DDI_FSM_2005_HIES_v01_M Scott Pontifex Thomas Foruw Accelerated Data Program 2012-07-16 NADA Version 01: Taken from "DDI_FSM_2005_HIES_v01_M" DDI that was done by metadata producers mentioned in "Metadata Production" section. Household Income and Expenditure Survey 2005 HIES 2005 FSM_2005_HIES_v01_M FSM Divison of Statistics Michael Levin Glenn McKinlay Chris Ryan NADA FSM Congress Office of Insular Areas, US Department of the Interior Public Law No. 13-81, Section 8(3)(j) Assistant Director, FSM Division of Statistics Income/Expenditure/Household Survey [hh/ies] The 2005 Household Income and Expenditure Survey (HIES) is the third of its kind to be conducted in the FSM by the FSM Division of Statistics. The first was in 1989 with no published outputs. The second was in 1998, which has comparable results to the current. The 2005 HIES was initially planned to be conducted in 2003 so as to standardize it to an 'every 5-year' survey. Funding constraints prevented this thus the delay to 2005. Version 2.0: Edited data; not anonymized; basis for public reports consumption/consumer behaviour [1.1] income, property and investment/saving [1.5] community, urban and rural life [13.1] The purpose of the HIES survey is to obtain information on the income, consumption pattern, incidence of poverty, and saving propensities for different groups of people in FSM. This information will be used to guide policy makers in framing socio-economic developmental policies and in initiating financial measures for improving economic conditions of the people. The 2005 FSM HIES asked income of all persons 15 years and over. It referred to income received during the calendar year 2004, and includes both cash and in-kind income. The survey has five primary objectives, namely to: 1) Rebase the FSM Consumer Price Index (CPI); 2) Provide data on the distribution of income and expenditures throughout the FSM; 3) Provide data for national accounts, particularly regarding income from home production activities and the consumption of goods and services derived form home production activities; 4) Provide nutritional information and food consumption patterns for the FSM families; and 5) Provide data for hardship study. Micronesia, Fed. Sts. National - Households - Individuals - Expenditure items The survey universe covered all persons living in their place of usual residence at the time of the survey. Income data were collected from persons aged 15 years and over while expenditure data were obtained from all household members at a household level. Persons living in institutions, such as school dormitories, hospital wards, hostels, prisons, as well as those whose usual residence were somewhere else were excluded from the survey. Sample survey data [ssd] The topics covered by the survey included: HOUSEHOLDS: dwelling characteristics, housing expenditure, household operations, clothing and footwear, education and health expenditure, and food expenditure. PERSONS: personal information, income and employment of individuals, including wage and salaries, self-employment, business activities ANNUAL EXPENDITURE ITEMS: total annual expenditure on commodity and utility items, type of expenditure and type of item. WEEKLY DIARY: recording of daily expenditures of items bought on credit or cash by each selected household over a 2 week period, recording of home grown/produced items, recording of cash, purchased items, and home produced items GIVEN/RECEIVED as gifts. FSM Divison of Statistics College of Micronesia Students The 2005 FSM Household Income and Expenditure Survey (HIES) used a sampling frame based on updated information on Enumeration Districts (ED) and household listing from the 2000 FSM Census. Based on this sampling frame, the four states of FSM were then classified as the domains of the survey. Each of the states was further divided into 3 strata, except for Kosrae which was not divided at all because it doesn't possess any outer islands and it has relatively good access to goods and services. The entire island was therefore classified under stratum 1. Each stratum was defined as follows: 1) State center and immediate surrounding areas: - High 'living standard' and has immediate access to goods and services. 2) Areas surrounding state center (rest of main island): - Medium 'living standard' and sometime limited access to goods and services 3) Outer islands: - Low 'living standard' and rare access to goods and services. Within each stratum, the HIES used a two-stage stratified sampling approach from which the sample was selected independently. First, enumeration districts (EDs) were drawn from each stratum using Proportion Probability to Size (PPS) sampling. Thus, the larger the ED size, the higher its probability of selection. About 69 EDs out of a total of 373 EDs were selected nationwide for the survey. Generally, one enumerator is assigned to each ED. Second, 20 households were systematically selected from an updated household listing for each of the selected EDs using a random start to come up with a total sample size of 1,380 households, or roughly 8.4 percent of all households in the state. Although it offered a fairly good representation of the total households in the nation, the final sample size showed a reduction of nearly 180 households from the 1,560 households, or 10 percent, initially selected for the survey. Detailed information on the changes made to the sample size can be found in the next section under "Deviations from Sample Design." The original plan to sample 1,560 households, or about 9.5 percent of all households in the nation was eventually reduced to 1,380 households, or about 8.4 percent of all households. The reduction of the sample size was due to fuel unavailability for transportation and uncertainty of field trip schedules to some of the selected outer islands. Dropping some of these islands from the sample was not expected to impact significantly on the accuracy of the survey results because independent weighting took place within each stratum, where islands were considered to be sufficiently homogenous. Face-to-face [f2f] Questionnaires and forms used for the 2005 FSM HIES consisted of 1) HIES Questionnaire and 2) Weekly Diaries. The HIES Questionnaire were provided to enumerators and should be filled out during the first visit to the household. Its main objective was to collect housing information, basic demographic information about members of the household and general household expenditures over the previous year. On the other hand, the weekly diaries, was an attempt to record household expenditure on a daily basis over the course of a 2 week period. Both the HIES questionnaire and the weekly diary were developed and modeled after similar forms from the 1998 FSM HIES Survey and the 2004 Palau HIES Survey. Dr. Micheal Levin from the US Census Bureau, International Program Center (IPC), Ms. Brihmer Johnson of the FSM Division of Statistics and Mr. Glenn McKinlay, statistics advisor to FSM Division of Statistics, provided crucial inputs to the overall design of these forms. All questionnaires and diaries used during the HIES were printed in English so it was extremely important that field interviewers understand the instuctions and questions contained within. Testing of the questionnaire were carried out by FSM Division of Statistics staffs who conducted "real" interviews with certain households in their neighborhood as well as having their own household be interviewed by a different office staff. Specific sections for both the HIES questionnaire and the weekly diaries are outlined below: I. HIES Questionnaire 1) General Household characteristics 2 ) Individual Person Characteristics 3) General Expenditure Listings - 12 Months Recall Period II. 2 Week Daily Diaries 1) Daily Expenditure Diary - Day1 (Mon) thru Day7 (Sun) 2) Home Produced Items 3) Gifts Given Away 4) Gifts Received 5) Unusual Expenses for Special Events The following major activities and observations took place during the field operation phase of the 2005 FSM HIES: RECRUITMENT OF FIELD WORKERS Survey workers were recruited from the College of Micronesia-Natioanal Campus, who were going back to their resident states for the summer. Competent enumerators and supervisors from previous surveys were also contacted and rehired if they were interested. All candidates were tested for competency (English language, following instructions, etc). TRAINING Training of enumerators and supervisors were carried out in the states 1 to 2 weeks before and during the survey reference date (June 1, 2005). Dr. Micheal Levin, from the US Census Bureau, International Program Center (IPC) conducted the training at the state field offices. Enumerators/supervisors at each fileld office were trained for two days using a verbatim training guide to ensure uniform understanding of procedures. Field-practice interviewing, a key part of the training process, was not carried out. Nevertheless, limited mock interviews involving office staffs as well as enumerators and supervisors were conducted to test the validity of the questionnaire and to familiarize key personnel with the interviewing process. The state branch office managers oversee the survey operations in each of the states. Selected staffs from the national office were relocated to Pohnpei and Chuuk field offices to assist in overseeing the project because of the short-staffing in these offices at the time of the survey. ENUMERATION The actual enumeration was officially scheduled beginning June 6, 2005, a week after the reference date, and continue on for four weeks until July 3, 2005. Enumeration was expected take place over a period of about four weeks. This period will provide for initial enumerator contact to obtain population and housing information, and general and regular expenses information for the 20 units assigned. On average, an interview was estimated to last for less than 2 hours as stated on the cover of the questionnaire. During the initial first two-week period, 10 two-week diaries will be dropped at households 1 to 10 to be picked up at a later date. For the remaining two weeks, another 10 two-weeks diaries will also be dropped off at households 11-20, while allowing 2 to 3 days review between these periods. Enumerators will make several follow-up visits at those units that received the weekly diaries to make sure that they are filled in appropriately and completely, and to pick them up at the end of each week for processing. This was primarily carried out by about 66 enumerators and 15 field supervisors. Except for a few EDs, each enumerator was assigned to an Enumeration District (ED) from which he/she was responsible for covering the 20 houing units previously selected. The following showed the overall distribution of EDs and housing units by state: Yap: 14 EDs (280 Housing Units) Chuuk: 24 EDs (500 Housing Unit) Pohnpei: 23 EDs (460 Housing Units) Kosrae: 7 EDs (140 Housing Unit) FSM: 68 EDs (1380 Housing Units) A total of about 3 to 5 enumerators reports to 1 field supervisor, who in turns reports to the state statistics office staffs, in particular the state survey coordinator. Overseeing all these different level of supervision was the national coordinator. Although questionnaires and weekly diaries were printed in English, most of the interviews were conducted in either one of the local dialects: Yapese, Ulithian, Woleaian or Satawalese, Chuukese, Pohnpeian or Kosraen. English, however, may also have been used but only for non-FSM households. The actual assignemnt of enumerators and supervisors by state and EDs are provided in the technical documents. Supervision of the HIES data collection process, at its lowest level, occurred in the field with field supervisors overseeing the enumerator's interviewing process and monitoring their daily progress. These individuals worked under the direction of the State Survey Coordinator and the National Coordinator who trained and help them in any difficult situation. It is the responsibility of each field supervisor to work closely with his/her assigned enumerators as well as the State Survey Coordinator to ensure that the survey runs smoothly and efficiently without undue difficulties. A field supervisor monitored a crew of about 3 to 5 enumerators previously assigned to similar number of Enumeration Districts (EDs). A total of about 15 field supervisors were contracted out for the 2005 FSM HIES. Of these 5 each were assigned to Chuuk and Pohnpei, 3 to Yap, and 2 to Kosrae. All field supervisors must accompany their enumerators for the first few interviews on the first few days to ensure that they understood the interviewing process and completing their assigned tasks completely and accurately. In this regard, the most important responsibility for a field supervisor was to make sure that all assigned tasks were completed accurately and on schedule. A field supervisor was also expected to keep the State Survey Coordinator informed of potential delays or problems. Specific details of each supervisor's tasks and responsibilities include: 1) Attending the training session for supervisors to learn enumeration procedures. 2) Learning the enumerators' job. 3 ) Participate in the training of your enumerators. 4) Supervise the Field Exercises during training. 5) Preparing and distributing enumerator assignments. 6) Conducting on-the-job training (as required). 7) Collecting enumerators' completed work. 8) Performing field reconciliation (if required) for a Block or ED. 9) Re-canvassing a Block or ED, if necessary. 10) Conducting first reviews, daily reviews, and final reviews of each enumerators' work. 11) Monitoring and reporting the progress of your staff using progress reports. 12) Visiting and enumerating households that refuse to cooperate with an enumerator. 13) Releasing enumerators who are unable to perform satisfactorily. 14) Reassigning work, when necessary. Those who have completed their assignment(s) may finish up the work of those unable to perform a satisfactory job. 15) Supervising and controlling the progress of enumeration in your assigned areas to ensure that work is completed on schedule. 16) Prepare a procedural history report for Phases I and II of the survey operation. Weights for the survey were calculated at the stratum level for each household. An estimate of the household population at the time of the survey was derived using population projections and average household size. These values were divided by the responding sample size for the stratum in order to produce the weight for the household. One outlier was identified during the data editing phase and as a result the weight for this household was set to 1. The weights for the remaining households within that stratum were adjusted accordingly. Data editing of the 2005 FSM HIES data occurred over several instances during the data processing phase of the project and afterwards prior to putting together the final report. After a two weeks office review and call backs right after the enumeration phase, the initial phase of data editing took place on July 18, 2005 when the data processing phase of the survey commenced. Training for editing and coding took place on the same day along with the signing of contracts for 10 office clerks recruited to carry out this phase of the survey. As part of their contract, these individuals were also hired to key in the data at a later time. One of their primary responsibily was to match geographic ids for questionnaire with corresponding diaries and ensure consistencies and valid entries accordingly. No computer consistency edit checks were run against the data during the keying/verification process since the programs for these processes were not available at the time. All data quality checks and edits were done at the US Bureau of Census. Further edits were applied to the data during the data analysis and report writing process. There were five types of checks performed: Structural check, Verification check, Consistency check, Macro Editing check, Data Quality assessment. Edit lists were also produced for health module, income and expenditure questionnaire which needed to be checked against the questionnaires. On the edit list, corrections of errors were made by crossing out incorrect or missing values and entering the correct values in red. Missing amounts that were also missing on the questionnaire will need to be estimated using estimates from questionnaires in the same Enumeration District (ED) batch. For the diaries, the batch files were concatenated for each state and exported to tab delimited files. These files were imported into Excel and the unit price for each item was calculated using quantities and weights where possible. Records for each item were then filtered out and check for outlier unit price values (both large and small values as well as missing values). Values for missing amounts were imputed from estimated using average prices from the items within the same ED. The office operations manual used for editing and coding the questionnaires and diaries is provided under "Technical Documents/Data Processing Documents/Office Editing & Coding." Original Sample Size: 1,560 Households Original Sampling fraction 9.5% Final Sample Size: 1,380 Households Final Sampling fraction 8.4% The response rate for the final sample size of 1,380 households is 100 percent. The majority of households originally selected for the survey did respond to the survey. Households which have moved to other unselected areas or elsewhere and those who refused to respond were replaced with nearby households that were willing to participate in the survey. No sampling error analysis of the survey was calculated. The questionnaire design of the 2005 HIES vary from that of the 1998 HIES rendering comparison of the data to the 2005 HIES limited. However, when the data permits, comparisons were made. Section 108 of the "Statistics and Census Act of 1988" guarantees confidentiality of all information collected during the 2005 FSM HIES. Disclosure of any data related to the HIES Survey must get full approval from the FSM Division of Statistics. Any Person provided with such data shall not: (1) Use the information furnished under the provisions of this chapter for any purpose other than for the purpose of conducting a census or sample survey, gathering statistical data, or for compiling and disseminating tabulations or other statistical materialsr; (2) Make any publication whereby the data furnished by any particular establishment or individual under this chapter can be identified; or (3) Permit anyone other than sworn employees of the FSM Division of Statistics to examine the individual reports, except in the prosecution of alleged violations of this Act. Similar provsions are also provided under Public Law 5-77 which prohibits any FSM Division of Statistics employees, including contactual workers from revealing any information contained in any questionnaire or report obtained from respondents to anyone except authorized survey staff. An oath of confidentiality places restraint upon all survey staff and contractors to guard and keep personal records confidential. Any printed publications issued by the FSM Division of Statistics contains information only in summary form, and are prepared for the benefit of the public. Assistant Director, FSM Division of Statistics Use of the dataset must be acknowledged using a citation which would include: - the Identification of the Primary Investigator - the title of the survey (including country, acronym and year of implementation) - the survey reference number - the source and date of download Example: Federated States of Micronesia (FSM), Divison of Statistics. FSM Household Income and Expenditure Survey 2005. Ref. FSM_2005_HIES_v01_M. Dataset downloaded from <http://www.spc.int/prism/data-catalogue> on [date]. The 2005 FSM HIES dataset is not specifically covered under any data access policy except for related provisions stipulated in section 107 of Chapter 1 of the "Statistics and Census Act of 1988", entitled "Dissemination of Statistical Data, Restrictions on Use" which specifically states that: "The Chief [of the National Statistics Office] may furnish copies of tabulations and other statistical materials which do not disclose the information reported by, or on behalf of, any particular respondent, and may make special statistical compilations or surveys, for departments, offices, and agencies of the National Government, and State and local governments." Likewise, any statistical information and reports furnished to the public should also be strictly anonymized to ensure its confidentiality. Because the dataset itself has not been fully anonymized, persons wishing to access it should contact the FSM Division of Statistics directly and should abide by the following terms and conditions: 1. The data and other materials will not be redistributed or sold to other individuals, institutions, or organizations without the written agreement of the FSM Division of Statistics. 2. The data will be used for statistical and scientific research purposes only. They will be used solely for reporting of aggregated information, and not for investigation of specific individuals or organizations. 3. No attempt will be made to re-identify respondents, and no use will be made of the identity of any person or establishment discovered inadvertently. Any such discovery would immediately be reported to the FSM Division of Statistis. 4. No attempt will be made to produce links among datasets provided by the FSM Division of Statistis , or among data from the FSM Division of Statistics and other datasets that could identify individuals or organizations. 5. Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the FSM Division of Statistics will cite the source of data in accordance with the Citation Requirement provided with each dataset. 6. An electronic copy of all reports and publications based on the requested data will be sent to the FSM Division of Statistis . The original collector of the data, the FSM Division of Statistis, and the relevant funding agencies bear no responsibility for use of the data or for interpretations or inferences based upon such uses. The data contained herein is provided "as is" without any expressed or implied warranty or responsibility. The FSM Division of Statistics accepts no responsibility for the use of such data nor for any interpretations or inferences based upon such uses. Housing This file contains the final edited housing datafile found in section 1A of the 2005 FSM Housing and Expenditure Survey questionnaire, specifically dealing with housing characteristics. It also contains recoded variables on household income, family poverty level, and completeness of kitchen and plumbing facilities. 0 104 Person This file contained the final edited person datafile found in section 11 of the 2005 FSM Housing and Expenditure Survey questionnaire, specifically dealing with personal information. It also contains recoded variables on labor force status, individual poverty level, subsistence activities and family relationships. 0 99 Expenditure items This file contains data related to sections 2 thru 10 of the HIES questionnaire particularly dealing with qualitative questions regarding household expenditures over the past 12 months starting on the reference (June 1, 2005). Detailed breakdown of this data file is shown below: SECTION 2. CONSTRUCTION & REPAIRS (12-MONTH RECALL PERIOD) SECTION 3. CONSUMER DURABLES - FURNITURE, ELECTRONIC ITEMS AND RECREATION ITEMS (12-MONTH RECALL PERIOD) SECTION 4. CONSUMER DURABLES - SMALL HOUSEHOLD APPLIANCES, TOOLS & HOUSEHOLD GOODS & SERVICES SECTION 5. CONSUMER NON-DURABLES (12-MONTH RECALL PERIOD) SECTION 6. TRANSPORTATION (12-MONTH RECALL PERIOD) SECTION 7. MEDICAL CARE (12-MONTH RECALL PERIOD) SECTION 8. LOANS (12-MONTH RECALL PERIOD) SECTION 9. EDUCATION (12-MONTH RECALL PERIOD) SECTION 10. MISCELLANEOUS (12-MONTH RECALL PERIOD) 0 49 Expenditures This file contains data related to sections 2 thru 10 of the HiES questionnaire particularly dealing with the actual amount of household expenditures over the past 12 months starting on the reference (June 1, 2005). Detailed breakdown of this data file is shown below: SECTION 2. CONSTRUCTION & REPAIRS (12-MONTH RECALL PERIOD) SECTION 3. CONSUMER DURABLES - FURNITURE, ELECTRONIC ITEMS AND RECREATION ITEMS (12-MONTH RECALL PERIOD) SECTION 4. CONSUMER DURABLES - SMALL HOUSEHOLD APPLIANCES, TOOLS & HOUSEHOLD GOODS & SERVICES (12-MONTH RECALL PERIOD) SECTION 5. CONSUMER NON-DURABLES (12-MONTH RECALL PERIOD) SECTION 6. TRANSPORTATION (12-MONTH RECALL PERIOD) SECTION 7. MEDICAL CARE (12-MONTH RECALL PERIOD) SECTION 8. LOANS (12-MONTH RECALL PERIOD) SECTION 9. EDUCATION (12-MONTH RECALL PERIOD) SECTION 10. MISCELLANEOUS (12-MONTH RECALL PERIOD) 0 166 Diary Record This file contains data obtained from the Week 1 and Week 2 Diaries particularly related to daily expenditures on purchased items, home produced items, and gifts whether received or given. 0 16 HIES INCOME & EXPENDITURE DATA Aggregated income and expenditure data of households, derived/recoded from the values collected through the questionnaire and diaries. 0 71 Municipality Municipality Municipality Municipality Municipality B. Municipality 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak Enumeration District Enumeration District Enumeration District Enumeration District Enumeration District C. ED Village Village Village Village Village D. Village Block Block Block Block Block E. Block (first three digits) Block A Block A Block A Block A Block A E. Block (fourth digit) Mapspot Mapspot Mapspot Mapspot Mapspot F1. Map Spot Household Number Household Number Household Number Household Number Household Number F2. Household No. All persons who occupy a housing unit and prepare their food together. Enumerator number Enumerator number Enumerator number Enumerator number Enumerator number G. Enumerator Type of unit Type of unit Type of unit Type of unit Type of unit K. Type of unit: 1. Occupied: Form _____ of ______ 2. Group quarters 3. Vacant: Year round use 4. Vacant: Seasonal use 5. Vacant: UHE Circle the appropriate (precoded) answer on the front cover of the questionnaire. OCCUPIED Circle item 1.Occupied for housing units occupied by persons whose usual home is the living quarters you are enumerating. 1.First form (a)Write in 1.Occupied: "Form 1 of 1 " if you use only one questionnaire at a housing unit. (b)Also write in 1.Occupied: "Form 1 of 2 " on the first questionnaire for a housing unit occupied by more than 10 persons. 2.Continuation If a housing unit has more than 10 persons, fill a "Continuation" questionnaire as: 1.Occupied: "Form 2 of 2 " . Do not ask the housing questions again on the continuation form. 1 Occupied 2 Group quarters 3 Vacant: year round use 4 Vacant: seasonal use 5 Vacant: UHE Vacant: status Vacant: status Vacant: status Vacant: status Vacant: status FOR VACANTS ONLY: L.Vacancy Status: 1. For rent 2. For sale only 3. Rent/sold,not occup. 4. Held, occasional use For VACANT unit/house, circle appropriate (precoded) answer. 1.HOW TO DETERMINE VACANCY STATUS Report the status of the vacant unit as of the day of enumeration. Do not depend on signs. Some houses for sale are also for rent, and a house with a "For Sale" sign may have already been sold; some houses with a "For Sale" sign may be occupied. Ask a reliable respondent such as a rental agent, building manager, or neighbor about the present status. 2.VACANCY STATUS DEFINED a."For rent" -- Includes vacant units which are for rent and vacant units offered either for rent or for sale. b."For sale only" -- Includes vacant units which are for sale only. The following instructions apply to vacant housing units in multi-unit buildings only: (1)Individual units for sale in a multi-unit building: In a cooperative or condominium apartment building, most units are offered "For sale only." Ask whether the unit is also for rent, and if it is, report it as being "For rent." (2)Entire multi-unit building for sale. Mark the individual units in it as follows: (a)If the individual vacant unit is offered for rent, mark it "For rent." (b)If the individual vacant unit is intended to be occupied by the new owner, mark it "For sale only." (c)If the individual unit is vacant because it is being held for sale of the entire building, mark it "Other vacant." (d)If the entire building is vacant and rentals are not being sought, mark all units "Other vacant." c."Rented or sold, not occupied" -- If any money rent has been paid or agreed upon, but the renter has not yet moved in, or if the unit has recently been sold but the new owner has not moved in, mark it "Rented or sold, not occupied." d."For seas/rec/occ" (For seasonal/recreational/occasional use) -- Includes vacant housing units such as: (1)Units intended for occupancy during only certain seasons of the year, such as beach cottages, hunting cabins, etc. (2)Units for weekend or other occasional use throughout the year. (3)Shared ownership or time-sharing condominiums. (4)Units held for herders, loggers, fish packers, and other workers not employed in farm work. e."For migrant workers" -- Includes vacant units intended for occupancy by migratory workers employed in farm work during the crop season. (Work in a cannery, a freezer plant, or a food processing plant is not farm work.) f."Other vacant" -- Includes vacant units which do not fall into any of the above classifications such as: (1)Housing units held for settlement of an estate. (2)Housing units held for occupancy of a caretaker, janitor or other employee. (3)Housing units held for personal reasons of the owner or renter. 1 For rent 2 For sale only 3 Rent/sold, not occup. 4 Held, occasional use Vacant: time Vacant: time Vacant: time Vacant: time Vacant: time VACANTS ONLY: M.Months vacant: 1. Less than 1 2. 1 up to 2 3. 2 up to 6 4. 6 up to 12 5. More than 1 yr HOW TO COMPUTE THE TIME Mark the time from the date the last occupants moved from the unit to the day of your first attempt at enumeration. For example, if the last occupants moved out on January 7 and you visit the unit on April 27, mark "2 up to 6" (2 up to 6 months). If the occupants moved out April 15, mark "less than 1" (less than 1 month). 1.FOR NEWLY CONSTRUCTED UNITS that have never been occupied, mark the time from the date construction was completed. Construction is considered to be completed when all the exterior windows and doors are in and final usable floors are in place. 2.FOR RECENTLY CONVERTED OR MERGED UNITS, report the time from the date conversion or merger was completed. a.Conversion is the creation of two or more housing units from fewer units through structural alteration or change in use. For example, one unit may be divided into two units or three units. b.Merger is the combining of two or more housing units into fewer units through structural alteration or change in use. For example, two units may be combined into one. 3.For vacant units which are entirely occupied by persons with a USUAL HOME ELSEWHERE (UHE), mark (X) the box "less than 1." 1 Less than 1 month 2 1-2 months 3 2-6 months 4 6-12 months 5 More than 1 year HH Population HH Population HH Population HH Population HH Population N. Population: Item N: Record the total number of people living in the housing unit here. Use two digits, filling a zero in the first box if less than 10 people live in the housing unit. Substitute Substitute Substitute Substitute Substitute O.This house: 1. Will be sub 2. Sub HH Item O: You will use this items only if you must SUBSTITUTE a unit. A substitution occurs when no one is ever home at the housing unit when you visit, and you determine that the unit is vacant, or the respondents in the housing unit refuse to cooperate with the survey, and you have filled a refusal form. If one of these events occurs: 1. The next time you check in with you supervisor or at the general office, discuss the situation at the unit and the refusal form with your supervisor or the office staff. If you and they determine that a substitute housing unit is needed, a new unit/replacement will be assigned to you. Normally, this unit will be to the right or to the left of the original unit. 2. If a new unit is to be assigned, record “1” in the box for item N on the ORIGINAL questionnaire, to indicate that this unit is vacant, or a refusal. 3. If a new unit is assigned, record “2” in the box for item N on the NEW questionnaire to indicate that this unit is the substituted unit. For item O, if you determine that the housing unit is vacant, or a refusal, fill as much information about the housing unit as possible, and mark the box in O to indicate that you are unable to conduct an interview. Return to the office with the form as you have completed it, and discuss with your supervisor whether a substitute house should be assigned. 1 To be substituted 2 Substituted HH enumeration status HH enumeration status HH enumeration status HH enumeration status HH enumeration status P. Household form status: 1.Completed 2. Last resort 3. On vacation/off-island 4. No longer exists 5. Converted business 6. Refusal This item shows whether or not the questionnaire was completed. If the questionnaire was not completed, information about why the questionnaire was not completed must be noted. 1.Completed. Record “1” for “completed” if the questionnaire was completed - all parts, including the housing, population, and annual and general expenditures. 2.Last Resort. Record “2” for “last resort” if all efforts to complete the questionnaire were unsuccessful. The enumerator visited the unit 3 times and could net find anyone home, even though all evidence was that the housing unit is occupied. Return to the 2005 Household Survey Office to obtain a substituted unit. 3.On vacation/off island. Record “3” for “on vacation/off island” if you find from neighbors or relatives that the whole household is off island for vacation or other reasons. Return to the 2005 Household Survey Office to obtain a substituted unit. 4.No longer exists. Record “4” for “no longer exists” if the unit is in disrepair, or no longer exists at all. When this happens, return to the 2005 Household Survey Office to obtain a substituted unit. 5.Converted business. Record “5” for “converted business” if this unit used to be a housing unit, but has since been converted for use as a business. Return to the 2005 Household Survey Office to obtain a substituted unit. 6.Refusal. Record “6” for “refusal” if the housing unit respondents refuse to answer the questions. If the household members answer part of the questionnaire, and then refuse to answer the other items because of respondent fatigue or other reasons, and you find that you are unable to obtain the rest of the information at a later time, check with you supervisors to see whether enough information was gathered for this unit. If enough information is recorded, the unit will be accepted. If insufficient information was gathered, then the 2005 Household Survey Office will assign another, substituted unit. 1 Completed 2 Last resort 3 On vacation/off-island 4 No longer exists 5 Converted business 6 Refusal Persons not listed Persons not listed Persons not listed Persons not listed Persons not listed H1a. When you told me the names of persons living here on June 1, did you leave anyone out because you were not sure if the person should be listed — for example, someone temporarily away on a business trip or vacation, a newborn baby still in the hospital, or a person who stays here once in a while and has no other home? 1. Yes 2. No If Yes, determine if you should add the person(s) based on the instructions for Question 1a. Housing units may be of many different types. Most people think of a housing unit as a single-family house surrounded by open space on all four sides. Some housing units are attached to other units such as row houses or townhouses. An apartment behind a store or a room above a garage may be a housing unit. Mobile homes are also housing units if they are occupied or intended to be occupied on the site where they are situated. Occupied boats, vans, tents, and other types of shelter are also housing units if they are someone's usual place of residence or if they are occupied by someone who has no usual residence. When you ask the census questions, use the appropriate term (house, apartment, mobile home, etc.) depending upon the type of housing unit you are enumerating. Ask at each occupied housing unit. Do not ask these questions at institutional or non-institutional group quarters. H1a.If the respondent answers that someone was left out because he or she was not sure if the person(s) should be listed, circle 1 for “Yes." For each person whose status is in doubt, determine if the person is a member of the household. Refer to the rules for question 1a on the questionnaire and Appendix A (Table of Residence Rules) in this manual. a.If the person(s) is a household member, list the name(s) in question 1a and complete all population questions for the person. (NOTE: This will require using a continuation questionnaire for the household if all ten person pages have been used.) b.If the person(s) is not a household member, determine if the person is a visitor who has a "Usual home elsewhere" (UHE). (1)If the person is a visitor who has a UHE, but has no one at the UHE who will report him or her, complete an Individual Census Report (ICR) for the visitor and write the address of the UHE in the space provided in question 1b on the ICR. (2)If the person is a visitor without a UHE, list the name(s) in question 1a and complete all population questions for the person. 