SIPP Home > Survey Content > Core Content > SIPP 1996 Panel Questionnaires > SIPP 1996 Panel Wave 2-12 Questionnaires > General Income Receipt
-OTHINT-
We have completed the questions on work
status. Next are questions on the receipt
of income from government programs, retirement
plans, or other sources.
PRESS ENTER TO CONTINUE
@
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-LMPNOW-
Did [fill TEMPNAME] receive any
severance pay or lump sum payments
from a pension or retirement plan
when [fill HESHE] left [fill HISHER] job(s)?
(1) Yes
(2) No
@
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-LMPFUTR-
[fill C_DODOES] [fill TEMPNAME] ever
expect to receive any such payments
from that/these job(s)?
(1) Yes
(2) No
@
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-LUMPTYP-
What type of payment?
ENTER (N) FOR NONE/NO MORE
(1) Lump sum from pension/retirement plan
(2) Severance pay
(3) Deferred payment(s) payable at some later date
(4) Something else
@1 @2 @3 @4
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-LMPELSE-
What kind of other payment was it?
@
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-VAYN-
Excluding regular military retirement pay,
insurance proceeds, and GI Bill benefits,
did [fill TEMPNAME] receive any payments from
the Department of Veterans Affairs (VA)?
(1) Yes
(2) No
@
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-PWVAYN-
Last time we recorded that [fill TEMPNAME]
received payments from the Department of
Veterans Affairs (VA) other than regular
military retirement pay, insurance
proceeds and GI Bill benefits.
Did [fill TEMPNAME] receive any of those
payments at anytime between [fill MONTH1+]
1st and today?
(1) Yes
(2) No
@
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-PWVAMTH-
In which month did [fill TEMPNAME] last
receive those payments from the Veterans
Administration?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
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-PWVAMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME] recibi¢
esos pagos del Departamento de Asuntos de Veteranos?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill S_MONTH1+]
(6) [fill S_MONTH2+]
(7) [fill S_MONTH3+]
(8) [fill S_MONTH4+]
(9) Otro
(N) Nunca Recibido
@
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-SSYN-
Did [fill TEMPNAME] receive any
Social Security payments?
(1) Yes
(2) No
@
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-SSCLDYN-
Did [fill TEMPNAME] receive any
Social Security payments on behalf of:
READ NAMES OF CHILDREN
(1) Yes (2) No @CHILD
Did [fill TEMPNAME] receive any Social
Security payments for [fill SELF]?
(1) Yes (2) No @SELF
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-PWSSYN-
Last time I recorded that [fill TEMPNAME]
received Social Security payments.
Did [fill TEMPNAME] receive any
Social Security payments at any time
between [fill MONTH1+] 1st and today?
(1) Yes
(2) No
@
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-PWSSCLDYN-
Last time I recorded that [fill TEMPNAME] received
Social Security [fill TEMP+] [fill TEMP2+]
At any time since [fill MONTH1+] 1st, did [fill TEMPNAME]
receive any Social Security payments especially for:
READ NAMES OF CHILDREN
(1) Yes (2) No @CHILD
Did [fill TEMPNAME] receive any Social Security payments
for [fill SELF]?
(1) Yes (2) No @SELF
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-PWSSMTH-
In which month did [fill TEMPNAME] last
receive payments from Social Security?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
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-PWSSMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ pagos de Seguro Social?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill S_MONTH1+]
(6) [fill S_MONTH2+]
(7) [fill S_MONTH3+]
(8) [fill S_MONTH4+]
(9) Otro
(N) Nunca Recibido
@
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-SSIYN-
Did [fill TEMPNAME] receive any income
from SSI, that is, a program called
Supplemental Security Income?
(1) Yes
(2) No
@
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-SSICLDYN-
Did [fill TEMPNAME] receive any
Supplemental Security Income (SSI) for:
READ NAMES OF CHILDREN
(1) Yes (2) No @CHILD
Did [fill TEMPNAME] receive any income from Supplemental
Security Income (SSI) for [fill SELF]?
(1) Yes (2) No @SELF
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-PWSSIYN-
Last time I recorded that [fill TEMPNAME]
received Supplemental Security Income
(SSI) payments.
