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el problema físico?

SPANISH

________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_009, PCHE_011, PCHE_012, PCHE_014, PCHE_015, PCHE_017, PCHE_018,
PCHE_020, PCHE_021
PCHE_023

25

PCHE_023_#
ASK

PCHE_009e=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Does the physical problem currently limit them?
ENGLISH

1. Yes
0. No
¿Lo(a) limita en este momento el problema físico?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_022
IF PCHE_023=1: PCHE_024; Else if PCHE_009f=1: PCHE_025; Else PCHE_028

26

PCHE_024_#
ASK

PCHE_023=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
How much does this physical problem limit them?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto lo(a) limita este problema físico?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_023=1
If PCHE_009f=1: PCHE_025; Else PCHE_028

27

PCHE_025_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_009f=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the other problem was first noticed?
ENGLISH

_________years
-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el otro problema?

SPANISH

_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age, or select
“Does not apply, they have had the condition since birth.”.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad, o seleccione “No
corresponde, tiene la afección desde su nacimiento.”

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_009, PCHE_011, PCHE_012, PCHE_014, PCHE_015, PCHE_017, PCHE_018,
PCHE_020, PCHE_021, PCHE_023, PCHE_024
PCHE_026

28

PCHE_026_#
ASK

PCHE_009f=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
Does the other problem currently limit them?
ENGLISH

1. Yes
0. No
¿Lo(a) limita en este momento el otro problema?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_025
IF PCHE_026=1: PCHE_027; Else PCHE_028

29

PCHE_027_#
ASK

PCHE_026=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)
FILLS (SPAN)
How much does this other problem limit them?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto lo(a) limita este otro problema?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_026=1
PCHE_028

30

PCHE_028_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does ^{FILL_YOUTHNAME} now have or have they ever had trouble seeing, hearing, or speaking?
ENGLISH

1.   Yes
0.   No
¿Tiene o ha tenido alguna vez ^{FILL_YOUTHNAME} problemas para ver, oír o hablar?

SPANISH

1.   Sí
0.   No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_008, PCHE_011, PCHE_012, PCHE_014, PCHE_015, PCHE_017, PCHE_018,
PCHE_020, PCHE_021, PCHE_023, PCHE_024, PCHE_026, PCHE_027
IF PCHE_028=1: PCHE_029; Else PCHE_051

31

f_PCHE_029_#
PCHE_029a_#/ PCHE_029b_#/ PCHE_029c_#/ PCHE_029d_#/ PCHE_029e_#/ PCHE_029f_#/ PCHE_029g_#/
PCHE_029g_OTHER_#
ASK
PCHE_028 = 1 (Continue PCHE Loop 1)
PCHE_029a, PCHE_029b, PCHE_029c, PCHE_029d, PCHE_029e, PCHE_029f, PCHE_029g:
QUESTION TYPE
Radio button grid
PCHE_029g_OTHER: Text
FILLS (ENG)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
FILLS (SPAN)

ENGLISH

SPANISH

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

What conditions has ^{FILL_YOUTHNAME} experienced?
COLUMN HEADERS:
1. Yes
0. No
ROW ITEMS:
a. Blindness in one eye [PCHE_029a]
b. Blindness in both eyes [PCHE_029b]
c. Other vision difficulty [PCHE_029c]
d. Deafness [PCHE_029d]
e. Hearing difficulty [PCHE_029e]
f. Speech impairment (such as lisp, stammering, or stuttering) [PCHE_029f]
g. Some other condition (Please describe: ___________________) [PCHE_029g]
[PCHE_029g_OTHER]
¿Qué afecciones ha experimentado ^{FILL_YOUTHNAME}?
COLUMN HEADERS:
1. Sí
0. No
ROW ITEMS:
a. Ceguera en un ojo [PCHE_029a]
b. Ceguera en los dos ojos [PCHE_029b]
c. Otra dificultad de visión [PCHE_029c]
d. Sordera [PCHE_029d]
e. Dificultad auditiva [PCHE_029e]
f. Deterioro del habla (como ceceo, tartamudeo o tartajeo) [PCHE_029f]
g. Alguna otra afección (describa: ___________________) [PCHE_029g] [PCHE_029g_OTHER]

RANGE
LIMITS

PCHE_029g_OTHER: Set max 100 characters

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Set variables as 1 if checked, 0 if not.
If PCHE_029g is checked, display PCHE_029g_OTHER text box

PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

IF NO OPTIONS ARE CHECKED, DISPLAY:
“You responded on a previous question that ^{FILL_YOUTHNAME} has had trouble
seeing, hearing, or speaking. If the condition that ^{FILL_YOUTHNAME} has or had is not
listed here, please select “Some other condition”. If ^{FILL_YOUTHNAME} has not had
trouble with these, please click “Back” to update your answer.”
IF NO OPTIONS ARE CHECKED, DISPLAY:

32

“Usted respondió en una pregunta anterior que ^{FILL_YOUTHNAME} ha tenido
problemas para ver, oír o hablar. Si la afección que tiene o tuvo ^{FILL_YOUTHNAME} no
aparece en esta lista, seleccione “Alguna otra afección”. Si ^{FILL_YOUTHNAME} no ha
tenido problemas con esto, haga clic en “Back” (Atrás) para actualizar su respuesta.”
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN

PCHE_028=1
IF PCHE_029a=1: PCHE_030; Else if PCHE_029b=1: PCHE_033; PCHE_029c=1: PCHE_036;
PCHE_029d=1: PCHE_039; PCHE_029e=1: PCHE_042; PCHE_029f=1: PCHE_045; Else:
PCHE_048

NEXT

PCHE_030_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_029a=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the blindness in one eye was first noticed?
__________years
ENGLISH
-9. Does not apply, they have had the condition since birth

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la ceguera en un ojo?
__________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES

33

LEAD-IN
NEXT

f_PCHE_029
PCHE_031

34

PCHE_031_#
ASK

PCHE_029a=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

Does the blindness in one eye currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La ceguera en un ojo limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_030
IF PCHE_031=1: PCHE_032; Else if PCHE_029b=1: PCHE_033; PCHE_029c=1: PCHE_036;
PCHE_029d=1: PCHE_039; PCHE_029e=1: PCHE_042; PCHE_029f=1: PCHE_045; Else if
PCHE_029g=1: PCHE_048; ELSE PCHE_051

35

PCHE_032_#
ASK

If PCHE_031=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the blindness in one eye limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita la ceguera en un ojo a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_031=1
IF PCHE_029b=1: PCHE_033; PCHE_029c=1: PCHE_036; PCHE_029d=1: PCHE_039;
PCHE_029e=1: PCHE_042; PCHE_029f=1: PCHE_045; Else if PCHE_029g=1: PCHE_048;
ELSE PCHE_051

36

PCHE_033_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_029b=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the blindness in both eyes was first noticed?
____________ years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la ceguera en los dos
ojos?
____________ años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_032, PCHE_031, f_PCHE_029
PCHE_034

37

PCHE_034_#
ASK

PCHE_029b=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the blindness in both eyes currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La ceguera en los dos ojos limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_033
IF PCHE_034=1: PCHE_035; PCHE_029c=1: PCHE_036; PCHE_029d=1: PCHE_039;
PCHE_029e=1: PCHE_042; PCHE_029f=1: PCHE_045; PCHE_029g=1: PCHE_048; ELSE
PCHE_051

38

PCHE_035_#
ASK

If PCHE_034=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the blindness in both eyes limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita la ceguera en los dos ojos a ^{FILL_YOUTHNAME}?

SPANISH

1.Un poco

2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_034
IF PCHE_029c=1: PCHE_036; PCHE_029d=1: PCHE_039; PCHE_029e=1: PCHE_042;
PCHE_029f=1: PCHE_045; PCHE_029g=1: PCHE_048; ELSE PCHE_051

39

PCHE_036_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_029c=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the other vision problem was first noticed?
__________years
ENGLISH

SPANISH

-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el otro problema de
visión?
__________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_035, PCHE_034, PCHE_032, PCHE_034, f_PCHE_029
PCHE_037

40

PCHE_037_#
ASK

PCHE_029c=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the other vision problem currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿El otro problema de visión limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_036
IF PCHE_037=1: PCHE_038; PCHE_029d=1: PCHE_039; PCHE_029e=1: PCHE_042;
PCHE_029f=1: PCHE_045; PCHE_029g=1: PCHE_048; ELSE PCHE_051

41

PCHE_038_#
ASK

PCHE_037=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the other vision problem limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita el otro problema de visión a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_037=1
IF PCHE_029d=1: PCHE_039; PCHE_029e=1: PCHE_042; PCHE_029f=1: PCHE_045;
PCHE_029g=1: PCHE_048; ELSE PCHE_051

42

PCHE_039_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_029d=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the deafness was first noticed?
________ years
ENGLISH

SPANISH

-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la sordera?
________ años

RANGE

-9. No corresponde, tiene la afección desde su nacimiento.
0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_038, PCHE_037, PCHE_035, PCHE_034, PCHE_032, PCHE_034, f_PCHE_029
PCHE_040

43

PCHE_040_#
ASK

PCHE_029d=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the deafness currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La sordera limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_039
IF PCHE_040=1: PCHE_041; PCHE_029f=1: PCHE_045; PCHE_048=1: PCHE_029g; ELSE
PCHE_051

44

PCHE_041_#
ASK

If PCHE_040=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the deafness limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita la sordera a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_040
IF PCHE_029f=1: PCHE_045; PCHE_029g=1: PCHE_048; ELSE PCHE_051

45

PCHE_042_#
ASK
QUESTION TYPE
FILLS (ENG)

If PCHE_029e=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the hearing difficulty was first noticed?
________ years
ENGLISH
-9. Does not apply, they have had the condition since birth

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la dificultad auditiva?
________ años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_041, PCHE_040, PCHE_038, PCHE_037, PCHE_035, PCHE_034, PCHE_032,
PCHE_034, f_PCHE_029
IF PCHE_043

46

PCHE_043_#
ASK

PCHE_029e=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the hearing difficulty currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La dificultad auditiva limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_042
IF PCHE_043=1: PCHE_044; PCHE_029f=1: PCHE_045; PCHE_029g=1: PCHE_048; ELSE
PCHE_051

47

PCHE_044_#
ASK

If PCHE_043=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the hearing difficulty limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita la dificultad auditiva a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_043
IF PCHE_029f=1: PCHE_045; PCHE_029g=1: PCHE_048; ELSE PCHE_051

48

PCHE_045_#
ASK
QUESTION TYPE
FILLS (ENG)

If PCHE_029f=1 (Continue PCHE Loop 1)
Numeric
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the speech impairment was first noticed?
________ years
ENGLISH

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el trastorno del habla?
________ años

RANGE

1-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_044, PCHE_043; PCHE_041, PCHE_040; PCHE_038, PCHE_037, PCHE_035,
PCHE_034, PCHE_032, PCHE_034, f_PCHE_029
IF PCHE_046

49

PCHE_046_#
ASK

PCHE_029f=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the speech impairment currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿Limita en este momento el trastorno del habla a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_045
IF PCHE_046=1: PCHE_047; PCHE_029g=1: PCHE_048; ELSE PCHE_051

50

PCHE_047_#
ASK

If PCHE_046=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

How much does the speech impairment limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita la discapacidad del habla a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_046=1
IF PCHE_029g=1: PCHE_048; ELSE PCHE_051

51

PCHE_048_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_029g=1 or if (PCHE_028=1 and PCHE_029=DK or REF) (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the other condition was first noticed?
ENGLISH

________years
- 9. Does not apply, they have had the condition since birth.
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la otra afección?