1 Yes 2 No Inclusion of everybody Inclusion of everybody Inclusion of everybody Inclusion of everybody Inclusion of everybody H1b. When you told me the names of persons living here on June 1, did you include everyone even though you were not sure that the person should be listed — for example, a visitor who is staying here temporarily or a person who usually lives somewhere else? 1. Yes 2. No If Yes, determine if you should delete the person(s) based on the instructions for Question 1a. Housing units may be of many different types. Most people think of a housing unit as a single-family house surrounded by open space on all four sides. Some housing units are attached to other units such as row houses or townhouses. An apartment behind a store or a room above a garage may be a housing unit. Mobile homes are also housing units if they are occupied or intended to be occupied on the site where they are situated. Occupied boats, vans, tents, and other types of shelter are also housing units if they are someone's usual place of residence or if they are occupied by someone who has no usual residence. When you ask the census questions, use the appropriate term (house, apartment, mobile home, etc.) depending upon the type of housing unit you are enumerating. Ask at each occupied housing unit. Do not ask these questions at institutional or non-institutional group quarters. H1b.If the respondent answers that someone was listed although he or she was not sure if the person(s) should be listed, circle 1.Yes. If you are not sure if the person(s) should be included, refer to the rules for question 1a on the question­naire and Appendix A (Table of Residence Rules) in this manual. a.If the person(s) is a household member, verify that the person is listed in question 1a and a person column has been completed for this person. All other population questions also should be completed for this person. b.If the person(s) is not a household member, determine if the person is a visitor who has a "Usual home elsewhere" (UHE). (1)If the person is a visitor who has a UHE, but has no one at the UHE to report him or her, complete an Individual Census Report (ICR) for the visitor and write the address of the UHE in the space provided in question 1b on the ICR. Be sure to cross out the name(s) in question 1a and cancel with a large X this person's column on pages 4 and 5. (2)If the person is a visitor without a UHE, verify that the person is listed in question 1a and a person column has been completed for this person. All other population questions also should be completed for this person. 1 Yes 2 No Building type Building type Building type Building type Building type H2a Which best describes this building? Include all apartments, flats, etc., even if vacant. Complete this item for all occupied housing units selected in your area. Circle only one answer for this question. 1.Count all occupied apartments in the house or building. Do not count stores or office space. 2.When one or more rooms have been added or built onto a mobile home or trailer, mark it as a "one-family house detached from any other house." If, however, only a porch or shed has been added, mark it as a "mobile home or trailer." 3."A one-family house" is a building that serves as living quarters for one household. a.Detached means there is open space on all sides or the house is joined only to a shed or garage. A one-family house which contains a business is also detached if the building has open space on all four sides. b.Attached means that the house is joined to another house or building by at least one wall which goes from ground to roof. Some examples are row houses (sometimes called townhouses), double houses, or houses attached to nonresidential structures. Each house is a separate attached structure if the dividing or common wall goes from ground to roof. 4.If the building has 2 or more apartments, determine the total number of living quarters, both occupied and vacant, in the whole building and circle the entry for the appropriate category. Separate apartments in an apartment house, even though each may be occupied by only one household, are not considered to be "one-family houses" as the whole building is occupied by more than one household. Do not classify it as detached or attached. 5."A boat or houseboat" - Circle item 8. A boat or houseboat if any boats or house-boats occupied as a housing unit. 6.Circle item 9. Other for any living quarters occupied as a housing unit that does not fit the other listed categories. Examples of living quarters that fit this category are abandoned cars, campers, tents, vans and caves. 1 One family detached 2 One family detached 3 Two apartments 4 3 or 4 apartments 5 5 to 9 apartments 6 10 to 19 apartments 7 20 or more apartments 8 Boat 9 Other Business property Business property Business property Business property Business property H2b If this is a ONE-FAMILY HOUSE — Is there a business (such as a store) or a medical office on this property? Complete H2b for all occupied one-family houses and mobile homes. 1.A business is easily recognizable. It will usually have a separate outside entrance and have the appearance of a business, such as a grocery store, restaurant, barbershop, etc. It may be either attached to the house or mobile home or it may be located elsewhere on the property. Some people use certain rooms in their houses for business or professional purposes which are not easily recognized from the outside. For example, a seamstress, tax consultant, salesperson, or accountant may use a room to meet customers and to work, but have made no recognizable alterations to the outside of the house. Do not consider these houses as having a business establishment. 2.A medical office is a doctor's or dentist's office regularly visited by patients. 1 YES 2 NO Tenure Tenure Tenure Tenure Tenure H3 Is this (house/apartment/condominium) — 1 Owned by someone in this household with a mortgage or loan? 2 Owned by someone in this household free and clear (without a mortgage?) 3 Rented for cash rent? 4 Occupied without payment of cash rent? If answer is either 1, 2 and 4, skip to H5. Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question and note skip pattern. 1.Circle 1 for "Owned by you or someone in this household with a mortgage or loan" if the house, apartment, or mobile home is mortgaged. The unit must be owner-occupied (that is, the owner or co-owner must live in the unit). Include units being bought on land contract or contract to purchase, deed of trust, purchase agreement and units built on leased land if the unit is mortgaged. And skip to H5 2.Circle 2 for "Owned by you or someone in this household free and clear (without a mortgage)" if there is no mortgage or other similar debt on the house, apartment, or mobile home. Include units built on leased land if the unit is owned outright without a mortgage. And skip to H5 3.Circle 3 for "Rented for cash rent" if any money rent is paid or contracted for. Include rented condominiums and cooperatives. (a)The rent may be paid by persons who are not living in the house or apartment, such as a relative or friend living elsewhere, or it may be paid by an organization, for example, a welfare agency. (b)"Continuing care," sometimes called life care, is a contract between an individual and a housing services provider. The contract requires the shelter, usually a house or apartment, and services such as meals, or transportation to shopping or recreation. For these kinds of living arrangements, record 3 for "Rented for cash rent." 4.Circle 4 for "Occupied without payment of cash rent" if the house or apartment is not owned or being bought by a member of the household and if money rent is not paid or contracted for. And skip to H5 EXAMPLES: ·military housing ·a unit which is owned by friends or relatives who live elsewhere and who allow occupancy without charge ·a house or apartment provided free to a janitor, caretaker, superintendent, or other employee in exchange for services. ·housing provided free to members of the clergy ·tenant farmer or sharecropper houses for which the occupants do not pay cash rent 1 Own, with mortgage 2 Own, no mortgage 3 Rent 4 Without rent Monthly rent Monthly rent Monthly rent Monthly rent Monthly rent H4 If this house is RENTED — What is the total monthly rent? Complete this item for all selected occupied housing units "rented for cash rent" in your assignment. Circle only one answer for this question. 1.Write in the amount of the rent agreed to or contracted for, even if the rent is unpaid or paid by someone else. Disregard pennies if 49 cents or less. If 50 cents or more, record the next highest dollar. For example, if the rent is $224.25, consider the rent to be $224; if the rent is $224.50, consider the rent to be $225. 2.If rent is not paid by the month, use the following table to convert the rent to a monthly rent: (Please refer to Questionnaire Reference Book in Technical Documents) 3.Report the rent agreed upon even if the rent includes furnishings, utilities, meals or services. 4.Report the rent for this unit only. The rent must apply only to this house, apartment, or mobile home. If the rent includes rent for a business unit or for living quarters occupied by another household, report that part of the total rent the respondent estimates to be for his or her unit only. For example, a renter pays $500 monthly for a house, but he or she occupies only the unit on the first floor and rents out the other unit on the second floor. The renter estimates that the first floor unit, if rented separately, would be worth $250. Report the monthly rent for this unit as $250. If the respondent has difficulty giving an estimated rent for his or her own unit, ask what part of the total floor space is included in his or her own living quarters and suggest that the rent be estimated on that basis. 5.Condominium fees or cooperative carrying charges - If a renter pays rent to the owner of a condominium or cooperative, and the condominium fee or cooperative carrying charge is also paid by the renter to the owner, report the combined amount. 6.Receipts from lodgers, roomers, others - Report the rent paid or scheduled to be paid to the landlord or rental agent, without deduction for any payments received from lodgers or roomers who are listed in question 1 as members of the household. Also do not deduct any part of the rent that may be paid by friends or relatives living elsewhere, or a church, agency, etc. Government subsidy Government subsidy Government subsidy Government subsidy Government subsidy H4a If the government is paying part of the rent, how much are they paying? H4a. If the Government of FSM or the U.S. Federal government is paying any part of the rent, record the amount - in U.S. dollars - that the government is paying. Other type subsidy Other type subsidy Other type subsidy Other type subsidy Other type subsidy H4b If a non-government organization is paying part of the rent, how much are they paying each month? H4b If a non-government organization, such as a construction company or Catholic Services or some other NGO (Non-government organization) is paying part of the rent, record the monthly amount that that agency is paying. Goods insurance Goods insurance Goods insurance Goods insurance Goods insurance H4c If you pay any insurance for your household goods, what is the annual amount? H4c If anyone in the housing unit is paying any insurance on household goods, report the annual paid for this insurance. Year built Year built Year built Year built Year built H5 about what year was this building first built? Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. 1.Write the number of the category corresponding to the period in which original construction was completed, not the time of any later remodeling, additions, or conversions. 2.In a single-unit building, if the occupants do not know the year built, ask how old the building was when they moved in. It may be helpful to ask the occupants if the building was built before World War II. If so, circle 8 for "1939 or earlier." 3.In buildings containing more than one unit, you may obtain this information from the owner, manager, or janitor. The entry for this question should be the same for all units in the same structure. 4.For units under construction which meet the housing unit definition, that is, all exterior windows and doors and final usable floors are in place, record 1 for 2004 or 2005. 5.For a mobile home, trailer, or houseboat, record the number for the appropriate category for the model year in which it was manufactured. 6.If the period when the building was first constructed cannot be estimated, circle 9 for "Don't know." 1 2004 or 2005 2 2000 to 2003 3 1995 to 1999 4 1990 to 1994 5 1980 to 1989 6 1970 to 1979 7 1940 to 1969 8 1939 or earlier 9 Don't know Year moved in Year moved in Year moved in Year moved in Year moved in H6 When did (Person listed on line 1) move into this unit? Please enter the year: ___ ___ ___ ___ Complete this item for all occupied housing units selected for your assignment. The "Person listed in line 1" refers to the first person listed in item 1a (page1). This person should be the household member (or one of the members) in whose name the house, apartment, or mobile home is owned, being bought, or rented. If there is no such person, any adult household member can be the person listed first on the listing item. 1.If the first person listed moved out and then moved back again, report the year of the most recent move; for example, for persons who have returned from the Armed Forces or those who have returned after completing college, enter the year they returned. 2.If the first person listed moved from one apartment to another in the same building, report the year moved into the present apartment. 3If the first person listed lived in the same mobile home but has moved to a different location in the same or another mobile home park, report the year when the person moved to the present location. 4.If the first person listed moved into a different mobile home at the same location, space, or site within the same mobile home park, report the year when the person first moved to the location, space, or site. Material: outside walls Material: outside walls Material: outside walls Material: outside walls Material: outside walls H7 What is the main type of material used for the outside walls of this building? 1. Poured concrete 2. Concrete blocks 3. Metal 4. Wood 5. Pre-fabricated combination of above 6. Other Complete this item for all occupied housing units selected for your assignment.. Circle only one answer for this question. Report the type of material which is used most. 1.Circle 1 for "Poured Concrete" if the major portion of the outside walls is of poured concrete. 2.Circle 2 for "Concrete Block" if the major portion of the outside walls is of concrete blocks. The wall may be covered with plaster cement. 3.Circle 3 for "Metal/Tin" if the major portion of the outside walls is of metal, including zinc, steel, tin, etc. 4.Circle 4 for "Wood" if the major portion of the outside walls is of wood, wood boards, plywood, etc. 5.Circle 5 for "Thatch" if the major portion of the outside walls is of thatch. 6.Circle 6 for "Other" for all other types of construction which cannot be described by the above categories. 1 Poured concrete 2 Concrete blocks 3 Metal 4 Wood 5 Prefab 6 Other Material: roof Material: roof Material: roof Material: roof Material: roof H8 what is the main type of material used for the roof of this building? Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. Report the type of material which is used most. 1.Circle 1 for "Poured Concrete" if the major portion of the roof is of poured concrete. 2.Circle 2 for "Metal/Tin" if the major portion of the roof is of metal such as zinc, steel, tin, etc. 3.Circle 3 for "Wood" if the major portion of the roof is of wood, wood boards, plywood, etc. 4.Circle 4 for "Thatch" if the major portion of the roof is of palm or pandanus thatch, palm leaves, straw, etc. 5.Write 5 for "Other" for all other types of construction which cannot be described by the above categories. 1 Pourde concrete 2 Metal 3 Wood 4 Thatch 5 Other Number of rooms Number of rooms Number of rooms Number of rooms Number of rooms H9 How many rooms do you have in this house/apartment? Count living rooms, dining rooms, kitchens, and bedrooms, but do not count bathrooms, balconies, foyers, or halls. Complete this item for all occupied housing units selected for your assignment. 1.Write in the total number of rooms. a.Count only whole rooms used for living purposes such as: oliving rooms odining rooms obedrooms okitchens ofinished attic or finished basement rooms orecreation rooms and family rooms opermanently enclosed porches suitable for year-round use olodger's rooms orooms used for offices by a person living in the unit b.Do not count: obathrooms ohalls, foyers, or vestibules obalconies or open porches oclosets oalcoves opantries okitchenettes, or strip or pullman kitchens olaundry, utility, or furnace rooms ounfinished attics or unfinished basements oother unfinished space used for storage ooffices used only by persons not living in the unit 2.A partially divided room, such as a dinette next to a kitchen or living room, is a separate room only if there is a partition from floor to ceiling, but not if the partition consists solely of shelves or cabinets. 3.If a room is used by occupants of more than one apartment, include the room with the unit from which it is most easily reached. Number of bedrooms Number of bedrooms Number of bedrooms Number of bedrooms Number of bedrooms H10 how many bedrooms do you have; that is, how many bedrooms would you list if this (house/apartment) were on the market for sale or rent? Complete this item for all occupied housing units selected for your assignment. 1.Count as bedrooms all rooms designed to be used as bedrooms; that is, the number of rooms that would be listed as bedrooms if the house, apartment, or mobile home were on the market for sale or for rent. Include all rooms intended to be used as bedrooms, even if they are currently being used for other purposes. 2.Write "No bedroom" and record 00 if the house or apartment consists of only one room, such as a one-room efficiency apartment. Piped water Piped water Piped water Piped water Piped water H11 do you have hot and cold piped water? 1. Yes, in this unit 2. Yes, in this building 3. No, only cold piped water in this unit 4. No, only cold piped water in this building 5. No, only cold piped water outside this building 6. No piped water If answer is Yes (1 to 2),continue on to H12 If answer is No (3 thru 6), go to H13 Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question and note skip pattern Piped water means a supply of water is available at a sink, washbasin, bathtub, or shower. The hot water need not be supplied continuously. Hot water supplied by an electric faucet attachment at the kitchen sink, an electric shower attachment, etc., is not piped hot water. Piped water may be located within the unit itself, or it may be in the hallway, or in a room used by several units in the building. It may even be necessary to go outdoors to reach that part of the building in which the piped water is located. 1.Circle 1 for "Yes, hot and cold in this unit" if there is hot and cold running water inside the house, apartment, or mobile home being enumerated. 2.Circle 2 for "Yes, hot and cold in this building" if there is hot and cold running water inside the house, apartment, or mobile home being enumerated. 3.Circle 3 for "No, cold only in this unit" if there is cold running water available inside the unit.(SKIP TO H13) 4.Circle 4 for "No, cold only in this building" if there is cold running water available inside the unit.(SKIP TO H13) 5.Circle 5 for "No, cold only outside this building" if there is only cold running water available outside the unit. (SKIP TO H13) 6.Circle 6 for "No, piped water" if there is no piped water on this property. (SKIP TO H13) 1 Yes, in unit 2 Yes, in building 3 No, only piped cold water in unit 4 No, only cold in building 5 No, only cold outside 6 No piped water Water heater energy Water heater energy Water heater energy Water heater energy Water heater energy H12 If answered Yes to H11, what type of energy powers your water heater? 1. Electricity 2. Gas 3. Solar 4. Other fuels Complete this item for all occupied housing units that have hot and cold piped water in the unit or in the building, selected for your assignment. Circle only one answer for this question. Write the number for only one box for this question. Write the number for the response for the energy the water heater uses most. In buildings containing more than one unit you may obtain this information from the owner, manager, or janitor. The entry for this question should be the same for all units in the same structure. 1.Circle 1 for "Electricity" when electricity is used. 2.Circle 2 for "Gas" when fuel such as bottled, tank, or LP gas is used. Bottled, tank, or LP gas is stored in tanks which are refilled or exchanged when empty. 3.Circle 3 for "Solar power" when solar power is used. 4.Circle 4 for "Other fuels" for any fuel not separately listed. 1 Electricity 2 Gas 3 Solar 4 Other fuels Bathing facilities Bathing facilities Bathing facilities Bathing facilities Bathing facilities H13 do you have a bathtub or shower? 1. Yes, in this unit 2. Yes, in this building 3. Yes, outside this building 4. No Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. Count a bathtub or shower only if the equipment is permanently connected to piped running water. Exclude portable bathtubs. 1.Circle 1 for "Yes, in this unit" if there is a bathtub or shower available inside the house or apartment you are enumerating. 2.Circle 2 for "Yes, in this building" if there is a bathtub or shower available inside the building but not in the unit being enumerated. 3.Circle 3 for "Yes, outside this building" if there is a bathtub or shower or shower outside the house or apartment being enumerated. 4.Circle 4 for "No" if: a.There are no installed bathing facilities; or b.There is no piped water in the building; or c.Only portable or temporary bathing facilities are available to the occupant. 1 Yes, in unit 2 Yes, in building 3 Yes, outside 4 No Flush toilet Flush toilet Flush toilet Flush toilet Flush toilet H14 do you have a flush toilet? 1. Yes, in this unit 2. Yes, in this building 3. Yes, outside this building 4. No, ventilated outhouse/privy 5. Other or none Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. A flush toilet is connected to piped water. If the respondent reports a flush toilet and also another type of toilet, report only the flush toilet. 1.Circle 1 for "Yes, in this unit" if the flush toilet is inside the house or apartment being enumerated. 2.Circle 2 for "Yes, in this building" if there is flush toilet available inside the building but not in the unit being enumerated. 3.Circle 3 for "Yes, outside this building" if there is a flush toilet outside the house or apartment being enumerated. 4.Circle 4 for "No, ventilated outhouse/privy outside the house or apartment being enumerated. 5.Circle 5 for "Other or none". 1 Yes, in unit 2 Yes, in building 3 Yes, outside 4 No, ventilated outhouse 5 Other or none Cooking fuel Cooking fuel Cooking fuel Cooking fuel Cooking fuel H15 which fuel is used most for cooking in this unit? 1. Electricity 2. Gas: bottled or tank (lpg) 3. Kerosene 4. Electricity and gas 5. Electricity and kerosene 6. Gas and kerosene 7. Wood 8. Other 9. No fuel used Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. These questions have to do with the fuel used for cooking. Question H18 has to do with general cooking activities, and question H19 has to do, specifically, with microwave oven. If the household does not have electricity, the answer for H19 will always be No. 1.Circle 1 for "Electric range" when an electric range is used. 2.Circle 2 for "Gas stove" when a gas stove is used. 3.Circle 3 for "Kerosene stove" when a kerosene stove is used. 4.Circle 4 for "Electricity and gas” when both electricity and gas are used. 5.Circle 5 for "Electricity and kerosene" when both electricity and kerosene stove are used. 6Circle 6 for “Gas and kerosene” when both gas and kerosene stove are used. 7.Circle 7 for “Wood” when only a wood stove is used. 8Circle 8 for “Other” when any other type of cooking facilities not listed above is used. 9.Circle 9 if “No fuel is used” 1 Electricity 2 Gas 3 Kerosene 4 Electricity or gas 5 Electricity and kerosene 6 Gas and Kerosene 7 Wood 8 Other 9 No fuel used Stove Stove Stove Stove Stove H16 do you have an electric or gas stove? 1. Yes 2. No If the household has an electric or gas stove, circle "1" for Yes. Otherwise, circle "2" for No. 1 Yes 2 No Microwave Microwave Microwave Microwave Microwave H16a do you have a microwave oven? 1. Yes 2. No If the household has a microwave oven, circle "1" for Yes. Otherwise circle "2" for No. 1 YES 2 NO Refrigerator Refrigerator Refrigerator Refrigerator Refrigerator H17 Do you have a refrigerator in this unit? 1. Yes, electric 2. Yes, gas 3. No refrigerator If "Yes," ask - What type? Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. 1.Circle 1 for "Yes, electric" if the unit has a refrigerator that is operated by electricity. 2.Circle 2 for "Yes, gas" if the unit has a refrigerator that is operated by gas. 3.Circle 3 for "No refrigerator" if there is no refrigerator. 1 Yes, electric 2 Yes, gas 3 No refrigerator Freezer Freezer Freezer Freezer Freezer H17a do you have a stand-alone freezer in this unit? 1. Yes 2. No If the household has a stand-alone freezer, circle "1" for Yes. Otherwise circle "2" for No. 1 Yes 2 No Sink with piped water Sink with piped water Sink with piped water Sink with piped water Sink with piped water H18 Do you have a sink with piped water in this unit? 1. Yes 2. No Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. Circle 1 for "Yes" if there is a sink with piped water in the building being enumerated. Circle 2 for "No" if there is no sink. NOTE: The sink has to be installed and the water running or available at the sink. 1 YES 2 NO Water source Water source Water source Water source Water source H19 do you get water from 1. A public system only? 2. A public system and cistern? 3. A cistern, tanks, or drums only? 4. Village water system? 5. A public standpipe? 6. Individual well or spring or other? Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. Mark the category for the source of the water used by the occupants of the house or apartment, whether or not it is in the building or some other place on the property, or if the occupants get water elsewhere. For example, if the occupants get water from neighbors, mark the category for the source of the neighbor's water. 1. A PUBLIC SYSTEM ONLY Circle the number of the appropriate response in the box if there is running water which comes from any common source supplying 5 or more houses or apartments. The water may be supplied by an island or city water system, water district, water company, etc., or it may be obtained from a well which supplies 5 or more houses or apartments. 2.A PUBLIC SYSTEM AND CISTERN Circle the number of the appropriate response in the box when there is running water which comes from a public system and there is also a cistern in which rain water is collected. 3.A CISTERN, TANKS, OR DRUMS ONLY Circle the number of the appropriate response in the box when the only source of water is a cistern, tanks or drums in which rain water is collected. Such sources usually serve only one structure. 4.VILLAGE WATER SYSTEM Circle the number of the appropriate response in the box when there is running water which comes from any common source of water supplied by the village or community water system. 5.A PUBLIC STANDPIPE Circle the number of the appropriate response in the box when there is a vertical pipe which is connected to a public water system, and from which nearby residents draw water. 6. INDIVIDUAL WELL OR A SPRING OR OTHER Circle the number of the appropriate response in the box when the water is obtained privately from an individual well, spring, rivers, irrigation canals, creeks, ponds, lakes, or other sources not listed separately. If the unit is connected to a public sewer - you have recorded either code 1 or code 2 - ask “Is public service 24 hours?” If the service is usually continuous, mark 1 for “Yes”, if the service is often interrupted, mark 2 for “No”. 1 Public system only 2 Public system/cistern 3 Cistern, tanks, drums only 4 Village water system 5 Public standpipe 6 Some other source Water 24 hour service Water 24 hour service Water 24 hour service Water 24 hour service Water 24 hour service Is public service 24 hours? 1. yes 2. no If the unit is connected to a public sewer - you have recorded either code 1 or code 2 - ask "Is public service 24 hours?" If the service is usually continuous, mark 1 for "Yes", if the service is often interrupted, mark 2 for "No". 1 Yes 2 No Drinking water purchased Drinking water purchased Drinking water purchased Drinking water purchased Drinking water purchased H20 do you purchase drinking water? 1. Yes 2. No Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. 1 YES 2 NO Public sewer Public sewer Public sewer Public sewer Public sewer H21 Is this building connected to a public sewer? 1. Yes, connected to public sewer 2. No, connected to septic tank or cesspool 3. No, use other means Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. 1.PUBLIC SEWER A public sewer may be operated by a government body or by a private organization. Circle 1 for "Yes, connected to public sewer" when the house or apartment is connected to a city, county, sanitary district, neighborhood, or subdivision sewer system. 2.SEPTIC TANK OR CESSPOOL A septic tank or cesspool is an underground tank or pit for disposal of sewage. Circle 2 for "No, connected to septic tank or cesspool" for units provided with this method of sewage disposal. Do not include in this category small sewage treatment plants which in some localities are called neighborhood septic tanks. 3.OTHER MEANS Circle 3 for “No” when sewage is disposed of in any other way or when use other means. 1 Yes, connected to public sewer 2 No, septic tank 3 No, use other means Air conditioning Air conditioning Air conditioning Air conditioning Air conditioning H22 Do you have air conditioning? Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. 1.Circle 1 for "Yes, a central air conditioning system" if a central installation which air conditions a number of rooms is used. In an apartment building, each apartment may have its own central system, or there may be several systems each providing central air conditioning for a group of apartments. A central system with individual room controls should be marked "Yes, a central air conditioning system". 2.Circle 2 or 3 for the appropriate box for the number of individual room units. 3.Circle 4 for "No" if the unit is not cooled by air conditioner. 1 Yes, central air 2 Yes, 1 individual room unit 3 Yes, 2 or more units 4 No Radio with Battery Radio with Battery Radio with Battery Radio with Battery Radio with Battery H23 do you have a battery operated radio? 1. Yes 2. No Count car radios, transistors, and other battery operated sets in working order or needing only new battery for operation. Complete this item for all occupied housing units selected for your assignment. Count only car radios, transistors, and other battery operated sets in working order or needing only new batteries for operation. 1 YES 2 NO Number of automobiles Number of automobiles Number of automobiles Number of automobiles Number of automobiles H24 How many automobiles, vans, and trucks of one-ton capacity or less are kept at home for use by members of this household? Complete this item for all occupied housing units selected for your assignment. Count passenger automobiles, vans, pickups, and small panel trucks of one-ton capacity or less which are kept at home for the use of household members. Count vehicles of all members of the household including lodgers or other non-relatives living in the house, apartment, or mobile home. 1.Include: a.Company cars, company vans, pickups, or small panel trucks of one-ton capacity or less, if kept at home for use of household members. b.Taxicabs, police cars, and government cars if kept at home for use of household members for non-business purposes. c.Vehicles that are rented or leased for one month or more. 2.Do not include: a.Automobiles, vans, and trucks kept at home by a household member, but used only for business purposes. b.Dismantled or dilapidated cars in an early stage of being junked or immobile cars used only as a source of power for some piece of machinery. Motor boat Motor boat Motor boat Motor boat Motor boat H24A How many boats with a motor are kept for use by member of this household? Complete this item for all occupied housing units selected for your assignment. Count boats kept at home for the use of household members. Count boats of all members of the household including lodgers or other non-relatives living in the house, apartment, or mobile home. 1.Include: a.Company boats if kept at home for use of household members. b.Boat taxis and government boats if kept at home for use of household members for non-business purposes. c.Boats that are rented or leased for one month or more. 2.Do not include: a.Boats kept at home by a household member, but used only for business purposes. b.Dismantled or dilapidated boats in an early stage of being junked . Telephone in unit Telephone in unit Telephone in unit Telephone in unit Telephone in unit H25 Do you have a telephone/cell phone in this unit? 1. Yes 2. No Complete this item for all occupied housing units selected for your assignment. Circle 1 for "Yes" only if there is a telephone in the respondent's house, apartment, or mobile home. Also, if respondent owned a cellphone instead. Circle 2 for "No" if there is no telephone in the respondent's house, apartment, mobile home, or if the respondent says there is one in the building, but it is not in the respondent's house, apartment, or mobile home. 1 YES 2 NO Telephone bill Telephone bill Telephone bill Telephone bill Telephone bill If Yes to H25, What was the last monthly bill? $__________ Include cellphone/calling card costs What is the monthly bill? If the household has a telephone ask for the average telephone bill (or most recent, if the household does not know the average bill). Include cellphone/calling card costs. Complete this item for all occupied housing units. 1.Enter the cost of the last monthly bill. If the last bill is unknown, report the average monthly cost of the phone or cell phone. 