Section 3, Part A - Work Experience and Income - Week 2 Diary Pick-up

Section 3, Part A collects detailed information about the work experience and income of each member of the household age 14 and older, including occupation, hours and weeks worked, deductions from pay, and amount of income from wages and salaries, self employment, and Social Security.

The next few questions are about income. We know people aren’t used to discussing their income, but please be assured that, like all other information you have provided, these answers will be kept strictly confidential.

  1. Enter 1 to continue.

Now I am going to ask about [YOU or the household member in question] work experience and income.
In the past 12 months, including paid vacation and sick leave, how many weeks did [YOU or the household member in question] work?
* If household member did not work, enter zero.

[enter value] ______________

  1. Did not work

In the weeks that [YOU or the household member in question] worked, how many hours did you/he/she usually work per week?

[enter value] _____________

Which of the following categories best describes the job in which [YOU or the household member in question] received the most earnings during the last 12 months?

  1. Administrator, manager
  2. Teacher
  3. Professional
  4. Administrative support, including clerical
  5. Sales, retail
  6. Sales, business goods and services
  7. Technician
  8. Protective service
  9. Private household service
  10. Other service
  11. Machine or transportation operator, laborer
  12. Construction workers, mechanics
  13. Farming
  14. Forestry, fishing, groundskeeping
  15. Armed Forces

For definitions Information Booklet »

Were/Was you/he/she:

  1. An employee of a PRIVATE company, business, or individual working for wages or salary?
  2. A FEDERAL government employee?
  3. A STATE government employee?
  4. A LOCAL government employee?
  5. Self-employed in your/his/her OWN business, partnership, professional practice, or farm?
  6. Working WITHOUT PAY in a family business or farm?

What was the main reason you/he/she did not work during the last 12 months?
Were/Was you/he/she -

  1. Retired?
  2. Taking care of home/family?
  3. Going to school?
  4. Ill, disabled, unable to work?
  5. Unable to find work?
  6. Doing something else?

The next few questions are about income DURING THE PAST 12 MONTHS, that is from [one year ago from current date] TO [yesterday’s date].
Did you receive any wages, salary, tips, bonuses, or commissions?

  1. Yes
  2. No

How much did you receive before taxes?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD A best reflects total wages and salaries for ALL JOBS during the PAST 12 MONTHS?

  1. $0-$4,999
  2. $5,000-$9,999
  3. $10,000-$14,999
  4. $15,000-$19,999
  5. $20,000-$29,999
  6. $30,000-$39,999
  7. $40,000-$49,999
  8. $50,000-$69,999
  9. $70,000-$89,999
  10. $90,000-$119,999
  11. $120,000 and over

For definitions Information Booklet »

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What was the amount of your last pay before any deductions?

[enter value] _____________

What period of time did this cover?

  1. One week
  2. Two weeks
  3. Month
  4. Quarter
  5. Year
  6. Twice a month
  7. Other

* Specify: [enter text] _____________

Does the respondent have a paper or electronic pay check record present for the last paycheck?

  1. Yes
  2. No

Was there any money deducted from your pay for -
Federal income tax?

  1. Yes
  2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
State or local income tax?

  1. Yes
  2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Private pension fund?

  1. Yes
  2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Government retirement?

  1. Yes
  2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Railroad retirement?

  1. Yes
  2. No

How much?[enter value] _____________

Was there any money deducted from your pay for -
Social Security including Medicare?

  1. Yes
  2. No

Are Social Security payments NORMALLY deducted from your pay?

  1. Yes
  2. No

Does the money deducted for Social Security cover only the Medicare portion of Social Security?

  1. Yes
  2. No

Other than Social Security, did any employer or union contribute to your pension or retirement plan in the last 12 months?

  1. Yes
  2. No

DURING THE PAST 12 MONTHS -
did you receive any self-employment income or have a loss?
(Report income from own businesses (farm or non-farm) including proprietorships and partnerships.)

  1. Yes
  2. No

What was the amount?
(Report net income after operating expenses. Include earnings as a tenant farmer or sharecropper.)

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD A best reflects income or loss from self-employment during the PAST MONTHS?

  1. Loss
  2. $0-$4,999
  3. $5,000-$9,999
  4. $10,000-$14,999
  5. $15,000-$19,999
  6. $20,000-$29,999
  7. $30,000-$39,999
  8. $40,000-$49,999
  9. $50,000-$69,999
  10. $70,000-$89,999
  11. $90,000-$119,999
  12. $120,000 and over

For definitions Information Booklet »

DURING THE PAST 12 MONTHS -
did you receive receive any Social Security or Railroad Retirement benefits?

  1. Yes
  2. No

What was the amount of the last Social Security or Railroad Retirement payment received?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD B best reflects the amount of your last Social Security or Railroad Retirement payment during the PAST 12 MONTHS?

  1. Less than $500
  2. $500-$699
  3. $700-$999
  4. $1,000-$1,299
  5. $1,300-$1,699
  6. $1,700 and over

For definitions Information Booklet »

Is this amount AFTER the deduction for a Medicare premium?

  1. Yes
  2. No

During the past 12 months, how many Social Security or Railroad Retirement payments did you receive? [enter value] _____________

DURING THE PAST 12 MONTHS –
did you receive any Supplemental Security Income (SSI) payments?

  1. Yes
  2. No

What was the amount?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the amount you received in Supplemental Security Income during the past 12 months??

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

DURING THE PAST 12 MONTHS –
did you place any money in a retirement plan such as an Individual Retirement Account (IRA) or Keogh? Do not include rollovers.

  1. Yes
  2. No

How much?[enter value] _____________

End of Section 3A

Go to Section 3 Part B - Work Experience and Income - Week 2 Diary Pick-up - Ask for entire household as a group »

Go to CE Diary Household Characteristics Questionnaire Home Page »

 

Last Modified Date: January 2, 2013