Did [fill TEMPNAME] receive any SSI
payments at any time between [fill MONTH1+]
1st and today?
(1) Yes
(2) No
@
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-PWSSICLDYN- Last time I recorded that [fill TEMPNAME]
received Supplemental Security Income, or SSI,
[fill TEMP+]
At any time since [fill I_MONTH5+] 1st, did [fill TEMPNAME]
receive any Supplemental Security Income (SSI) for:
READ NAMES OF CHILDREN
(1) Yes (2) No @CHILD
Did [fill TEMPNAME] receive any income from Supplemental
Security Income (SSI) for [fill SELF]?
(1) Yes (2) No @SELF
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-PWSSIMTH-
In which month did [fill TEMPNAME] last
receive Supplemental Security Income payments?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
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-PWSSIMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME] recibi¢
pagos de Seguridad de Ingreso Suplemental?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill S_MONTH1+]
(6) [fill S_MONTH2+]
(7) [fill S_MONTH3+]
(8) [fill S_MONTH4+]
(9) Otro
(N) Nunca Recibido
@
[#------------------------------------------------------------
-STSSIYN-
Did [fill TEMPNAME] also receive a SEPARATE
SSI payment from the State or local welfare
office?
(1) Yes
(2) No
@
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-DSYN-
Earlier I recorded that [fill TEMPNAME]
[fill HAVHAS] a health condition which limits
the kind or amount of work [fill TEMPNAME]
can do. Did [fill TEMPNAME] receive any income
[fill TEMP5+] [fill TEMP6+] because of
[fill PTEMPNAME] health condition?
(1) Yes
(2) No
@
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-DSTYP-
What kind of income was that?
Anything else?
ENTER (N) FOR NO MORE
(1) Workers' Compensation
(2) Payments from a sickness, accident, or disability
insurance policy purchased on your own
(3) Employer disability payments
(4) Pension from company or union including income from profit-sharing plans
(5) Federal Civil Service or other Federal civilian employee pension
(6) State government pension
(7) Local government pension
(8) U.S. Military retirement pay exclude payments from the
Department of Veterans Affairs (VA)
(9) U.S. Government Railroad Retirement
(10) Black Lung payments
(11) Other
@1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @11
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-OTHRTYPE-
What was the specific "other" source of
the income [fill TEMPNAME] received because
of [fill HISHER] health condition?
@
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-PWDSYN-
Last time we recorded that [fill TEMPNAME]
received income because of a health condition
or disability from the following source(s).
[fill HEALDIS(<1>)]
[fill HEALDIS(<2>)]
[fill HEALDIS(<3>)]
[fill HEALDIS(<4>)]
[fill HEALDIS(<5>)]
[fill HEALDIS(<6>)]
[fill HEALDIS(<7>)]
[fill HEALDIS(<8>)]
[fill HEALDIS(<9>)]
[fill HEALDIS(<10>)]
[fill HEALDIS(<11>)]
Did [fill TEMPNAME] receive income from any of
these sources during the time period from
[fill MONTH1+] up to today?
(1) Yes
(2) No
@YN
Which ones?
(A) All sources listed
(N) None/No more
@1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @11
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-DISREC1-
In which month did [fill TEMPNAME] last receive
[fill DITYP]?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Other
(N) Never Received
@
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-DISYR1-
When did [fill TEMPNAME] last receive
[fill DITYP]?
MONTH: @MON
YEAR: @YEAR
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-DISYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ [fill DITYP]?
MES: @MON
A¥O: @YEAR
[#--------------------------------------------------------------------
-OTHDIS-
Did [fill TEMPNAME] receive income from any
other source during this time period because
of a health condition?
(1) Yes
(2) No
@
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-ODISTYP-
What kind of income was that?
Anything else?