2.If the respondent doesn't know the exact cost, an approximate figure will do. Ask additional questions as necessary to obtain a reasonable estimate (for example, "Is the cost greater than $50 or less than $50?", etc.). In some cases, it may be easier for you to compute the cost from information given by the respondent. If so, ask whether your estimate sounds reasonable before entering the amount. Electric power Electric power Electric power Electric power Electric power H26 Does this house/apartment have electric power? 1. Yes 2. Yes - Included in the rent. 3. No Complete this item for all occupied housing units selected for your assignment. If the housing unit has electricity, determine whether or not it is included in the rent. ·If the house has electric power, and it is not included in the rent, ask for the amount of the last monthly electric bill ·If the house has electric power, and it is included in the rent, Circle “2” in the box, and go on to the next question. ·If the house has no electric power, Circle “3” in the box and go on to the next question. 1 Yes, not included in rent 2 Yes, included in rent 3 No Electric bill Electric bill Electric bill Electric bill Electric bill If answer to H26 is 1, What was the last monthly bill for electricity for this unit? $_________ 1.Enter the last month's costs in the spaces provided. Report the last month's or average monthly cost if the respondent pays the entire utility or fuel bill (even if these bills are unpaid), or if all or part of the respondent's utility or fuel bill is paid by a welfare agency, relative, or friend. If part of the cost of the utility or fuel is paid by the landlord and part paid by the occupants, report only the part paid by the occupants. If the respondent pays the entire utility or fuel bill for a multi-unit building (for example, he or she is the landlord), report only the amount for his or her own housing unit. If necessary, accept an estimate. 2.If the respondent doesn't know the exact cost, an approximate figure will do. Ask additional questions as necessary to obtain a reasonable estimate (for example, "Is the cost greater than $50 or less than $50?", etc.). In some cases, it may be easier for you to compute the fuel or utility costs from information given by the respondent. If so, ask whether your estimate sounds reasonable before entering the amount. If electricity and water are billed together, try to obtain an estimate for each of the utilities separately. If this is not possible, enter the combined amount on the electricity line and bracket { } the two utilities. 3.If the house or apartment is rented or is a condominium, enter the costs for utilities and fuels only if they are paid in addition to the rent or the condominium fee. If a utility or fuel is included in the rent or the condominium fee, mark the appropriate box. 4.Circle “3” if the utility or fuel is not used, if it is not available to the household, or if it is provided to the renter or owner free of charge. 5.If the respondent has moved in recently, ask for his/her estimate based on previous experience and general knowledge of fuel and utility costs. Emphasize that we need an estimate in order to determine total housing costs for all housing units on a comparable basis. Television Television Television Television Television H27 Do you have a television set? 1. Yes 2. No Complete this item for all occupied housing units selected for your assignment. Circle only one answer for this question. For H27, Do you have a television set? 1.Circle “1” for "Yes" if there is a TV in the housing unit being enumerated. 2.Circle "2" for "No" if no TVs are in the house unit being enumerated. 1 YES 2 NO Cable TV Cable TV Cable TV Cable TV Cable TV H27a Do you have Cable TV? 1. Yes 2. No For H27a, Do you have Cable TV? 1.Circle "1" for "Yes" if there is Cable TV hooked up in the housing unit being enumerated. 2.Circle "2" for "No" if the housing unit has no Cable TV hook up 1 YES 2 NO Cable bill Cable bill Cable bill Cable bill Cable bill H27b. If Yes to H27a, What was the last monthly bIll? $ _________ Code 998 if included in rent For H27b, IF the housing unit has Cable TV, ask the amount of the last monthly bill? 1.Record the amount if Cable TV is hooked up in the housing unit being enumerated, and the household pays for the hook up. 2.Record "999" if Cable TV is included in the rent, for rental units. 998 included in rent Computer Computer Computer Computer Computer H28 Do you have a computer at home? 1. Yes 2. No If no, skip to H30 Complete this item for all occupied housing units selected for your assignment. 1.Include all laptops and desktops computers members of the household. 2. Do not include Company or Government computers that are not available to household members or computers that are inoperable. 1 YES 2 NO Internet access Internet access Internet access Internet access Internet access H29 Do you have internet access in your unit? 1 Yes 2 No If no, skip to H30 Complete this item for all occupied housing units selected for your assignment. H29 Do you have internet access in your unit? 1. Yes 2. No ·Circle 1 for “Yes”, if the household has internet access ·Circle 2 for “No”, if the housing unit does not have internet access 1 YES 2 NO Internet connection Internet connection Internet connection Internet connection Internet connection H29a If answered Yes to H29, do you connect over the telephone line or do you have a broadband connection, such as cable? 1 Phone line 2 Broadband H29a If yes, do you connect over the telephone line or do you have a broadband, such as cable or DSL connection? 1 Phone line 2 Broadband ·Circle “1” for phone line if the housing unit obtains its internet connection through the phone line ·Circle “2” for broadband, if the housing unit obtains its internet connection by broadband 1 Phone line 2 Broadband Internet w/ cable Internet w/ cable Internet w/ cable Internet w/ cable Internet w/ cable H29b. If answered Yes to H29, was the last monthly bill for your internet connection included in your telephone/cable bill? 1.Yes 2. No H29b If yes, what was the last monthly bill for your internet connection or was it included in your telephone/cable bill? If you paid, how much was it? $_________ ·Circle “1” if the housing unit pays for its internet connection directly, and THEN fill in the amount of the last monthly bill ·Circle “2” if the housing unit does not pay for its internet connection directly, but pays through its phone or TV cable bill instead 1 Yes 2 No Internet bill Internet bill Internet bill Internet bill Internet bill If separate, how much was it? $_________ H29b If yes, what was the last monthly bill for your internet connection or was it included in your telephone/cable bill? If you paid, how much was it? $_________ ·Circle “1” if the housing unit pays for its internet connection directly, and THEN fill in the amount of the last monthly bill ·Circle “2” if the housing unit does not pay for its internet connection directly, but pays through its phone or TV cable bill instead Gas bill Gas bill Gas bill Gas bill Gas bill H30 What was the last monthly bill for gas for this unit? $_________ Exclude transportation gas. Complete this item for all occupied housing units selected for your assignment. 1.Enter the last monthly bill in the space provided. DO NOT include transportation gas. Report the last monthly bill if the respondent pays the entire utility or fuel bill (even if these bills are unpaid), or if all or part of the respondent's utility or fuel bill is paid by a welfare agency, relative, or friend. If part of the cost of the utility or fuel is paid by the landlord and part paid by the occupants, report only the part paid by the occupants. If the respondent pays the entire utility or fuel bill for a multi-unit building (for example, he or she is the landlord), report only the amount for his or her own housing unit. If necessary, accept an estimate. 2.If the respondent doesn't know the exact cost, an approximate figure will do. Ask additional questions as necessary to obtain a reasonable estimate (for example, "Is the cost greater than $50 or less than $50?", etc.). In some cases, it may be easier for you to compute the fuel or utility costs from information given by the respondent. If so, ask whether your estimate sounds reasonable before entering the amount. 3.If the house or apartment is rented, enter the costs for utilities and fuels only if they are paid in addition to the rent. If a utility or fuel is included in the rent, mark the appropriate box. 4.Report “0” if the utility or fuel is not used, if it is not available to the household, or if it is provided to the renter or owner free of charge. If the respondent has moved in recently, ask for his/her estimate based on previous experience and general knowledge of fuel and utility costs. Emphasize that we need an estimate in order to determine total housing costs for all housing units on a comparable basis. Water bill Water bill Water bill Water bill Water bill H31 What was the last monthly bill for water for this unit? $_________ Complete this item for all occupied housing units selected for your assignment. ·If the household paid for water, report the amount using the guidelines below ·If the household did not pay for water, but it was included in the rent, Circle “1” for Yes. ·Ask all housing units whether they pay for water from a public utility - Circle “1” for Yes or “2” for No. 1.Enter the last monthly bill in the space provided. Report the last monthly bill if the respondent pays the entire utility or fuel bill (even if these bills are unpaid), or if all or part of the respondent's utility or fuel bill is paid by a welfare agency, relative, or friend. If part of the cost of the utility or fuel is paid by the landlord and part paid by the occupants, report only the part paid by the occupants. If the respondent pays the entire utility or fuel bill for a multi-unit building (for example, he or she is the landlord), report only the amount for his or her own housing unit. If necessary, accept an estimate. 2.If the respondent doesn't know the exact cost, an approximate figure will do. Ask additional questions as necessary to obtain a reasonable estimate (for example, "Is the cost greater than $50 or less than $50?", etc.). In some cases, it may be easier for you to compute the fuel or utility costs from information given by the respondent. If so, ask whether your estimate sounds reasonable before entering the amount. 3.If the house or apartment is rented, enter the costs for utilities and fuels only if they are paid in addition to the rent. If a utility or fuel is included in the rent, mark the appropriate box. 4.Report “0” if the utility or fuel is not used, if it is not available to the household, or if it is provided to the renter or owner free of charge. If the respondent has moved in recently, ask for his/her estimate based on previous experience and general knowledge of fuel and utility costs. Emphasize that we need an estimate in order to determine total housing costs for all housing units on a comparable basis. Water w/ rent Water w/ rent Water w/ rent Water w/ rent Water w/ rent If no payment in H31 was it included in the rent? 1. Yes 2. No · If the household did not pay for water, but it was included in the rent, Circle “1” for Yes. 1 Yes 2 No Water from public utility Water from public utility Water from public utility Water from public utility Water from public utility H31a Do you pay for water from a public utility? 1 Yes 2 No · Ask all housing units whether they pay for water from a public utility - Circle “1” for Yes or “2” for No. 1 YES 2 NO Other Utility bill Other Utility bill Other Utility bill Other Utility bill Other Utility bill H32. What was the last monthly bill for any other utilities (kerosene, wood, etc)? $__________ · Ask all housing units whether they pay for water from a public utility - Circle “1” for Yes or “2” for No. Value of House Value of House Value of House Value of House Value of House Ask only if someone in this household OWNS OR IS BUYING this house, apartment, or boat H33. What is the value of this dwelling; that is, how much do you think it would cost to build this dwelling now? $_______________ Complete this item for owner-occupied or vacant-for-sale only housing units. 1.If the respondent cannot answer the question because he or she thinks an exact figure is needed, ask the respondent for an estimate.Help the respondent by explaining that the answer can be provided in a range rather than an exact dollar amount. 2.If the respondent has never thought of selling the property, ask whether he or she knows of a sale of a similar property in the neighborhood. If so, suggest that he or she estimate the value of the house, condominium, or mobile home accordingly. 3.If the respondent does not understand what is meant by"this property", explain that it includes: a.FOR A ONE-FAMILY HOUSE-- (a) the entire building in which the owner lives, and (b) the land on which it stands, and (c) any additional buildings such as garages on the same plot of land. b.FOR A CONDOMINIUM OR COOPERATIVE -- (a)the owner's individual unit, and (b)the owner's share of the common area. c.FOR A NONCONDOMINIUM MULTI-UNIT BUILDING -- if the respondent owns a multi-unit building and lives in an apartment in the building, report the value of the building, the land, and any additional buildings such as a garage on the same plot of land. d.FOR A MOBILE HOME OR TRAILER -- (a)the mobile home or trailer, and (b)the land or lot on which it is currently placed. 4.If the respondent indicates that he or she owns the house (or mobile home) but not the land, ask the respondent to estimate the combined value of the house (or mobile home) and the land. 5.If joint ownership exists, report the value of the entire property whether or not all the owners live in the house, condominium, or mobile home. 6.If the respondent appears unwilling to answer the question, assure him or her that the estimate given is confidential and cannot be used for taxation or assessment. Home insurance Home insurance Home insurance Home insurance Home insurance For this property: H34. What was the annual payment for home owner's insurance? $__________ Complete this item for owner-occupied or vacant-for-sale only housing units. For H34 Homeowner's insurance: ·Report for this property only. Do not report for any properties held for business purposes. ·Report the annual payment for homeowner's insurance. If the payments are made semi-annually or monthly, use the correspondences in the Enumerator' Instructions to assist in determining the annual amount. ONLY annual amounts are to be reported ·If the respondent does not know that annual payment, try to obtain an estimate and record that Property taxes Property taxes Property taxes Property taxes Property taxes H35. How much were 2004 property taxes? $__________ For H35 Property Taxes: ·Report for this property only. Do not report for any properties held for business purposes. ·Report the annual payment for property taxes. If the payments are made semi-annually or monthly, use the correspondences in the Enumerator' Instructions to assist in determining the annual amount. ONLY annual amounts are to be reported ·If the respondent does not know that annual payment, try to obtain an estimate and record that Number of mortgages Number of mortgages Number of mortgages Number of mortgages Number of mortgages H36. How many loans for this property are you currently making repayments on? Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. Main mortgage institution Main mortgage institution Main mortgage institution Main mortgage institution Main mortgage institution Type of lending institution: 1=bank 2=finance company 3=gov. Agency 4=other Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 Bank 2 Finance Company 3 Gov. Agency 4 Others Main mortgage start month Main mortgage start month Main mortgage start month Main mortgage start month Main mortgage start month Month and Year repayments started Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December Main mortgage start year Main mortgage start year Main mortgage start year Main mortgage start year Main mortgage start year Month and Year repayments started Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. Main Mortgage purpose Main Mortgage purpose Main Mortgage purpose Main Mortgage purpose Main Mortgage purpose Purpose of loan: 1 Owner occupied, 2 Other, Specify ===> Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 Owner-Occupied 2 Others Main Mortgage security Main Mortgage security Main Mortgage security Main Mortgage security Main Mortgage security Loan security: 1=1st mortgage, 2=2nd mortgage, 3=Other security, 4=Unsecured Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 1st mortgage 2 2nd mortgage 3 Other security 4 Unsecured Main Mortgage interest Main Mortgage interest Main Mortgage interest Main Mortgage interest Main Mortgage interest Amount of interest, principal paid & period covered: Interest: $____________ Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. Main Mortgage principal Main Mortgage principal Main Mortgage principal Main Mortgage principal Main Mortgage principal Amount of interest, principal paid & period covered: Principal: $____________ Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. Main Mortgage period Main Mortgage period Main Mortgage period Main Mortgage period Main Mortgage period Amount of interest, principal paid & period covered: Period (specify): Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 0 to 4 years 2 5 to 9 years 3 10 to 14 years 4 15 to 19 years 5 20 to 24 years 6 25 to 29 years 7 30 to 34 years 8 35 to 39 years 9 40 and over Main Mortgage owed Main Mortgage owed Main Mortgage owed Main Mortgage owed Main Mortgage owed Amount of principal outstanding: $____________ Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. Main Mortgage rate Main Mortgage rate Main Mortgage rate Main Mortgage rate Main Mortgage rate What is the current interest rate on this loan? % Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. Main Mortgage type Main Mortgage type Main Mortgage type Main Mortgage type Main Mortgage type Is the loan fixed or adjustable? 1. Fixed 2. Adjustable Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 Fixed 2 Adjustable 2nd Mortgage institution 2nd Mortgage institution 2nd Mortgage institution 2nd Mortgage institution 2nd Mortgage institution Type of lending institution: 1=bank 2=finance company 3=gov. Agency 4=other Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 Bank 2 Finance Company 3 Gov. Agency 4 Others 2nd Mortgage start month 2nd Mortgage start month 2nd Mortgage start month 2nd Mortgage start month 2nd Mortgage start month Month and Year repayments started Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December 2nd Mortgage start year 2nd Mortgage start year 2nd Mortgage start year 2nd Mortgage start year 2nd Mortgage start year Month and Year repayments started Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 2nd Mortgage purpose 2nd Mortgage purpose 2nd Mortgage purpose 2nd Mortgage purpose 2nd Mortgage purpose Purpose of loan: 1 Owner occupied, 2 Other, Specify ===> Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 Owner-Occupied 2 Others 2nd Mortgage security 2nd Mortgage security 2nd Mortgage security 2nd Mortgage security 2nd Mortgage security Loan security: 1=1st mortgage, 2=2nd mortgage, 3=Other security, 4=Unsecured Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 1st mortgage 2 2nd mortgage 3 Other security 4 Unsecured 2nd Mortgage interest 2nd Mortgage interest 2nd Mortgage interest 2nd Mortgage interest 2nd Mortgage interest Amount of interest, principal paid & period covered: Interest: $____________ Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 2nd Mortgage principal 2nd Mortgage principal 2nd Mortgage principal 2nd Mortgage principal 2nd Mortgage principal Amount of interest, principal paid & period covered: Principal: $____________ Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 2nd Mortgage period 2nd Mortgage period 2nd Mortgage period 2nd Mortgage period 2nd Mortgage period Amount of interest, principal paid & period covered: Period (specify): Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 0 to 4 years 2 5 to 9 years 3 10 to 14 years 4 15 to 19 years 5 20 to 24 years 6 25 to 29 years 7 30 to 34 years 8 35 to 39 years 9 40 and over 2nd Mortgage owed 2nd Mortgage owed 2nd Mortgage owed 2nd Mortgage owed 2nd Mortgage owed Amount of principal outstanding: $____________ Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 2nd Mortgage rate 2nd Mortgage rate 2nd Mortgage rate 2nd Mortgage rate 2nd Mortgage rate What is the current interest rate on this loan? % Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 2nd Mortgage type 2nd Mortgage type 2nd Mortgage type 2nd Mortgage type 2nd Mortgage type Is the loan fixed or adjustable? 1. Fixed 2. Adjustable Complete this item for all owner-occupied one-family houses, mobile homes, or condominiums. 1.Enter the regular monthly payment required by the lender for all loans on this property. Consider persons holding contracts to be lenders. Report the entire payments regardless of what is included in it. 2.Report the amounts even if the payments are delinquent or are paid by someone else. 3.Enter 0 on the box provided and skip to Section 2. Construction and Repairs. Report information about any mortgages on this property, or the house itself. The mortgage could be with a bank or with an individual. 1 Fixed 2 Adjustable Condominium Condominium Condominium Condominium Condominium H37 Is this unit part of a condominum? 1. Yes 2. No This question is asked at all occupied units. Circle “1” for Yes, if the housing unit is part of a condominium. Circle “2” for No, if the housing unit is not part of a condominium. 1 Yes 2 No Condo-fee Condo-fee Condo-fee Condo-fee Condo-fee If Yes to H37, what is the monthly condo common fee? $ __________ If the unit is part of a condominium unit, record the current monthly condominium common fee. Household income Household income Household income Household income Household income Family income Family income Family income Family income Family income Related persons Related persons Related persons Related persons Related persons Family type Family type Family type Family type Family type 1 Married couple, male RP 2 Married couple, female RP 3 Male RP, no spouse 4 Female RP, no spouse 5 Male RP, non-family HH 6 Female RP, non-family HH 7 Male living alone 8 Female living alone Family poverty level Family poverty level Family poverty level Family poverty level Family poverty level Not in universe Workers in family Workers in family Workers in family Workers in family Workers in family None 1 One worker 2 Two workers 3 Three workers 4 Four or more workers Complete plumbing Complete plumbing Complete plumbing Complete plumbing Complete plumbing 1 Yes 2 No Complete kitchen Complete kitchen Complete kitchen Complete kitchen Complete kitchen 1 Yes 2 No Related children age 0 to 17 Related children age 0 to 17 Related children age 0 to 17 Related children age 0 to 17 Related children age 0 to 17 Related children age 5 to 17 Related children age 5 to 17 Related children age 5 to 17 Related children age 5 to 17 Related children age 5 to 17 Related children age 0 to 5 Related children age 0 to 5 Related children age 0 to 5 Related children age 0 to 5 Related children age 0 to 5 Weight Weight Weight Weight Weight Municipality Municipality Municipality Municipality Municipality B. Municipality 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak Enumeration District Enumeration District Enumeration District Enumeration District Enumeration District C. ED 1 ED002 2 ED005 3 ED008 4 ED011 5 ED013 6 ED014 7 ED019 8 ED024 9 ED027 10 ED028 11 ED030 12 ED038 13 ED044 14 ED047 15 ED001 16 ED007 17 ED029 18 ED034 19 ED040 20 ED045 21 ED061 22 ED164 23 ED055 24 ED083 25 ED067 26 ED073 27 ED079 28 ED092 29 ED100 30 ED106 31 ED112 32 ED117 33 ED123 34 ED145 35 ED160 36 ED050 37 ED057 38 ED060 39 ED068 40 ED072 41 ED080 42 ED085 43 ED096 44 ED105 45 ED111 46 ED116 47 ED012 48 ED017 49 ED023 50 ED032 51 ED043 52 ED065 53 ED090 54 ED003 55 ED006 56 ED010 57 ED016 58 ED021 Village Village Village Village Village D. Village Block Block Block Block Block E. Block (first three digits) Block A Block A Block A Block A Block A E. Block (fourth digit) Mapspot Mapspot Mapspot Mapspot Mapspot F1. Map Spot Household Number Household Number Household Number Household Number Household Number F2. Household No. All persons who occupy a housing unit and prepare their food together. Person sequence number Person sequence number Person sequence number Person sequence number Person sequence number 1b. Person Number (from list, page 1) Sex Sex Sex Sex Sex 2. Is...male or female? 1. Male 2. Female Write the correct number on the basis of observation. If this is not possible, a person's sex can usually be determined from the name or relationship entry. If you cannot determine sex, such as when the name is common to both sexes (Leslie, Jean, Francis, etc.), ask "Is..... male or female?" 1 Male 2 Female Relationship Relationship Relationship Relationship Relationship 3. How is ... related to (Person 1)? 1. Householder 2. Spouse 3. Natural or adopted son/daughter 4. Stepson/stepdaughter 5. Brother/sister 6. Father/mother 7. Grandchild 8. Other relative: If not related to Person 1: 9. Roomer, boarder, or foster child 10.Housemate, roommate 11. Unmarried partner 12. Other non-relative 0.GENERAL Write the number for the appropriate box to describe the relationship of each person to the "First person listed on the roster." If the person is related to Person 1 by blood, marriage, or adoption, but is not the "Husband/wife," "Natural-born or adopted son/daughter," "Stepson/stepdaughter," "Brother/sister," "Father/mother," or "Grandchild" of Person 1, mark (X) the box for "Other relative" and print the person's exact relationship in the space provided. If a person is not related to Person 1, mark the entry, as applicable, for "Roomer, boarder, or foster child," "Housemate, roommate," "Unmarried partner," or "Other nonrelative." Be sure all entries marked are in terms of relationship to the "First person listed on the roster." For example, the wife of a married son living with the son's father (entered as Person 1) should be reported as "Other relative," not "Husband/wife." The child of an "Unmarried partner" of Person 1 should be reported as "Other nonrelative." IF the householder is a female, then her spouse will be listed as "Husband". That is, everyone is still related to HER, not the other way around. BE SURE THAT ALL ENTRIES MARKED ARE IN TERMS OF RELATIONSHIP TO THE HOUSEHOLDER. For example, the wife of a married son living with the son's father (entered as Person 1 - the Householder) should be reported as "daughter-in-law" or "son's wife", not "Wife". 1.PERSON LISTED AS PERSON 1 ON THE FRONT COVER There is no entry to mark for the "Person listed first on the front cover." 2.HUSBAND/WIFE Write the appropriate number for "Husband/wife" for the person reported as the husband or wife of the "First person listed on the roster." There may be other married couples in the household but the entry for "Husband/wife" should only be marked for the person reported as married to the "First person listed on the roster." 3.NATURAL-BORN OR ADOPTED SON/DAUGHTER Write 3 for "Natural-born or adopted son/daughter" for a child who is a son or daughter of the "First person listed on the roster" by birth, regardless of the age of the child. Mark "Natural-born or adopted son/daughter" for a child who is a son or daughter of the "First person listed on the roster" by legal adoption, regardless of the age of the child, only in cases where the "First person listed on the roster" is not also the stepparent of the child. Sons-in-law and daughters-in-law should be marked "Other relative" (see instruction 9 below). Foster children should be marked "Roomer, boarder, or foster child." 4.STEPSON/STEPDAUGHTER Write 4 for "Stepson/stepdaughter" for a child who is the son or daughter of the "First person listed on the roster" through marriage but not by birth, regardless of the age of the child (exclude sons-in-law and daughters-in-law). If the "Stepson/stepdaughter" of the "First person listed on the roster" has also been legally adopted by the "First person listed on the roster" mark "Stepson/stepdaughter" but do not mark "Natural-born or adopted son/daughter." In other words, "Stepson/stepdaughter" takes precedence over "Adopted son/daughter." 5.BROTHER/SISTER Write 5 for "Brother/sister" for the brother or sister of the "First person listed on the roster." Stepbrothers, stepsisters, and brothers and sisters by adoption should be marked "Brother/sister." Brothers-in-law and sisters-in-law should be marked "Other relative" (see instruction 9 below). 6.FATHER/MOTHER Write 6 for "Father/mother" for the father or mother of the "First person listed on the roster." Mark parents by birth, stepparents, and parents by adoption as "Father/mother." Parents-in-law should be marked "Other relative" (see instruction 9 below). 7.GRANDCHILD Write 7 for "Grandchild" for the grandson or granddaughter of the "First person listed on the roster." 8.OTHER RELATIVE Write 8 for "Other relative" for anyone else related to the "First person listed on the roster" by blood, marriage, or adoption (sister-in-law, nephew, aunt, mother-in-law, son-in-law, daughter-in-law, cousin, grandparent, great-grandchild, etc.), and print the exact relationship in the space provided. 9.ROOMER, BOARDER, OR FOSTER CHILD Write 9 for "Roomer, boarder, or foster child" for a roomer, boarder, lodger, or relative of such, and for foster children or foster adults of the "First person listed on the roster." 10.HOUSEMATE, ROOMMATE Write 10 for "Housemate, roommate" for persons who are not relatives of the "First person listed on the roster" and who share living quarters primarily in order to share expenses. 11.UNMARRIED PARTNER Write 11 for "Unmarried partner" for a person who is not a relative of the "First person listed on the roster," who shares living quarters and who has a close personal relationship with the "First person listed on the roster." 12.OTHER NONRELATIVE Write 12 for "Other nonrelative" for a person who is not related by blood, marriage, or adoption to the "First person listed on the roster" but is related to an "Unmarried partner" or "Housemate, roommate" or who cannot be described by the categories given. 13.CONTINUATION QUESTIONNAIRES - When more than ten people are to be entered, a continuation questionnaire is required. This must be a questionnaire of the SAME type (a short-form with an original short-form questionnaire, or a long-form with an original long-form questionnaire). Do not enter anyone in the "Person 1 column" on the continuation questionnaire, and be sure all relationships marked on the continuation questionnaire refer to Person 1 on the original (first form) questionnaire. 1 Householder 2 Spouse 3 Child 4 Stepchild 5 Sibling 6 Parent 7 Grandchild 8 Other relative 9 Roomer-boarder 10 Housemate 11 Unmarried 12 Nonrelative The member of a household who owns or rents the living quarters. If there is no such person, any household member who is at least 15 years of age. Ethnic origin (principal) Ethnic origin (principal) Ethnic origin (principal) Ethnic origin (principal) Ethnic origin (principal) 4. What is ...'s ethnic origin or race? Write in the category or categories the person considers himself/herself to be. If the respondent is unable to give a response or does not understand the question, say - “Ethnic origin or race refers to a person's origin or descent, "roots," or heritage. Ethnic origin may refer to where the person the person's parents or ancestors were born. There is no set rule as to how many generations are to be taken into account in determining ethnic origin or race. A person may report his or her ethnic origin or race based on the origin or race of a parent, a grandparent, or more distant ancestors. 1.HOW TO DETERMINE ANCESTRY IN SPECIAL SITUATIONS a.When the respondent reports where more than one ethnic origin or race (for example, White Chamorro), print the first two groups reported. b.When only a GENERAL answer like "Asian," "Micronesian," or "European" is reported: 1)Ask for a more specific group. 2)If the respondent does not know the specific ethnic origin or race, print the answer reported. 2.RULES FOR ENTERING ANCESTRY WHEN "AMERICAN" IS GIVEN a.If the respondent says he or she is "American", explain that ethnic origin or race refers to the origin or "roots" of the person or the person's ancestors (other than the United States). If the respondent still says "American," then print American. b.If the respondent gives "American" in addition to a specific origin group, such as "Chamorro-American," "Hawaiian-American," etc., print the entire answer. 10 Yapese 11 Ulithian/Fais 12 Woleaian 13 Satawalese 20 Chuukese 21 Southern Namonea 22 Faichuukese 23 Mortlockese 24 Pattiw 25 Halls 26 Weito 30 Pohnpeian 31 Ngatikese 32 Nukuoroan 33 Kapingamarangan 34 Mokilese 35 Pingelapese 40 Kosraean 50 Carolinian 51 Guam Chamorro 52 CNMI Chamorro 53 Palauan 54 Marshallese 55 Kiribati 56 Nauruan 57 Tuvaluan 60 Samoan 61 Fijian 62 Papua New Guinea 69 Other Pacific Is 70 Australian 71 New Zealander 72 Hawaiian 73 American 74 Canadian 75 European 76 German 79 Other European 80 Filipino 81 Japanese 82 Korean 83 Chinese 84 Taiwanese 95 Latin American 96 African 98 Other countries Month of birth Month of birth Month of birth Month of birth Month of birth 5a. What is ...'s date of birth? (Month/Day/Year) Print each person's date of birth in the space provided, recording first the month, then the day, and then the year of birth. If year of birth is not known, ask for an estimate. 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December Day of birth Day of birth Day of birth Day of birth Day of birth 5a. What is ...'s date of birth? (Month/Day/Year) Print each person's date of birth in the space provided, recording first the month, then the day, and then the year of birth. If year of birth is not known, ask for an estimate. Year of birth Year of birth Year of birth Year of birth Year of birth 5a. What is ...'s date of birth? (Month/Day/Year) Print each person's date of birth in the space provided, recording first the month, then the day, and then the year of birth. If year of birth is not known, ask for an estimate. Age Age Age Age Age 5b. Age Print each person's age at last birthday in the space provided. If the exact age is not known, ask for an estimate. For babies who are not yet one year old, print "OO". Marital status Marital status Marital status Marital status Marital status 6. What is ...'s marital status? 1. Now married 2. Consensually married 3. Widowed 4. Divorced 5. Separated 6. Never married 1.NOW MARRIED Write 1 for "Now married" for a married person regardless of whether his or her spouse is living in the household unless they are separated. For example, mark "Now married" for persons who are temporarily living apart because the spouse is employed elsewhere or is in the Armed Forces, or who are temporarily living apart for any other SIMILAR reason. Couples who live together (unmarried persons, persons in common-law marriages, etc.) should report the marital status they consider to be most appropriate. 2.SEPARATED Write 2 for "Separated" for persons who have been deserted or who have parted because they no longer want to live together (whether or not legally separated) but have not obtained a divorce. 3.WIDOWED Write 3 for "Widowed" for persons whose spouse has died and they have not remarried. 4.DIVORCED Write 4 for "Divorced" for persons who have been deserted or who have parted because they no longer want to live together AND have obtained a divorce. 5.NEVER MARRIED Write 5 for "Never married" for a person who has never married or whose only marriage has been annulled. Also, mark "Never married" for persons born February 1990 or later. 