SPANISH

________años
- 9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_047, PCHE_046; PCHE_044, PCHE_043; PCHE_041, PCHE_040; PCHE_038,
PCHE_037, PCHE_035, PCHE_034, PCHE_032, PCHE_034, f_PCHE_029
PCHE_049

52

PCHE_049_#
ASK

PCHE_029g=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the other condition currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La otra afección limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_048
IF PCHE_049=1: PCHE_050; Else PCHE_051

53

PCHE_050_#
ASK

If PCHE_049=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the other condition limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita la otra afección a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_049=1
PCHE_051

54

PCHE_051_#
ASK

All (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does ^{FILL_YOUTHNAME} now have or have they ever had a part of their body that is or was
deformed, missing, or had permanent stiffness?
ENGLISH

1.   Yes   
0.   No
¿Tiene o ha tenido alguna vez ^{FILL_YOUTHNAME} una parte de su cuerpo que esté o haya estado
deformada, que le falte, o que tenga rigidez permanente?

SPANISH

1.   Sí   
0.   No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_047, PCHE_046; PCHE_044, PCHE_043; PCHE_041, PCHE_040; PCHE_038,
PCHE_037, PCHE_035, PCHE_034, PCHE_032, PCHE_034, f_PCHE_029, PCHE_028
IF PCHE_051=1: PCHE_052; Else PCHE_065

55

f_PCHE_052_#
PCHE_052a_#/ PCHE_052b_#/ PCHE_052c_#/ PCHE_052d_#/ PCHE_052d_OTHER_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_051 = 1 (Continue PCHE Loop 1)
PCHE_052a, PCHE_052b, PCHE_052c, PCHE_052d: Radio button grid
PCHE_052d_OTHER: Text
Create ﬁll, FILL_YOUTHNAME: Fill ‘YOUTHNAME’ from preload

FILLS (SPAN)
Create ﬁll, FILL_YOUTHNAME: Fill ‘YOUTHNAME’ from preload
What part or parts of their body were deformed, missing, or had permanent stiffness?
COLUMN HEADERS:
1. Yes
0. No
ENGLISH

ROW ITEMS:
a. Missing finger, hand, arm, toe, foot, or leg [PCHE_052a]
b. Permanent stiffness or any deformity of the back, foot, or leg [PCHE_052b]
c. Permanent stiffness or any deformity of the fingers, hand, or arm [PCHE_052c]
d. Some other condition (Please describe: ___________________) [PCHE_052d]
[PCHE_052d_OTHER]
¿Qué parte o partes del cuerpo estaban deformadas, faltaban o tenían rigidez permanente?
COLUMN HEADERS:
1. Sí
0. No

SPANISH

ROW ITEMS:
a. Dedo, mano, brazo, dedo del pie, pie o pierna faltantes [PCHE_052a]
b. Rigidez permanente o deformidad de la espalda, del pie o de la pierna [PCHE_052b]
c. Rigidez permanente o deformidad de los dedos, de la mano o del brazo [PCHE_052c]
d. Alguna otra afección (describa: ___________________) [PCHE_052d] [PCHE_052d_OTHER]

RANGE
LIMITS

PCHE_052d_OTHER: Set max 100 characters

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Set variable to 1 if checked, 0 if not.
If PCHE_052d is checked, display PCHE_052d_OTHER text box
IF NO OPTIONS ARE CHECKED, DISPLAY:
“You responded on a previous question that ^{FILL_YOUTHNAME} has or had a part of
their body that is or was deformed, missing, or had permanent stiﬀness. If the condition
that ^{FILL_YOUTHNAME} has or had is not listed here, please select “Some other
condition”. If ^{FILL_YOUTHNAME} has not had a condition or problem, please click the
“Back” button to update your answer.”
IF NO OPTIONS ARE CHECKED, DISPLAY:
“Usted respondió en una pregunta anterior que ^{FILL_YOUTHNAME} tiene o ha tenido
deformación, falta o rigidez permanente de una parte del cuerpo. Si la afección que tiene
o tuvo ^{FILL_YOUTHNAME} no aparece en esta lista, seleccione “Alguna otra afección”. Si

PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

56

^{FILL_YOUTHNAME} no ha tenido ninguna afección o problema, haga clic en “Back”
(Atrás) para actualizar su respuesta.
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_051=1
IF PCHE_052a=1: PCHE_053; PCHE_052b=1: PCHE_056; PCHE_052c=1: PCHE_059; Else
PCHE_062

57

PCHE_053_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_052a=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the missing finger, hand, arm, toe, foot, or leg was first
noticed or occurred?
ENGLISH

________years
- 9. Does not apply, they have had the condition since birth.
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez que no tenía un dedo,
mano, brazo, dedo del pie, pie o pierna, o le ocurrió esto?

SPANISH

________años
- 9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_052
PCHE_054

58

PCHE_054_#
ASK

PCHE_052a=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the missing finger, hand, arm, toe, foot, or leg currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿El dedo, mano, brazo, dedo del pie, pie o pierna que falta limita en este momento a
^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_053
IF PCHE_054=1: PCHE_055; PCHE_052b=1: PCHE_056; PCHE_052c=1: PCHE_059;
PCHE_052d: PCHE_062; Else PCHE_065

59

PCHE_055_#
ASK

If PCHE_054=1(yes) (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the missing finger, hand, arm, toe, foot, or leg currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento el dedo, mano, brazo, dedo del pie, pie o pierna que falta a
^{FILL_YOUTHNAME}?

SPANISH

1.Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_054
IF PCHE_052b=1: PCHE_056; PCHE_052c=1: PCHE_059; PCHE_052d: PCHE_062; Else
PCHE_065

60

PCHE_056_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_052b=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the permanent stiffness or any deformity of the back, foot,
or leg was first noticed?
ENGLISH

________years
- 9. Does not apply, they have had the condition since birth.
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la rigidez permanente o
deformidad de la espalda, del pie o de la pierna?

SPANISH

________años
- 9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_052, PCHE_055, PCHE_054
PCHE_057

61

PCHE_057_#
ASK

PCHE_052b=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the permanent stiffness or any deformity of the back, foot, or leg currently limit
^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La rigidez permanente o deformidad de la espalda, del pie o de la pierna limitan en este momento a
^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_056
IF PCHE_057=1: PCHE_058; PCHE_052c=1: PCHE_059; PCHE_052d: PCHE_062; Else
PCHE_065

62

PCHE_058_#
ASK

If PCHE_057=1(yes) (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the permanent stiffness or any deformity of the back, foot, or leg currently limit
^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limitan en este momento la rigidez permanente o deformidad de la espalda, del pie o de la
pierna a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_057
PCHE_052c=1: PCHE_059; PCHE_052d: PCHE_062; Else PCHE_065

63

PCHE_059_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_052c=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the permanent stiffness or any deformity of the fingers,
hand, or arm was first noticed?
ENGLISH

_________ years
-9. Does not apply, they have had the condition since birth.
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la rigidez permanente o
deformidad de los dedos, de la mano o del brazo?

SPANISH

_________ años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_052, PCHE_055, PCHE_054, PCHE_058, PCHE_057
PCHE_060

64

PCHE_060_#
ASK

PCHE_052c=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the permanent stiffness or any deformity of the fingers, hand, or arm currently limit
^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La rigidez permanente o deformidad de los dedos, de la mano o del brazo limita en este momento a
^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_059
IF PCHE_060=1: PCHE_061; PCHE_052d: PCHE_062; Else PCHE_065

65

PCHE_061_#
ASK

PCHE_060=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the permanent stiffness or any deformity of the fingers, hand, or arm currently limit
^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la rigidez permanente o deformidad de los dedos, de la mano o del
brazo a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_060=1
IF PCHE_052d: PCHE_062; Else PCHE_065

66

PCHE_062_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_052d=1 or if (PCHE_051=1 and PCHE_052=DK or REF) (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the other part or parts of their body that were deformed,
missing, or had permanent stiffness was first noticed or occurred?
ENGLISH

_________years
-9. Does not apply, they have had the condition since birth
¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez que otra parte de su cuerpo
estaba deformada, faltaba o tenía rigidez permanente, o cuando ocurrió esto?

SPANISH

_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_052, PCHE_055, PCHE_054, PCHE_058, PCHE_057, PCHE_061, PCHE_060
PCHE_063

67

PCHE_063_#
ASK

PCHE_052d=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the other part or parts of their body that were deformed, missing, or had permanent stiffness
currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La otra parte o partes del cuerpo deformadas, faltantes o con rigidez permanente limitan en este
momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_062
IF PCHE_063=1: PCHE_064; Else PCHE_065

68

PCHE_064_#
ASK

IF PCHE_063=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the other part or parts of their body that were deformed, missing, or had permanent
stiffness currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la otra parte o partes del cuerpo deformadas, faltantes o con rigidez
permanente a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_063
PCHE_065

69

PCHE_065_#
ASK

ALL (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does ^{FILL_YOUTHNAME} now have or have they ever had any other chronic health condition or lifethreatening disease such as asthma, heart condition, anemia, diabetes, or cancer?
ENGLISH

1.  Yes   
0.  No
¿Tiene ^{FILL_YOUTHNAME} ahora o ha tenido alguna vez alguna otra afección crónica de salud o
enfermedad que pone en peligro la vida, como asma, afecciones del corazón, anemia, diabetes o
cáncer?

SPANISH

1.  Sí   
0.  No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_051, f_PCHE_052, PCHE_054, PCHE_055, PCHE_057, PCHE_058, PCHE_060,
PCHE_061, PCHE_063, PCHE_064
IF PCHE_065=1: PCHE_066; Else PCHE_088

70

f_PCHE_066_#
PCHE_066a_#/ PCHE_066b_#/ PCHE_066c_#/ PCHE_066d_#/ PCHE_066e_#/ PCHE_066f_#/ PCHE_066g_#/
PCHE_066g_OTHER_#
ASK
PCHE_065 = 1 (Continue PCHE Loop 1)
PCHE_066a, PCHE_066b, PCHE_066c, PCHE_066d, PCHE_066e, PCHE_066f, PCHE_066g:
QUESTION TYPE
Radio button grid
PCHE_066g_OTHER: Text
FILLS (ENG)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
What condition or conditions has ^{FILL_YOUTHNAME} had?
COLUMN HEADERS:
1. Yes
0. No

ENGLISH

ROW ITEMS:
a. Asthma [PCHE_066a]
b. Heart condition [PCHE_066b]
c. Anemia [PCHE_066c]
d. Diabetes [PCHE_066d]
e. Cancer [PCHE_066e]
f. Epilepsy [PCHE_066f]
g. Some other condition (Please describe: ___________________________________________)
[PCHE_066g] [PCHE_066g_OTHER]
¿Qué afección o afecciones ha tenido ^{FILL_YOUTHNAME}?
COLUMN HEADERS:
1. Sí
0. No

SPANISH

ROW ITEMS:
a. Asma [PCHE_066a]
b. Afección del corazón [PCHE_066b]
c. Anemia [PCHE_066c]
d. Diabetes [PCHE_066d]
e. Cáncer [PCHE_066e]
f. Epilepsia [PCHE_066f]
g. Alguna otra afección (describa: ___________________________________________)
[PCHE_066g] [PCHE_066g_OTHER]

RANGE
LIMITS

PCHE_066g_OTHER: Set max 100 characters

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Set variables as 1 if checked, 0 if not.
If PCHE_066g is checked, display PCHE_066g_OTHER text box
IF NO OPTIONS ARE SELECTED, DISPLAY:

PROGRAM. NOTES
CHECK (ENG)

71

CHECK (SPAN)

“You responded on a previous question that ^{FILL_YOUTHNAME} has or had a chronic
health condition or life-threatening disease. If the condition that ^{FILL_YOUTHNAME}
has or had is not listed here, please select “Some other condition”. If
^{FILL_YOUTHNAME} has not had a condition or problem, please click “Back” to update
your answer.”
IF NO OPTIONS ARE SELECTED, DISPLAY:
“Usted respondió en una pregunta anterior que ^{FILL_YOUTHNAME} tiene o ha tenido un
problema de salud crónico o una enfermedad que pone en peligro la vida. Si la afección
que tiene o tuvo ^{FILL_YOUTHNAME} no aparece en esta lista, seleccione “Alguna otra
afección”. Si ^{FILL_YOUTHNAME} no ha tenido ninguna afección o problema, haga clic en
“Back” (Atrás) para actualizar su respuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_065=1
IF PCHE_066a=1: PCHE_067; Else if PCHE_066b=1: PCHE_070; PCHE_066c=1: PCHE_073;
PCHE_066d=1: PCHE_076; PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082; Else:
PCHE_085