(N) None/No more
(1) Worker's Compensation
(2) Payments from a sickness, accident, or disability
insurance policy purchased on your own
(3) Employer disabilty payments
(4) Pension from company or union including income
from profit-sharing plans
(5) Federal Civil Service or other Federal civilian
employee pension
(6) State government pension
(7) Local government pension
(8) U.S.Military retirement pay excluding payments from the
Department of Veterans Affairs (VA)
(9) U.S. Government Railroad Retirement
(10) Black Lung Payments
(11) Other
@1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @11
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-OTHRDIS-
What was the specific "other" source of
the income [fill TEMPNAME] received because
of [fill HISHER] health condition?
@
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-RTYN-
Earlier I recorded that [fill TEMPNAME] retired
from a previous job. [fill TEMP5+]
[fill TEMP6+] [fill TEMP7+] [fill TEMPNAME]
receive any [fill TEMP4+] retirement income?
(1) Yes
(2) No
@
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-RTTYP-
What kind of income was that?
Anything else?
ENTER (N) FOR NONE/NO MORE
(1) Pension from company or union
including income from profit-sharing plans
(2) Federal Civil Service or other Federal civilian employee pension
(3) State government pension
(4) Local government pension
(5) U.S. Military retirement pay exclude payments from the
Department of Veterans Affairs (VA)
(6) U.S. Government Railroad Retirement
(7) National Guard or Reserve Forces retirement
(8) Other
@1 @2 @3 @4 @5 @6 @7 @8
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-RETOTHR-
What is the specific "other" source of the
retirement income that [fill TEMPNAME] received.
@
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-LIFEYN-
Did [fill TEMPNAME] receive any REGULAR retirement
income from a paid-up life insurance policy
or any other annuities?
(1) Yes
(2) No
@
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-PWRTYN-
Last time we recorded that [fill TEMPNAME] received
retirement income from the following source(s).
[fill RETIRE(<1>)]
[fill RETIRE(<2>)]
[fill RETIRE(<3>)]
[fill RETIRE(<4>)]
[fill RETIRE(<5>)]
[fill RETIRE(<6>)]
[fill RETIRE(<7>)]
[fill RETIRE(<8>)]
Did [fill TEMPNAME] receive income from any of these
sources during the time period from [fill MONTH1+] up to today?
(1) Yes
(2) No
@YN
Which ones?
(A) All sources listed
(N) None/No more
@1 @2 @3 @4 @5 @6 @7 @8
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-RETREC1-
In which month did [fill TEMPNAME] last
receive [fill RITYP]?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Other
(N) Never Received
@
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-RETYR1-
When did [fill TEMPNAME] last receive
[fill RITYP]?
MONTH: @MON
YEAR: @YEAR
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-RETYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME] recibi¢
[fill RITYP]?
MES: @MON
A¥O: @YEAR
[#--------------------------------------------------------------------
-OTHRET-
Did [fill TEMPNAME] receive retirement income
from any other source during this time period?
(1) Yes
(2) No
@
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-ORETTYP-
What kind of income was that?
Anything else?
(N) None/No more
(1) Pension from company or union including income
from profit-sharing plans
(2) Federal Civil Service or other Federal civilian
employee pension
(3) State government pension
(4) Local government pension
(5) U.S. Military retirement pay - exclude payments from
the Department of Veterans Affairs (VA)
(6) U.S. Government Railroad Retirement
(7) National Guard or Reserve Forces retirement
(8) Other
@1 @2 @3 @4 @5 @6 @7 @8
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-OTHRRET-
What was the specific "other" source of the
retirement income [fill TEMPNAME] received?
@
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-SRYN-
[fill TEMP5+]
[fill TEMP6+][fill TEMP7+]
[fill TEMP8+] [fill TEMPNAME] receive any
[fill TEMP9+] income as a result of being
a [fill TEMP+]?
(1) Yes
(2) No
@
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-SRTYP- What kind of income was that?
Anything else?
ENTER (N) FOR NONE/NO MORE
(1) Pension from company or union including income
from profit-sharing plans
(2) Veterans' compensation or pension
(3) Federal Civil Service or other Federal civilian employee pension
(4) U.S. Government Railroad Retirement
(5) State government pension
(6) Local government pension
(7) Income from paid-up life insurance policies or annuities
(8) U.S. Military retirement pay. Exclude payments from the
Department of Veterans Affairs (VA)
(9) Black Lung benefits
(10) Worker's Compensation
(11) Payments from estate or trust
(12) National Guard or Reserve Forces retirement
(13) Other
@1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @11 @12 @13
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-SUROTH-
What was the specific "other" source of
income [fill TEMPNAME] received as a
[fill TEMP2+]?