1 Now married 2 Consensually married 3 Widowed 4 DIvorced 5 Separated 6 Never married State of birth State of birth State of birth State of birth State of birth 7. Where was ...'s mother living when ... was born? Print the island/ municipal and state in FSM, U.S. State or territory, or foreign country in the space below 1.For persons born in FSM: Print the name of the village in which the mother was living when the person was born. Do NOT report the hospital unless the mother was living in that area at the time of the birth. If she went to the hospital to give birth, give the village where she was living before she went to the hospital. 2.For persons born in the United States: Print the name of the State in which the person was born. If the person was born in Washington, D.C., print District of Columbia. 3.For persons born in another U.S. territory: If the person was born in a different U.S. territory or commonwealth, print Puerto Rico, Virgin Islands, Guam or American Samoa. 4.For persons born elsewhere: If the person was born in a foreign country, print the name of the foreign country or area where the person was born. Use current boundaries, not boundaries at the time of the person's birth. Specify whether Northern Ireland or the Republic of Ireland (Eire); East or West Germany; North or South Korea; England, Scotland, or Wales (not Great Britain or United Kingdom). Specify the particular country or island in the Caribbean, (not, for example, West Indies). 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 200 Chuuk 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 400 Kosrae 401 Lelu 402 Malem 403 Utwe 404 Tafunsak 551 Guam 552 CNMI 553 Palau 554 Marshall Islands 555 Kiribati 556 Nauru 557 Tuvalu 560 Samoa 561 Fiji 562 Papua New Guinea 569 Other Pacific Is 570 Australia 571 New Zealand 572 Hawaii 573 US excluding Haw 574 Canada 575 United Kingdom 576 Germany 579 Other Europe 580 Philippines 581 Japan 582 Korea 583 China 584 Tawian 589 Other Asia 595 Latin America 596 Africa 598 Other countries Citizenship Citizenship Citizenship Citizenship Citizenship 8. Is ... a CITIZEN of FSM? 1. Code “1”, if the person was born in FSM. 2.If the person is a Naturalized FSM citizen, record "2". 3.If the person was born in the United States, Puerto Rico, CNMI, American Samoa, or Guam, record "3" for "Yes, born in the United States or other US territory." 4.If the person was born abroad of a US parent or parents or Naturalized US, so is a US citizen, record 4. 5.Record "5" for "No, not citizen/national (permanent residence)" if the person is not a citizen, but is residing permanently in FSM - regardless of actual legal status. 6.Record "6" for "No, not citizen/national (temporary residence)" if the person is not a citizen, but is residing only temporarily in FSM and intends to return to the previous or another country of residence. 1 Born in the FSM 2 FSM citizen by naturalization 3 Born in US or US territory 4 Other US citizen 5 Permanent non-citizen 6 Temporary non-citizen School attendance School attendance School attendance School attendance School attendance 9. At any time since April 1, 2005, has .. attended regular school or college? 1. No 2. Yes, public school or college 3. Yes, private If "Yes," ask Public or private? 1.Write the appropriate "Yes" entry for persons who have attended any "regular" school or college since April 1, 2005. 3.EDUCATION THAT IS USUALLY NOT IN A "REGULAR" SCHOOL OR COLLEGE Write 2 for "No, has not attended since February 1" for those enrolled only in the following types of schools: a.Vocational, trade, or business schools outside the "regular" system, such as television repair schools, barber's colleges, or secretarial schools. b.Adult education classes, unless the schooling is being counted for credit in a "regular" school system, such as toward a high school diploma. c.On-the-job training. d.Correspondence courses unless they are taken from a "regular" school, such as a university, and count for credit in a "regular" school system. 4.TYPE OF SCHOOL a.A public school is any school that is controlled and supported primarily by a local, county, State, or Federal Government. b.A private school is a private or parochial school that is supported and controlled primarily by a religious organization or other private group. Private schools may be religious or nonreligious elementary schools, secondary schools, colleges, universities, professional schools, Montessori schools, or nursery schools (including pre-schools and pre-kindergartens). c.Do not assume that the name of the school indicates whether it is public or private. Also payment of tuition at college does not indicate the school is private. 1 No, has not attended 2 Yes, public school or college 3 Yes, private school or college a."Regular" schooling advances a person toward an elementary school certificate, a high school diploma, or a college, university, or professional school (such as law or medicine) degree. b."Regular" schools may be either public, parochial (church-related), or other private. Attendance can be either by day or night, full or part time. A school does not have to be graded to qualify as a "regular" school. c.Tutoring should be counted only if credit for it can be obtained in a "regular" school. Educational attainment Educational attainment Educational attainment Educational attainment Educational attainment 10.How much school has ... COMPLETED? 31. No school completed 32. Nursery school 33. Kindergarten 1. – 11. Grades 1 to 11 12. 12th grade, no diploma 13. HIGH SCHOOL GRADUATE — DIPLOMA or equivalent (GED) 14. Some college but no degree 15. Associate degree in college — Occupational program 16. Associate degree in college — Academic program 17. Bachelor's degree (For example: BA, AB, BS) 18. Master's degree (For example: MA, MS, Med, MSW, MBA) 19. Higher level degree (For example: MD, DDS, LLB, JD, PhD, EdD) Read categories if person is unsure. Circle the number for the highest level COMPLETED or degree RECEIVED. If currently enrolled, mark the level of previous grade attended or highest degree received. For persons who have not graduated from high school, write the appropriate number for the highest grade or year of "regular" school completed. For persons who have attended college but have not received a degree, write 14 for "Some college but no degree." For persons who have one or more college degrees, mark the entry for the highest degree. Record the highest level of regular schooling the person has completed. Exclude vocational training, that is not creditable in the "regular" school system. See definition of "regular" school in instructions for question 9. 1.For a person now attending a "regular" school, write the number for the box for highest grade, year or degree successfully completed. For persons enrolled in elementary school or high school, including middle school and junior high school, mark the category containing the previous grade the person was enrolled in. Write 14 for "Some college but no degree" if the person is enrolled in college but has not completed a degree. If the person is enrolled in college but has completed at least one degree, mark the category for the highest degree this person has received. 2.Write 31 for "No school completed" for persons who have never attended a "regular" school or have not completed the first year attended, such as nursery school or kindergarten. 3.For those who have completed only nursery school or kindergarten thus far, write the appropriate number. 4.If the person successfully completed the 12th grade but did not receive a diploma, GED credentials or attend college, write 12 for "12th grade, NO DIPLOMA." 5.If the person reports completion of the highest level in an ungraded or foreign school, estimate the equivalent grade level in the "regular" American school system. 6.Vocational, business, and technical schools: For persons who have attended "post-graduate" high school courses or vocational or business school courses not creditable toward a college degree, after completing high school, write 13 for "HIGH SCHOOL GRADUATE...." These include technical, vocational, or paraprofessional training, and training in hospital schools. 7.College: For persons who attended college, mark the box for the highest academic degree they obtained. a.Write 15 for "Associate degree in college--Occupational program" if the highest degree was an associate degree in a program that prepared the person for a specific occupation. Course work may or may not be creditable toward a bachelor's degree. b.Write 16 for "Associate degree in college--Academic program" if the highest degree was an associate degree primarily in the arts and sciences and transferrable to a bachelor's degree program. c.Write 19 for "Professional school degree" if one or more degrees were earned in such fields as medicine, dentistry, chiropractic medicine, optometry, osteopathic medicine, pharmacy, podiatry, veterinary medicine, law or theology. Do not include vocational training for a trade such as barber school or cosmetology, secretarial school, trade school or bartending. 8.Do not include vocational certificates or diplomas from post-secondary vocational, trade, business, technical, hospital, or paraprofessional schools unless they were college level associate, bachelor's or master's degrees. 9.Do not include honorary degrees awarded by colleges and universities to individuals for their accomplishments. Include only "earned" degrees. 1 1st 2 2nd 3 3rd 4 4th 5 5th 6 6th 7 7th 8 8th 9 9th 10 10th 11 11th 12 12th 13 High school graduate 14 Some college 15 AA - occupational 16 AA - academic 17 BA 18 MS 19 Higher level 20 None 21 Nursery school 22 Kindergarten 31 No school completed 32 Nursery school 33 Kindergarten Lived here 5 years ago Lived here 5 years ago Lived here 5 years ago Lived here 5 years ago Lived here 5 years ago 11a. Did ... live in this house or apartment 5 years ago (on June 1, 2000)? 1. Born after June 1, 2000 2. Yes 3. No If answer is 1 (born after June 1, 2000) - Go to questions for next person If answer is 2 (Yes) - skip to 11c a.If the person is under 5 years old, write 1 for "Born after April 1, 2000." Then turn to the next page for the next person. b.Write 2 for "Yes" if the person lived in this same house or apartment on April 1, 2000, even if he or she moved away and came back between then and now. Then go to question 15a. c.Write 2 for "Yes" if the person is living in an institution and was a resident of the same institution 5 years earlier even if he or she was in a different room or building. Then go to question 15a. d.Write 2 for "Yes" if the person lived in a different mobile home in the same location within the same mobile home park. Then go to question 15a. e.Write 3 for "No" if the person lived in the same mobile home but at a different location in that mobile home park or in a different mobile home park. f.Write 3 for "No" if the person did not live in the same house or apartment on April 1, 2000. 1 Under 5 years old 2 Yes 3 No State of residence 5 years ago State of residence 5 years ago State of residence 5 years ago State of residence 5 years ago State of residence 5 years ago 11b Where did ... live 5 years ago? Print Island/Municipal and State in FSM, U.S. State or territory, or foreign country in the space below If you wrote 3 for "No" in question 11a, print the location of the person's usual residence on April 1, 2000. If the person had no usual residence on April 1, 2000, report the place where he or she was staying on that date. Report actual residence rather than legal residence if they were different. a.If the person lived in FSM on April 1, 2000, print the name of the island on which he or she was living. b.If the person lived in a U.S. State on April 1, 2000, print the name of the State in which he or she was living. If the person was living in Washington, D.C., print District of Columbia. c.If the person lived in a different U.S. territory or commonwealth, print the name of the territory or commonwealth, such as Puerto Rico, Virgin Islands, American Samoa or Guam. d.If the person lived elsewhere on April 1, 2000, print the name of the foreign country or area where the person was living. Specify whether Northern Ireland or the Republic of Ireland (Eire); East or West Germany; North or South Korea; England, Scotland, or Wales (not Great Britain or United Kingdom). Specify the particular country or island in the Caribbean, (not, for example, West Indies). 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak 551 Guam 552 CNMI 553 Palau 554 Marshall Islands 555 Kiribati 556 Nauru 557 Tuvalu 560 Samoa 561 Fiji 562 Papua New Guinea 569 Other Pacific Is 570 Australia 571 New Zealand 572 Hawaii 573 US excluding Haw 574 Canada 575 United Kingdom 576 Germany 579 Other Europe 580 Philippines 581 Japan 582 Korea 583 China 584 Tawian 589 Other Asia 595 Latin America 596 Africa 598 Other countries Language spoken at home Language spoken at home Language spoken at home Language spoken at home Language spoken at home 11c. What language does … usually speak at home? IF THIS PERSON IS LESS THAN 15 YEARS OLD, GO TO THE NEXT PERSON. OTHERWISE GO TO 12 Print the language spoken at home. If this person speaks two or more languages at home and cannot determine which is spoken most often, report the first language the person learned to speak. 10 Yapese 11 Ulithian 12 Woleaian 13 Satawalese 20 Chuukese 21 Southern Namonea 22 Faichuukese 23 Mortlockese 24 Pattiw 25 Halls 26 Weito 30 Pohnpeian 31 Ngatikese 32 Nukuoroan 33 Kapingamarangan 34 Mokilese 35 Pingelapese 40 Kosraean 50 Carolinian 51 Guam Chamorro 52 CNMI Chamorro 53 Palauan 54 Marshallese 55 Kiribati 56 Nauruan 57 Tuvaluan 60 Samoan 61 Fijian 62 Papua New Guinea 69 Other Pacific Is 70 English 72 Hawaiian 75 European 80 Filipino 81 Japanese 82 Korean 83 Chinese 84 Taiwanese 95 Spanish 98 Other languages Military service Military service Military service Military service Military service 12. Has ... ever been on active-duty military service in the Armed Forces of the United States or ever been in the United States military Reserves or the National Guard? 1. Yes, now on active duty 2. Yes, on active duty in past, but not now 3. Yes, service in Reserves or National Guard only 4. No "Active duty" does NOT include training for the military Reserves or National Guard. Ask Question 12 on military service only to people 15 years and over, those born before April 1, 1990. Do not ask this question, or any of the subsequent questions to people less than 15 years old. Active duty personnel are those currently in the Armed Forces either because they enlisted or because they were previously Reserves or on National Guard duty and were activated because of the wars in Afghanistan or Iraq. Active duty in the past includes people were in the Armed Forces in the past. These military service personnel do not include people who were in the Reserves or the National Guard who did not see active duty. Reserves or National Guard include people who are currently in the Reserves or National Guard but are not currently on Active Duty No is to be recorded for all other people 15 years and over - those who are not on Active Duty now, were not on Active Duty in the past, and are not currently in the Reserves or National Guard. For persons 15 years old and over 1 Active duty now 2 Previous active duty 3 Reserves or National Guard 4 No Children ever born Children ever born Children ever born Children ever born Children ever born If this person is female, ask - 13a How many babies has ... ever had, not counting still births? Do not count stepchildren or children ... has adopted. - If none, skip to 14 a.Ask of all females born before April 1, 1990. b.Count all live births the woman has ever had, including any babies who died (even shortly after birth) or who no longer live with her. Be sure to include any children born to this woman during a previous marriage and those born out of wedlock. c.Do not count this woman's stepchildren, foster children, or children she has adopted. d.Exclude miscarriages and stillbirths (a birth at which the baby showed no sign of life). If there is any doubt about whether a birth was a stillbirth, do not count that birth among the babies a woman has ever had. For females 15 years old and over Children still alive Children still alive Children still alive Children still alive Children still alive 13b Of these babies, how many are still alive? a.Ask of all females born before April 1, 1990. b.Count all children the woman has ever had who are still alive. Exclude any babies who died (even shortly after birth) Be sure to include any children born to this woman during a previous marriage and those born out of wedlock and who are still alive. c.Do not count this woman's stepchildren, foster children, or children she has adopted. d.Exclude miscarriages and stillbirths (a birth at which the baby showed no sign of life). For females 15 years old and over Last child's birth month Last child's birth month Last child's birth month Last child's birth month Last child's birth month 13c What is the date of birth of the last child (Month/day/year)?? Date of birth of last child. a.Record the month, day, and year of birth of the last child born to the respondent. If the respondent has had no children, don't ask the question (Go on to Question 14). b.If the respondent knows only the month and year of last birth, record that information. If the respondent knows only the year of last birth, record that. If the respondent does not know the year of birth, obtain an estimate. 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December Last child's birth day Last child's birth day Last child's birth day Last child's birth day Last child's birth day 13c What is the date of birth of the last child (Month/day/year)?? Date of birth of last child. a.Record the month, day, and year of birth of the last child born to the respondent. If the respondent has had no children, don't ask the question (Go on to Question 14). b.If the respondent knows only the month and year of last birth, record that information. If the respondent knows only the year of last birth, record that. If the respondent does not know the year of birth, obtain an estimate. Last child's birth year Last child's birth year Last child's birth year Last child's birth year Last child's birth year 13c What is the date of birth of the last child (Month/day/year)?? Date of birth of last child. a.Record the month, day, and year of birth of the last child born to the respondent. If the respondent has had no children, don't ask the question (Go on to Question 14). b.If the respondent knows only the month and year of last birth, record that information. If the respondent knows only the year of last birth, record that. If the respondent does not know the year of birth, obtain an estimate. Work last week Work last week Work last week Work last week Work last week 14 Did .. work at any time LAST WEEK, either full time or part time? 1. Yes, worked full time or part time at a job or business AND did NO subsistence 2. Yes, worked full time/part time at a job/business AND did subsistence activity 3. Yes, did subsistence activity only 4. No Work includes part-time work such as delivering papers, or helping without pay in a family business or farm; it also includes active duty in the Armed Forces. Work does NOT include own housework, school work, or volunteer work. Subsistence activity includes fishing, growing crops, etc., NOT primarily for commercial purposes. If 3 (Yes, did subsistence activity only) - Skip to17 If 4 (No) - Skip to 18 1."... last week": The time period covered is the full calendar week, Sunday through Saturday, preceding the date the census questionnaire is completed. 2.Count as work: 1)Paid work as an employee for someone else, including: -work for pay "in kind" (meals, living quarters, or supplies received in place of cash wages); -work at piece rates, on commission, or for tips; 2)Work in the person's own business, professional practice, or farm. 3)Work with or without pay in a business or farm operated by a relative. 4)Part-time work, such as an hour or two after school and babysitting for pay. 3.Do not count as work: 1)Work around the house, such as the person's own housework, yard work, or odd jobs around the house (painting the porch, cutting grass, etc.). 2)Unpaid baby-sitting for family, relatives, or friends. 3)Unpaid volunteer work for church, Red Cross, etc. 4)Work done by a resident of an institution. Tasks performed by residents of institutions are not considered "work" for the purposes of the census. For persons 15 years old and over 1 Yes, paid and no subsistence 2 Yes, paid and subsistence 3 Yes, Subsistence only 4 No Hours of work last week Hours of work last week Hours of work last week Hours of work last week Hours of work last week 15 How many hours did ... work LAST WEEK at all jobs? Subtract any time off and add any overtime or extra hours worked: 1.The question refers to the actual number of hours worked last week, not the "usual" or "regular" hours. Do not count lunch hours, sick leave, and vacation leave, but include overtime or extra hours worked last week. 2.Two or More Jobs If a person worked at two or more jobs last week, enter the total number of hours worked at all jobs. 3.Exact Hours Unknown If the respondent cannot immediately report the number of hours worked last week, try to find out the number of hours worked each day and add them up. For persons 15 years old and over Location of work Location of work Location of work Location of work Location of work 16. Where did ... usually work LAST WEEK? If ... worked at more than one location, ask--Where did ... work most last week? Print the Island/municipal, FSM state or other country where …worked. If did No subsistence, Skip to 21-23 1.Question 16 refers to the actual geographic location (village) of the plant, office, store, or other establishment where the person worked most of the time during the last week. Exclude subsistence activity. The location should include the name of the village or area of the island. 2.If the person worked in an office or shop in his/her own home, or on a farm where he/she also lives. enter the location of the person's residence. 3.If the person's employer operates in more than one location (such as a bank, grocery store chain, or public school system), enter the exact location or branch where the person worked most of the time last week. 4.If the person worked at more than one location last week, but reported to the same location each day to begin work, enter the location where he/she reported. If the person did not report to the same location each day to begin work, print the location where he or she worked most of the time last week. 5.If the person worked offshore or as an officer or crew member on a vessel, and did not report to a central headquarters or pier, print "at sea" as the place of work in question 16. 6.For a farm or other work place in open country, give as complete information as possible by specifying the name of the nearest village. 7.If the person worked in another territory, commonwealth, U.S. State, or a foreign country, print the name of the work place location in question 16. For persons 15 years old and over 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak 551 Guam 552 CNMI 553 Palau 554 Marshall Islands 555 Kiribati 556 Nauru 557 Tuvalu 560 Samoa 561 Fiji 562 Papua New Guinea 569 Other Pacific Is 570 Australia 571 New Zealand 572 Hawaii 573 US excluding Haw 574 Canada 575 United Kingdom 576 Germany 579 Other Europe 580 Philippines 581 Japan 582 Korea 583 China 584 Tawian 589 Other Asia 595 Latin America 596 Africa 598 Other countries Subsistence produce sold last week Subsistence produce sold last week Subsistence produce sold last week Subsistence produce sold last week Subsistence produce sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes Was any of the subsistence sold last week? This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 Yes 2 No Subsistence produce sold last week - fish Subsistence produce sold last week - fish Subsistence produce sold last week - fish Subsistence produce sold last week - fish Subsistence produce sold last week - fish 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes a. fish and seafood This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not sold 3 Sold Value of fish sold last week Value of fish sold last week Value of fish sold last week Value of fish sold last week Value of fish sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes a. fish and seafood - Amount sold This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Subsistence produce sold last week - pigs Subsistence produce sold last week - pigs Subsistence produce sold last week - pigs Subsistence produce sold last week - pigs Subsistence produce sold last week - pigs 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes b. pigs This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not Sold 3 Sold Value of pigs sold last week Value of pigs sold last week Value of pigs sold last week Value of pigs sold last week Value of pigs sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes b. pigs - Amount sold This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Subsistence produce sold last week - sakau Subsistence produce sold last week - sakau Subsistence produce sold last week - sakau Subsistence produce sold last week - sakau Subsistence produce sold last week - sakau 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes c. sakau This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not Sold 3 Sold Value of sakau sold last week Value of sakau sold last week Value of sakau sold last week Value of sakau sold last week Value of sakau sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes c. sakau - Amount sold This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Subsistence produce sold last week - betelnut Subsistence produce sold last week - betelnut Subsistence produce sold last week - betelnut Subsistence produce sold last week - betelnut Subsistence produce sold last week - betelnut 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes d. betelnut This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not Sold 3 Sold Value of betelnut sold last week Value of betelnut sold last week Value of betelnut sold last week Value of betelnut sold last week Value of betelnut sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes d. betelnut - Amount sold This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Subsistence produce sold last week - other agri/garden products Subsistence produce sold last week - other agri/garden products Subsistence produce sold last week - other agri/garden products Subsistence produce sold last week - other agri/garden products Subsistence produce sold last week - other agri/garden products 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes e. other agriculture/gardening products This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not Sold 3 Sold Value of other agri/garden products sold last week Value of other agri/garden products sold last week Value of other agri/garden products sold last week Value of other agri/garden products sold last week Value of other agri/garden products sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes e. other agriculture/gardening products - Amount sold This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Subsistence produce sold last week - handicrafts Subsistence produce sold last week - handicrafts Subsistence produce sold last week - handicrafts Subsistence produce sold last week - handicrafts Subsistence produce sold last week - handicrafts 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes f. handicrafts This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not Sold 3 Sold Value of handicrafts sold last week Value of handicrafts sold last week Value of handicrafts sold last week Value of handicrafts sold last week Value of handicrafts sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes f. handicrafts - Amount sold This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Other subsistence produce sold last week Other subsistence produce sold last week Other subsistence produce sold last week Other subsistence produce sold last week Other subsistence produce sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes g. other subsistence activities This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. 1 None 2 Not Sold 3 Sold Value of other subsistence produce sold last week Value of other subsistence produce sold last week Value of other subsistence produce sold last week Value of other subsistence produce sold last week Value of other subsistence produce sold last week 17. Which of the following subsistence activities did ... do last week? Mark all appropriate boxes g. other subsistence activities - Amount sold If this person had paid employment last week, go to 21-23 on the next page. This question is asked only to people who said they did subsistence in question 14 - either with paid employment (code 2), or subsistence only (code 3). Ask about each item separately. If they say “yes” they did fish or collect seafood last week, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. After asking these questions if the person had employment in question 14 - code 2, skip to items 21 to 23 on the next page. These people will not be considered unemployed. If the person did only subsistence, ask questions 18 to 20 about unemployment to see whether they were looking for paid employment. Temporary absence from work Temporary absence from work Temporary absence from work Temporary absence from work Temporary absence from work 18. Was ... on layoff from a job or business LAST WEEK? 1. Yes, on layoff 2. Yes, on vacation, temporary illness, labor dispute, etc. 3. No If "No," ask - Was ... temporarily absent or on vacation from a job or business last week? 1.Write "1" for "Yes, on layoff" if the person had been laid off, and had not yet returned to work. 2.Write "2" for "Yes, on vacation, temporary illness" if the person was temporarily away from work because of vacation or temporary illness but would return to work as soon as returning from vacation or recovering from illness. 3.Write "3" for "No" for persons not on layoff and not on vacation or off because of illness. Write "3" for persons on call to work whenever there is a need for their services (such as substitute teachers) and for seasonal workers during an off season. For persons 15 years old and over 1 Yes, on layoff 2 Yes, vacation, temporary illness, labor dispute, etc. 3 No Look for work Look for work Look for work Look for work Look for work 19a. Has ... been looking for work during the last 4 weeks? 1. Yes 2. No If NO - Skip to 20 Write "1" for "Yes" if this person tried to get a job or start a business or professional practice during the last 4 weeks, such as registering at a public or private employment office, being on call at a personnel placement office or nurses' register, meeting with prospective employers, etc. Other examples of looking for work are: a.Placing or answering advertisements for help. b.Writing letters of application. c.Checking with a union or other workers' organization. d.Visiting locations where employers pick up temporary help. e.Investigating possibilities for starting a professional practice or opening a business. For persons 15 years old and over 1 Yes 2 No Take job if available Take job if available Take job if available Take job if available Take job if available 19b. Could ... have taken a job LAST WEEK if one had been offered? 1. No, already has a job 2. No, temporarily ill 3. No, other reasons (in school,etc.) 4. Yes could have taken a job If "No," ask - For what reason? "...last week": The time period covered is the full calendar week, Sunday through Saturday, preceding the date the census questionnaire is completed. Write "1" for "No, already has a job" if the person was on layoff or was to report to a job within 30 days. If there was another reason why the person could not take a job last week, do not write "1", but write the number of the appropriate response. Write "2" for "No, temporarily ill" for persons who were temporarily ill, so could not have taken a job. Write "2" only if the illness is expected to last less than 31 days; for longer illnesses, write "3" for "No, other reasons (in school, etc.)." Write "4" for "yes, could have taken a job" if the person could have taken a job. For persons 15 years old and over 1 No, already has a job 2 No, temporarily ill 3 No, other reasons 4 Yes, could have taken a job Year when last worked Year when last worked Year when last worked Year when last worked Year when last worked 20. In what year did ... last work, even for a few days? If Never worked, write "Never worked". [Code 9998 for never worked] If Never worked, or last worked in June, 2000 or earlier, skip to 26 1."Work" is defined in the same way as for question 19. 2.The date last worked is the most recent year in which the person did any work at all, even for a few days, and not necessarily the year last worked at a full-time job. 3.For residents of institutions, this question refers to the date they last worked outside the institution. For persons 15 years old and over 9998 Never worked 9999 NR Industry Industry Industry Industry Industry 21-23 The following questions ask about the job worked for pay last week. If ... had more than one job, describe the one ... worked the most hours. If ... didn't work, the questions refer to the most recent job or business since June, 2000. 21 For whom did ... work? If now on active duty, write "Armed Forces"; otherwise, print the name of the company, business or other employer. Provide actual agency, like Department of Education, NOT Yap State Government. QUESTIONS 21-23: GENERAL INSTRUCTIONS FOR CURRENT OR MOST RECENT JOB ACTIVITY (INDUSTRY, OCCUPATION, AND CLASS OF WORKER) 1.CURRENT OR MOST RECENT JOB ACTIVITY "Current" here means "last week," the same week referenced in question 20a. If a person had more than one job, enter the job at which he or she worked the most hours last week. If a person had no job or business last week, give the information for the last (most recent) job held in 2000 or later. 2.JOB DESCRIPTION All parts of questions 21-23 must refer to the same job. Be sure the entries present a consistent description. See Appendixes B and C for examples of unacceptable and acceptable entries. 3.ACTIVE DUTY WITH U.S. ARMED FORCES If the person is now on active duty in the U.S. Armed Forces, or if the person is not now employed but was on active duty in the U.S. Armed Forces in his or her last job since 2000; print the branch of service in the Armed Forces in question 22. The Armed Forces include Army, Air Force, Navy, Marine Corps, and Coast Guard. Industry: 1.If not U.S. Armed Forces, print the name of the company, business, or employer: a.The full name of the company, business, government agency, or other employer must be entered. Abbreviations of company names are not acceptable. b.For employers without company names, such as a dentist's or lawyer's office or a construction contractor, print the name of the employer. For self-employed people without a company name, print "self-employed." c.For employees of a government agency, report the specific organization for which the person worked. Be sure to state whether the organization is Federal (U.S.), territorial or one of the islands. 2.a.The entry here should tell clearly and specifically what the company or business does at the location where the person worked. In order to give a clear and exact description of the industry, the entry must state or indicate both a general and specific function for the employer; for example, dairy farm, pen manufacturer, wholesale grocery, retail book store, shoe repair service. The words "mine," "store" "repair service," etc., show the general function. The words "dairy," "book," "shoe," etc., indicate specific function. b.Multiple Activity Businesses Many firms carry on more than one kind of business or industrial activity. If there is more than one kind of business or industrial activity to report, answer question 26 as follows: 1)If the activities are carried on in separate places, describe the activity where the person actually worked. Example:A company makes copy machines in one plant, and chemicals used to make copies in another. Report "chemicals for copy machine" for the people working in the chemical plant. 