72

PCHE_067_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_066a=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the asthma was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el asma?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_066
PCHE_068

73

PCHE_068_#
ASK

IF PCHE_066a=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the asthma currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿El asma limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_067
IF PCHE_068=1: PCHE_069; Else if PCHE_066b=1: PCHE_070; PCHE_066c=1: PCHE_073;
PCHE_066d=1: PCHE_076; PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082;
PCHE_066g=1: PCHE_085; Else PCHE_088

74

PCHE_069_#
ASK

If PCHE_068=1(yes) (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the asthma currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento el asma a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_068=1
IF PCHE_066b=1: PCHE_070; PCHE_066c=1: PCHE_073; PCHE_066d=1: PCHE_076;
PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082; PCHE_066g=1: PCHE_085; Else
PCHE_088

75

PCHE_070_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_066b=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the heart condition was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la afección del corazón?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_066, PCHE_068, PCHE_069
PCHE_071

76

PCHE_071_#
ASK

IF PCHE_066b=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the heart condition currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La afección del corazón limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_070
PCHE_071=1: PCHE_072; PCHE_066c=1: PCHE_073; PCHE_066d=1: PCHE_076;
PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082; PCHE_066g=1: PCHE_085; Else
PCHE_088

77

PCHE_072_#
ASK

If PCHE_071=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the heart condition currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la afección del corazón a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_071=1
IF PCHE_066c=1: PCHE_073; PCHE_066d=1: PCHE_076; PCHE_066e=1: PCHE_079;
PCHE_066f=1: PCHE_082; PCHE_066g=1: PCHE_085; Else PCHE_088

78

PCHE_073_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_066c=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the anemia was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la anemia?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_066, PCHE_068, PCHE_069, PCHE_071, PCHE_072
PCHE_074

79

PCHE_074_#
ASK

PCHE_066c=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the anemia currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La anemia limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_073
IF PCHE_074=1: PCHE_075; PCHE_066d=1: PCHE_076; PCHE_066e=1: PCHE_079;
PCHE_066f=1: PCHE_082; PCHE_066g=1: PCHE_085; Else PCHE_088

80

PCHE_075_#
ASK

If PCHE_074=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the anemia currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la anemia a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_074=1
PCHE_066d=1: PCHE_076; PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082;
PCHE_066g=1: PCHE_085; Else PCHE_088

81

PCHE_076_#
ASK
QUESTION TYPE
FILLS (ENG)

PCHE_066d=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the diabetes was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la diabetes?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_066, PCHE_068, PCHE_069, PCHE_071, PCHE_072, PCHE_074, PCHE_075
PCHE_077

82

PCHE_077_#
ASK

IF PCHE_066d=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the diabetes currently limit ^{FILL_YOUTHNAME}?

ENGLISH

1. Yes
0. No
¿Limita en este momento la diabetes a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_076
IF PCHE_077=1: PCHE_078; PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082;
PCHE_066g=1: PCHE_085; Else PCHE_088

83

PCHE_078_#
ASK

If PCHE_077=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the diabetes currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la diabetes a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_077=1
IF PCHE_066e=1: PCHE_079; PCHE_066f=1: PCHE_082; PCHE_066g=1: PCHE_085; Else
PCHE_088

84

PCHE_079_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_066e=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the cancer was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez el cáncer?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_066, PCHE_068, PCHE_069, PCHE_071, PCHE_072, PCHE_074, PCHE_075,
PCHE_077, PCHE_078
PCHE_080

85

PCHE_080_#
ASK

IF PCHE_066e=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the cancer currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿El cáncer limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI
PCHE_079
IF PCHE_080=1: PCHE_081; PCHE_066f=1: PCHE_082; PCHE_066g=1: PCHE_085; Else
PCHE_088

86

PCHE_081_#
ASK

If PCHE_080=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How much does the cancer currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento el cáncer a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_080=1
IF PCHE_066f=1: PCHE_082; PCHE_066g: PCHE_085; Else PCHE_088

87

PCHE_082_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_066f=1 (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the epilepsy was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la epilepsia?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

0-18
Max 2 digits
15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_066, PCHE_068, PCHE_069, PCHE_071, PCHE_072, PCHE_074, PCHE_075,
PCHE_077, PCHE_078, PCHE_080, PCHE_081
PCHE_083

88

PCHE_083_#
ASK

IF PCHE_066f=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the epilepsy currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La epilepsia limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_082
PCHE_083=1: PCHE_084; PCHE_066g: PCHE_085; Else PCHE_088

89

PCHE_084_#
ASK

If PCHE_083=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

How much does the epilepsy currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la epilepsia a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_083=1
IF PCHE_066g=1: PCHE_085; Else PCHE_088

90

PCHE_085_#
ASK
QUESTION TYPE
FILLS (ENG)

IF PCHE_066g=1 or if (PCHE_065=1 and PCHE_066=DK or REF) (Continue PCHE Loop 1)
Numeric
Radio special answer option
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
How old was ^{FILL_YOUTHNAME} when the other condition was first noticed?
_________years
ENGLISH
-9. Does not apply, they have had the condition since birth.

SPANISH

¿Qué edad tenía ^{FILL_YOUTHNAME} cuando se detectó por primera vez la otra afección?
_________años
-9. No corresponde, tiene la afección desde su nacimiento.

RANGE

0-18

LIMITS

Max 2 digits

LOOP MAX

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
INCLUDE SEPARATE NUMBOX FOR YEARS WITH A CORRESPONDING LABEL; ALSO
INCLUDE A SINGLE SELECT OPTION TO INDICATE THAT THIS DOES NOT APPLY
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK:
Please enter a number between 0 (birth) and ^{FILL_YOUTHAGE} years of age.
IF OUT OF RANGE OR GREATER THAN ^{FILL_YOUTHAGE}, DISPLAY A HARD CHECK: Ingrese
un número entre 0 (nacimiento) y ^{FILL_YOUTHAGE} años de edad.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PCHE_066, PCHE_068, PCHE_069, PCHE_071, PCHE_072, PCHE_074, PCHE_075,
PCHE_077, PCHE_078, PCHE_080, PCHE_081, PCHE_083, PCHE_084
PCHE_086

91

PCHE_086_#
ASK

IF PCHE_066g=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does the other condition currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1. Yes
0. No
¿La otra afección limita en este momento a ^{FILL_YOUTHNAME}?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_085
Next: PCHE_086=1: PCHE_087; Else PCHE_088

92

PCHE_087_#
ASK

If PCHE_086=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

How much does the other condition currently limit ^{FILL_YOUTHNAME}?
ENGLISH

1.   Limits a little
2.   Limits a lot
¿Cuánto limita en este momento la otra afección a ^{FILL_YOUTHNAME}?

SPANISH

1.   Un poco
2.   Mucho

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_086=1
PCHE_088

93

PCHE_088_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Does ^{FILL_YOUTHNAME} regularly (such as daily or weekly) take any medicine or prescription drugs
related to a chronic condition?
ENGLISH

1. Yes
0. No
¿^{FILL_YOUTHNAME} toma regularmente (por ejemplo, todos los días o todas las semanas) algún
medicamento o fármacos con receta relacionados con una afección crónica?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_065, PCHE_068, PCHE_069, PCHE_071, PCHE_072, PCHE_074, PCHE_075,
PCHE_077, PCHE_078, PCHE_080, PCHE_081, PCHE_083, PCHE_084, PCHE_086,
PCHE_087
PCHE_089

94

PCHE_089_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Is there a place you or another caregiver usually take ^{FILL_YOUTHNAME} when they are sick, or you
need advice about their health?
ENGLISH

1. Yes
0. No
¿Hay algún lugar al que usted u otro(a) cuidador(a) suelen llevar a ^{FILL_YOUTHNAME} cuando está
enfermo(a) o necesita recomendaciones sobre su salud?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_088
PCHE_089=1: PCHE_090; Else PCHE_091

95

PCHE_090_#
ASK

IF PCHE_089=1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Where does ^{FILL_YOUTHNAME} usually go first? Please choose only one.

ENGLISH

1. Doctor’s office or outpatient clinic
2. Community Health Clinic or Public Health Clinic
3. Hospital Emergency Room
4. Hospital Outpatient Department
5. Urgent Care
6. Clinic within a drug store or grocery store
7. School (Nurse’s Office, Athletic Trainer’s Office)
8. Other Clinic or Health Center
9. Some other place
¿A dónde suele ir ^{FILL_YOUTHNAME} primero? Elija una sola opción.

SPANISH

1. Consultorio de un doctor o clínica ambulatoria
2. Clínica de salud comunitaria o clínica de salud pública
3. Sala de emergencias del hospital
4. Departamento para pacientes ambulatorios del hospital
5. Atención médica urgente
6. Clínicas dentro de farmacias o tiendas de comestibles
7. Escuela (oficina de enfermería, oficina de los entrenadores o de atletismo)
8. Otra clínica o centro de salud
9. Algún otro lugar

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_089=1
PCHE_091

96

PCHE_091_#
ASK

ALL (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
About how long has it been since ^{FILL_YOUTHNAME} last visited a doctor or other health care
provider for a routine checkup?
ENGLISH

1.   Less than a year
2.   Between 1 and 2 years ago
3.   2 to 5 years ago
4.   More than 5 years ago
0.   Does not apply, youth has never had a routine checkup
¿Hace cuánto tiempo aproximadamente visitó ^{FILL_YOUTHNAME} por última vez a un doctor u otro
proveedor de atención médica para un chequeo de rutina?

SPANISH

1.   Menos de un año
2.   Hace entre 1 y 2 años
3.   Hace entre 2 y 5 años
4.   Hace más de 5 años
0.   No corresponde, el(la) joven nunca se ha hecho un chequeo de rutina

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_090, PCHE_089
PCHE_092

97

PCHE_092_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
About how long has it been since ^{FILL_YOUTHNAME} last visited a dentist or other oral health care
provider for a routine checkup or dental cleaning?

ENGLISH

1.
2.
3.
4.
5.
0.

Less than 6 months
6 months to 1 year ago
Between 1 and 2 years ago
2 to 5 years ago
More than 5 years ago
Does not apply, youth has never had a routine dental checkup or cleaning

¿Hace cuánto tiempo aproximadamente visitó ^{FILL_YOUTHNAME} por última vez a un dentista u
otro proveedor de atención médica bucodental para un chequeo de rutina o una limpieza dental?

SPANISH

1.
2.
3.
4.
5.
0.

Menos de 6 mes
Hace de 6 meses a 1 año
Hace entre 1 y 2 años
Hace entre 2 y 5 años
Hace más de 5 años
No corresponde, el(la) joven nunca se ha hecho un chequeo de rutina

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_091
PCHE_093

98

PCHE_093_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
During the past 12 months, how many times was ^{FILL_YOUTHNAME} injured or ill and had to be
treated by a health care provider?
ENGLISH

0.  Never
1.  1-3 times
2.  4 or more times
Durante los últimos 12 meses, ¿cuántas veces se lesionó o enfermó ^{FILL_YOUTHNAME} y tuvo que
recibir tratamiento por parte de un proveedor de atención médica?