2)If the activities are carried on in the same place, describe the major business or activity at that location. Example:A shoe factory also makes some leather purses at the same plant. If shoes are the major product, all people working at the plant should be reported as "shoe factory." c.Government Organizations The names of government organizations are often not descriptive of their business or activity. Be sure that the entry describes exactly what the activity is. For example, an entry of "FSM Public Works" in question 26 might be one or any combination of the following: "Road building," "Road repair," "Contracting for road building (repair)." d.Domestic or Other Private Household Workers When the name of a single individual is given as the employer, there should be an indication of whether the person works at a place of business or in a private home. The proper entry in question 26 for a domestic worker employed in the home of another person is "private home." For a person cleaning a doctor's office which is located in the doctor's own home, the proper entry is "doctor's office." e.Examples of unacceptable and acceptable entries for kind of business or industry are given in Appendix B. For persons 15 years old and over 10 AG.HUNT.FISHERY 11 GROWING CROPS 12 FARMING LIVESTCK 13 MIXED FARMING 14 AG.ANIMAL HUSBAN 15 HUNTING TRAPPING 20 FORESTRY,LOGGING 50 FISHING 100 MINNING,QUARRYNG 101 M&Q HARDCOAL 102 M&Q LIGNITE 103 EXTRACTION PEAT 111 EXTR.CRUDE PET 112 AGRICULTURE SERV 120 MINING OF URANIM 131 MINING OF IRNORE 132 MINING NONFEROUS 141 QUARRYING STONE 142 M&Q N.E.C 150 MANU.FOOD BEV 151 PRODUCTION PRCSS 152 MAN.DAIRY PROD 153 MAN. GRAIN MILL 154 MAN. OTHER FOOD 155 MAN. OF BEVERAGE 160 MAN. OF TOBACCO 170 TEXTILES 171 SPINNING 172 OTHER TEXTILES 173 KNITTED FABRICS 180 MAN. WEARING APP 181 MAN. EX. FUR APP 182 DRESS. & DYEING 190 MAN. OF LEATHER 191 TANNING AND DRES 192 MAN. FOOTWEAR 200 MANU.OF WOOD PRO 201 SAWMILLING WOOD 202 MAN. OF WOOD PRO 210 MAN. PAPER PROD 999 Unknown/other Occupation Occupation Occupation Occupation Occupation 21-23 The following questions ask about the job worked for pay last week. If ... had more than one job, describe the one ... worked the most hours. If ... didn't work, the questions refer to the most recent job or business since June, 2000. 22 What kind of work was ... doing? This is the occupation, like primary school teacher, medical officer, cashier, etc. QUESTIONS 21-23: GENERAL INSTRUCTIONS FOR CURRENT OR MOST RECENT JOB ACTIVITY (INDUSTRY, OCCUPATION, AND CLASS OF WORKER) 1.CURRENT OR MOST RECENT JOB ACTIVITY "Current" here means "last week," the same week referenced in question 20a. If a person had more than one job, enter the job at which he or she worked the most hours last week. If a person had no job or business last week, give the information for the last (most recent) job held in 2000 or later. 2.JOB DESCRIPTION All parts of questions 21-23 must refer to the same job. Be sure the entries present a consistent description. See Appendixes B and C for examples of unacceptable and acceptable entries. 3.ACTIVE DUTY WITH U.S. ARMED FORCES If the person is now on active duty in the U.S. Armed Forces, or if the person is not now employed but was on active duty in the U.S. Armed Forces in his or her last job since 2000; print the branch of service in the Armed Forces in question 22. The Armed Forces include Army, Air Force, Navy, Marine Corps, and Coast Guard. Occupation: 1.The entry should describe the kind of work the person does. The entry is acceptable if it tells clearly and specifically what the person does; for example, janitor, production clerk, TV repairer, auto body mechanic, welder, or shoe repairer. a.Sufficient Detail - One-word occupational descriptions are often not acceptable. For example, we need to know what type of nurse or engineer, clerk, teacher, etc., a person is. (Practical nurses, registered nurses, and nurses' aides are put in different groups in census statistics so a full description is necessary.) b.Describing Farm Workers - People who operate their own farm or ranch should be reported as farmer or rancher. Those who operate a farm for another owner should be reported as farm manager. Those who supervise other farm workers but report to a farmer or farm manager should be reported by their major activity such as general farm worker, field worker, farm equipment operator, etc. c.Examples of unacceptable and acceptable entries for kind of work are given in Appendix C. 2.QUESTION 22 In question 22, we asked what kind of work this person did; that is, what a person is called who performs this kind of work. We also need specific information on the most important activities and duties performed. For many occupations, the entry for duties differs from the entry for kind of work performed. The occupation of painter is an example of this. One could reply "paint houses" whereas another reports "toy painter." For persons 15 years old and over 11 ARMED FORCES 111 LEGISLATORS 112 SEN_GOVT OFFICLS 113 TRAD_CHIEF&HEADV 114 SEN_OFFICL_SP_IN 120 CORPORATE MANAGR 121 DIRECTOR&CHF_EXE 122 PROD&OPER DEPT_M 131 GENERAL MANAGERS 200 PROFESSIONALS 210 ENGINEERS 211 PHYSICSTS&R_PROF 212 MATHEMAT&REL_PRO 213 COMPUTING PROFES 214 ARCHITCT&R_PROFE 220 DOCTORS/DENTIST 221 L_SCI&HEALTH PRO 222 HEALTH PRO EX.NU 223 NURSNG&MIDWIF PR 230 TEACHING PROFF 231 COL,UNIV&H_T_PRO 232 SE_ED TEACH_PROF 233 PRIM&P_PRIM T_PR 234 SP_ED T_PROFESSI 235 OTHER TEACH_PROF 240 PROFF. OTHERS 241 BUSINESS PROFESS 242 LEGAL PROFESSION 243 ARCHIV,LIB&R_I_P 244 SOC_SCI&R_PROFES 245 WRITRS&CRE_PER_A 246 RELIGIOUS PROFES 300 TECH.ASS.PROFF 310 ENGINEERS ASSPRO 311 PHYS&ENGIN SC_TE 312 COMPUTR ASS.PROF 313 OPTICL&EL_EQ_OPE 314 SHIP&ACRAFT_CO&T 315 SAFTY&QUAL_INSPE 320 HEALTH ASSOC 321 LSCI_TECH&R_AS_P 322 MDRN_HEALTH EX.N 323 NURSNG&MIDW AS_P 324 TRAD_MED_PRAC&FH 330 TEACHING ASSPROF 331 PRIM_ED_T_AS_PRO 332 P_PRIM ED_T_AS_P 333 SP_ED T_ASSOC_PR 334 OTHR T_ASSOC_PRO 340 PROFF.OTH.ASSOC 341 FIN&SALES ASS_PR 342 BUS_SER_AG&TR_BR 343 ADMIN ASSOC_PROF 344 CUS,TAX&REL_G_AP 345 POLICE INSP&DETE 346 SOCWORK ASSO_PRO 347 ARTIST,ENT&SP_AP 400 CLERKS 410 OFFICE CLERKS 411 SECRET&KBRD_O_CL 412 NUMERICAL CLERKS 413 MAT_REC&TRANS_CL 414 LIBRARY MAIL RE 420 CLERKS CUST.SERV 421 LIB,MAIL&R_CLERK 422 CLIENT_INFO_CLRK 500 SERV. WORKDR 510 PERSONAL PROTECT 511 T_ATTENTD&R_WRKR 512 HSEKPNG,RES&R_WK 513 PER_CARE&R_WORKR 514 OTHR PER_CA&R_WR 515 ASTROL,FORT&R_WR 516 PROTECTVE SER WR 520 SALESPERSON 521 FASHN&OTHR MODEL 522 SHOP SPERSN&DEMO 523 STALL&MARKT SPER 600 AG.&.FISHERY WRK 610 SKLL MRKT OR 611 MARKT GAR&CR_GRO 612 MAR_OR_A&AN&R_WR 613 MAR_OR_C&ANIM_PR 614 FORESTRY&R_WORKR 615 FISHRY WRK,HUN&T 621 SUB_AGRI&FISH WR 700 CRAFT REL.WRKRS 710 CRAFTS_WRKRS 711 MINRS_SHF,SC&CAR 712 BLDG FRAM&R_T_WR 713 BLDG FIN&R_T_WRK 714 PAINT,BLDGST&R_W 720 TRADE WORKERS 721 METL MLDRS&R_WRK 722 BSMTH,TMKR&R_TWR 723 MACHINRY MECH&FI 724 ELECTRI&ELECT EQ 730 HANDICRAFT 731 PRECISION WORKER 732 POTTR,G_MKRS&R_W 733 HANDICRAFT WRKRS 734 PRINTNG&R_T_WRKR 740 CRAFT AND RELWOR 741 FOOD PROC&R_T_WR 742 WOOD TREA&R_T_WR 743 TEXTLE,GAR&R_WRK 744 PELT,LEA&SHM TWR 800 MACH.OPERATOR 810 IND. PLNT OPER 811 MINING&MIN PR_OP 812 METAL PRO_PLNT_O 813 GLASS,CER&R_P_OP 814 WOOD_PR&PM_P_OPE 815 CHEM_PRO&R_P_OPE 816 POWER PROD&R_P_O 817 AUTOM_ASSY&R_OPE 820 OPERATORS:STAT 821 MET&MIN P_MACH_O 822 CHEM_PROD MACH_O 823 RUBB&PLAST_P_M_O 824 WOOD_PROD_M_OPER 825 PRINTNG,BNDG M_O 826 TEXTL,FUR&LP_M_O 827 FOOD&R_PROD M_OP 828 ASSEMBLERS 829 OTHR MACH OPER&A 830 DRIVERS 831 LOC_ENG DRI&R_WR 832 MOTOR VEHCLE DRI 833 AGRI&OTHR MP_OPE 834 SHIPS CREW&R_WRK 900 ELEM. OCCUPATION 910 SALES ELEM.OCC 911 ST VENDRS&R_WRKR 912 SHOE CLNG&O_EL_O 913 DOM_&R_HLPR&CLNR 914 BLDG CTAKR&R_CLN 915 MESS,PORT,&R_WRK 916 GARB_COL&R_LABOU 920 LABORERS:AG.FSH 930 CONST. LABORERS 931 MINING&CONST_LAB 932 MANUFA_LABOURERS 933 TRANS_LAB&FR_HAN 999 UNKNOWN/OTHERS Class of worker Class of worker Class of worker Class of worker Class of worker 21-23 The following questions ask about the job worked for pay last week. If ... had more than one job, describe the one ... worked the most hours. If ... didn't work, the questions refer to the most recent job or business since June, 2000. 23 Who did ... work for? QUESTIONS 21-23: GENERAL INSTRUCTIONS FOR CURRENT OR MOST RECENT JOB ACTIVITY (INDUSTRY, OCCUPATION, AND CLASS OF WORKER) 1.CURRENT OR MOST RECENT JOB ACTIVITY "Current" here means "last week," the same week referenced in question 20a. If a person had more than one job, enter the job at which he or she worked the most hours last week. If a person had no job or business last week, give the information for the last (most recent) job held in 2000 or later. 2.JOB DESCRIPTION All parts of questions 21-23 must refer to the same job. Be sure the entries present a consistent description. See Appendixes B and C for examples of unacceptable and acceptable entries. 3.ACTIVE DUTY WITH U.S. ARMED FORCES If the person is now on active duty in the U.S. Armed Forces, or if the person is not now employed but was on active duty in the U.S. Armed Forces in his or her last job since 2000; print the branch of service in the Armed Forces in question 22. The Armed Forces include Army, Air Force, Navy, Marine Corps, and Coast Guard. Class of worker: All parts of questions 21 to 23 must refer to the same job. Be sure that the entries present a consistent description. Question 23 can frequently be determined if complete and specific information has been obtained in questions 21 and 22. If there is any doubt at all, you must confirm the correct entry with the respondent. a."Employee of a PRIVATE company or business or of an individual, for wages, salary, or commissions" This also includes compensation by tips, piece rates or pay "in kind," if received from a nongovernmental source, regardless of whether the source is a large corporation or a single individual. This category is also for employees of churches, unions, YMCA's, political parties, professional associations, not-for-profit hospitals and similar organizations. Note that only non-government organizations belong here, with the exception of foreign governments as noted below. Also included in this category are people who work for condominium and cooperative housing projects, other cooperative businesses, mutual and fraternal insurance companies, mutual savings banks, and credit unions. b."FSM GOVERNMENT employee": Use "2" for FSM government, including employees of public schools, government-owned bus lines, government-owned electric power utilities, etc. c."Municipal Government": record "3" for Municipal government employees. d."U.S./Other Government": use "4" for U.S. and other government employees. Include persons elected to paid offices and civilian employees of the Armed Forces. Also write "4" for "Federal GOVERNMENT employee" for active duty members of the U.S. Armed Forces. Employees of foreign governments, the United Nations, or other formal international organizations controlled by governments should write "4" for other Government. e."SELF-EMPLOYED in own business, professional practice, or farm" "Own business" refers to work for profit or fees in the person's own business, farm, shop, office, etc. It does not include managers or other executives hired to manage a business or farm, salespersons working for a commission, or officers of corporations. This category includes sole proprietorships and partnerships, but the company cannot be incorporated. Some people who own all or most of the stock in a privately held corporation consider themselves self-employed and should ALSO be marked in this category. f."Working WITHOUT PAY in family business or farm" This category refers to work on a farm or in a business operated by a relative. Room and board and a cash allowance are not counted as pay for these family workers. Do not check this category, however, if the worker receives money which is considered to be wages for work performed. Instead, write "1" for "Employee of a PRIVATE company or business or of an individual, for wages, salary, or commissions." For persons 15 years old and over 1 Municipal government 2 State government 3 National government 4 Other government agency 5 Government owned enterprise 6 Private company 7 Non-profit 8 Self employed 9 Working without pay Paid work last year Paid work last year Paid work last year Paid work last year Paid work last year 24a Last year (2004), did ... work, even for a few days, at a paid job or in a business or farm? 1. Yes 2. No If NO, Skip to 25 "Work" has the same definition as for question 14. Count part-time as well as full-time jobs and active duty in the Armed Forces. If this question reminds the person of work more recent than the year marked in question 20, make any necessary changes in the earlier questions. For persons 15 years old and over 1 Yes 2 No Weeks of work last year Weeks of work last year Weeks of work last year Weeks of work last year Weeks of work last year 24b. How many weeks did ... work in 2004? Count paid vacation, paid sick leave, and military service? Weeks ===> Ask this question of all persons who are marked "Yes" in question 24a. Count as weeks worked any week in which work was done, even for one hour, or any week for which wages or salary were received. Include weeks on active duty in the Armed Forces, on paid vacation, or on paid leave. For example, enter "52" for a school teacher who worked 40 weeks and was paid for a full year. If the year's work is reported in months, multiply the number of full months of work by 4.33 to obtain the number of weeks worked. For persons 15 years old and over Usual hours of work last year Usual hours of work last year Usual hours of work last year Usual hours of work last year Usual hours of work last year 24c During the weeks WORKED in 2004, how many hours did ... usually work each week? If the hours worked per week varied considerably during 2004, get an approximate average of the hours worked per week. For persons 15 years old and over Subsistence produce sold last year Subsistence produce sold last year Subsistence produce sold last year Subsistence produce sold last year Subsistence produce sold last year 25. Last year (2004) did … do any subsistence activities? This question is asked of all adults. If they say “No”, they did no subsistence activities, go to question 26 for income. 1 Yes 2 No Subsistence produce sold last year - fish Subsistence produce sold last year - fish Subsistence produce sold last year - fish Subsistence produce sold last year - fish Subsistence produce sold last year - fish 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? a. fish and seafood For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of fish sold last year Value of fish sold last year Value of fish sold last year Value of fish sold last year Value of fish sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? a. fish and seafood - Amount sold For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Subsistence produce sold last year - pigs Subsistence produce sold last year - pigs Subsistence produce sold last year - pigs Subsistence produce sold last year - pigs Subsistence produce sold last year - pigs 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? b. pigs For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of pigs sold last year Value of pigs sold last year Value of pigs sold last year Value of pigs sold last year Value of pigs sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? b. pigs - Amount sold For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Subsistence produce sold last year - sakau Subsistence produce sold last year - sakau Subsistence produce sold last year - sakau Subsistence produce sold last year - sakau Subsistence produce sold last year - sakau 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? c. sakau For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of sakau sold last year Value of sakau sold last year Value of sakau sold last year Value of sakau sold last year Value of sakau sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? c. sakau - Amount sold For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Subsistence produce sold last year - betelnut Subsistence produce sold last year - betelnut Subsistence produce sold last year - betelnut Subsistence produce sold last year - betelnut Subsistence produce sold last year - betelnut 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? d. betelnut For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of betelnut sold last year Value of betelnut sold last year Value of betelnut sold last year Value of betelnut sold last year Value of betelnut sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? d. betelnut - Amount sold For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Subsistence produce sold last year - other agri/garden products Subsistence produce sold last year - other agri/garden products Subsistence produce sold last year - other agri/garden products Subsistence produce sold last year - other agri/garden products Subsistence produce sold last year - other agri/garden products 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? e. other agriculture/gardening products For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of other agri/garden products sold last year Value of other agri/garden products sold last year Value of other agri/garden products sold last year Value of other agri/garden products sold last year Value of other agri/garden products sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? e. other agriculture/gardening products - Amount sold For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Subsistence produce sold last year - handicrafts Subsistence produce sold last year - handicrafts Subsistence produce sold last year - handicrafts Subsistence produce sold last year - handicrafts Subsistence produce sold last year - handicrafts 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? f. handicrafts For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of handicrafts sold last year Value of handicrafts sold last year Value of handicrafts sold last year Value of handicrafts sold last year Value of handicrafts sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? f. handicrafts - Amount sold For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Other subsistence produce sold last year Other subsistence produce sold last year Other subsistence produce sold last year Other subsistence produce sold last year Other subsistence produce sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? g. other subsistence activities For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. 1 None 2 Not Sold 3 Sold Value of other subsistence produce sold last year Value of other subsistence produce sold last year Value of other subsistence produce sold last year Value of other subsistence produce sold last year Value of other subsistence produce sold last year 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? g. other subsistence activities - Amount sold SUM the amounts shown and record in 26b For those who say “yes”, ask about each item separately. If they say “yes” they did fish or collect seafood any time in 2004, then ask whether they sold any of the fish they caught or seafood they collected. If they did sell any, ask what was the cash amount of the product sold. Repeat the questions for each item on the list: fish and seafood, then pigs, then sakau, then betelnut, then “other agriculture or garden products”, then handicrafts, then “any other subsistence activities”. Check the box if they did any of that subsistence activity, and then ask how much they did. Annual subsistence Annual subsistence Annual subsistence Annual subsistence Annual subsistence 25. Last year (2004) did … do any subsistence activities? Mark all appropriate boxes. Ask Was any of the subsistence sold last year? If yes, ask – What was the cash amount of the product sold? SUM the amounts shown. After asking all the items in the series, sum the amounts in the last column, and put the sum at the bottom of that column. Then, also put the sum in 26b for own business amounts. However, if they also have a Mom and Pop store or other business, the amount in 26b must be the sum of all parts. For persons 15 years old and over Wages Wages Wages Wages Wages 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26a How much ... earn in income from wages, salary, commissions, bonuses, or tips? Report amount before deductions for taxes, bonds, dues, etc. GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- 1.Definition of wage or salary income - Wage or salary income is the total amount of money earned by a person working as an employee for a private enterprise (unincorporated business or farm) or a branch of government. Wage or salary income includes "take-home" pay plus all deductions for withholding tax, Social Security, union dues, bonds, uniforms, etc. If a respondent knows only the amount of "take-home" pay, ask for an estimate of the deduction in order to obtain total wage or salary income. 2. Specific types of wage or salary income - In addition to what is ordinarily considered wage or salary income, the following types of money receipts are also to be included as wage or salary income: a. Piece-rate payments - Money received for work done at a specific amount per piece. b. Commissions - Money received by a person for transacting business for another person or corporation. c. Tips - Payments received as supplements to wages or for services rendered to the customer. d. Bonuses - Payments made by employers as supplements to wage or salary income. e. Salary of farm manager - Periodic, regular payments received by a farm manager, supervisor, or overseer. f. Armed Forces pay - Money received as payment for service in the Armed Forces is wage or salary income. It includes base pay plus cash housing and/or subsistence allowance (but not the value of rent-free quarters), incentive pay, longevity pay, flight pay, etc. g. National Guard or reserve pay - Payments received for training period in the National Guard or its military reserve units. h. Wages for babysitting or mowing lawns - Payments received for care of persons who do not live in the babysitter's home or mowing lawns for other persons. i. Sick leave pay - Payments received in place of wages while an employee is not at work because of illness. j. Assistantships and teaching fellowships - The money that graduate students receive for teaching part time or for working part time for a college or university is included as wage or salary income. For persons 15 years old and over Business income Business income Business income Business income Business income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26b How much did ... earn from (his/her) own farm or nonfarm business, proprietorship, or partnership? Report net income after business or operating expenses. Farm business includes products grown as subsistence such as taro, betelnut, etc., but were actually sold last year; non-farm includes subsistence fishing but the fish were actually sold. GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- If the person did subsistence activities in 2004, and they summed the amounts in question 25, then the amount in question 26b must be the sum of those payments as well as any other business income. FOR OWN NONFARM BUSINESS, PROPRIETORSHIP, OR PARTNERSHIP: 1. Total money receipts - Include as total (gross) money receipts all money received from goods sold or services rendered plus the value of any net inventory increase. 2. Business expenses - Include as business expenses the cost of merchandise purchased; expense for rent, heat, light, and power used in the business; annual depreciation of machinery and other business property; accidental damages to business property; decrease in the value of inventory; wages and salaries paid to employees; expense allowances; business taxes; interest on business mortgages or debts, etc. Do not count as business expenses money spent for the purchase of buildings or machinery, or for permanent improvements of existing buildings or machinery. However, count the annual depreciation on such improvements or purchases as an expense. Do not count personal expenditures, such as money spent for personal income taxes, life insurance, food, and shelter as business expenses. The so-called salary that some owners of unincorporated businesses pay themselves is not a business expense. Count these "salaries" as part of gross receipts. FOR FARM BUSINESS: 1. Total money receipts - Include as total money receipts, income received from: (1) the sale of farm products, (2) participation in government farm programs such as payments for natural crop disasters, price supports, or incentive payments, (3) net income from custom farm work, (4) net income from recreational services provided by the farmer such as proceeds from hunting and fishing, or camping, and (5) commodity credit loans which were not repaid in 1994. 2. Farm operating expenses - Include as farm expenses the cost of feed, fertilizer, seeds, bulbs, plants, trees, sprays, insecticides, hardware, dairy supplies, tools, livestock purchases, rental of machinery, cash wages for farm hands, cash rent paid or cash profits paid to the owner, interest on farm mortgages, building repairs, depreciation on farm equipment, farm taxes, etc. 3. Sharecroppers and tenant farmers - Sharecropper and tenant farmers generally live on and farm land owned by another (landlord). Many types of arrangements can be made between the landlord and farmer by which the farmer receives payment. For example, the farmer may receive a specified share of the crop or the farmer may pay the landlord a predetermined amount. The landlord may extend credit to the farmer or pay advances on the farmer's share of the crop before the crop is harvested. Any cash or credit advances should be added to the amount of cash settlement (between farmer and landlord) on the crop to obtain net income. For persons 15 years old and over Housing allowances Housing allowances Housing allowances Housing allowances Housing allowances 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26c How much did ... receive in housing/accommodation allowances and rent payment from an employer? Include annual equivalent value of housing utilities if provided free. GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- If the person received a housing or accommodation allowance and rent payments from an employer, report the total amount here. For persons 15 years old and over Renting Renting Renting Renting Renting 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26d How much did ... earn from renting or leasing land or houses? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- If the person received payments from renting or leasing land or houses, but the total amount received during all of 2004 here. For persons 15 years old and over Interest income Interest income Interest income Interest income Interest income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26e How much did ... receive in interest, dividends, royalty income, or income from estates and trusts? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- 1.Interest - Money received or credited to a person's account by institutions such as a bank for the use of money. Notes, bonds, deposits in banks and savings and loan associations, credit unions, and postal savings certificates are the most common sources of interest. Include interest accruing to a savings account, regardless of whether the person actually withdrew the interest. 2. Dividends- Payments made by corporations and mutual funds to stockholders. 3. Net rental income - The total money received from the rental of property of real estate, or from roomers or boarders, less all rental expenses. a. Net income of property (including farm property) is cash rent received from property less the expenses incurred by the landlord in connection with the property. Expenses include depreciation, taxes, repairs, insurance, interest paid on mortgages, fees paid for a real estate agent's commissions, etc. b. Net rental income from roomers and boarders is the total cash receipts less all expenses, such as the cost of food served to boarders, laundry, share of the rent used to pay the wages of a housekeeper for cleaning, share of the rent used to pay for the house, (or the estimated share of the taxes, depreciation, interest, etc.). 4. Net royalty income - Include net royalties which consist of gross royalties less deductions. Gross royalties include income from oil, gas, and other mineral rights, income from patents, copyrights on literary works, trademarks, formulas, and so on. Deductions against gross royalties are made for depletion, depreciation, office rent, legal fees, clerical help, interest, taxes, and similar items. 5. Estates and trust funds - Periodic payments received from estate or trust fund. For persons 15 years old and over Pell grants Pell grants Pell grants Pell grants Pell grants 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26f How much did ... receive from Pell Grants or other educational grants and scholarships? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- If the person received money from Pell Grants or other educational grants and scholarships, but the total amount of all these payments in the space for 26e. If the grant was over a school year, put the total amount for the whole school year, even though only part of it was used in 2004. For persons 15 years old and over Social Security income Social Security income Social Security income Social Security income Social Security income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26g How much did ... receive in Social Security? Income payments to retired workers, dependents, and disabled workers. GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- 1. Include as Social Security, payments by the Federal government made under retirement, survivors, and disability insurance programs to retired persons, to dependents of deceased insured workers, or to disabled workers. 2. Some persons receiving Social Security checks will have already had the premiums for Medicare (health insurance) deducted from their checks. You should count the amount of these deducted health insurance premiums as income. During 1994 these deductions amounted to $31.90 per month per person. Include deductions for children and other household members who were also covered by Medicare, but do not receive Social Security checks. 3. If Social Security payments were increased in early 1990, be sure that the Social Security entry reflects the total amount of the previous monthly payments received during the calendar year 1994. 4. Include also in question 26g retirement, disability, and survivor benefit payments made under the Railroad Retirement Act. These payments are received in the form of checks from the U.S. Government. a. Married couples receiving joint check - Most married couples receiving Social Security or Railroad Retirement receive a joint amount in a single check. If the respondent can tell you how much is for each member, report these amounts separately for husband and wife. If not, report the total amount on the husband's page, and write "0" in question 26g on the wife's page. b. Benefit checks for childrenIf the person reports that he/she is receiving two Social Security checks, one for himself/herself and one for his/her children, follow the procedures outlined below: (1) If the individual amounts allotted to each child are unknown, include the total amount for the person to whom the check is made out. (2) If the individual amounts allotted to each person are known, enter these amounts on the appropriate page for each person 15 years old and over. Include any amounts for persons under 15 years old with the amount for the person to whom the check is made out. For persons 15 years old and over Retirement income Retirement income Retirement income Retirement income Retirement income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26h. How much did ... receive from retirement, survivor, or disability pensions? Include payments from companies, unions, Federal or FSM government, and U.S. military. GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- 1. Private pensions - Private retirement pensions include money received by a retired person or his or her survivors from a former employer or labor union, either directly or through an insurance company. 2. Government employee pensions - Include money received from retirement pensions paid by Federal, State, county, or other governmental agencies to former employees (including members of the Armed Forces) or their survivors. Include deductions - Monthly pension checks may already have taxes and/or health insurance premiums deducted. If the respondent gives a monthly amount, add any deductions that may have been made to obtain an accurate annual amount. 3. Disability pensions - Disability income is received by persons as the result of some severe and/or permanent illness, injury, or disability. Sources include worker's compensation; company or union disability; Federal, State, or local government disability; U.S. military retirement disability; accident or disability insurance; Black Lung miner's disability, etc. 4. Annuities - Annuities include money received periodically as a return on an investment wherein a person purchases the right to receive a monthly, annual, or other periodic income. Include also as annuities periodic payments from paid-up endowment policies and from life insurance policies. 5. IRA and KEOGH Plans - Include regular income from Individual Retirement Accounts (IRA) or KEOGH plans for individuals who are 59-1/2 years old and over or disabled. For persons 15 years old and over Public assistance income Public assistance income Public assistance income Public assistance income Public assistance income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26i How much did ... receive from government programs or other public assistance or welfare? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- If the person received any Public Assistance or Welfare benefits in 2004 report it in the space provided. For persons 15 years old and over Remittances inside FSM Remittances inside FSM Remittances inside FSM Remittances inside FSM Remittances inside FSM 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26j How much did ... receive from remittances from inside FSM? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- Include as remittances from other households on FSM received periodically (weekly, monthly, etc.) from persons outside the household, such as voluntary contributions by nonresident relatives or friends, money received by parents from children not living with them, and voluntary allotment checks sent by U.S. Armed Forces personnel to relatives not living with them. Exclude occasional gifts or contributions. For persons 15 years old and over Remittance outside FSM Remittance outside FSM Remittance outside FSM Remittance outside FSM Remittance outside FSM 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26k How much did ... receive from remittances from outside FSM? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- Include as remittances money from Hawaii or the U.S. Mainland received periodically (weekly, monthly, etc.) from persons outside the household, such as voluntary contributions by nonresident relatives or friends, money received by parents from children not living with them, and voluntary allotment checks sent by U.S. Armed Forces personnel to relatives not living with them. Exclude occasional gifts or contributions. For persons 15 years old and over Per diems Per diems Per diems Per diems Per diems 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26l How much did ... save from per diems or business trips paid for by others? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- If the person saved any money from any per diem or business trip paid for by the government or an employer, but the amount here. Remember that these income amounts are confidential and will NOT be reported to any tax office or the employer or the government. For persons 15 years old and over Other income Other income Other income Other income Other income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26m How much did ... receive from unemployment compensation, child support or alimony, or any other REGULAR source of income? Do NOT include lump-sum payments such as money from an inheritance or the sale of a home. GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- 1. Unemployment compensation - Unemployment compensation includes any money received in 1994 from State unemployment insurance funds, railroad unemployment benefits, strike benefits paid from union funds, and supplemental unemployment benefits paid by private companies (auto companies, etc.) to held replace wages during times of layoffs. This includes Federal Supplementary Compensation payments made by the Federal government to persons who have exhausted their state unemployment compensation payments. Also include money received for training allowances, transportation, and/or subsistence by persons undergoing classroom training provided through the JTPA (Job Training Partnership Act) which provides training for persons receiving welfare payments under Aid to Families with Dependent Children. This money and training will have been provided through the State or local government. 2. Child support - Child support is money received for the support of children not living with one parent as the result of a divorce or legal separation. In some cases, child support may be paid indirectly through the court. 3. Alimony - Include as alimony, money received periodi­cally after a divorce or legal separa­tion. 4. Any other source of income received regularly - Include under "any other source" the types of income described in sections (a) through (d) below. a. Assistance from private charities - Periodic income received from a private charitable organization such as the Red Cross, church, etc. b. Other regular contributions from persons not living in the household - Income as contributions, money received periodically (weekly, monthly, etc.) from persons outside the household, such as voluntary contributions by nonresident relatives or friends, money received by parents from children not living with them, and voluntary allotment checks sent by Armed Forces personnel to relatives not living with them. Exclude occasional gifts or contributions. c. Nonservice scholarships and fellowships - Cash scholarships, fellowships, or stipends received by students for which no service or work was required. d. Any other source - Include any other sources of money income received regularly but not specified in questions 26a through 26l. For persons 15 years old and over Gifts from inside FSM Gifts from inside FSM Gifts from inside FSM Gifts from inside FSM Gifts from inside FSM 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26n What was the total value of all gifts … received from inside the FSM, including gifts from family members in other households, traditional gifts, and election gifts? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- Report the amount of the value of all gifts received from relatives or friends inside the FSM, including traditional gifts and election gifts. Estimate the value of the gifts, and determine the sum of all the gifts, and report that in the space. For persons 15 years old and over Gifts from outside FSM Gifts from outside FSM Gifts from outside FSM Gifts from outside FSM Gifts from outside FSM 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26o What was the total value of all gifts … received from outside the FSM, including gifts from family members in other households, traditional gifts, and election gifts? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- Report the amount of the value of all gifts received from relatives or friends inside the FSM, including traditional gifts and election gifts. Estimate the value of the gifts, and determine the sum of all the gifts, and report that in the space. For persons 15 years old and over Total personal income Total personal income Total personal income Total personal income Total personal income Do not ask this question if 26a through 26o are complete. Instead, sum these entries and enter the amount below. What was ...'s total income in 2004? GENERAL INSTRUCTIONS FOR INCOME QUESTIONS 26 TO 27 1.CONVERT TO ANNUAL TOTAL Be sure that the dollar amounts represent the total amount received during the 12 months of 2004 for the particular type of income. If, for example, the amount is given in terms of a weekly or monthly payment, find out how many weeks or months it was received in 2004 and convert it to an annual total. 2.USE OF INCOME TAX FORM Accept answers from an income tax form if the person offers them. Do not, however, ask the respondent to refer to income tax forms. If an income tax form is used, make certain the amounts you enter for each person are for that person only; many income tax returns show the combined income of husband and wife. Also remind the respondent that certain types of income are not taxable (for example, unemployment compensation and public assistance). Ask whether the person received any such additional money income in 2004. If Form 1040 contains the combined income of husband and wife, find out what share was received by each person. 3.WHAT TO DO IF A RESPONDENT IS UNWILLING TO ANSWER INCOME QUESTIONS a.Stress Confidentiality If the respondent fears that the income data will be disclosed to other persons or to other government agencies, explain that you, as well as other census employees, are sworn to keep the answers confidential. The law provides penalties of imprisonment and fine for disclosures. Not even agents of the Federal Bureau of Investigation (FBI) or the Internal Revenue Service (IRS) can look at census records. Explain that data about individuals are never published; only statistical summaries of groups of people are published and only in a way that no individual can be identified. b.Explain Why Tax Returns Alone Are Not Enough If the respondent does not understand why the data cannot be obtained from income tax returns instead of being asked in the census, explain that the income data given on tax returns cannot be used to meet all statistical needs because not all people file returns and not all kinds of income are taxable (and hence are not reported on tax returns). Also, the tax returns do not show age, family relationship, education, and other items needed to study the social and economic status of the people of FSM. ----------------------------------------------------- Total income is the sum of all dollar amounts entered in questions 26a through 26o. If the person had no income in 2004 ("No" in questions 26a through 26o), write "0" in all of the boxes. If the net income in questions 26a and 26o or the sum total for question 27 was a loss, write "Loss" above the dollar amount. For persons 15 years old and over ESR ESR ESR ESR ESR 1 Civilian at work 2 Civilian with job,not at work 3 Unemployed 4 Military at work 5 Military not at work 6 Not in labor force, w/ subsistence work 7 Not in labor force, no substistence Person's Poverty level Person's Poverty level Person's Poverty level Person's Poverty level Person's Poverty level Not in universe 1 Below Poverty Line 2 Below Poverty Line 100 Above Poverty Line Subfamily number Subfamily number Subfamily number Subfamily number Subfamily number Subfamily relationship Subfamily relationship Subfamily relationship Subfamily relationship Subfamily relationship 1 Not in Subfamily 2 Married couple-no kids 3 Married couple & kids 4 Single parent 5 Child in married couple 6 Child in mother & child 7 Child in father & child 9 Missing Both parents in house Both parents in house Both parents in house Both parents in house Both parents in house 1 No parents in the house 2 1 parent in the house 3 both parents in the house Own children 0 to 5 Own children 0 to 5 Own children 0 to 5 Own children 0 to 5 Own children 0 to 5 Own children 6 to 17 Own children 6 to 17 Own children 6 to 17 Own children 6 to 17 Own children 6 to 17 Labor Force Status Labor Force Status Labor Force Status Labor Force Status Labor Force Status 1 At work less than 35 hours 2 At work 35 or more hours 3 Unemployed 4 Not in labor force, no subsistence 5 Subsistence only In Labor Force In Labor Force In Labor Force In Labor Force In Labor Force 1 Yes 2 No Age of last child Age of last child Age of last child Age of last child Age of last child Municipality Municipality Municipality Municipality Municipality B. Municipality 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak Enumeration District Enumeration District Enumeration District Enumeration District Enumeration District C. ED 1 ED002 2 ED005 3 ED008 4 ED011 5 ED013 6 ED014 7 ED019 8 ED024 9 ED027 10 ED028 11 ED030 12 ED038 13 ED044 14 ED047 15 ED001 16 ED007 17 ED029 18 ED034 19 ED040 20 ED045 21 ED061 22 ED164 23 ED055 24 ED083 25 ED067 26 ED073 27 ED079 28 ED092 29 ED100 30 ED106 31 ED112 32 ED117 33 ED123 34 ED145 35 ED160 36 ED050 37 ED057 38 ED060 39 ED068 40 ED072 41 ED080 42 ED085 43 ED096 44 ED105 45 ED111 46 ED116 47 ED012 48 ED017 49 ED023 50 ED032 51 ED043 52 ED065 53 ED090 54 ED003 55 ED006 56 ED010 57 ED016 58 ED021 Village Village Village Village Village D. Village Block Block Block Block Block E. Block (first three digits) Block A Block A Block A Block A Block A E. Block (fourth digit) Mapspot Mapspot Mapspot Mapspot Mapspot F1. Map Spot Household Number Household Number Household Number Household Number Household Number F2. Household No. All persons who occupy a housing unit and prepare their food together. Construction/repairs done Construction/repairs done Construction/repairs done Construction/repairs done Construction/repairs done These questions are on construction, maintenance, alterations or repairs done on your own or other units, including those you did yourself and those you paid someone to do. Section 2. Construction and Repairs (12-month recall period) 1. Yes 2. No In the last 12 months how much money did you spend on the following? If any item was charged over time, provide the monthly repayment. These questions have to do with construction, maintenance, alterations, or repairs done on this unit, including those done by household members, and those done by other people. All of the repairs must have been done in the LAST 12 MONTHS, so it is important to check receipts for materials and repairs. 1 YES 2 NO Appliances purchased Appliances purchased Appliances purchased Appliances purchased Appliances purchased Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Major Appliances 1. Yes 2. No Note the following about the consumer durables, furniture, electronic items, and recreation items: Section 3. Consumer Durables, furniture: These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. Include any item purchased by your household and given to another household. Major Appliances The following section is about major appliances purchased in the last 12 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Computer/related devices purchased Computer/related devices purchased Computer/related devices purchased Computer/related devices purchased Computer/related devices purchased Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Computers and related electronic devices 1. Yes 2. No Note the following about the consumer durables, furniture, electronic items, and recreation items: Section 3. Consumer Durables, furniture: These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. Include any item purchased by your household and given to another household. Computers and related electronic devices The following section is about computers and related electronic devices purchased in the last 12 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Electronic Goods puchased Electronic Goods puchased Electronic Goods puchased Electronic Goods puchased Electronic Goods puchased Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Electronic Goods 1. Yes 2. No Note the following about the consumer durables, furniture, electronic items, and recreation items: Section 3. Consumer Durables, furniture: These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. Include any item purchased by your household and given to another household. 3C. Electronic goods The following section is about electronic goods purchased in the last 12 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Household Furnishings purchased Household Furnishings purchased Household Furnishings purchased Household Furnishings purchased Household Furnishings purchased Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Household Furnishings and Operations 1. Yes 2. No Note the following about the consumer durables, furniture, electronic items, and recreation items: Section 3. Consumer Durables, furniture: These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. Include any item purchased by your household and given to another household. 3D. Household Furnishings and Floor Coverings The following section is about household furnishings and floor coverings purchased in the last 12 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Floor Coverings purchased Floor Coverings purchased Floor Coverings purchased Floor Coverings purchased Floor Coverings purchased Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Floor Coverings 1. Yes 2. No Note the following about the consumer durables, furniture, electronic items, and recreation items: Section 3. Consumer Durables, furniture: These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. Include any item purchased by your household and given to another household. 3D. Household Furnishings and Floor Coverings The following section is about household furnishings and floor coverings purchased in the last 12 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Sports, recreation and exercise equipment purchased Sports, recreation and exercise equipment purchased Sports, recreation and exercise equipment purchased Sports, recreation and exercise equipment purchased Sports, recreation and exercise equipment purchased These questions are about sports, recreation, and exercise equipment that you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Section 3a. Consumer Durables - Sports, Recreation, and Exercise Equipment (12-Month Recall Period) 1. Yes 2. No Note the following about the consumer durables, furniture, electronic items, and recreation items: Section 3. Consumer Durables, furniture: These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. Include any item purchased by your household and given to another household. 3E. Sports, Recreation, and Exercise Equipment The following section is about sports, recreation, and exercise equipment purchased in the last 12 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Small Applicances purchased Small Applicances purchased Small Applicances purchased Small Applicances purchased Small Applicances purchased Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Small Household Appliances 1. Yes 2. No PLEASE NOTE THAT THE ITEMS FOR WHICH YOU WILL BE GATHERING EXPENDITURE INFORMATION HAVE MUCH SMALLER EXPENDITURES AND BECAUSE OF THAT, THE REFERENCE PERIOD FOR THESE ITEMS ARE NOW 3 MONTHS RATHER THAN 12 MONTHS. BY CHANGING THE REFERENCE PERIOD FOR THESE ITEMS, IT WILL IMPROVE THE ACCURACY OF THE DATA PROVIDED BY THE HOUSEHOLD RESPONDENTS. Section 4 … Consumer Durables - Small Household Appliances, Tools and Household Goods and Services These questions are about household goods and services the respondent purchased in the last 3 months. Have them include anything they bought with a credit card or cash. The respondents provide the total purchase price and monthly repayments. 4A. Small Household Appliances The following section is about small household appliances purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Tools purchased Tools purchased Tools purchased Tools purchased Tools purchased Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Tools, Hardware and Supplies 1. Yes 2. No PLEASE NOTE THAT THE ITEMS FOR WHICH YOU WILL BE GATHERING EXPENDITURE INFORMATION HAVE MUCH SMALLER EXPENDITURES AND BECAUSE OF THAT, THE REFERENCE PERIOD FOR THESE ITEMS ARE NOW 3 MONTHS RATHER THAN 12 MONTHS. BY CHANGING THE REFERENCE PERIOD FOR THESE ITEMS, IT WILL IMPROVE THE ACCURACY OF THE DATA PROVIDED BY THE HOUSEHOLD RESPONDENTS. Section 4 … Consumer Durables - Small Household Appliances, Tools and Household Goods and Services These questions are about household goods and services the respondent purchased in the last 3 months. Have them include anything they bought with a credit card or cash. The respondents provide the total purchase price and monthly repayments. 4B. Tools, Hardware and Housekeeping Supplies The following section is about tools, hardware and housekeeping supplies purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Housekeeping Supplies purchased Housekeeping Supplies purchased Housekeeping Supplies purchased Housekeeping Supplies purchased Housekeeping Supplies purchased Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Housekeeping Supplies 1. Yes 2. No PLEASE NOTE THAT THE ITEMS FOR WHICH YOU WILL BE GATHERING EXPENDITURE INFORMATION HAVE MUCH SMALLER EXPENDITURES AND BECAUSE OF THAT, THE REFERENCE PERIOD FOR THESE ITEMS ARE NOW 3 MONTHS RATHER THAN 12 MONTHS. BY CHANGING THE REFERENCE PERIOD FOR THESE ITEMS, IT WILL IMPROVE THE ACCURACY OF THE DATA PROVIDED BY THE HOUSEHOLD RESPONDENTS. Section 4 … Consumer Durables - Small Household Appliances, Tools and Household Goods and Services These questions are about household goods and services the respondent purchased in the last 3 months. Have them include anything they bought with a credit card or cash. The respondents provide the total purchase price and monthly repayments. 4B. Tools, Hardware and Housekeeping Supplies The following section is about tools, hardware and housekeeping supplies purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Household Services purchased Household Services purchased Household Services purchased Household Services purchased Household Services purchased Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Services 1. Yes 2. No PLEASE NOTE THAT THE ITEMS FOR WHICH YOU WILL BE GATHERING EXPENDITURE INFORMATION HAVE MUCH SMALLER EXPENDITURES AND BECAUSE OF THAT, THE REFERENCE PERIOD FOR THESE ITEMS ARE NOW 3 MONTHS RATHER THAN 12 MONTHS. BY CHANGING THE REFERENCE PERIOD FOR THESE ITEMS, IT WILL IMPROVE THE ACCURACY OF THE DATA PROVIDED BY THE HOUSEHOLD RESPONDENTS. Section 4 … Consumer Durables - Small Household Appliances, Tools and Household Goods and Services These questions are about household goods and services the respondent purchased in the last 3 months. Have them include anything they bought with a credit card or cash. The respondents provide the total purchase price and monthly repayments. 1 YES 2 NO Household equipment repairs Household equipment repairs Household equipment repairs Household equipment repairs Household equipment repairs Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Equipment Repairs, Service Contracts, Furniture Repair, etc. 1. Yes 2. No PLEASE NOTE THAT THE ITEMS FOR WHICH YOU WILL BE GATHERING EXPENDITURE INFORMATION HAVE MUCH SMALLER EXPENDITURES AND BECAUSE OF THAT, THE REFERENCE PERIOD FOR THESE ITEMS ARE NOW 3 MONTHS RATHER THAN 12 MONTHS. BY CHANGING THE REFERENCE PERIOD FOR THESE ITEMS, IT WILL IMPROVE THE ACCURACY OF THE DATA PROVIDED BY THE HOUSEHOLD RESPONDENTS. Section 4 … Consumer Durables - Small Household Appliances, Tools and Household Goods and Services These questions are about household goods and services the respondent purchased in the last 3 months. Have them include anything they bought with a credit card or cash. The respondents provide the total purchase price and monthly repayments. 4D. Household Equipment Repairs, Service Contracts, Furniture Repair The following section is about household equipment repairs, service contracts, and furniture repair purchased in the last 3 months. Ask the respondents whether they purchased each item in the order listed. 1 YES 2 NO Male clothes purchase Male clothes purchase Male clothes purchase Male clothes purchase Male clothes purchase Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Men's and Boys' Apparel 1. Yes 2. No 5A. Men's and Boys' Apparel The following section is about men's and boys' apparel purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Female clothes purchase Female clothes purchase Female clothes purchase Female clothes purchase Female clothes purchase Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Women's apparel 1. Yes 2. No 5B. Women's apparel The following section is about women's apparel purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Footware purchased Footware purchased Footware purchased Footware purchased Footware purchased Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Footwear 1. Yes 2. No 5C. Footwear The following section is about footwear purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Baby items purchased Baby items purchased Baby items purchased Baby items purchased Baby items purchased Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Infants Clothing, Watches, Jewelry and Hairpieces 1. Yes 2. No 5D. Infants' Clothing, Watches, Jewelry, and Hairpieces The following section is about infants clothing, watches, jewelry and hairpieces purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Accessories purchased or rented Accessories purchased or rented Accessories purchased or rented Accessories purchased or rented Accessories purchased or rented Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Watches, Jewelry, Hairpieces, Clothing rental and storage 1. Yes 2. No 5D. Infants' Clothing, Watches, Jewelry, and Hairpieces The following section is about infants clothing, watches, jewelry and hairpieces purchased in the last 3 months. Ask the respondents whether they purchased each appliance in the order listed. 1 YES 2 NO Other items purchased Other items purchased Other items purchased Other items purchased Other items purchased Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Other items 1. Yes 2. No 5E. Other Items The following section is about any other items purchased in the last 3 months. Ask the respondents whether they purchased any other items that are not listed anywhere else. 1 YES 2 NO Medical items purchased Medical items purchased Medical items purchased Medical items purchased Medical items purchased Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Medicines and Medical Supplies 1. Yes 2. No 5F. Medicines and Medical Supplies The following section is about medicines and medical supplies purchased in the last 3 months. Ask the respondents whether they purchased item in the order listed. 1 YES 2 NO Vehicle registration/insurance/safety expense Vehicle registration/insurance/safety expense Vehicle registration/insurance/safety expense Vehicle registration/insurance/safety expense Vehicle registration/insurance/safety expense Section 6A. Transportation – Vehicle Registration/Insurance/Safety (12-Month Recall Period) The questions below concern the number and type of vehicles that are rented, leased or owned by each household member and the expenditures for each.. In the first column, please enter the type of vehicle, make and model. Include any vehicle in your household and that you pay fully for in another household. In this Section, vehicles include: cars, vans, trucks, motorbikes, boats or any other motor vehicles. In column 2, indicate vehicle category (rented, leased or purchased) by entering the number by a household member. Enter the appropriate expenditures for each vehicle in Columns 3, 4 and 5. Vehicles: Registration/Insurance/Safety Inspection. The following questions are about registration, insurance, and safety inspection fees on ALL vehicles including cars, trucks, motorbikes, boats (including separate outboard motor), or any other motor vehicle. 1. Yes 2. No Type of vehicle: Record whether at least one vehicle is present for the household. If no vehicles, mark “2” for no and go to section 6B. 1 YES 2 NO Vehicle maintenance and repairs Vehicle maintenance and repairs Vehicle maintenance and repairs Vehicle maintenance and repairs Vehicle maintenance and repairs The questions below concern vehicle maintenance costs and refers to the vehicles entered above (including maintenance of outboard motors). Enter information for each vehicle. Enter the type of vehicle, make and model. In columns 2, 3, and 4, enter the average monthly costs for each of the categories over the past 3 months. Section 6B. Transportation – Vehicle Maintenance and Repairs (3-Month Recall Period) 1. Yes 2. No Type of vehicle: Record whether at least one vehicle is present for the household. If no vehicles, mark “2” for no and go to section 6B. 1 YES 2 NO Insurance claims Insurance claims Insurance claims Insurance claims Insurance claims In the last 12 months have you received any money from an insurance policy for a vehicle which was "written off" or stolen? 1. Yes 2. No If anyone in this household sold a vehicle in the last 12 months, report that fact here. If yes, record 1, and ask the rest of the questions in this section. If no, record “2” for no, and go to Section 6B 1 Yes 2 No Month of insurance claim Month of insurance claim Month of insurance claim Month of insurance claim Month of insurance claim When did you receive the money? (Month) ___ ___ Record the month and year that the respondent received the money for the vehicle - that is, when the sale went through 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December Year of insurance claim Year of insurance claim Year of insurance claim Year of insurance claim Year of insurance claim When did you receive the money? (Year) ___ ___ ____ ____ Record the month and year that the respondent received the money for the vehicle - that is, when the sale went through Vehicle type - insurance claim Vehicle type - insurance claim Vehicle type - insurance claim Vehicle type - insurance claim Vehicle type - insurance claim Type of vehicle Report the type of vehicle using the codes in Section 6A 1 Car 2 Pick-up 3 Van 4 Motorbike 5 Boat 6 Other Net gain from insurance claim Net gain from insurance claim Net gain from insurance claim Net gain from insurance claim Net gain from insurance claim How much did you receive after paying off what was still owed? Report the amount received after paying off any remain loan(s) for the vehicle Vehicle purchase/rent/lease Vehicle purchase/rent/lease Vehicle purchase/rent/lease Vehicle purchase/rent/lease Vehicle purchase/rent/lease The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. Do not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Section 6C. Transportation - Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) 1. Yes 2. No If a vehicle, whether new or used, was purchased by any member of the household in the 12 months preceding the survey, fill in the information in Section 6C. 1 YES 2 NO Vehicle sales Vehicle sales Vehicle sales Vehicle sales Vehicle sales The questions below concern the sale by any household member of any vehicle (including an outboard motor) owned by a household member. Enter information for each vehicle. Enter the type of vehicle, make and model. Enter appropriate expenditures for each vehicle in Columns 3, 4 and 5. Section 6D. Transportation –Vehicle Sales (12-Month Recall Period) 1. Yes 2. No If a vehicle, whether new or used, was sold by any member of the household in the 12 months preceding the survey, fill in the information in Section 6D. 1 YES 2 NO Off-island travel Off-island travel Off-island travel Off-island travel Off-island travel Section 6E. Transportation - Off-Island Travel (12-Month Recall Period) In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? 1. Yes 2. No *Note that HH stands for "household member" and Non-HH for "non-household member". So, if the travel was for a household member circle the HH entry; if the travel was for a non-household member - someone not living in the household - circle the NHH. This block of questions concerns off-island travel during the 12 months before the survey. Record only personal travel. If anyone in the household traveled outside FSM during the last 12 months for personal reasons (that is, NOT for the government or for business purposes), and the household members had any personal expenses, record "1" for "Yes." If no one in the house traveled during the last 12 months, record "2" for "No." 1 YES 2 NO No. of off-island trips No. of off-island trips No. of off-island trips No. of off-island trips No. of off-island trips Section 6E. Transportation - Off-Island Travel (12-Month Recall Period) If YES, how many? If anyone in the household did travel during the last 12 months, record the total number of trips of all household members. Health insurance Health insurance Health insurance Health insurance Health insurance Section 7. Medical Care (12-Month Recall Period) Section 7A. Health Insurance: Are any of the household members currently paying for regular or supplemental health insurance? 1. Yes 2. No 1 YES 2 NO Doctor's fees Doctor's fees Doctor's fees Doctor's fees Doctor's fees Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor's Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? 1. Yes 2. No Ask whether any payments were made to General Practitioners or family doctors during the last 3 months. If yes, mark “1” in the box, and ask the questions for Section 7B. If no, record “2” in the box, and go on to Section 7C. 1 YES 2 NO Other health specialist's fees Other health specialist's fees Other health specialist's fees Other health specialist's fees Other health specialist's fees Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? 1. Yes 2. No Ask whether any payments were made to other health specialists (not General Practitioners or family doctors) during the last 3 months. If yes, mark “1” in the box, and ask the questions for Section 7C. If no, record “2” in the box, and go on to Section 7D. 1 YES 2 NO Medical institution expense Medical institution expense Medical institution expense Medical institution expense Medical institution expense Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? 1. Yes 2. No Ask whether any payments were made to hospitals, dispensaries, or nursing homes during the last 3 months. If yes, mark “1” in the box, and ask the questions for Section 7D. If no, record “2” in the box, and go on to Section 7E. 1 YES 2 NO Other health practitioncer's fees Other health practitioncer's fees Other health practitioncer's fees Other health practitioncer's fees Other health practitioncer's fees Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. 1. Yes 2. No Ask whether any payments were made to any other medical or other health practitioner during the last 3 months. If yes, mark “1” in the box, and ask the questions for Section 7E. If no, record “2” in the box, and go on to Section 8. 1 YES 2 NO Non-car loans Non-car loans Non-car loans Non-car loans Non-car loans Section 8. Loans (12-Month Recall Period) Section 8A. Loans - [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? 1. Yes 2. No This series of questions concerns loans. Note that the initial question asks about whether anyone in the household is making "regular payments for anything on rent-to-own purchase, personal or some other type of loans?" 1 YES 2 NO No. of non-car loans No. of non-car loans No. of non-car loans No. of non-car loans No. of non-car loans Section 8. Loans (12-Month Recall Period) Section 8A. Loans - [DO NOT include Car loans] If yes, how many loans do you have? Record the total of all loans outstanding, even if the household has more than three loans. Credit cards ownership Credit cards ownership Credit cards ownership Credit cards ownership Credit cards ownership Section 8B. Credit cards or charge accounts such as VISA? 1. Yes 2. No Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. If any household member used a credit card or had a credit account in the last 12 months, record "1" for yes, and then record how many total accounts all members of the household had during the last 12 months. Although only 3 accounts will be reported in detail, count all accounts for the "How many" box. If no one had an account, record "2" for "No." 1 YES 2 NO No. of credit cards No. of credit cards No. of credit cards No. of credit cards No. of credit cards Section 8B. Credit cards or charge accounts such as VISA? If Yes, how many? Report how many total accounts Education fees Education fees Education fees Education fees Education fees Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? 