SPANISH

0.  Nunca
1. 1-3 veces
2. 4 o más veces

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_092
PCHE_094

99

PCHE_094_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

ENGLISH

SPANISH

Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Some injuries and illnesses are not treated by a health care provider. During the past 12 months,
how many times did ^{FILL_YOUTHNAME} miss one or more days of usual activities (such as work or
school) due to an injury or illness that was not treated by a health care provider?
0.  Never
1.  1-3 times
2.  4 or more times
Algunas lesiones y enfermedades no son tratadas por un proveedor de atención médica. Durante
los últimos 12 meses, ¿cuántas veces faltó ^{FILL_YOUTHNAME} uno o más días a sus actividades
habituales (como el trabajo o la escuela) debido a una lesión o enfermedad que no fue tratada por
parte de un proveedor de atención médica?
0. Nunca
1.  1-3 veces
2.  4 o más veces

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_093
PCHE_095

100

PCHE_095_#
ASK

All respondents (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

ENGLISH

SPANISH

Use ﬁll, FILL_YOUTHNAME, from PCHE_001
During the past 12 months, has ^{FILL_YOUTHNAME} received any treatment or counseling from a
mental health professional? Mental health professionals include psychiatrists, psychologists,
psychiatric nurses, and clinical social workers.
1. Yes
0. No
Durante los últimos 12 meses, ¿ha recibido ^{FILL_YOUTHNAME} algún tratamiento o
asesoramiento por parte de un profesional de la salud mental? Los profesionales de la salud mental
incluyen psiquiatras, psicólogos, enfermeros psiquiátricos y trabajadores sociales clínicos.
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_094
PCHE_095=1: PCHE_097; Else PCHE_096

101

PCHE_096_#
ASK

If PCHE_095 ≠1 (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

ENGLISH

Use ﬁll, FILL_YOUTHNAME, from PCHE_001
During the past 12 months, did ^{FILL_YOUTHNAME} need any treatment or counseling from a
mental health professional?
1. Yes
0. No
Durante los últimos 12 meses, ¿necesitó ^{FILL_YOUTHNAME} algún tratamiento o
asesoramiento por parte de un profesional de la salud mental?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_095
PCHE_097

102

PCHE_097_#
ASK

ALL (Continue PCHE Loop 1)

QUESTION TYPE

Radio

FILLS (ENG)

Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

ENGLISH

Use ﬁll, FILL_YOUTHNAME, from PCHE_001
During the past 12 months, has ^{FILL_YOUTHNAME} taken any medication because of difficulties
with their emotions, concentration, or behavior?
1. Yes
0. No
Durante los últimos 12 meses, ¿ha tomado ^{FILL_YOUTHNAME} algún medicamento debido a
dificultades con sus emociones, concentración o comportamiento?

SPANISH

1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_096, PCHE_095
f_PCHE_098

103

f_PCHE_098_#
PCHE_098a_#/ PCHE_098b_#/ PCHE_098c_#/ PCHE_098d_#/ PCHE_098e_#/ PCHE_098f_#/ PCHE_098g_#/
PCHE_098h_#/ PCHE_098i_#/ PCHE_098j_#
ASK
ALL (End PCHE Loop 1)
QUESTION TYPE

FILLS (ENG)

Radio grid
Use ﬁll, FILL_YOUTHNAME, from PCHE_001
Create ﬁll, FILL STATECHIP: ‘STATEPROGRAM1’
Create ﬁll, FILL_STATEMED: ‘STATEPROGRAM2’
Use ﬁll, FILL_YOUTHNAME, from PCHE_001

FILLS (SPAN)

Create ﬁll, FILL STATECHIP: ‘STATEPROGRAM1’
Create ﬁll, FILL_STATEMED: ‘STATEPROGRAM2’
Is ^{FILL_YOUTHNAME} covered by health insurance that includes physician and/or hospital care
through any of the following? Please indicate which type(s) of insurance coverage they currently
have—note that this may be more than one type.
COLUMN HEADERS:
1. Yes
0. No

ENGLISH

ROW ITEMS:
Private insurance through their own job, union, or business [PCHE_098a]
Private insurance through a parent or guardian’s job, union, or business [PCHE_098b]
Private insurance through someone else’s job, union, or business [PCHE_098c]
Insurance purchased through the HealthCare.gov marketplace, directly from an insurer, or
through a professional or retirement association [PCHE_098d]
Insurance through a federal (such as Children's Health Insurance Program [CHIP], Medicaid,
etc.) or state program (such as ^{FILL_STATECHIP}, ^{FILL_STATEMED}, etc.) [PCHE_098e]
Medicare, the plan for people 65 or older and some younger people with specific disabilities
that is sponsored by the federal government [PCHE_098f]
Military-related health plan such as TRICARE, CHAMPUS, CHAMPVA, or VA hospital care
[PCHE_098g]
Indian Health Service [PCHE_098h]
Another type of health insurance [PCHE_098i]
Does not apply, this child is not covered by health insurance [PCHE_098j]
¿Tiene ^{FILL_YOUTHNAME} cobertura por un seguro médico que incluya atención médica y/o
hospitalaria a través de alguno de los siguientes? Indique qué tipo o tipos de cobertura de seguro
tiene en este momento; tenga en cuenta que puede haber más de un tipo.

SPANISH

COLUMN HEADERS:
1. Sí
0. No
ROW ITEMS:
Seguro privado a través de su propio trabajo, sindicato o empresa [PCHE_098a]

104

Seguro privado a través del trabajo, el sindicato o la empresa de un padre/madre o tutor(a)
[PCHE_098b]
Seguro privado a través del trabajo, sindicato o empresa de otra persona [PCHE_098c]
Seguro comprado a través del mercado en HealthCare.gov, directamente de una aseguradora
o a través de una asociación profesional o de jubilación [PCHE_098d]
Seguro a través de un programa federal (como el Programa de Seguro Médico para Niños
[CHIP, por sus siglas en inglés], Medicaid, etc.) o estatal (como ^{FILL_STATECHIP},
^{FILL_STATEMED}, etc.) [PCHE_098e]
Medicare, el plan para personas de 65 años o más y algunas personas más jóvenes con
discapacidades específicas que patrocina el Gobierno federal [PCHE_098f]
Un plan de salud relacionado con el ejército, como TRICARE, CHAMPUS, CHAMPVA o la
atención hospitalaria de Asuntos de los Veteranos (VA, por sus siglas en inglés) [PCHE_098g]
Programa de Salud para Indígenas Estadounidenses [PCHE_098h]
Otro tipo de seguro médico [PCHE_098i]
No corresponde, este(a) niño(a) no tiene cobertura de un seguro médico [PCHE_098j]
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

CHECK (SPAN)

15
Loop through PPCL Loop 1 (PCHE_001 through f_PCHE_098) for each youth on
YOUTHROSTER until LOOPNUMBER=YOUTHROSTERNUM or max loops reached (15).
Set variables as 1 if checked, 0 if not.
If PCHE_098j=1 and any other item =1, display soft check:
You reported that this child had at least one type of insurance, and you also reported
that this child is not covered by health insurance. Please review and update your
response.
If PCHE_098j=1 and any other item =1, display soft check:
Usted informó que este(a) niño(a) tenía al menos un tipo de seguro médico y también
informó que este(a) niño(a) no tiene cobertura de un seguro médico. Revise y actualice
sus respuestas.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

PCHE_097
PEXP_001

105

NLSY27
Child Expectations

Preloads:
YOUTH_NAME: Preload from ES Screener for all youth
YOUTHROSTERNUM: Total number of eligible youth in the household, created in ES018_LOOP_END
General Programming Instructions:
NOTE THAT THIS ENTIRE MODULE WILL NEED TO BE REPEATED FOR EACH ELIGIBLE YOUTH IN THE
HOUSEHOLD.
Paradata:
Capture item level timing.
Include a time/date stamp at beginning and end of module.
General Notes:
• Do not display response option numbers/letters.
• Do not display DK and REF on each screen at loading.
o If R tries to move forward without providing a response, display DK (‘Don’t know’) and REF (‘Prefer
not to answer’) on screen.
• Spanish: display DK (‘No lo sé’) and REF (‘Prefiero no contestar’) on screen.
 Unless otherwise noted, include a soft prompt for R to respond or select DK/REF option:
“Your answers are very important. Please consider selecting a response.”
• Spanish: “Sus respuestas son muy importantes. Considere la posibilidad de
seleccionar una respuesta.”

o

If R still tries to move forward without answering, assign REF code to missing response.

PEXP_001_#
ASK

All respondents (Begin PEXP_loop)

QUESTION TYPE

Numeric
CREATE FILL YOUTHNAME_#: FILL YOUTHNAMEYOUTH_NAME_# FROM PRELOADS.
CREATE FILL FILL_PEXPINTRO.
If LOOPNUMBER=1, FILL_PEXPINTRO:
When we ask a question, we would like you to give us a number from 0 to 100, where "0"
means that you think there is absolutely no chance, and "100" means that you think the
event is absolutely certain to happen. You can think of the percent chance that some
event will occur as the number of chances out of 100 that the event will take place.
For example, no one can ever be sure about tomorrow's weather, but if you think that
rain is very unlikely tomorrow, you might say that there is a 6 percent chance. If you
think there is a very good chance that it will rain tomorrow, you might say that there
is an 82 percent chance of rain. If you are positive that it will rain tomorrow, you
would say there is a 100 percent chance of rain.

FILLS

What do you think the percent chance is that ^{YOUTHNAME_#} will get the flu sometime
in the next year?
Percent chance: ____________ %
ELSE FILL_PEXPINTRO: Empty
CREATE FILL YOUTHNAME_#: FILL YOUTHNAME_# FROM PRELOADS.
CREATE FILL FILL_PEXPINTRO.
If LOOPNUMBER=1, FILL_PEXPINTRO:
Cuando le hagamos una pregunta, quisiéramos que nos dé un número del 0 al 100,
teniendo en cuenta que “0” significa que cree que no hay absolutamente ninguna
posibilidad y que “100” significa que no tiene dudas de que esto ocurrirá. Puede pensar en
la posibilidad de que un suceso ocurra como un porcentaje o como un número de
posibilidad en una escala del 1 al 100.
FILLS (SPAN)

Por ejemplo, nadie puede garantizar cómo estará el tiempo mañana, pero si cree que es
muy poco probable que llueva mañana, podría decir que hay un 6 por ciento de
probabilidad de lluvia. Si cree que la probabilidad de que llueva mañana es muy alta,
podría decir que hay un 82 por ciento de probabilidad de lluvia. Si tiene certeza de que
lloverá mañana, puede decir que hay un 100 por ciento de probabilidad de lluvia. 
¿Cuál cree que es el porcentaje de probabilidad de que ^{YOUTHNAME_#} tenga gripe en
algún momento del próximo año?

ENGLISH

Porcentaje de probabilidad: ____________ %
 
ELSE FILL_PEXPINTRO: Empty
Next, we would like to ask your best guess about how likely you think something will happen in
^{YOUTHNAME_#}’s future.
^{FILL_EXPINTRO}

SPANISH

A continuación, nos gustaría que nos diera su mejor estimación sobre la probabilidad de que algo
suceda en el futuro de ^{YOUTHNAME_#}.
^{FILL_EXPINTRO}

RANGE

0-100

LIMITS

Max 3 digits

LOOP MAX

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

PROGRAM. NOTES

CHECK (ENG)
CHECK (SPAN)

Create variable PEXP_LOOP[#].YOUTH_UID=YOUTH_UID_#
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
between 0 and 100.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número entre
0 y 100.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES

PEXP_LOOP

LEAD-IN
NEXT

PCHE_051, PEXP_007_#
PEXP_002_#

PEXP_002_#
ASK

All respondents (continue PEXP_LOOP)

QUESTION TYPE

Numeric

FILLS

Use FILL YOUTHNAME_# from PEXP_001_#

FILLS (SPAN)

Use FILL YOUTHNAME_# from PEXP_001_#

The next questions ask about ^{YOUTHNAME_#}'s school and work situation at the time of their 20th
birthday.
ENGLISH

Using a scale from 0 to 100, where 0 means absolutely no chance that the event will happen and 100
means that the event is absolutely certain to happen, what do you think the percent chance is that
^{YOUTHNAME_#} will have received a high school diploma by the time they turn 20?
Percent chance: ____________ %
Las siguientes preguntas son sobre la situación escolar y laboral de ^{YOUTHNAME_#} en el momento
en que cumpla los 20 años.