1. Yes 2. No Education fees do not include payments made by outside agencies such as Pell grant, loans, etc. - report only your out-of-pocket expenses. Questions on education expenses are asked for the whole housing unit at once, and for each level of education separately. Hence, you ask about expenses for colleges and universities, then for secondary school, then primary school, etc. 1 YES 2 NO Amount of education fees Amount of education fees Amount of education fees Amount of education fees Amount of education fees Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? If yes, how much? Miscellaneous expenses Miscellaneous expenses Miscellaneous expenses Miscellaneous expenses Miscellaneous expenses Section 10. Miscellaneous Expenses (12-Month Recall Period) 1. Yes 2. No In this section enter the amount spent by all household members for each of these categories in the past 12 months 1 YES 2 NO Municipality Municipality Municipality Municipality Municipality B. Municipality 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak Enumeration District Enumeration District Enumeration District Enumeration District Enumeration District C. ED Village Village Village Village Village D. Village Block Block Block Block Block E. Block (first three digits) Block A Block A Block A Block A Block A E. Block (fourth digit) Mapspot Mapspot Mapspot Mapspot Mapspot F1. Map Spot Household Number Household Number Household Number Household Number Household Number F2. Household No. All persons who occupy a housing unit and prepare their food together. Household record no. Household record no. Household record no. Household record no. Household record no. Record number indicator for the household. Construction activity Construction activity Construction activity Construction activity Construction activity Section 2. Construction and Repairs (12-month recall period) These questions are on construction, maintenance, alterations or repairs done on your own or other units, including those you did yourself and those you paid someone to do. In the last 12 months how much money did you spend on the following? If any item was charged over time, provide the monthly repayment. Item 201 Dwelling under construction 202 Building addition like extra room, porch 203 Remodeling one or more rooms 204 Remodeling or renovating one or more outside rooms 205 Repairing roof or gutters 206 Landscaping and yard maintenance 207 Air conditioning 208 Outside improvements like fence, driveway 209 Plumbing or water heater installation/repair 210 Electrical repairs or improvements 211 Install, repair, replace window panes, screens 212 Hurricane shutters 213 Other improvement or repairs Total cost - construction activity Total cost - construction activity Total cost - construction activity Total cost - construction activity Total cost - construction activity Section 2. Construction and Repairs (12-month recall period) These questions are on construction, maintenance, alterations or repairs done on your own or other units, including those you did yourself and those you paid someone to do. In the last 12 months how much money did you spend on the following? If any item was charged over time, provide the monthly repayment. Total Spent Monthly payment - construction activity Monthly payment - construction activity Monthly payment - construction activity Monthly payment - construction activity Monthly payment - construction activity Section 2. Construction and Repairs (12-month recall period) These questions are on construction, maintenance, alterations or repairs done on your own or other units, including those you did yourself and those you paid someone to do. In the last 12 months how much money did you spend on the following? If any item was charged over time, provide the monthly repayment. Monthly payment Appliance Appliance Appliance Appliance Appliance Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Major Appliances Item 301 Stove/range/oven (electric) 302 Stove/range/oven (gas) 303 Range hood exhaust fan 304 Refrigerator 305 Freezer 306 Dishwasher 307 Garbage disposal 308 Radio (all types) 309 Microwave oven 310 Washing machine 311 Clothes dryer 312 Generator 313 Water heater 314 Air conditioner 315 Rice Cooker 316 Sewing machine 317 Other major appliances Condition - appliance Condition - appliance Condition - appliance Condition - appliance Condition - appliance Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Major Appliances 1. New 2. Used 1 New 2 Used Cost - appliance Cost - appliance Cost - appliance Cost - appliance Cost - appliance Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Major Appliances Total Spent Monthly payment - appliance Monthly payment - appliance Monthly payment - appliance Monthly payment - appliance Monthly payment - appliance Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Major Appliances Monthly payment Computer related device Computer related device Computer related device Computer related device Computer related device Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Computers and related electronic devices Item 321 Home computer 322 Combination printer/fax … 323 Copier 324 Fax 325 Printer/photo printer 326 CD/DVD burner 327 Floppy disks/CDs/DVDs 328 External memory/hard disk 329 Scanner 330 Software and accessories 331 Other computer equipment 332 Digital camera 333 Non-digital camera 334 Photo accessories Condition - computer related device Condition - computer related device Condition - computer related device Condition - computer related device Condition - computer related device Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Computers and related electronic devices 1. New 2. Used 1 New 2 Used Total cost - computer related device Total cost - computer related device Total cost - computer related device Total cost - computer related device Total cost - computer related device Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Computers and related electronic devices Total Spent Monthly payment - computer related device Monthly payment - computer related device Monthly payment - computer related device Monthly payment - computer related device Monthly payment - computer related device Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Computers and related electronic devices Monthly payment Electronic good Electronic good Electronic good Electronic good Electronic good Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Electronic Goods Item 341 Television 343 Video cassettes recorder (VCR) or combination DVD/VCR 344 DVD player 345 Satellite dishes 346 Camcorder/video recorder 347 Video machine (e.g. X-box) 349 Home stereo and or entertainment system 350 Cassette player/Tape recorders 351 CD Player 352 Speakers or Surround-sound speakers 353 Other audio and or video equipment 354 Portable video games (Gameboy) 355 Car audio and/or video equipment & installation 356 Telephones/answering machines 357 Cell/cellular/text telephones 358 Karaoke/karaoke microphone 359 Typewriters/calculator/other office machine 360 Pager 361 Other electronic equipment 362 Personal Digital assistant (PDA), palm pilotcorder Condition - electronic good Condition - electronic good Condition - electronic good Condition - electronic good Condition - electronic good Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Electronic Goods 1. New 2. Used 1 New 2 Used Total cost - electronic good Total cost - electronic good Total cost - electronic good Total cost - electronic good Total cost - electronic good Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Electronic Goods Total Spent Monthly payment - electronic good Monthly payment - electronic good Monthly payment - electronic good Monthly payment - electronic good Monthly payment - electronic good Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Electronic Goods Monthly payment Furniture Furniture Furniture Furniture Furniture Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Household Furnishings and Operations Item 371 Bedroom furniture 372 Living room, kitchen furniture 373 Dining room furniture 374 Kitchen furniture 375 Other furniture Condition - furniture Condition - furniture Condition - furniture Condition - furniture Condition - furniture Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Household Furnishings and Operations 1. New 2. Used 1 New 2 Used Total cost - furniture Total cost - furniture Total cost - furniture Total cost - furniture Total cost - furniture Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Household Furnishings and Operations Total Spent Monthly payment - furniture Monthly payment - furniture Monthly payment - furniture Monthly payment - furniture Monthly payment - furniture Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Household Furnishings and Operations Monthly Payment Floor covering Floor covering Floor covering Floor covering Floor covering Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Floor Coverings Item 381 Rugs, carpets, etc. 382 Linoleum (hard surface) 383 Woven mats 384 Other floor coverings Condition - Floor covering Condition - Floor covering Condition - Floor covering Condition - Floor covering Condition - Floor covering Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Floor Coverings 1. New 2. Used 1 New 2 Used Total cost - Floor covering Total cost - Floor covering Total cost - Floor covering Total cost - Floor covering Total cost - Floor covering Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Floor Coverings Total Spent Monthly payment - Floor covering Monthly payment - Floor covering Monthly payment - Floor covering Monthly payment - Floor covering Monthly payment - Floor covering Section 3. Consumer Durables, Furniture, Electronic Items and Recreation Items (12-month recall period) These questions are about household items you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Floor Coverings Monthly Payment Recreation equipment Recreation equipment Recreation equipment Recreation equipment Recreation equipment Section 3a. Consumer Durables - Sports, Recreation, and Exercise Equipment (12-Month Recall Period) These questions are about sports, recreation, and exercise equipment that you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Item 390 Health and exercise equipment 391 Camping equipment 392 Hunting/fishing equipment 393 Water sports equipment 394 Automobile custom accessories (e.g., custom wheels) 395 Bicycles/tricycles 396 Golf and golfing equipment 397 Tennis rackets & equipment 398 Other sporting goods/equipment 399 Acoustic/electric musical equip Condition - recreation equipment Condition - recreation equipment Condition - recreation equipment Condition - recreation equipment Condition - recreation equipment Section 3a. Consumer Durables - Sports, Recreation, and Exercise Equipment (12-Month Recall Period) These questions are about sports, recreation, and exercise equipment that you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. 1. New 2. Used 1 New 2 Used Total cost - recreation equipment Total cost - recreation equipment Total cost - recreation equipment Total cost - recreation equipment Total cost - recreation equipment Section 3a. Consumer Durables - Sports, Recreation, and Exercise Equipment (12-Month Recall Period) These questions are about sports, recreation, and exercise equipment that you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Total Spent Monthly payment - recreation equipment Monthly payment - recreation equipment Monthly payment - recreation equipment Monthly payment - recreation equipment Monthly payment - recreation equipment Section 3a. Consumer Durables - Sports, Recreation, and Exercise Equipment (12-Month Recall Period) These questions are about sports, recreation, and exercise equipment that you purchased in the last 12 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Monthly payment Small appliance Small appliance Small appliance Small appliance Small appliance Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Small Household Appliances Item 401 Small electric kitchen appliances (e.g., toaster, toaster oven) 402 Electric personal care appliances (electric razor, hair dryer) 403 Water dispenser 404 Electric floor cleaning equipment 405 Other small appliances Condition - small appliance Condition - small appliance Condition - small appliance Condition - small appliance Condition - small appliance Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Small Household Appliances 1. New 2. Used 1 New 2 Used Total Cost - small appliance Total Cost - small appliance Total Cost - small appliance Total Cost - small appliance Total Cost - small appliance Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Small Household Appliances Total Spent Monthly payment - small appliance Monthly payment - small appliance Monthly payment - small appliance Monthly payment - small appliance Monthly payment - small appliance Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Small Household Appliances Monthly payment Tools Tools Tools Tools Tools Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Tools, Hardware and Supplies Item 411 Lawn mower 412 Weed wacker/bush cutter 413 Chain saw 415 Other hand tools (electric or battery power) 416 Other hand tools (non-power) 418 Outdoor equip. and supplies 419 Other hardware/supplies 420 Kitchen utencils 421 Firearms Condition - tools Condition - tools Condition - tools Condition - tools Condition - tools Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Tools, Hardware and Supplies 1. New 2. Used 1 New 2 Used Total cost - tools Total cost - tools Total cost - tools Total cost - tools Total cost - tools Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Tools, Hardware and Supplies Total Spent Monthly payment - tools Monthly payment - tools Monthly payment - tools Monthly payment - tools Monthly payment - tools Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Tools, Hardware and Supplies Monthly payment Housekeeping supplies Housekeeping supplies Housekeeping supplies Housekeeping supplies Housekeeping supplies Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Housekeeping Supplies Item 421 Household cleaning products 422 Household paper products 423 Other housekeeping supplies 424 Misc. Housekeeping supplies Condition - housekeeping supplies Condition - housekeeping supplies Condition - housekeeping supplies Condition - housekeeping supplies Condition - housekeeping supplies Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Housekeeping Supplies 1. New 2. Used 1 New 2 Used Total cost - housekeeping supplies Total cost - housekeeping supplies Total cost - housekeeping supplies Total cost - housekeeping supplies Total cost - housekeeping supplies Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Housekeeping Supplies Total Spent Monthly payment - housekeeping supplies Monthly payment - housekeeping supplies Monthly payment - housekeeping supplies Monthly payment - housekeeping supplies Monthly payment - housekeeping supplies Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Housekeeping Supplies Monthly payment Household Service Household Service Household Service Household Service Household Service Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Services 425 Housekeeping services 426 Cooking services 427 Driving services 428 Moving, storage, freight services 429 Repair of household items 430 Other household services Household Service new/used Household Service new/used Household Service new/used Household Service new/used Household Service new/used Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Services 1. New 2. Used 1 New 2 Used Household Service Total cost Household Service Total cost Household Service Total cost Household Service Total cost Household Service Total cost Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Services Total Spent Household Service monthly payment Household Service monthly payment Household Service monthly payment Household Service monthly payment Household Service monthly payment Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Services Monthly payment HH equipment repair HH equipment repair HH equipment repair HH equipment repair HH equipment repair Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Equipment Repairs, Service Contracts, Furniture Repair, etc. Item 431 Kitchen appliances repair 432 Electronic items repair 433 Computer or related items repair 434 Lawn equipment repair 435 Hand or power tools repair 436 Photographic items repair 437 Sport/recreational equip repair 438 Termites or pest control services 439 Service contracts for appliances 440 Service contracts, electronic goods 441 Service contracts for computers 442 Furniture repair 443 Other household goods repairs Condition - HH equipment repair Condition - HH equipment repair Condition - HH equipment repair Condition - HH equipment repair Condition - HH equipment repair Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Equipment Repairs, Service Contracts, Furniture Repair, etc. 1. New 2. Used 1 New 2 Used Total cost - HH equipment repair Total cost - HH equipment repair Total cost - HH equipment repair Total cost - HH equipment repair Total cost - HH equipment repair Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Equipment Repairs, Service Contracts, Furniture Repair, etc. Total Spent Monthly payment - HH equipment repair Monthly payment - HH equipment repair Monthly payment - HH equipment repair Monthly payment - HH equipment repair Monthly payment - HH equipment repair Section 4. Consumer Durables - Small Household Appliances, Tools & Household Goods & Services (12-Month Recall Period) Household Equipment Repairs, Service Contracts, Furniture Repair, etc. Monthly payment Male apparel Male apparel Male apparel Male apparel Male apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Men's and Boys' Apparel Item 501 Men's suits 502 Men's dress shirts 503 Men's casual shirts/tee shirts 504 Men's pants/shorts 505 Men’s accessories (belts, suspenders, underwear, etc) 506 Other men's apparel 507 Boys' pants/shorts, including uniforms 508 Other boys’ apparel Condition - male apparel Condition - male apparel Condition - male apparel Condition - male apparel Condition - male apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Men's and Boys' Apparel 1. New 2. Used 1 New 2 Used Total cost - male apparel Total cost - male apparel Total cost - male apparel Total cost - male apparel Total cost - male apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Men's and Boys' Apparel Total Spent Monthly payment - male apparel Monthly payment - male apparel Monthly payment - male apparel Monthly payment - male apparel Monthly payment - male apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Men's and Boys' Apparel Monthly payment Female apparel Female apparel Female apparel Female apparel Female apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Women's apparel Item 511 Women's outerwear 512 Women's dresses 513 Women's suits and separates 514 Women's underwear, nightwear, 515 Women’s accessories (belts, scarfs,etc) 516 Other women's apparel 517 Girls' dresses and other apparel, including uniforms 518 Other girls’ accessories Condition - female apparel Condition - female apparel Condition - female apparel Condition - female apparel Condition - female apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Women's apparel 1. New 2. Used 1 New 2 Used Total cost - female apparel Total cost - female apparel Total cost - female apparel Total cost - female apparel Total cost - female apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Women's apparel Total Spent Monthly payment - female apparel Monthly payment - female apparel Monthly payment - female apparel Monthly payment - female apparel Monthly payment - female apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Women's apparel Monthly payment Shoes Shoes Shoes Shoes Shoes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Footwear Item 521 Men's footwear 522 Boys' footwear 523 Girls' footwear 524 Women’s footwear 525 Infant’s/toddler’s footwear Condition - Shoes Condition - Shoes Condition - Shoes Condition - Shoes Condition - Shoes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Footwear 1. New 2. Used 1 New 2 Used Total cost - Shoes Total cost - Shoes Total cost - Shoes Total cost - Shoes Total cost - Shoes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Footwear Total Spent Monthly payment - Shoes Monthly payment - Shoes Monthly payment - Shoes Monthly payment - Shoes Monthly payment - Shoes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Footwear Monthly payment Baby clothes Baby clothes Baby clothes Baby clothes Baby clothes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Infants Clothing, Watches, Jewelry and Hairpieces Item 531 Infant’s coats or jackets 532 Infant’s dresses 533 Other infants clothing 534 Infant’s diapers Condition - Baby clothes Condition - Baby clothes Condition - Baby clothes Condition - Baby clothes Condition - Baby clothes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Infants Clothing, Watches, Jewelry and Hairpieces 1. New 2. Used 1 New 2 Used Total cost - Baby clothes Total cost - Baby clothes Total cost - Baby clothes Total cost - Baby clothes Total cost - Baby clothes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Infants Clothing, Watches, Jewelry and Hairpieces Total Spent Monthly payment - Baby clothes Monthly payment - Baby clothes Monthly payment - Baby clothes Monthly payment - Baby clothes Monthly payment - Baby clothes Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Infants Clothing, Watches, Jewelry and Hairpieces Monthly payments Miscellaneous apparel Miscellaneous apparel Miscellaneous apparel Miscellaneous apparel Miscellaneous apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Watches, Jewelry, Hairpieces, Clothing rental and storage Item 541 Watches 542 Jewelry 543 Hairpieces or wigs 544 Sewing materials to make clothes 545 Other sewing materials 546 Clothing services 547 Clothing repair, altering, tailoring 548 Shoe repair 549 Watch or jewelry repair 550 Clothing rental 551 Clothing storage 552 Other items Condition - Miscellaneous apparel Condition - Miscellaneous apparel Condition - Miscellaneous apparel Condition - Miscellaneous apparel Condition - Miscellaneous apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Watches, Jewelry, Hairpieces, Clothing rental and storage 1. New 2. Used 1 New 2 Used Total cost - Miscellaneous apparel Total cost - Miscellaneous apparel Total cost - Miscellaneous apparel Total cost - Miscellaneous apparel Total cost - Miscellaneous apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Watches, Jewelry, Hairpieces, Clothing rental and storage Total Spent Monthly payment - Miscellaneous apparel Monthly payment - Miscellaneous apparel Monthly payment - Miscellaneous apparel Monthly payment - Miscellaneous apparel Monthly payment - Miscellaneous apparel Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Watches, Jewelry, Hairpieces, Clothing rental and storage Monthly payment Other items Other items Other items Other items Other items Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Other items Item Condition - Other items Condition - Other items Condition - Other items Condition - Other items Condition - Other items Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Other items 1. New 2. Used 1 New 2 Used Total cost - Other items Total cost - Other items Total cost - Other items Total cost - Other items Total cost - Other items Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Other items Total Spent Monthly payment - Other items Monthly payment - Other items Monthly payment - Other items Monthly payment - Other items Monthly payment - Other items Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Other items Monthly payment Medicines Medicines Medicines Medicines Medicines Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Medicines and Medical Supplies Item 561 Prescription drugs 562 Non-prescription drugs 563 Bandages/Band-Aids, etc. 564 Prescription eyeglasses/contact lens 565 Non-Prescription eyeglasses 566 Other medical supplies 568 Contact lenses 569 Sunglasses Condition - Medicines Condition - Medicines Condition - Medicines Condition - Medicines Condition - Medicines Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Medicines and Medical Supplies 1. New 2. Used 1 New 2 Used Total cost - Medicines Total cost - Medicines Total cost - Medicines Total cost - Medicines Total cost - Medicines Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Medicines and Medical Supplies Total Spent Monthly payment - Medicines Monthly payment - Medicines Monthly payment - Medicines Monthly payment - Medicines Monthly payment - Medicines Section 5. Consumer Non-Durables - Apparel (12-Month Recall Period) These questions are about apparel items you purchased in the last 3 months. Please include anything bought with a credit card or cash. If any item was charged over time, provide the monthly repayment. Include any item purchased by your household and given to someone else or to another household. Medicines and Medical Supplies Monthly payment Vehicle Vehicle Vehicle Vehicle Vehicle Section 6A. Transportation – Vehicle Registration/Insurance/Safety (12-Month Recall Period) The questions below concern the number and type of vehicles that are rented, leased or owned by each household member and the expenditures for each. In the first column, please enter the type of vehicle, make and model. Include any vehicle in your household and that you pay fully for in another household. In this Section, vehicles include: cars, vans, trucks, motorbikes, boats or any other motor vehicles. In column 2, indicate vehicle category (rented, leased or purchased) by entering the number by a household member. Enter the appropriate expenditures for each vehicle in Columns 3, 4 and 5. Type of Vehicle, Make and Model At least one vehicle: 1 Car 2 Pick-up 3 Van 4 Motorbike 5 Boat 6 Others Status - Vehicle Status - Vehicle Status - Vehicle Status - Vehicle Status - Vehicle Section 6A. Transportation – Vehicle Registration/Insurance/Safety (12-Month Recall Period) The questions below concern the number and type of vehicles that are rented, leased or owned by each household member and the expenditures for each. In the first column, please enter the type of vehicle, make and model. Include any vehicle in your household and that you pay fully for in another household. In this Section, vehicles include: cars, vans, trucks, motorbikes, boats or any other motor vehicles. In column 2, indicate vehicle category (rented, leased or purchased) by entering the number by a household member. Enter the appropriate expenditures for each vehicle in Columns 3, 4 and 5. Rented = 1 Leased = 2 Purchased = 3 1 Rented 2 Leased 3 Purchased Amount for registration - Vehicle Amount for registration - Vehicle Amount for registration - Vehicle Amount for registration - Vehicle Amount for registration - Vehicle Section 6A. Transportation – Vehicle Registration/Insurance/Safety (12-Month Recall Period) The questions below concern the number and type of vehicles that are rented, leased or owned by each household member and the expenditures for each. In the first column, please enter the type of vehicle, make and model. Include any vehicle in your household and that you pay fully for in another household. In this Section, vehicles include: cars, vans, trucks, motorbikes, boats or any other motor vehicles. In column 2, indicate vehicle category (rented, leased or purchased) by entering the number by a household member. Enter the appropriate expenditures for each vehicle in Columns 3, 4 and 5. Registration Amount for insurance premium - Vehicle Amount for insurance premium - Vehicle Amount for insurance premium - Vehicle Amount for insurance premium - Vehicle Amount for insurance premium - Vehicle Section 6A. Transportation – Vehicle Registration/Insurance/Safety (12-Month Recall Period) The questions below concern the number and type of vehicles that are rented, leased or owned by each household member and the expenditures for each. In the first column, please enter the type of vehicle, make and model. Include any vehicle in your household and that you pay fully for in another household. In this Section, vehicles include: cars, vans, trucks, motorbikes, boats or any other motor vehicles. In column 2, indicate vehicle category (rented, leased or purchased) by entering the number by a household member. Enter the appropriate expenditures for each vehicle in Columns 3, 4 and 5. Insurance Premium Amount for safety inspection - Vehicle Amount for safety inspection - Vehicle Amount for safety inspection - Vehicle Amount for safety inspection - Vehicle Amount for safety inspection - Vehicle Section 6A. Transportation – Vehicle Registration/Insurance/Safety (12-Month Recall Period) The questions below concern the number and type of vehicles that are rented, leased or owned by each household member and the expenditures for each. In the first column, please enter the type of vehicle, make and model. Include any vehicle in your household and that you pay fully for in another household. In this Section, vehicles include: cars, vans, trucks, motorbikes, boats or any other motor vehicles. In column 2, indicate vehicle category (rented, leased or purchased) by entering the number by a household member. Enter the appropriate expenditures for each vehicle in Columns 3, 4 and 5. Safety Inspection 6b Vehicle 6b Vehicle 6b Vehicle 6b Vehicle 6b Vehicle Section 6B. Transportation – Vehicle Maintenance and Repairs (3-Month Recall Period) The questions below concern vehicle maintenance costs and refers to the vehicles entered above (including maintenance of outboard motors). Enter information for each vehicle. Enter the type of vehicle, make and model. In columns 2, 3, and 4, enter the average monthly costs for each of the categories over the past 3 months. Type of Vehicle, Make and Model At least one vehicle: 1 Car 2 Pick-up 3 Van 4 Motorbike 5 Boat 6 Others Repair cost - Vehicle Repair cost - Vehicle Repair cost - Vehicle Repair cost - Vehicle Repair cost - Vehicle Section 6B. Transportation – Vehicle Maintenance and Repairs (3-Month Recall Period) The questions below concern vehicle maintenance costs and refers to the vehicles entered above (including maintenance of outboard motors). Enter information for each vehicle. Enter the type of vehicle, make and model. In columns 2, 3, and 4, enter the average monthly costs for each of the categories over the past 3 months. Repair costs Specify type of repair Monthly gas - Vehicle Monthly gas - Vehicle Monthly gas - Vehicle Monthly gas - Vehicle Monthly gas - Vehicle Section 6B. Transportation – Vehicle Maintenance and Repairs (3-Month Recall Period) The questions below concern vehicle maintenance costs and refers to the vehicles entered above (including maintenance of outboard motors). Enter information for each vehicle. Enter the type of vehicle, make and model. In columns 2, 3, and 4, enter the average monthly costs for each of the categories over the past 3 months. Average monthly gasoline Monthly oil - Vehicle Monthly oil - Vehicle Monthly oil - Vehicle Monthly oil - Vehicle Monthly oil - Vehicle Section 6B. Transportation – Vehicle Maintenance and Repairs (3-Month Recall Period) The questions below concern vehicle maintenance costs and refers to the vehicles entered above (including maintenance of outboard motors). Enter information for each vehicle. Enter the type of vehicle, make and model. In columns 2, 3, and 4, enter the average monthly costs for each of the categories over the past 3 months. Average monthly cost of oil/other liquids New vehicle New vehicle New vehicle New vehicle New vehicle Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Type of Vehicle, Make and Model At least one vehicle: 1 Car 2 Pick-up 3 Van 4 Motorbike 5 Boat 6 Others Status - new vehicle Status - new vehicle Status - new vehicle Status - new vehicle Status - new vehicle Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Purchase=1 Rented = 2 Leased = 3 1 Rented 2 Leased 3 Purchased Condition - new vehicle Condition - new vehicle Condition - new vehicle Condition - new vehicle Condition - new vehicle Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. New = 1 Used = 2 1 New 2 Used Total cost - new vehicle Total cost - new vehicle Total cost - new vehicle Total cost - new vehicle Total cost - new vehicle Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Total Cost Down payment - new vehicle Down payment - new vehicle Down payment - new vehicle Down payment - new vehicle Down payment - new vehicle Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Down Payment in the past 12 months Monthly payment - new vehicle Monthly payment - new vehicle Monthly payment - new vehicle Monthly payment - new vehicle Monthly payment - new vehicle Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Monthly payment Sales Sales Sales Sales Sales Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Type of Vehicle, Make and Model At least one vehicle: 1 Car 2 Pick-up 3 Van 4 Motorbike 5 Boat 6 Others Total Price - Sales Total Price - Sales Total Price - Sales Total Price - Sales Total Price - Sales Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Total Selling Price Downpayment - Sales Downpayment - Sales Downpayment - Sales Downpayment - Sales Downpayment - Sales Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Down Payment in the past 12 months Monthly income - Sales Monthly income - Sales Monthly income - Sales Monthly income - Sales Monthly income - Sales Section 6C. Transportation – Vehicle Purchasing/Renting/Leasing (12-Month Recall Period) The questions below concern the expenditures that household members spent on renting, leasing or purchasing vehicles (including outboard motors). Entries should be made for each vehicle. DO not include vehicles or boats rented or leased by a business or employer. Enter the type of vehicle, make and model. In column 2, enter the appropriate category. In column 3, indicate whether the vehicle is new or used. Complete the total cost in column 4, the down payment if it occurred in the previous 12 months in column 5, and the monthly payment in column 6. Monthly payment from buyer to seller Destination Destination Destination Destination Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Destination Traveller - Destination Traveller - Destination Traveller - Destination Traveller - Destination Traveller - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. HH / non-HH* *Note that HH stands for “household member” and Non-HH for “non-household member”. So, if the travel was for a household member circle the HH entry; if the travel was for a non-household member – someone not living in the household – circle the NHH. 1 Household member 2 Non Household member Mode of travel - Destination Mode of travel - Destination Mode of travel - Destination Mode of travel - Destination Mode of travel - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Fares 1. Air 2. Other 1 Air 2 Other Fare - Destination Fare - Destination Fare - Destination Fare - Destination Fare - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Fares $ Accommodation - Destination Accommodation - Destination Accommodation - Destination Accommodation - Destination Accommodation - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Accommodation 1. Hotel/Motel 2. Other 1 Hotel 2 Other Cost of accommodation - Destination Cost of accommodation - Destination Cost of accommodation - Destination Cost of accommodation - Destination Cost of accommodation - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Accommodation $ Other expense 1 - Destination Other expense 1 - Destination Other expense 1 - Destination Other expense 1 - Destination Other expense 1 - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Other expenses (specify) 1 Other expense 2 - Destination Other expense 2 - Destination Other expense 2 - Destination Other expense 2 - Destination Other expense 2 - Destination Section 6E. Transportation – Off-Island Travel (12-Month Recall Period) Off-Island Travel: In the last 12 months, has any household member had any expenses related to any off-island trips, excluding business trips? If yes, enter the destination, round-trip fare, accommodation and other expenditures. Record the Island/Municipal in the FSM if travel was within the FSM, the US State, or foreign country if outside FSM. Other expenses (specify) 2 Health insurance Health insurance Health insurance Health insurance Health insurance Section 7. Medical Care (12-Month Recall Period) Section 7A. Health Insurance: Health Insurance Company/Plan Name No. covered - Health insurance No. covered - Health insurance No. covered - Health insurance No. covered - Health insurance No. covered - Health insurance Section 7. Medical Care (12-Month Recall Period) Section 7A. Health Insurance: Number of persons in this household covered? Amount of last payment - Health insurance Amount of last payment - Health insurance Amount of last payment - Health insurance Amount of last payment - Health insurance Amount of last payment - Health insurance Section 7. Medical Care (12-Month Recall Period) Section 7A. Health Insurance: Last payment amount Last payment period covered - Health insurance Last payment period covered - Health insurance Last payment period covered - Health insurance Last payment period covered - Health insurance Last payment period covered - Health insurance Section 7. Medical Care (12-Month Recall Period) Section 7A. Health Insurance: Period covered: (1) weekly, (2) biweekly (3) monthly (4) other 1 Weekly, 2 Biweekly 3 Monthly 4 Other Amount charged off - Health insurance Amount charged off - Health insurance Amount charged off - Health insurance Amount charged off - Health insurance Amount charged off - Health insurance Section 7. Medical Care (12-Month Recall Period) Section 7A. Health Insurance: How much is charged to a business/refunded? Doctor Doctor Doctor Doctor Doctor Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor’s Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? If yes, please enter type of service, gross payment or co-payment, any refund and net payment below. Name of doctor/provider Treatment - Doctor Treatment - Doctor Treatment - Doctor Treatment - Doctor Treatment - Doctor Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor’s Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? If yes, please enter type of service, gross payment or co-payment, any refund and net payment below. Type of treatment Fee - Doctor Fee - Doctor Fee - Doctor Fee - Doctor Fee - Doctor Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor’s Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? If yes, please enter type of service, gross payment or co-payment, any refund and net payment below. Doctor’s total charge Paid by patient - Doctor Paid by patient - Doctor Paid by patient - Doctor Paid by patient - Doctor Paid by patient - Doctor Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor’s Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? If yes, please enter type of service, gross payment or co-payment, any refund and net payment below. Patient payment/ co-payment Paid by insurance - Doctor Paid by insurance - Doctor Paid by insurance - Doctor Paid by insurance - Doctor Paid by insurance - Doctor Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor’s Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? If yes, please enter type of service, gross payment or co-payment, any refund and net payment below. Part paid by insurance or party Location - Doctor Location - Doctor Location - Doctor Location - Doctor