SPANISH

En una escala del 0 al 100, en la que “0” significa que no hay absolutamente ninguna posibilidad de
que esto ocurra y “100” significa que no tiene dudas de que ocurrirá, ¿cuál cree que es el porcentaje
de probabilidad de que ^{YOUTHNAME_#} reciba un diploma de escuela secundaria para cuando
cumpla los 20 años?
Porcentaje de probabilidad: ____________ %

RANGE

0-100

LIMITS

Max 3 digits

LOOP MAX

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
between 0 and 100.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número entre
0 y 100.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES

PEXP_LOOP

LEAD-IN
NEXT

PEXP_001_#
PEXP_003_#

PEXP_003_#
ASK

All respondents (continue PEXP_LOOP)

QUESTION TYPE
FILLS

Numeric
Use FILL YOUTHNAME_# from PEXP_001_#

FILLS (SPAN)

Use FILL YOUTHNAME_# from PEXP_001_#

ENGLISH

SPANISH

What do you think the percent chance is that ^{YOUTHNAME_#} will serve time in jail or prison
between now and when they turn 20?
Percent chance: ____________ %
¿Cuál cree que es el porcentaje de probabilidad de que ^{YOUTHNAME_#} pase tiempo en la cárcel o
prisión entre ahora y cuando cumpla los 20 años?
Porcentaje de probabilidad: ____________ %

RANGE

0-100

LIMITS

Max 3 digits

LOOP MAX

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
between 0 and 100.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número entre
0 y 100.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES

PEXP_LOOP

LEAD-IN
NEXT

PEXP_002_#
PEXP_004_#

PEXP_004_#
ASK

All respondents (continue PEXP_LOOP)

QUESTION TYPE
FILLS

Numeric
Use FILL YOUTHNAME_# from PEXP_001_#

FILLS (SPAN)

Use FILL YOUTHNAME_# from PEXP_001_#

ENGLISH

SPANISH

What do you think the percent chance is that ^{YOUTHNAME_#} will become the parent of a baby
sometime between now and when they turn 20?
Percent chance: ____________ %
¿Cuál cree que es el porcentaje de probabilidad de que ^{YOUTHNAME_#} sea padre/madre de un
bebé en algún momento entre ahora y cuando cumpla los 20 años?
Porcentaje de probabilidad: ____________ %

RANGE

0-100

LIMITS

Max 3 digits

LOOP MAX

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
between 0 and 100.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número entre
0 y 100.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES

PEXP_LOOP

LEAD-IN
NEXT

PEXP_003_#
PEXP_005_#

PEXP_005_#
ASK

All respondents (continue PEXP_LOOP)

QUESTION TYPE
FILLS

Numeric
Use FILL YOUTHNAME_# from PEXP_001_#

FILLS (SPAN)

Use FILL YOUTHNAME_# from PEXP_001_#

Now think ahead to when ^{YOUTHNAME_#} turns 30 years old.

ENGLISH

Still using a scale from 0 to 100, where 0 means absolutely no chance that the event will happen and
100 means that the event is absolutely certain to happen, what do you think the percent chance is
that ^{YOUTHNAME} will have a four-year college degree by the time they turn 30?
Percent chance: ____________ %
Ahora piense en el futuro, cuando ^{YOUTHNAME_#} cumpla 30 años.

SPANISH

Siga usando una escala del 0 al 100, en la que “0” significa que no hay absolutamente ninguna
posibilidad de que esto ocurra y “100” significa que no tiene dudas de que ocurrirá, ¿cuál cree que es
el porcentaje de probabilidad de que ^{YOUTHNAME} haya recibido un diploma de universidad de
4 años para cuando cumpla los 30 años?
Porcentaje de probabilidad: ____________ %

RANGE

0-100

LIMITS

Max 3 digits

LOOP MAX

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
between 0 and 100.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número entre
0 y 100.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES

PEXP_LOOP

LEAD-IN
NEXT

PEXP_004_#
PEXP_006_#

PEXP_006_#
ASK

All respondents (continue PEXP_LOOP)

QUESTION TYPE
FILLS

Numeric
Use FILL YOUTHNAME_# from PEXP_001_#

FILLS (SPAN)

Use FILL YOUTHNAME_# from PEXP_001_#

ENGLISH

SPANISH

What do you think the percent chance is that ^{YOUTHNAME_#} will have enough money to support
themself comfortably by age 30?
Percent chance: ____________ %
¿Cuál cree que es el porcentaje de probabilidad de que ^{YOUTHNAME_#} tenga el dinero suficiente
para sustentarse de manera cómoda para cuando cumpla los 30 años?
Porcentaje de probabilidad: ____________ %

RANGE

0-100

LIMITS

Max 3 digits

LOOP MAX

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Please enter a number
between 0 and 100.
IF NUMBER ENTERED IS OUT OF RANGE, DISPLAY HARD CHECK: Ingrese un número entre
0 y 100.

PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES

PEXP_LOOP

LEAD-IN
NEXT

PEXP_005_#
PEXP_007_#

PEXP_007_#
ASK

All respondents (End PEXP_LOOP)

QUESTION TYPE
FILLS

Radio
Use FILL YOUTHNAME_# from PEXP_001_#

FILLS (SPAN)

Use FILL YOUTHNAME_# from PEXP_001_#

As things stand now, what is the highest diploma or degree you expect ^{YOUTHNAME_#} will
receive?

ENGLISH

0. Do not expect them to receive a diploma or degree
1. High school equivalency such as GED (General Education Development) or HiSET (High School
Equivalency Test)
2. High school diploma (Regular 12-year program)
3. Associate/Junior college (AA, AS)
4. Bachelor's degree (BA, BS)
5. Master's degree (MA, MBA, MS)
6. Doctoral degree (PhD, EdD)
7. Professional school degree (MD, DDS, JD)
Como están las cosas ahora, ¿cuál es el diploma o título más alto que usted espera que reciba
^{YOUTHNAME_#}?

SPANISH

0. No espera que reciba un diploma o título
1. Título equivalente al de la escuela secundaria/preparatoria, como el Desarrollo de Educación
General (GED, por sus siglas en inglés) o la Prueba de Equivalencia de Escuela Secundaria (HiSET, por
sus siglas en inglés)
2. Diploma de escuela secundaria/preparatoria (programa regular de 12 años)
3. Título de dos años (Associate)/escuela semisuperior (AA, AS, por sus siglas en inglés)
4. Título de cuatro años (BA, BS, por sus siglas en inglés)
5. Maestría (MA, MBA, MS, por sus siglas en inglés)
6. Doctorado (PhD, EdD, por sus siglas en inglés)
7. Título profesional (MD, DDS, JD, por sus siglas en inglés)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through PEXP_LOOP (PEXP_001_# - PEXP_007_#) for each roster line in
YOUTHROSTER until YOUTHROSTERNUM is reached, with a max of 15 times.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PEXP_006_#
IF LOOP NUM = YOUTHROSTERNUM OR LOOP NUM = 15: PCFB_001;
Else PEXP_001_#

Parent/Caregiver
Child Family Background (PCFB)
PRELOADS:
YOUTH_NAME_#: Name of all eligible youth, created in ES018_LOOP_END
YOUTHROSTERNUM: Total number of eligible youth in the household, HHS
HHSMODE = CASI or CAWI
Paradata:
Capture item level timing
Include a time/date stamp at beginning and end of screener
GENERAL PROGRAMMING NOTES:
ALL ITEMS ARE REQUIRED.
•
•

Do not display response option numbers/letters.
Do not display DK and REF on each screen at loading.
o If R tries to move forward without providing a response, display DK (‘Don’t know’) and REF (‘Prefer
not to answer’) on screen.
 Unless otherwise noted, include a soft prompt for R to respond or select DK/REF option:
“Your answers are very important. Please consider selecting a response.”
o If R still tries to move forward without answering, assign REF code to missing response.

PCFB_001_# 
ASK

All respondents (Begin PCFB Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Create ﬁll FILL YOUTHNAME_#: Fill with YOUTH_NAME from sample preload

FILLS (SPAN)

Create ﬁll FILL YOUTHNAME_#: Fill with YOUTH_NAME from sample preload

When you think about how you act toward ^{YOUTHNAME_#}, in general, would you say you are very
supportive, somewhat supportive, or not very supportive?
ENGLISH

SPANISH

1. Very supportive
2. Somewhat supportive
3. Not very supportive
Cuando piensa en cómo actúa usted con respecto a ^{YOUTHNAME_#}, en general, ¿diría que usted le
brinda mucho apoyo, algo de apoyo o no mucho apoyo?
1. Mucho apoyo
2. Algo de apoyo
3. No mucho apoyo

RANGE
LIMITS
LOOP MAX

PROGRAM. NOTES

15
Loop through YOUTH_RELATIONSHIP_LOOP: PCFB_001_# – PCFB_003_# for each eligible
youth until LOOP NUMBER = YOUTHROSTERNUM with a max of 15 loops reached.
Create variable PCFBLOOP1[#].YOUTH_UID=YOUTH_UID_#

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

PEXP_007
PCFB_002_#

PCFB_002_# 
ASK

All respondents (continue PCFB Loop 1)

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCFB_001: FILL YOUTHNAME_#

FILLS (SPAN)

Use ﬁll from PCFB_001: FILL YOUTHNAME_#

In general, would you say you are permissive or strict about making sure ^{YOUTHNAME_#} does the
things they are supposed to do?
ENGLISH

1. Permissive (not strict)
2. Strict
En general, ¿diría que usted es permisivo(a) o estricto(a) a la hora de asegurarse de que
^{YOUTHNAME_#} haga las cosas que se supone que debe hacer?

SPANISH

1. Permisivo(a), no estricto(a)
2. Estricto(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through YOUTH_RELATIONSHIP_LOOP: PCFB_001_# – PCFB_003_# for each eligible
youth until LOOP NUMBER = YOUTHROSTERNUM with a max of 15 loops reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI, CAWI

NOTES
LEAD-IN
NEXT

YOUTH RELATIONSHIP LOOP
PCFB_001_#
PCFB_003_#

PCFB_003_#
ASK

All respondents (EndPCFB Loop 1 )

QUESTION TYPE

Radio button

FILLS (ENG)

Use ﬁll from PCFB_001: FILL YOUTHNAME_#

FILLS (SPAN)
Use ﬁll from PCFB_001: FILL YOUTHNAME_#
How close do you feel to ^{YOUTHNAME_#}?

ENGLISH

1.
2.
3.
4.
5.

Extremely close
Quite close
Somewhat close
Not very close
Not close at all

¿Qué tan cercano(a) se siente a ^{YOUTHNAME_#}?

SPANISH

1.
2.
3.
4.
5.

Extremadamente cercano(a)
Bastante cercano(a)
Un poco cercano(a)
No mucho cercano(a)
Para nada cercano(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

15
Loop through YOUTH_RELATIONSHIP_LOOP: PCFB_001_# – PCFB_003_# for each eligible
youth until LOOP NUMBER = YOUTHROSTERNUM with a max of 15 loops reached.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CASI, CAWI
PCFB_002_#
IF LOOP NUMBER < YOUTHROSTERNUM: Loop again (PCFC_001_#)
ELSE: GO TO NEXT MODULEMODULE

NLSY27 Specifications Formatting
Parent/Caregiver Debriefing Questions

PRELOADS:
MODE: CASI, CAWI
YOUTHNAME: From screener
YOUTHROSTER: From screener
YOUTHROSTERNUM: From screener
YOUTH_NAME
GENERAL PROGRAMMER NOTES:
Display DK “don’t know” and REF “prefer not to answer” items only after respondent attempts to
advance to the next screen without selecting/entering a response.
If respondent advances to the next screen without selecting DK or REF, assign REF value.
Capture item level timing.
Include a time/date stamp at beginning and end of module.

f_PRDB_1
PRDB_INT1/PRDB_INT2/PRDB_WEB1/PRDB_WEB2/PRDB_WEB3
ASK
All respondents
QUESTION TYPE

Radio grid
Create FILL_MODE: IF MODE = CASI, FILL_MODE:
a. Answering questions using the laptop computer [PRDB_INT1]
b. Using the calendars on the laptop computer to give dates for events [PRDB_INT2]
FILLS
Else, if MODE = CAWI: FILL_MODE:
a. Logging into the web survey [PRDB_WEB1]
b. Answering questions in the web survey [PRDB_WEB2]
c. Using the calendar feature to give dates for events [PRDB_WEB3]
Create FILL_MODE: IF MODE = CASI, FILL_MODE:
a. Responder preguntas usando la computadora portátil [PRDB_INT1]
b. Usar los calendarios de la computadora portátil para anotar fechas de eventos
[PRDB_INT2]
FILLS (SPAN)
Else, if MODE = CAWI: FILL_MODE:
a. Iniciar sesión en la encuesta web [PRDB_WEB1]
b. Responder preguntas en la encuesta web [PRDB_WEB2]
c. Usar la función del calendario para anotar fechas de eventos [PRDB_WEB3]
Finally, we have a few questions about how you felt overall during the interview.
How easy did you find the following?