Location - Doctor Section 7. Medical Care (12-Month Recall Period) Section 7B. Doctor’s Fees: In the last 12 months, have you made any payments to a General Practitioner or a family doctor? If yes, please enter type of service, gross payment or co-payment, any refund and net payment below. On island / Off island 1 On Island 2 Off Island Specialist Specialist Specialist Specialist Specialist Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? If yes, please enter type of service, gross payment or co-payment, any refund and net payment. Name of health specialist Treatment - Specialist Treatment - Specialist Treatment - Specialist Treatment - Specialist Treatment - Specialist Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? If yes, please enter type of service, gross payment or co-payment, any refund and net payment. Type of specialist or treatment Fee - Specialist Fee - Specialist Fee - Specialist Fee - Specialist Fee - Specialist Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? If yes, please enter type of service, gross payment or co-payment, any refund and net payment. Total charge Paid by patient - Specialist Paid by patient - Specialist Paid by patient - Specialist Paid by patient - Specialist Paid by patient - Specialist Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? If yes, please enter type of service, gross payment or co-payment, any refund and net payment. Patient payment/co-payment Paid by insurance - Specialist Paid by insurance - Specialist Paid by insurance - Specialist Paid by insurance - Specialist Paid by insurance - Specialist Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? If yes, please enter type of service, gross payment or co-payment, any refund and net payment. Part paid by insurance or party Location - Specialist Location - Specialist Location - Specialist Location - Specialist Location - Specialist Section 7. Medical Care (12-Month Recall Period) Section 7C. Other Health Specialists Fees: In the last 12 months, have you made any payments to a Health Specialist? If yes, please enter type of service, gross payment or co-payment, any refund and net payment. On island / Off island 1 On Island 2 Off Island Hospital Hospital Hospital Hospital Hospital Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? If yes, please enter the name, type of service, total charge, patient reimbursement, refund or co-payment, the total paid and whether it was on islands or off-island. Name of hospital, dispensary or nursing home Treatment - Hospital Treatment - Hospital Treatment - Hospital Treatment - Hospital Treatment - Hospital Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? If yes, please enter the name, type of service, total charge, patient reimbursement, refund or co-payment, the total paid and whether it was on islands or off-island. Type of service Cost - Hospital Cost - Hospital Cost - Hospital Cost - Hospital Cost - Hospital Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? If yes, please enter the name, type of service, total charge, patient reimbursement, refund or co-payment, the total paid and whether it was on islands or off-island. Total charge Paid by patient - Hospital Paid by patient - Hospital Paid by patient - Hospital Paid by patient - Hospital Paid by patient - Hospital Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? If yes, please enter the name, type of service, total charge, patient reimbursement, refund or co-payment, the total paid and whether it was on islands or off-island. Patient payment/co-payment Paid by insurance - Hospital Paid by insurance - Hospital Paid by insurance - Hospital Paid by insurance - Hospital Paid by insurance - Hospital Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? If yes, please enter the name, type of service, total charge, patient reimbursement, refund or co-payment, the total paid and whether it was on islands or off-island. Part paid by insurance or party Location - Hospital Location - Hospital Location - Hospital Location - Hospital Location - Hospital Section 7. Medical Care (12-Month Recall Period) Section 7D. Hospital, Dispensary or Nursing Home. In the last 12 months, have you made any payments to a Hospital, Dispensary or a Nursing Home, including adult/elderly home care)? If yes, please enter the name, type of service, total charge, patient reimbursement, refund or co-payment, the total paid and whether it was on islands or off-island. On island Off island 1 On Island 2 Off Island Other health practitioner Other health practitioner Other health practitioner Other health practitioner Other health practitioner Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. If yes, please enter type of service, gross payment or co-payment, any refund and net payment Name of health specialist Treatment - Other health practitioner Treatment - Other health practitioner Treatment - Other health practitioner Treatment - Other health practitioner Treatment - Other health practitioner Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. If yes, please enter type of service, gross payment or co-payment, any refund and net payment Type of specialist or treatment Fee - Other health practitioner Fee - Other health practitioner Fee - Other health practitioner Fee - Other health practitioner Fee - Other health practitioner Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. If yes, please enter type of service, gross payment or co-payment, any refund and net payment Total charge Paid by patient - Other health practitioner Paid by patient - Other health practitioner Paid by patient - Other health practitioner Paid by patient - Other health practitioner Paid by patient - Other health practitioner Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. If yes, please enter type of service, gross payment or co-payment, any refund and net payment Patient payment/co-payment Paid by insurance - Other health practitioner Paid by insurance - Other health practitioner Paid by insurance - Other health practitioner Paid by insurance - Other health practitioner Paid by insurance - Other health practitioner Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. If yes, please enter type of service, gross payment or co-payment, any refund and net payment Part paid by insurance or party Location - Other health practitioner Location - Other health practitioner Location - Other health practitioner Location - Other health practitioner Location - Other health practitioner Section 7. Medical Care (12-Month Recall Period) Section 7E. Medical or Other Health Practitioner: In the last 12 months, have you made any payments to any other medical or health Practitioner? This includes opticians, optometrists, repair of glasses, contact lenses, dentists or dental specialists & traditional/local doctors. If yes, please enter type of service, gross payment or co-payment, any refund and net payment On island Off island 1 On Island 2 Off Island Lender Lender Lender Lender Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Lender: (Enter code from above) 1 Bank 2 Insurance company 3 Finance company 4 Credit union 5 Other Purpose of loan - Lender Purpose of loan - Lender Purpose of loan - Lender Purpose of loan - Lender Purpose of loan - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Main purpose: (Specify) 1 Traditional Activ. 2 Medical 3 Religious Activ. 4 Personal 5 Others Loan type - Lender Loan type - Lender Loan type - Lender Loan type - Lender Loan type - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Type: 1 Rent to own, 2 Personal loan, 3 other 1 Rent to own, 2 Personal loan, 3 Other Start month of repayments - Lender Start month of repayments - Lender Start month of repayments - Lender Start month of repayments - Lender Start month of repayments - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Month/year repayments started Start year of repayments - Lender Start year of repayments - Lender Start year of repayments - Lender Start year of repayments - Lender Start year of repayments - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Month/year repayments started Loan amount - Lender Loan amount - Lender Loan amount - Lender Loan amount - Lender Loan amount - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Amount borrowed Payment amount - Lender Payment amount - Lender Payment amount - Lender Payment amount - Lender Payment amount - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Each repayment & period covered Amount Payment period - Lender Payment period - Lender Payment period - Lender Payment period - Lender Payment period - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] Each repayment & period covered Period Amount refunded - Lender Amount refunded - Lender Amount refunded - Lender Amount refunded - Lender Amount refunded - Lender Section 8. Loans (12-Month Recall Period) Section 8A. Loans – [DO NOT include Car loans] The questions below concern any loans that any members of the household have and have not paid back. Are you currently making regular payments for anything on rent-to-own purchase, personal or some other type of loans? Interviewer: Exclude credit cards and other revolving credit, or other loan used for this dwelling or other property. [Use the following codes for lenders below: 1 bank, 2 insurance company, 3 finance company, 4 credit union, 5 other (Specify), and, if other, specify the type of lender.] How much charged to business or refunded? No. of purchases - credit card No. of purchases - credit card No. of purchases - credit card No. of purchases - credit card No. of purchases - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (a) Number of purchases on last bill (enter NONE if none) Service charge paid - credit card Service charge paid - credit card Service charge paid - credit card Service charge paid - credit card Service charge paid - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (b) Did you have a service or credit charge for previous purchases on your last bill? 1 Yes 2 No Amount of Service charge - credit card Amount of Service charge - credit card Amount of Service charge - credit card Amount of Service charge - credit card Amount of Service charge - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (b) Did you have a service or credit charge for previous purchases on your last bill? $ Cash advance charge paid - credit card Cash advance charge paid - credit card Cash advance charge paid - credit card Cash advance charge paid - credit card Cash advance charge paid - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (c) Did you have a service or credit for cash advances on your last bill? 1 Yes 2 No Amount of cash advance charge - credit card Amount of cash advance charge - credit card Amount of cash advance charge - credit card Amount of cash advance charge - credit card Amount of cash advance charge - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (c) Did you have a service or credit for cash advances on your last bill? $ Combined charges - credit card Combined charges - credit card Combined charges - credit card Combined charges - credit card Combined charges - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (d) Combined service or credit charge for cash advances and purchases if (b) and (c) are not separated on bill Bill period - credit card Bill period - credit card Bill period - credit card Bill period - credit card Bill period - credit card Section 8. Loans (12-Month Recall Period) Section 8B. Credit cards or charge accounts such as VISA? Include charge accounts at individual stores if the store charges interest when the full amount is not paid each month. (e) Period covered 1 One month 2 Other unit School location School location School location School location School location Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? Education fees do not include payments made by outside agencies such as Pell grant, loans, etc. – report only your out-of-pocket expenses Code: 1 = in FSM 2 = not FSM 1 In FSM 2 Not in FSM Meaning of Variable 'record': 1 = College or University 2 = Secondary School 3 = Primary School 4 = Nursery or Preschoold AND Day care 5 = Other School 6 = Amount paid by someone outside this household Tuition fee Tuition fee Tuition fee Tuition fee Tuition fee Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? Education fees do not include payments made by outside agencies such as Pell grant, loans, etc. – report only your out-of-pocket expenses Tuition/books Meaning of Variable 'record': 1 = College or University 2 = Secondary School 3 = Primary School 4 = Nursery or Preschoold AND Day care 5 = Other School 6 = Amount paid by someone outside this household Housing cost for education Housing cost for education Housing cost for education Housing cost for education Housing cost for education Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? Education fees do not include payments made by outside agencies such as Pell grant, loans, etc. – report only your out-of-pocket expenses Housing Meaning of Variable 'record': 1 = College or University 2 = Secondary School 3 = Primary School 4 = Nursery or Preschoold AND Day care 5 = Other School 6 = Amount paid by someone outside this household Food expenses in school Food expenses in school Food expenses in school Food expenses in school Food expenses in school Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? Education fees do not include payments made by outside agencies such as Pell grant, loans, etc. – report only your out-of-pocket expenses Food or board Meaning of Variable 'record': 1 = College or University 2 = Secondary School 3 = Primary School 4 = Nursery or Preschoold AND Day care 5 = Other School 6 = Amount paid by someone outside this household Other education expenses Other education expenses Other education expenses Other education expenses Other education expenses Section 9. Education. (12-Month Recall Period) In the past 12 months, have you paid any education fees? Education fees do not include payments made by outside agencies such as Pell grant, loans, etc. – report only your out-of-pocket expenses Others Meaning of Variable 'record': 1 = College or University 2 = Secondary School 3 = Primary School 4 = Nursery or Preschoold AND Day care 5 = Other School 6 = Amount paid by someone outside this household Recipient location - remittance Recipient location - remittance Recipient location - remittance Recipient location - remittance Recipient location - remittance Section 10. Miscellaneous Expenses (12-Month Recall Period) In this section enter the amount spent by all household members for each of these categories in the past 12 months REMITTANCES: 950 How much did all members of your family give as cash or gifts to other individuals or families (1) in FSM or (2) outside FSM? Place and Code: Cash given - remittance Cash given - remittance Cash given - remittance Cash given - remittance Cash given - remittance Section 10. Miscellaneous Expenses (12-Month Recall Period) In this section enter the amount spent by all household members for each of these categories in the past 12 months REMITTANCES: 950 How much did all members of your family give as cash or gifts to other individuals or families (1) in FSM or (2) outside FSM? Cash Gift given - remittance Gift given - remittance Gift given - remittance Gift given - remittance Gift given - remittance Section 10. Miscellaneous Expenses (12-Month Recall Period) In this section enter the amount spent by all household members for each of these categories in the past 12 months REMITTANCES: 950 How much did all members of your family give as cash or gifts to other individuals or families (1) in FSM or (2) outside FSM? TYPE OF GIFT(S) (e.g., freezer, car, medical expenses) Value of gift - remittance Value of gift - remittance Value of gift - remittance Value of gift - remittance Value of gift - remittance Section 10. Miscellaneous Expenses (12-Month Recall Period) In this section enter the amount spent by all household members for each of these categories in the past 12 months REMITTANCES: 950 How much did all members of your family give as cash or gifts to other individuals or families (1) in FSM or (2) outside FSM? Total value of gifts Other expenditure Other expenditure Other expenditure Other expenditure Other expenditure Section 10. Miscellaneous Expenses (12-Month Recall Period) In this section enter the amount spent by all household members for each of these categories in the past 12 months 953 Water containers of 3 gallons or more 954 Water trucked to residence 955 Licenses 961 Health spa establishments 962 Body and facial massage 963 Salons 964 Manicures and pedicures 965 Haircuts 966 Hair dying and coloring 967 Hair weaving, extensions, and other 968 Nutrition centers 971 Weddings 972 Christenings 973 Funerals 974 Other traditional feasts and events 975 Other family events 976 Church activities 977 School fund-raising, charitable organizations, and other donations 981 Legal and accounting fees 982 Computer and other games 983 Life insurance premiums 984 Dry cleaningg services 985 Fitness centers 986 Annual fees for social or sports clubs and credit cards 987 Child support 988 Other 989 Shuttle bus service 990 Mutual funds, stocks, and bonds 991 Alimony 992 Veterinary services 993 Child day care 994 After school programs 995 Home security alarm systems Amount for other expenditure Amount for other expenditure Amount for other expenditure Amount for other expenditure Amount for other expenditure Section 10. Miscellaneous Expenses (12-Month Recall Period) In this section enter the amount spent by all household members for each of these categories in the past 12 months $ Municipality Municipality Municipality Municipality Municipality B. Municipality 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak Enumeration District Enumeration District Enumeration District Enumeration District Enumeration District D. ED Village Village Village Village Village C. Village Block Block Block Block Block E. Block (first three digits) Block A Block A Block A Block A Block A E. Block (fourth digit) Mapspot Mapspot Mapspot Mapspot Mapspot F. Map Spot Household Number Household Number Household Number Household Number Household Number G. Household No. All persons who occupy a housing unit and prepare their food together. Week day Week day Week day Week day Week day Day # - Day of Week 1 Monday 2 Tuesday 3 Wednesday 4 Thursday 5 Friday 6 Saturday 7 Sunday Transaction Transaction Transaction Transaction Transaction 1 Purchased 2 Home produced 3 Gift - purchased item 4 Gift - home produced 5 Received - purchased item 6 Received - home produced These are sections of the Diary where the transaction was recorded. A purchase - constitutes anything (food item, clothing article, gasoline, soap, etc.) that you or any member of your household buys for the use of the household as a whole or for the exclusive use of any member of the household. It also includes purchases you paid for anyone outside of the household. Home-produced - items may be anything produced in the home. For example, in the case of food such items might include root crops, livestock, vegetables, fruits, self-caught fish, self-collected shellfish, etc.; in the case of material things, home-produced items may include hand-woven floor mats, baskets, storyboards, spearguns, etc. Make certain that each item is described properly under the ITEM DESCRIPTION column, that the weight or number of pieces of identical items is recorded under the NUMBER column, that the retail unit price is estimated and recorded under the UNIT column, and that the total estimated retail dollar value is calculated and recorded under the ESTIMATED LOCAL RETAIL VALUE column. Gifts Given - may include any item given, including money, food item, article of clothing, and so on. Items that qualify as gifts include those purchased in a store, home grown (root crops, vegetables, fruits), self-caught or collected (fish, shellfish, crustaceans), or homemade (baskets, mats, spearguns) - anything that your household or any member of your household gives to another household or someone not a member of your household for which no money or payment is expected. Note that although payment is not anticipated payment for the gifts given, you nevertheless should record the estimated dollar value of each item given away as a gift. Gifts Received - may include any item received by your household or any member of your household from another household or someone who is not a member of your household. Do not treat items exchanged among members of your own family as gifts received. For example, if a household member's birthday falls within a week when the Daily Expenditures Diary is kept, the present given to this person should not be recorded as a gift received; however, the expenditure should be recorded on the Daily Expenditures Form under the ITEM BOUGHT column. Item Item Item Item Item Item Description Utilization Utilization Utilization Utilization Utilization For home produced and gift items. 1 Used 2 Sold 3 Given 4 Received These are determined by the section of the Diary where the transaction was recorded. Number Number Number Number Number Quantity Number Unit Unit Unit Unit Unit Quantity Unit 1 Each 2 Cans 3 Bottles 4 Pounds 5 Gallons 6 Cases 7 Packages 8 Dozens 9 Box 10 Carton 11 Other Cash Cash Cash Cash Cash Cash Items bought Credit Credit Credit Credit Credit Credit Items bought Buying on credit - means purchasing without cash - the cash payment ultimately made on a later date. Record such purchases the day the transaction takes place, not for the future date the cash payment is promised to be made. Total Value Total Value Total Value Total Value Total Value Est. Local Retail Value Home produced and gift items State State State State State A. State 1 Yap 2 Chuuk 3 Pohnpei 4 Kosrae Municipality Municipality Municipality Municipality Municipality B. Municipality 101 Rumung 102 Maap 103 Gagil 104 Tomil 105 Fanif 106 Weloy 107 Rull 108 Gilman 109 Kanifay 110 Dalipebinaw 111 Ulithi 112 Fais 113 Sorol 114 Ngulu 115 Woleai 116 Eauripik 117 Ifalik 118 Faraulep 119 Elato 120 Lamotrek 121 Satawal 201 Weno 202 Piis_Penau 203 Fono 204 Tonoas 205 Fefen 206 Siis 207 Uman 208 Parem 209 Eot 210 Udot 211 Romanum 212 Fanapanges 213 Wonei 214 Paata 215 Tol 216 Polle 217 Nama 218 Losap 219 Piis_Emwar 220 Namoluk 221 Ettal 222 Lekinoch 223 Oneop 224 Satowan 225 Kuttu 226 Moch 227 Ta 228 Houk 229 Polowat 230 Pollap 231 Tamatam 232 Makur 233 Onoun 234 Onou 235 Unanu 236 Piherech 237 Nomwin 238 Fananu 239 Ruo 240 Murillo 301 Madolenihmw 302 U 303 Nett 304 Sokehs 305 Kitti 306 Kolonia 307 Mwokilloa 308 Pingelap 309 Sapwuafik 310 Nukuoro 311 Kapingamarangi 401 Lelu 402 Malem 403 Utwe 404 Tafunsak Enumeration District Enumeration District Enumeration District Enumeration District Enumeration District C. ED Village Village Village Village Village D. Village Block Block Block Block Block E. Block (first three items of the Block code) Block A Block A Block A Block A Block A E. Block (fourth item of the Block code) Mapspot Mapspot Mapspot Mapspot Mapspot F1. Map Spot Household Number Household Number Household Number Household Number Household Number F2. Household No. All persons who occupy a housing unit and prepare their food together. Weight Weight Weight Weight Weight Household Size Household Size Household Size Household Size Household Size N. Population Sex of HH Head Sex of HH Head Sex of HH Head Sex of HH Head Sex of HH Head 4. What is ...'s ethnic orgin or race? Household Heads 1 Male 2 Female No of workers No of workers No of workers No of workers No of workers Occupation of HH Head Occupation of HH Head Occupation of HH Head Occupation of HH Head Occupation of HH Head 21-23 The following questions ask about the job worked for pay last week. If ... had more than one job, describe the one ... worked the most hours. If ... didn't work, the questions refer to the most recent job or business since June, 2000. 22 What kind of work was ... doing? This is the occupation, like primary school teacher, medical officer, cashier, etc. Household Heads 11 ARMED FORCES 111 LEGISLATORS 112 SEN_GOVT OFFICLS 113 TRAD_CHIEF&HEADV 114 SEN_OFFICL_SP_IN 120 CORPORATE MANAGR 121 DIRECTOR&CHF_EXE 122 PROD&OPER DEPT_M 131 GENERAL MANAGERS 200 PROFESSIONALS 210 ENGINEERS 211 PHYSICSTS&R_PROF 212 MATHEMAT&REL_PRO 213 COMPUTING PROFES 214 ARCHITCT&R_PROFE 220 DOCTORS/DENTIST 221 L_SCI&HEALTH PRO 222 HEALTH PRO EX.NU 223 NURSNG&MIDWIF PR 230 TEACHING PROFF 231 COL,UNIV&H_T_PRO 232 SE_ED TEACH_PROF 233 PRIM&P_PRIM T_PR 234 SP_ED T_PROFESSI 235 OTHER TEACH_PROF 240 PROFF. OTHERS 241 BUSINESS PROFESS 242 LEGAL PROFESSION 243 ARCHIV,LIB&R_I_P 244 SOC_SCI&R_PROFES 245 WRITRS&CRE_PER_A 246 RELIGIOUS PROFES 300 TECH.ASS.PROFF 310 ENGINEERS ASSPRO 311 PHYS&ENGIN SC_TE 312 COMPUTR ASS.PROF 313 OPTICL&EL_EQ_OPE 314 SHIP&ACRAFT_CO&T 315 SAFTY&QUAL_INSPE 320 HEALTH ASSOC 321 LSCI_TECH&R_AS_P 322 MDRN_HEALTH EX.N 323 NURSNG&MIDW AS_P 324 TRAD_MED_PRAC&FH 330 TEACHING ASSPROF 331 PRIM_ED_T_AS_PRO 332 P_PRIM ED_T_AS_P 333 SP_ED T_ASSOC_PR 334 OTHR T_ASSOC_PRO 340 PROFF.OTH.ASSOC 341 FIN&SALES ASS_PR 342 BUS_SER_AG&TR_BR 343 ADMIN ASSOC_PROF 344 CUS,TAX&REL_G_AP 345 POLICE INSP&DETE 346 SOCWORK ASSO_PRO 347 ARTIST,ENT&SP_AP 400 CLERKS 410 OFFICE CLERKS 411 SECRET&KBRD_O_CL 412 NUMERICAL CLERKS 413 MAT_REC&TRANS_CL 414 LIBRARY MAIL RE 420 CLERKS CUST.SERV 421 LIB,MAIL&R_CLERK 422 CLIENT_INFO_CLRK 500 SERV. WORKDR 510 PERSONAL PROTECT 511 T_ATTENTD&R_WRKR 512 HSEKPNG,RES&R_WK 513 PER_CARE&R_WORKR 514 OTHR PER_CA&R_WR 515 ASTROL,FORT&R_WR 516 PROTECTVE SER WR 520 SALESPERSON 521 FASHN&OTHR MODEL 522 SHOP SPERSN&DEMO 523 STALL&MARKT SPER 600 AG.&.FISHERY WRK 610 SKLL MRKT OR 611 MARKT GAR&CR_GRO 612 MAR_OR_A&AN&R_WR 613 MAR_OR_C&ANIM_PR 614 FORESTRY&R_WORKR 615 FISHRY WRK,HUN&T 621 SUB_AGRI&FISH WR 700 CRAFT REL.WRKRS 710 CRAFTS_WRKRS 711 MINRS_SHF,SC&CAR 712 BLDG FRAM&R_T_WR 713 BLDG FIN&R_T_WRK 714 PAINT,BLDGST&R_W 720 TRADE WORKERS 721 METL MLDRS&R_WRK 722 BSMTH,TMKR&R_TWR 723 MACHINRY MECH&FI 724 ELECTRI&ELECT EQ 730 HANDICRAFT 731 PRECISION WORKER 732 POTTR,G_MKRS&R_W 733 HANDICRAFT WRKRS 734 PRINTNG&R_T_WRKR 740 CRAFT AND RELWOR 741 FOOD PROC&R_T_WR 742 WOOD TREA&R_T_WR 743 TEXTLE,GAR&R_WRK 744 PELT,LEA&SHM TWR 800 MACH.OPERATOR 810 IND. PLNT OPER 811 MINING&MIN PR_OP 812 METAL PRO_PLNT_O 813 GLASS,CER&R_P_OP 814 WOOD_PR&PM_P_OPE 815 CHEM_PRO&R_P_OPE 816 POWER PROD&R_P_O 817 AUTOM_ASSY&R_OPE 820 OPERATORS:STAT 821 MET&MIN P_MACH_O 822 CHEM_PROD MACH_O 823 RUBB&PLAST_P_M_O 824 WOOD_PROD_M_OPER 825 PRINTNG,BNDG M_O 826 TEXTL,FUR&LP_M_O 827 FOOD&R_PROD M_OP 828 ASSEMBLERS 829 OTHR MACH OPER&A 830 DRIVERS 831 LOC_ENG DRI&R_WR 832 MOTOR VEHCLE DRI 833 AGRI&OTHR MP_OPE 834 SHIPS CREW&R_WRK 900 ELEM. OCCUPATION 910 SALES ELEM.OCC 911 ST VENDRS&R_WRKR 912 SHOE CLNG&O_EL_O 913 DOM_&R_HLPR&CLNR 914 BLDG CTAKR&R_CLN 915 MESS,PORT,&R_WRK 916 GARB_COL&R_LABOU 920 LABORERS:AG.FSH 930 CONST. LABORERS 931 MINING&CONST_LAB 932 MANUFA_LABOURERS 933 TRANS_LAB&FR_HAN 999 UNKNOWN/OTHERS Industry of HH Head Industry of HH Head Industry of HH Head Industry of HH Head Industry of HH Head 21-23 The following questions ask about the job worked for pay last week. If ... had more than one job, describe the one ... worked the most hours. If ... didn't work, the questions refer to the most recent job or business since June, 2000. 21. For whom did ... work? If now on active duty, write "Armed Forces"; otherwise, print the name of the company, business or other employer. Provide actual agency, like Department of Education, NOT Yap State Government. Household Heads 10 AG.HUNT.FISHERY 11 GROWING CROPS 12 FARMING LIVESTCK 13 MIXED FARMING 14 AG.ANIMAL HUSBAN 15 HUNTING TRAPPING 20 FORESTRY,LOGGING 50 FISHING 100 MINNING,QUARRYNG 101 M&Q HARDCOAL 102 M&Q LIGNITE 103 EXTRACTION PEAT 111 EXTR.CRUDE PET 112 AGRICULTURE SERV 120 MINING OF URANIM 131 MINING OF IRNORE 132 MINING NONFEROUS 141 QUARRYING STONE 142 M&Q N.E.C 150 MANU.FOOD BEV 151 PRODUCTION PRCSS 152 MAN.DAIRY PROD 153 MAN. GRAIN MILL 154 MAN. OTHER FOOD 155 MAN. OF BEVERAGE 160 MAN. OF TOBACCO 170 TEXTILES 171 SPINNING 172 OTHER TEXTILES 173 KNITTED FABRICS 180 MAN. WEARING APP 181 MAN. EX. FUR APP 182 DRESS. & DYEING 190 MAN. OF LEATHER 191 TANNING AND DRES 192 MAN. FOOTWEAR 200 MANU.OF WOOD PRO 201 SAWMILLING WOOD 202 MAN. OF WOOD PRO 210 MAN. PAPER PROD 999 Unknown/other Education of HH Head Education of HH Head Education of HH Head Education of HH Head Education of HH Head 10.How much school has ... COMPLETED? Read categories if person is unsure. Circle the number for the highest level COMPLETED or degree RECEIVED. If currently enrolled, mark the level of previous grade attended or highest degree received. Household Heads 1 1st 2 2nd 3 3rd 4 4th 5 5th 6 6th 7 7th 8 8th 9 9th 10 10th 11 11th 12 12th 13 High school graduate 14 Some college 15 AA - occupational 16 AA - academic 17 BA 18 MS 19 Higher level 20 None 21 Nursery school 22 Kindergarten 31 No school completed 32 Nursery school 33 Kindergarten 11.Cereal Products 11.Cereal Products 11.Cereal Products 11.Cereal Products 11.Cereal Products 12.Meat & Poultry 12.Meat & Poultry 12.Meat & Poultry 12.Meat & Poultry 12.Meat & Poultry 13.Fish 13.Fish 13.Fish 13.Fish 13.Fish 14.Fruit & Vegetables 14.Fruit & Vegetables 14.Fruit & Vegetables 14.Fruit & Vegetables 14.Fruit & Vegetables 15.Dairy & Vegetable Products 15.Dairy & Vegetable Products 15.Dairy & Vegetable Products 15.Dairy & Vegetable Products 15.Dairy & Vegetable Products 16.Non-alcoholic beverages 16.Non-alcoholic beverages 16.Non-alcoholic beverages 16.Non-alcoholic beverages 16.Non-alcoholic beverages 17.Miscellaneous Food 17.Miscellaneous Food 17.Miscellaneous Food 17.Miscellaneous Food 17.Miscellaneous Food 18.Meals away from home 18.Meals away from home 18.Meals away from home 18.Meals away from home 18.Meals away from home 21.Alcoholic beverages 21.Alcoholic beverages 21.Alcoholic beverages 21.Alcoholic beverages 21.Alcoholic beverages 22.Tobacco 22.Tobacco 22.Tobacco 22.Tobacco 22.Tobacco 31.Clothing Supplies 31.Clothing Supplies 31.Clothing Supplies 31.Clothing Supplies 31.Clothing Supplies 32.Footwear 32.Footwear 32.Footwear 32.Footwear 32.Footwear 41.Household Maintenance & Repairs 41.Household Maintenance & Repairs 41.Household Maintenance & Repairs 41.Household Maintenance & Repairs 41.Household Maintenance & Repairs 42.Rent 42.Rent 42.Rent 42.Rent 42.Rent 51.Fuel 51.Fuel 51.Fuel 51.Fuel 51.Fuel 52.Electricity 52.Electricity 52.Electricity 52.Electricity 52.Electricity 53.Water 53.Water 53.Water 53.Water 53.Water 61.Educational Services 61.Educational Services 61.Educational Services 61.Educational Services 61.Educational Services 62.Medical Services 62.Medical Services 62.Medical Services 62.Medical Services 62.Medical Services 63.Personal Goods 63.Personal Goods 63.Personal Goods 63.Personal Goods 63.Personal Goods 64.Recreational Services 64.Recreational Services 64.Recreational Services 64.Recreational Services 64.Recreational Services 65.Transportation & Communication 65.Transportation & Communication 65.Transportation & Communication 65.Transportation & Communication 65.Transportation & Communication 71.Durable furniture & equipment 71.Durable furniture & equipment 71.Durable furniture & equipment 71.Durable furniture & equipment 71.Durable furniture & equipment 72.Non-durable furnishings 72.Non-durable furnishings 72.Non-durable furnishings 72.Non-durable furnishings 72.Non-durable furnishings 73.Utensils & Accessories 73.Utensils & Accessories 73.Utensils & Accessories 73.Utensils & Accessories 73.Utensils & Accessories 74.Household Operations 74.Household Operations 74.Household Operations 74.Household Operations 74.Household Operations 75.Personal Care & Effects 75.Personal Care & Effects 75.Personal Care & Effects 75.Personal Care & Effects 75.Personal Care & Effects 81.Other non-specified expenditures 81.Other non-specified expenditures 81.Other non-specified expenditures 81.Other non-specified expenditures 81.Other non-specified expenditures 82.Income Tax 82.Income Tax 82.Income Tax 82.Income Tax 82.Income Tax 83.Imputed Rent 83.Imputed Rent 83.Imputed Rent 83.Imputed Rent 83.Imputed Rent 84.Gifts Given 84.Gifts Given 84.Gifts Given 84.Gifts Given 84.Gifts Given 85.Gifts Received 85.Gifts Received 85.Gifts Received 85.Gifts Received 85.Gifts Received TOTEXP TOTEXP TOTEXP TOTEXP TOTEXP 1 Wage and Salary 1 Wage and Salary 1 Wage and Salary 1 Wage and Salary 1 Wage and Salary 2 Business Income 2 Business Income 2 Business Income 2 Business Income 2 Business Income 3 Allowance Income 3 Allowance Income 3 Allowance Income 3 Allowance Income 3 Allowance Income 4 Rental Income 4 Rental Income 4 Rental Income 4 Rental Income 4 Rental Income 5 Interest and Dividends 5 Interest and Dividends 5 Interest and Dividends 5 Interest and Dividends 5 Interest and Dividends 6 Pell Grants 6 Pell Grants 6 Pell Grants 6 Pell Grants 6 Pell Grants 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26f How much did ... receive from Pell Grants or other educational grants and scholarships? For persons 15 years old and over 7 Social Security Income 7 Social Security Income 7 Social Security Income 7 Social Security Income 7 Social Security Income 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26g How much did ... receive in Social Security? Income payments to retired workers, dependents, and disabled workers. For persons 15 years old and over 8 Pension Income 8 Pension Income 8 Pension Income 8 Pension Income 8 Pension Income 9 Government Programs 9 Government Programs 9 Government Programs 9 Government Programs 9 Government Programs 10 Remittances from inside FSM 10 Remittances from inside FSM 10 Remittances from inside FSM 10 Remittances from inside FSM 10 Remittances from inside FSM 11 Remittances from outside FSM 11 Remittances from outside FSM 11 Remittances from outside FSM 11 Remittances from outside FSM 11 Remittances from outside FSM 12 Per diems 12 Per diems 12 Per diems 12 Per diems 12 Per diems 26 The following questions are about income received during 2004. If an exact amount is not known, accept a best estimate. Report dollar amounts ONLY; do not report cents - if cents are reported, round to the nearest dollar amount. 26l How much did ... save from per diems or business trips paid for by others? For persons 15 years old and over 13 Other Regular Income 13 Other Regular Income 13 Other Regular Income 13 Other Regular Income 13 Other Regular Income 14 Gifts received from inside FSM 14 Gifts received from inside FSM 14 Gifts received from inside FSM 14 Gifts received from inside FSM 14 Gifts received from inside FSM 15 Gifts received from outside FSM 15 Gifts received from outside FSM 15 Gifts received from outside FSM 15 Gifts received from outside FSM 15 Gifts received from outside FSM 16 Subsistence Activities 16 Subsistence Activities 16 Subsistence Activities 16 Subsistence Activities 16 Subsistence Activities 17 Imputed Rent 17 Imputed Rent 17 Imputed Rent 17 Imputed Rent 17 Imputed Rent Total Income Total Income Total Income Total Income Total Income Total Income Brackets Total Income Brackets Total Income Brackets Total Income Brackets Total Income Brackets 1 Less than 2,500 2 2,500-3,999 3 4,000-5,999 4 6,000-9,999 5 10,000-14,999 6 15,000-19,999 7 20,000-29,999 8 30,000-49,999 9 50000 and above Total Expenditure Brackets Total Expenditure Brackets Total Expenditure Brackets Total Expenditure Brackets Total Expenditure Brackets 1 Less than 2,500 2 2,500-3,999 3 4,000-5,999 4 6,000-9,999 5 10,000-14,999 6 15,000-19,999 7 20,000-29,999 8 30,000-49,999 9 50000 and above Ethnicity of Household Head Ethnicity of Household Head Ethnicity of Household Head Ethnicity of Household Head Ethnicity of Household Head 4. What is ...'s ethnic orgin or race? Household Heads 1 Yapese 2 Yap Outer Islander 3 Chuukese 4 Mortlockese 5 Pohnpeian 6 Pohnpei Outer Islander 7 Kosraean 8 Other Pacific Islander 9 White 10 Asian 11 Others HH Per capita income HH Per capita income HH Per capita income HH Per capita income HH Per capita income Household per capita income - total income of the household divided by the number of household members Estimated population Estimated population Estimated population Estimated population Estimated population Estimated population represented by the respondent household