ENGLISH

COLUMN HEADERS:
1. Very easy
2. Somewhat easy
3. Not very easy
4. Not easy at all
0. Not applicable
ROW ITEMS:
^{FILL_MODE}

Por último, tenemos algunas preguntas sobre cómo se sintió en general durante la entrevista.
¿Qué tan fácil le resultó lo siguiente?

SPANISH

COLUMN HEADERS:
1. Muy fácil
2. Algo fácil
3. No muy fácil
4. Para nada fácil
0. No corresponde
ROW ITEMS:
^{FILL_MODE}

RANGE

LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PRDB_2

f_PRDB_2
PRDB_2_1/PRDB_2_2/PRDB_2_3/PRDB_2_4/PRDB_2_O
ASK
All
QUESTION TYPE

Radio grid, Text
Create ﬁll FILL_NUMYOUTH.
FILLS
If YOUTHROSTERNUM=1, FILL_NUMYOUTH: ‘child’
Else FILL_NUMYOUTH: ‘children’
Create ﬁll FILL_NUMYOUTH.
FILLS (SPAN)
If YOUTHROSTERNUM=1, FILL_NUMYOUTH: ‘su hijo(a)
Else FILL_NUMYOUTH: ‘sus hijos(as)’
Do you have any of the following concerns about your ^{^{FILL_NUMYOUTH} participating in this study in the
future?
COLUMN HEADERS:
1. Yes
0. No

ENGLISH

ROW ITEMS:
1. Questions that are uncomfortable for them to answer [PRDB_2_1]
2. Whether their information will stay private [PRDB_2_2]
3. How often they will be asked to complete surveys [PRDB_2_3]
4. Other [PRDB_2_4]
Please describe your concerns about your ^{FILL_NUMYOUTH} participating in this study in the future
_____________________________________ [PRDB_2_O]
¿Tiene alguna de las siguientes preocupaciones sobre la participación de ^{FILL_NUMYOUTH} en este
estudio en el futuro?
COLUMN HEADERS:
1. Sí
0. No

SPANISH

ROW ITEMS:
1. Preguntas que resulten incómodas de responder [PRDB_2_1]
2. La privacidad de su información [PRDB_2_2]
3. Con qué frecuencia se pedirá que complete(n) encuestas [PRDB_2_3]
4. Otras [PRDB_2_4]
Describa sus preocupaciones acerca de la participación de ^{FILL_NUMYOUTH} en este estudio en el
futuro
_____________________________________ [PRDB_2_O]

RANGE
LIMITS

PRDB_2_O: Max 120 characters

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)

If PRDB_2_4 = 1, DISPLAY PRDB_2_O: ‘Please describe your concerns about your
child(ren) participating in this study in the future.’

MODE

CASI

NOTES
LEAD-IN
NEXT

f_PRDB_1
f_PRDB_3

f_PRDB_3
PRDB_3_1/PRDB_3_2/PRDB_3_3/PRDB_3_4/PRDB_3_5/PRDB_3_6/PRDB_3_7/PRDB_3_8/PRDB_3_9/PRDB_3_
10/PRDB_3_11/PRDB_3_12/PRDB_3_13/PRDB_3_14/PRDB_3_15
ASK
All
QUESTION TYPE
FILLS

FILLS (SPAN)

Radio button
FILL_CHILDREN: IF YOUTHROSTERNUM = 1, FILL_CHILDREN: For your child listed below,
ELSE, FILL_CHILDREN: For each of your children listed below,
FILL YOUTHROSTER
FILL_CHILDREN: IF YOUTHROSTERNUM = 1, FILL_CHILDREN: Pensando en el(la) hijo(a)
que está enumerado(a) a continuación,
ELSE, FILL_CHILDREN: Pensando en cada uno(a) de los(as) hijos(as) enumerados(as) a
continuación,
FILL YOUTHROSTER
^{CHILDREN} indicate how likely you think it is they will participate in the next round of this
study.
COLUMN HEADERS:
1. Very likely
2. Somewhat likely
3. Not very likely
4. Not at all likely

ENGLISH

SPANISH

ROW ITEMS
^{YOUTHROSTER} [PRDB_3_1]
[PRDB_3_2]
[PRDB_3_3]
[PRDB_3_4]
[PRDB_3_5]
[PRDB_3_6]
[PRDB_3_7]
[PRDB_3_8]
[PRDB_3_9]
[PRDB_3_10]
[PRDB_3_11]
[PRDB_3_12]
[PRDB_3_13]
[PRDB_3_14]
[PRDB_3_15] .
^{CHILDREN} indique qué tan probable cree que es que participe(n) en la próxima ronda de este
estudio.
COLUMN HEADERS:
1. Muy probable
2. Algo probable
3. No es muy probable
4. Para nada probable
ROW ITEMS
^{YOUTHROSTER} [PRDB_3_1]

[PRDB_3_2]
[PRDB_3_3]
[PRDB_3_4]
[PRDB_3_5]
[PRDB_3_6]
[PRDB_3_7]
[PRDB_3_8]
[PRDB_3_9]
[PRDB_3_10]
[PRDB_3_11]
[PRDB_3_12]
[PRDB_3_13]
[PRDB_3_14]
[PRDB_3_15] .
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PRDB_2
If YOUTHROSTERNUM=1: END
Else: PRDB_4

PRDB_4
ASK

YOUTHROSTERNUM>1

QUESTION TYPE

Radio

FILLS
FILLS (SPAN)
Think about the questions you answered about youth in your household. How confident are you that
your answers were as complete and correct as possible for all the youth you were asked about?
ENGLISH

1. Very confident
2. Somewhat confident
3. Not very confident
4. Not confident at all
Piense en las preguntas que respondió sobre los jóvenes de su hogar. ¿Qué tan seguro(a) está de que
sus respuestas fueron lo más completas posibles para todos los jóvenes sobre los que se le preguntó?

SPANISH

1. Muy seguro(a)
2. Algo seguro(a)
3. No muy seguro(a)
4. Para nada seguro(a)

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CASI

NOTES
LEAD-IN
NEXT

f_PRDB_3
END

NLSY27 Specifications Formatting
Parent Re-Start Interview (PRSI)
Preloads:
SPCUID: HH_UID of primary P/C selected for interview
SPCNAME: Name of parent/guardian selected for parent/caregiver interview
ALTPCUID: HH_UID of alternate P/C selected for interview
ALTPCNAME: Name of alternate parent/guardian selected for parent/caregiver interview
General Programming Instructions
All items are required.
Do NOT display DK “don’t know” and REF “prefer not to answer” items.
Capture item level timing.
Include a time/date stamp at beginning and end of module.
If the alternate P/C begins the survey after the primary P/C had started it, the data entered by the first
parent should be deleted. If a survey is reset because the P/C cannot remember their PIN, all data
previously entered should also be deleted. Each time that the data for the case is deleted, the following
information should be stored:
Instance of data deletion (first, second, third time, etc.), Date of data deletion, Last item visited

PRSI_NAME
ASK

All

QUESTION TYPE

Radio
Create ﬁll, FILL_SPCNAME: ‘SPCNAME’
FILLS (ENG)
Create ﬁll, FILL_ALTPCNAME: ‘ALTPCNAME’
Create ﬁll, FILL_SPCNAME: ‘SPCNAME’
FILLS (SPAN)
Create ﬁll, FILL_ALTPCNAME: ‘ALTPCNAME’
Please select your name from this list of possible respondents:

ENGLISH

1.
2.
3.

^{FILL_SPCNAME}
^{FILL_ALTPCNAME}
None of these

Seleccione su nombre de esta lista de posibles personas encuestadas:
SPANISH

4.
5.
6.

^{FILL_SPCNAME}
^{FILL_ALTPCNAME}
Ninguna de estas opciones

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Only display response option 2 if ALTPCNAME is not missing

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD‗IN

NEXT

PINF_010
If PRSI_NAME=3: PRSI_INELIGIBLE
Else if PRSI_NAME=1 and SPCUID=RPC_UID: PRSI_PIN
Else if PRSI_NAME=2 and ALTPCUID=RPC_UID: PRSI_PIN
Else if PRSI_NAME=2: PC_CONSENT
Else if PRSI_NAME=1 and ALTPCUID=RPC_UID: PRSI_INELIGIBLE

PRSI_PIN
ASK

All

QUESTION TYPE

Numeric

FILLS (ENG)
FILLS (SPAN)
Please enter the 4-digit PIN number you created when you started the survey:
ENGLISH
Enter PIN:
Ingrese el número PIN de 4 dígitos que creó cuando comenzó la encuesta:
SPANISH
Ingrese el PIN:
RANGE
4 digits
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

If PRSI_PIN≠PINF_010a_PIN, display hard check: This PIN does not match the PIN you
created. Please try again. If you cannot remember your PIN, please call XXX-XXX-XXXX to
reset the survey.
If PRSI_PIN≠PINF_010a_PIN, display hard check: Este PIN no coincide con el PIN que creó.
Inténtelo de nuevo. Si no recuerda su PIN, llame al XXX-XXX-XXXX para restablecer la
encuesta.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD‗IN
NEXT

PRSI_NAME
Return to last item visited in the P/C instrument

PRSI_INELIGIBLE
ASK

All

QUESTION TYPE

Informational
Use ﬁll from PRSI_NAME, FILL_ALTPCNAME.
Create ﬁll, FILL_INELIGIBLE.
If PRSI_NAME=1, FILL_INELIGIBLE: You are no longer eligible to participate in this study.
^{FILL_ALTPCNAME} is the only person who can complete the survey.
Else FILL_INELIGIBLE: You are not an eligible respondent for this study.
Use ﬁll from PRSI_NAME, FILL_ALTPCNAME.

FILLS (ENG)

Create ﬁll, FILL_INELIGIBLE.
If PRSI_NAME=1, FILL_INELIGIBLE: Ya no cumple los requisitos para participar en este estudio.
^{FILL_ALTPCNAME} es la única persona que puede completar la encuesta.
Else FILL_INELIGIBLE: Usted no cumple los requisitos para tomar parte en este estudio.
Thank you for your interest. ^{FILL_INELIGIBLE}

FILLS (SPAN)

ENGLISH
SPANISH

Gracias por su interés. ^{FILL_INELIGIBLE}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAPI, CAWI

NOTES
LEAD‗IN
NEXT

PRSI_NAME
END

Parent Caregiver Breakoff Module
PCGPAUSE
ASK
QUESTION TYPE

IF BREAKOFF SELECTED AT ANY POINT DURING P/CG INTERVIEW
PCGPIN: Numeric
PCGBRK: Radio button
Create ﬁll, FILL_PCGMODE
IF MODE = CAPI, FILL_PCGMODE = “Otherwise, please wait for the interviewer to
return.”
IF MODE = CAWI, FILL_PCGMODE = “Otherwise, please click Save and close to exit the
survey for now.

FILLS (ENG)

-8. Save and Close
For your protection, this page will time out after 20 minutes of inactivity and you will need
to re-enter the survey via the main login screen with your access code.”
Create ﬁll, FILL_PCGMODE
IF MODE = CAPI, FILL_PCGMODE = “De lo contrario, espere a que regrese el(la)
entrevistador(a).”
IF MODE = CAWI, FILL_PCGMODE = “De lo contrario, haga clic en “Guardar y cerrar”
para salir de la encuesta por ahora.

FILLS (SPAN)

-8. Guardar y cerrar
Para su protección, la página caducará después de 20 minutos de inactividad, y usted
deberá volver a ingresar a la encuesta a través de la pantalla principal de inicio de sesión
con su código de acceso.”

ENGLISH

SPANISH

You have paused the survey. To continue the survey, please select Continue below. For your
protection, you will be asked to enter the PIN you created at the beginning of the survey.
{FILL_PCGMODE}
-9. Continue now
-7. Interviewer returned
Usted ha pausado la encuesta. Para continuar con la encuesta, seleccione “Continuar” a continuación.
Para su protección, se le pedirá que introduzca el PIN que creó al inicio de la encuesta.
{FILL_PCGMODE}
-9. Continuar
-7. Interviewer returned

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)

CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN

NEXT

CAPI

IF PCGBRK=-9: PRSI_PIN
IF MODE = CAPI AND PCGBRK = -7: PCGIVRPSWRD
IF MODE = CAWI AND PCGBRK = -8 : PCGBRKOFFTHNK
ELSE: DO NOT ADVANCE SCREEN.

PCGIVRPSWRD
ASK

IF MODE = CAPI AND PCGBRK = -9

QUESTION TYPE

Textbox

FILLS (ENG)
FILLS (SPAN)
ENGLISH

INTERVIEWER: PLEASE ENTER THE PASSWORD TO CONTINUE

SPANISH

INTERVIEWER: PLEASE ENTER THE PASSWORD TO CONTINUE

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

Password = RTI2026
If password is not entered correctly, do not allow the screen to advance.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CAPI

IF PCGIVRPSWRD = RTI2026: PCGBRKOFF
ELSE: DO NOT ADVANCE

PCGBRKOFF
ASK

IF MODE = CAPI OR CATI AND PCGBRK = -9

QUESTION TYPE

Radio Button

FILLS (ENG)
FILLS (SPAN)
INTERVIEWER: YOU HAVE REACHED THIS SCREEN BECAUSE THE RESPONDENT INDICATED THEY DID
NOT WANT TO CONTINUE THE INTERVIEW AT THE PRESENT TIME. PLEASE SELECT ONE OPTION
BELOW.
ENGLISH

SPANISH

1. THE RESPONDENT WANTS TO CONTINUE INTERVIEW AT LATER DATE
0. THE RESPONDENT DOES NOT WANT TO CONTINUE INTERVIEW
INTERVIEWER: YOU HAVE REACHED THIS SCREEN BECAUSE THE RESPONDENT INDICATED THEY DID
NOT WANT TO CONTINUE THE INTERVIEW AT THE PRESENT TIME. PLEASE SELECT ONE OPTION
BELOW.
1.
0.

THE RESPONDENT WANTS TO CONTINUE INTERVIEW AT LATER DATE
THE RESPONDENT DOES NOT WANT TO CONTINUE INTERVIEW

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

If PCGBRKOFF = 1, Set CMS status code = PENDING
If PCGBRKOFF = 0, Set CMS Status code = BREAKOFF

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CAPI / CATI
PCGIVRPSWRD
IF PCGBRKOFF = 1: PCGBRKOFFTHNK;
ELSE: PCGINCENT

PCGBRKOFFTHNK
ASK

IF PCGBRKOFF = 1

QUESTION TYPE

Instruction
Create Fill FILL_BRKOFFTHANK
Create ﬁll FILL_CASEID: ‘CASEID’
IF MODE = CAPI , FILL_BRKOFFTHANK, “INTERVIEWER: THANK R FOR THEIR TIME. CLICK
HERE TO SCHEDULE BEST TIME FOR FOLLOW UP IN NLSY SCHEDULER (WILL OPEN IN
NEW WINDOW).:
https://nlsyscheduler.rti.org/Scheduler/Appointment/^{FILL_CASEID}?key=C94BCFC58EA5-4B19-B069-CD52A236819A “

FILLS (ENG)

FILLS (SPAN)

IF MODE = CAWI, FILL_BRKOFFTHANK, “Thank you for your time. You can return to
complete the survey online at any time using the same link and access code you used
to begin the survey. You will also need to enter the PIN you created at the beginning
of the survey. Otherwise, someone will contact you soon to complete the interview. ”
Create Fill FILL_BRKOFFTHANK
Create ﬁll FILL_CASEID: ‘CASEID’
IF MODE = CAPI , FILL_BRKOFFTHANK, “INTERVIEWER: THANK R FOR THEIR TIME. CLICK
HERE TO SCHEDULE BEST TIME FOR FOLLOW UP IN NLSY SCHEDULER (WILL OPEN IN
NEW WINDOW).:
https://nlsyscheduler.rti.org/Scheduler/Appointment/^{FILL_CASEID}?key=C94BCFC58EA5-4B19-B069-CD52A236819A “
IF MODE = CAWI, FILL_BRKOFFTHANK, “Gracias por su tiempo. Puede volver a completar
la encuesta por internet en cualquier momento usando el mismo enlace y código de
acceso que usó para comenzar la encuesta. También tendrá que introducir el PIN que
creó al inicio de la encuesta. Como alternativa, alguien se pondrá en contacto con
usted en breve para completar la entrevista. ”

ENGLISH

{FILL_BRKOFFTHANK}

SPANISH

{FILL_BRKOFFTHANK}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

CAWI / CAPI / CATI

IF MODE = CAPI/CATI, IFMS SCHEDULER
ELSE: END.

NLSY P/CG Incentive Module
PRELOADS
PRELOAD THE FOLLOWING VARIABLES FROM THE ELIGIBILITY SCREENER:
Eligibility screener status (if breakoﬀ)

PRELOAD THE FOLLOWING VARIABLES FROM THE HOUSEHOLD CAPI SCREENER:
HHS012_ADDRESS1
HHS012_ADDRESS2
HHS012_CITY
HHS012_STATE
HHS012_ZIP
HHS Status (if breakoﬀ)
PCGINCNTAMT

PCGINCTCC
ASK

ALL

QUESTION TYPE

Computer Check
Create ﬁll, FILL_PCGINCNTAMT
IF SCRNRBRKOFF = 1, FILL_PCGINCNTAMT = ‘5’
ELSE IF HHSBRKOFF = 1, FILL_PCGINCNTAMT = ‘5’
ELSE, FILL_PCGINCNTAMT using preload = ‘{PCGINCNTAMT}’

FILLS (ENG)

FILLS (SPAN)

Create ﬁll, FILL_PCGINCNTAMT
IF SCRNRBRKOFF = 1, FILL_PCGINCNTAMT = ‘5’
ELSE IF HHSBRKOFF = 1, FILL_PCGINCNTAMT = ‘5’
ELSE, FILL_PCGINCNTAMT using preload = ‘{PCGINCNTAMT}’

ENGLISH
SPANISH
RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

This is a computer check to route based on respondent breakoﬀ status, either broken oﬀ
from the screener or broken oﬀ from a later module. This impacts the incentive amount.

CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

In-Person/CAWI

NOTES
LEAD-IN
NEXT

Breakoﬀ module, P/CG Information
PCGINCENT

PCGINCENT
ASK

ALL

QUESTION TYPE

Radio button
Create ﬁll, FILL_PCGMODEINCENT
If MODE = CATI, FILL_PCGMODEINCENT: ‘3. Cash mailed to you. Cash will take about 14
days to arrive.’
If MODE = IN PERSON, FILL_PCGMODEINCENT:’4. Or I can give you Cash now.
Else, FILL_PCGMODEINCENT: empty

FILLS (ENG)

Create ﬁll, FILL_PCGINCNTAMT
FILL_PCGINCNTAMT = 50

FILLS (SPAN)

Create ﬁll, FILL_PCGMODEINCENT
If MODE = CAWI, FILL_PCGMODEINCENT: ‘3. Efectivo enviado por correo
postal. El efectivo tardará unos 14 días en llegar.’
If MODE = IN PERSON, FILL_PCGMODEINCENT:’4. O puedo darle efectivo ahora.
Else, FILL_PCGMODEINCENT: empty
Create ﬁll, FILL_PCGINCNTAMT
FILL_PCGINCNTAMT = 50

Thank you for taking the time to answer these questions. As a token of appreciation for completing
this part of the study, we would like to give you $^{FILL_PCGINCNTAMT}. Would you prefer to
receive…?
1. An electronic gift card that can be used online or in stores. This option includes online
shopping (like Amazon), restaurants you can visit (like Starbucks or fast food), or
Mastercard. These cards do not expire.
^{FILL_MODEINCENT}

ENGLISH

Gracias por tomarse el tiempo de responder estas preguntas. Como muestra de agradecimiento
por completar esta parte del estudio, quisiéramos darle $^{FILL_PCGINCNTAMT} dólares.
¿Preﬁere recibir...?
SPANISH

1. Una tarjeta de regalo electrónica que puede usarse por internet o en tiendas. Esta
opción incluye compras por internet (como Amazon), restaurantes que puede visitar
(como Starbucks o restaurantes de comida rápida), o Mastercard. Estas tarjetas no
caducan.
^{FILL_MODEINCENT}

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

If PCGINCENT = DK or REF or missing, display soft check: This is required to send you our
token of appreciation. If you do not select an option, you will not receive the
$^{FILL_PCGINCNTAMT}.

CHECK (SPAN)

If PCGINCENT = DK or REF or missing, display soft check: Esto es necesario para que
podamos enviarle la muestra de agradecimiento. Si no selecciona ninguna opción, no
recibirá los $^{FILL_PCGINCNTAMT} dólares.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

In-Person/CAWI
Breakoﬀ module, Youth Information
If PCGINCENT= 1: PCGINCTDLVRY
Else if PCGINCENT= 3: f_PCGINCTNAME
Else: PCGINCT_THANK

PCGINCTDLVRY
ASK

If (PCGINCENT= 1)

QUESTION TYPE

Radio button

FILLS (ENG)
FILLS (SPAN)
Would you like to receive the electronic gift card by email or by text?
ENGLISH

1. By email
2. By text
¿Desea recibir la tarjeta de regalo electrónica por correo electrónico o por mensaje de texto?

SPANISH

1. Por correo electrónico
2. Por mensaje de texto

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

If PCGINCTDLVRY= DK or REF or missing, display soft check: This is required to send you
the $^{FILL_PCGINCNTAMT}. If you do not select an option, you will not receive the
$^{FILL_PCGINCNTAMT}.
If PCGINCTDLVRY= DK or REF or missing, display soft check: Esto es necesario para enviarle
los $^{FILL_PCGINCNTAMT} dólares. Si no selecciona ninguna opción, no recibirá los
$^{FILL_PCGINCNTAMT} dólares.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES
LEAD-IN
NEXT

In-PersonCAWI
PCGINCENT = 1
IF PCGINCTDLVRY = 1: f_PCGINCT_EMAIL
IF PCGINCTDLVRY = 2: f_PCGINCT_PHONE

f_PCGINCT_EMAIL
PCGINCT_EMAIL1 / PCGINCT_EMAIL2
ASK
IF PCGINCTDLVRY = 1
QUESTION TYPE

Textbox

FILLS (ENG)

Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT
FILLS (SPAN)
Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT
Please provide your email address where you would like us to send your $^{FILL_PCGINCNTAMT}
electronic }.gift card.
Enter email address: ____________________ [PCGINCT_EMAIL1]

ENGLISH

Please conﬁrm email address: ____________________ [PCGINCT_EMAIL2]
Indique la dirección de correo electrónico a la que desea que le enviemos sus $^{FILL_PCGINCNTAMT}
dólares en forma de una tarjeta de regalo electrónica.
SPANISH

Ingrese la dirección de correo electrónico: ____________________ [PCGINCT_EMAIL1]
Conﬁrme la dirección de correo electrónico: ____________________ [PCGINCT_EMAIL2]

RANGE
LIMITS

PCGINCT_EMAIL1: 50 characters
PCGINCT_EMAIL2: 50 characters

LOOP MAX
PROGRAM. NOTES
If email is not in valid format, display hard check: Please enter a valid email address.

CHECK (ENG)

If PCGINCT_EMAIL1 != PCGINCT_EMAIL2, display hard check: The email addresses you
provided do not match. Please check that the correct email address is entered in both
boxes.
If PCGINCT_EMAIL1 & PCGINCT_EMAIL2 = DK or REF or missing, display hard check: This
is required to send you the $^{FILL_PCGINCNTAMT}.
If email is not in valid format, display hard check: Ingrese una dirección de correo
electrónico válida.

CHECK (SPAN)

If PCGINCT_EMAIL1 != PCGINCT_EMAIL2, display hard check: Las direcciones de correo
electrónico que ingresó no coinciden. Revise que la dirección de correo electrónico sea
correcta en ambas casillas.
If PCGINCT_EMAIL1 & PCGINCT_EMAIL2 = DK or REF or missing, display hard check:
Esto es necesario para enviarle los $^{FILL_PCGINCNTAMT} dólares.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE
NOTES

In-PersonCAWI

LEAD-IN
NEXT

IF PCGINCTDLVRY = 1
PCGINCT_THANK

f_PCGINCT_PHONE
PCGINCT_PHONE1 / PCGINCT_PHONE2
ASK
IF PCGINCTDLVRY = 2
QUESTION TYPE

Numeric

FILLS (ENG)

Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT
FILLS (SPAN)
Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT
Please provide your cell phone number where you would like us to send your $^{FILL_PCGINCNTAMT}
electronic gift card.
Enter cell phone number: ___-___-____ [PCGINCT_PHONE1]

ENGLISH

Please conﬁrm cell phone number: ___-___-____ [PCGINCT_PHONE2]
Indique el número de teléfono móvil al que desea que le enviemos sus $^{FILL_PCGINCNTAMT}
dólares en forma de una tarjeta de regalo electrónica.
SPANISH

Ingrese el número de teléfono móvil: ___-___-____ [PCGINCT_PHONE1]
Conﬁrme su número de teléfono móvil: ___-___-____ [PCGINCT_PHONE2]

RANGE
LIMITS

PCGINCT_PHONE1: 10 digits
PCGINCT_PHONE2: 10 digits

LOOP MAX
PROGRAM. NOTES

CHECK (ENG)

Only allow numbers to be entered. Check phone number is entered in valid format.
If either variable is < 10 digits, display hard check: Please enter a valid cell phone
number.
If PCGINCT_PHONE1 != PCGINCT_PHONE2, display hard check: The phone numbers you
provided do not match. Please check that the correct phone number is entered in both
boxes.
If PCGINCT_PHONE1 & PCGINCT_PHONE2 = DK or REF or missing, display hard check:
This is required to send you the $^{FILL_PCGINCNTAMT}.
If either variable is < 10 digits, display hard check: Ingrese un número de teléfono móvil
válido.

CHECK (SPAN)

If PCGINCT_PHONE1 != PCGINCT_PHONE2, display hard check: Los números de teléfono
provistos no coinciden. Revise que haya ingresado el número de teléfono correcto en
ambas casillas.
If PCGINCT_PHONE1 & PCGINCT_PHONE2 = DK or REF or missing, display hard check:
Esto es necesario para enviarle los $^{FILL_PCGINCNTAMT} dólares.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

In-PersonCAWI

NOTES
LEAD-IN
NEXT

IF PCGINCTDLVRY = 2
PCGINCT_THANK

f_PCGINCTNAME
PCGINCTFN / PCGINCTLN
ASK
IF PCGINCENT= 3 AND MODE = CATI
QUESTION TYPE

Textbox

FILLS (ENG)

Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT

FILLS (SPAN)
Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT
Please provide your ﬁrst and last name.
First name: ____________________ [PCGINCTFN]

ENGLISH

Last name: ____________________ [PCGINCTLN]
Indique su nombre y apellido.
SPANISH

Nombre: ____________________ [PCGINCTFN]
Apellido: ____________________ [PCGINCTLN]

RANGE
LIMITS

PCGINCTFN: 30 characters
PCGINCTLN: 50 characters

LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)

If PCGINCTFN or PCGINCTLN = DK or REF or missing, display hard check: This is required
to send you the $^{FILL_PCGINCNTAMT} cash.
If PCGINCTFN or PCGINCTLN = DK or REF or missing, display hard check: Esto es necesario
para enviarle los $^{FILL_PCGINCNTAMT} dólares en efectivo.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI

NOTES
LEAD-IN
NEXT

PCGINCENT= 3
PCGINCTMAIL

PCGINCTMAIL
ASK

IF PCGINCENT= 3

QUESTION TYPE

Radio button
Use ﬁll from HHS012_ADDRESS1: ‘FILL_ADDRESS1’
Use ﬁll from HHS012_ADDRESS2: ‘FILL_ADDRESS2’
Use ﬁll from HHS012_CITY: ‘FILL_CITY’
Use ﬁll from HHS012_STATE: ‘FILL_STATE’
Use ﬁll from HHS012_ZIP: ‘FILL_ZIP’

FILLS (ENG)

FILLS (SPAN)

Use ﬁll from HHS012_ADDRESS1: ‘FILL_ADDRESS1’
Use ﬁll from HHS012_ADDRESS2: ‘FILL_ADDRESS2’
Use ﬁll from HHS012_CITY: ‘FILL_CITY’
Use ﬁll from HHS012_STATE: ‘FILL_STATE’
Use ﬁll from HHS012_ZIP: ‘FILL_ZIP’

We have your mailing address recorded as:

ENGLISH

^{FILL_ADDRESS1}
^{FILL_ADDRESS2}
^{FILL_CITY}
^{FILL_STATE}
^{FILL_ZIP}
Is this correct?
1. YES
0. NO
Tenemos registrada su dirección como:

SPANISH

^{FILL_ADDRESS1}
^{FILL_ADDRESS2}
^{FILL_CITY}
^{FILL_STATE}
^{FILL_ZIP}
¿Es esto correcto?
1. Sí
0. No

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)

MODE

CAWI

NOTES
LEAD-IN

f_PCGINCTNAME
IF PCGINCTMAIL = 0: f_PCGINCT_ADDRESS
IF PCGINCTMAIL = 1: PCGINCT_THANK

NEXT

f_PCGINCT_ADDRESS
PCGINCT_ADDRESS1/ PCGINCT_ADDRESS2/PCGINCT_CITY/PCGINCT_STATE/PCGINCT_ZIP
ASK
IF PCGINCTMAIL = 2
PCGINCT_ADDRESS1: Text
PCGINCT_ADDRESS2: Text
QUESTION TYPE
PCGINCT_CITY: Text
PCGINCT_STATE: Dropdown
PCGINCT_ZIP: Numeric
FILLS (ENG)
FILLS (SPAN)
What is your mailing address?

ENGLISH

ADDRESS LINE 1: [PCGINCT_ADDRESS1]
ADDRESS LINE 2: [PCGINCT_ADDRESS2]
CITY: [PCGINCT_CITY]
STATE: [PCGINCT_STATE]
ZIP CODE: [PCGINCT_ZIP]
What is your mailing address?

SPANISH

Línea 1 de la dirección: [PCGINCT_ADDRESS1]
Línea 2 de la dirección: [PCGINCT_ADDRESS2]
Ciudad: [PCGINCT_CITY]
Estado: [PCGINCT_STATE]
Código postal: [PCGINCT_ZIP]

RANGE
LIMITS

PCGINCT_STATE: List states in alphabetical order
PCGINCT_ADDRESS1: Max 100 characters
PCGINCT_ADDRESS2: Max 100 characters
PCGINCT_CITY: Max 100 characters
PCGINCT_ZIP: Max 5 numbers

LOOP MAX
PROGRAM. NOTES
If zip code does not include exactly 5 numbers, display hard check: “PLEASE ENTER A
VALID 5-DIGIT ZIP CODE”
CHECK (ENG)

If PCGINCT_ADDRESS1 or PCGINCT_CITY or PCGINCT_STATE or PCGINCT_ZIP = DK or REF
or missing, display hard check: This is required to send you the $^{FILL_PCGINCNTAMT}
cash.

If zip code does not include exactly 5 numbers, display hard check: “INGRESE UN
CÓDIGO POSTAL VÁLIDO DE 5 DÍGITOS”
CHECK (SPAN)

If PCGINCT_ADDRESS1 or PCGINCT_CITY or PCGINCT_STATE or PCGINCT_ZIP = DK or REF or
missing, display hard check: Esto es necesario para enviarle los $^{FILL_PCGINCNTAMT}
dólares en efectivo.

HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

CAWI

NOTES
LEAD-IN
NEXT

IF PCGINCTMAIL = 2
PCGINCT_THANK

PCGINCT_THANK
ASK

ALL

QUESTION TYPE

Informational
Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT
Create ﬁll, FILL_INCENTTYPE
If PCGINCTDLVRY= 1, FILL_INCENTTYPE: ‘You should receive an email with a link to your
$^{FILL_PCGINCNTAMT} electronic gift card in the next 10 minutes’
If PCGINCTDLVRY= 2, FILL_INCENTTYPE: ‘You should receive a text message with a link to
your $^{FILL_PCGINCNTAMT} electronic gift card in the next 10 minutes’
If PCGINCENT = 3, FILL_INCENTTYPE: ‘You should receive $^{FILL_PCGINCNTAMT} cash in
the mail in the next 14 days’
If PCGINCENT = 4, FILL_INCENTTYPE: ‘Here is your $^{FILL_PCGINCNTAMT}.

FILLS (ENG)

Use ﬁll from PCGINCENT: FILL_PCGINCNTAMT

FILLS (SPAN)

ENGLISH
SPANISH

Create ﬁll, FILL_INCENTTYPE
If PCGINCTDLVRY= 1, FILL_INCENTTYPE: ‘Debería recibir un correo electrónico con un
enlace a su tarjeta de regalo electrónica de $^{FILL_PCGINCNTAMT} dólares dentro
de los próximos 10 minutos’
If PCGINCTDLVRY= 2, FILL_INCENTTYPE: ‘Debería recibir un mensaje de texto con un
enlace a su tarjeta de regalo electrónica de $^{FILL_PCGINCNTAMT} dólares dentro
de los próximos 10 minutos’
If PCGINCENT = 3, FILL_INCENTTYPE: ‘Debería recibir $^{FILL_PCGINCNTAMT} dólares en
efectivo por correo dentro de los próximos 14 días’
If PCGINCENT = 4, FILL_INCENTTYPE: ‘Aquí tiene sus $^{FILL_PCGINCNTAMT} dólares.

Thank you. ^{FILL_INCENTTYPE}.
Gracias. ^{FILL_INCENTTYPE}.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

In-Person/CAWI

NOTES
LEAD-IN
NEXT

f_PCGINCT_ADDRESS, PCGINCTMAIL, f_PCGINCT_PHONE, f_PCGINCT_EMAIL
ES0_47A

PCGINCT_CLOSE
ASK

ALL

QUESTION TYPE

Informational

FILLS (ENG)
FILLS (SPAN)
ENGLISH

INTERVIEWER: THANK R FOR THEIR TIME AND CLOSE OUT INTERVIEW.

SPANISH

INTERVIEWER: THANK R FOR THEIR TIME AND CLOSE OUT INTERVIEW.

RANGE
LIMITS
LOOP MAX
PROGRAM. NOTES
CHECK (ENG)
CHECK (SPAN)
HELP TEXT (ENG)
HELP TEXT (SPAN)
MODE

In-Person/CAWI

NOTES
LEAD-IN
NEXT

PCGINCT_THANK
End.
File Type	application/pdf
Author	Cone, Alex
File Modified	2025:08:28 12:25:52-04:00
File Created	2025:08:28 12:06:46-04:00