@
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-PWSRYN- Last time we recorded that [fill TEMPNAME] received income
as a result of being a [fill TEMP+] from the following source(s).
[fill WIDOW(<1>)]
[fill WIDOW(<2>)]
[fill WIDOW(<3>)]
[fill WIDOW(<4>)]
[fill WIDOW(<5>)]
[fill WIDOW(<6>)]
[fill WIDOW(<7>)]
[fill WIDOW(<8>)]
[fill WIDOW(<9>)]
[fill WIDOW(<10>)]
[fill WIDOW(<11>)]
[fill WIDOW(<12>)]
[fill WIDOW(<13>)]
Did [fill TEMPNAME] receive income from any of these
sources during the time period from [fill MONTH1+] up to today?
(1) Yes (2) No @YN
Which ones? (A) All sources listed (N) None/No more
@1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @11 @12 @13
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-SURREC1-
In which month did [fill TEMPNAME] last receive
[fill SITYP]?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Other
(N) Never Received
@
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-SURYR1-
When did [fill TEMPNAME] last receive
[fill SITYP]?
MONTH: @MON
YEAR: @YEAR
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-SURYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ [fill SITYP]?
MES: @MON
A¥O: @YEAR
[#--------------------------------------------------------------------
>ENDSUR1<
[roster end SUR]
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-OTHSUR-
Did [fill TEMPNAME] receive income from
any other source during this time period
as a result of being a [fill TEMP+]?
(1) Yes
(2) No
@
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-OSURTYP- What kind of income was that?
Anything else?
(1) Pension from company or union including income from
profit-sharing plans
(2) Veterans' compensation or pension
(3) Federal Civil Service or other Federal civilian employee pension
(4) U.S. Government Railroad Retirement
(5) State government pension
(6) Local government pension
(7) Income from paid-up life insurance policies or annuities
(8) U.S. Military retirement pay. Exclude payments
from the Department of Veterans Affairs (VA)
(9) Black Lung benefits
(10) Worker's Compensation
(11) Payments from estate or trust
(12) National Guard or Reserve Forces retirement
(13) Other
(N) None/No more
@1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @11 @12 @13
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-SUROTHR-
What was the specific "other" source of income
[fill TEMPNAME] received as a [fill TEMP2+]?
@
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-FCCYN-
Did [fill TEMPNAME] receive any foster
child care?
(1) Yes
(2) No
@
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-PWFCCYN-
Last time I recorded that [fill TEMPNAME] received
Foster Child Care payments.
Did [fill TEMPNAME] receive any Foster Child Care
payments at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
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-PWFCCYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
pagos por cuidado de hijos de crianza.
¨Recibi¢ [fill S_TEMPNAME] alg£n pago por cuidado de hijos de crianza
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
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-PWFCCMTH-
In which month did [fill TEMPNAME] last receive
Foster Child Care payments?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
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-PWFCCMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ pagos por cuidado de hijos de crianza?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
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-FCCYR1-
When did [fill TEMPNAME] last receive
Foster Child Care payments?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-FCCYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ pagos por cuidado de hijos de crianza?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-CSAGREE-
Have support payments ever been court ordered
or informally agreed to for [fill TEMP2+]
(1) Yes
(2) No
@
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-CSYN-
Did [fill TEMPNAME] receive any kind of
financial support payments from the
[fill GICHILD]'s other parent?
(1) Yes
(2) No
@
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-CSYN.2-
¨Recibi¢ [fill S_TEMPNAME] alg£n tipo de pagos
de asistencia econ¢mica del padre/madre de [fill GICHILD]?
(1) S¡
(2) No
@
[#-----------------------------------------------------------
-PWCSYN-
Last time I recorded that [fill TEMPNAME] received
Child Support payments.
Did [fill TEMPNAME] receive any Child Support
payments at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
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-PWCSYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
pagos de pensi¢n para menores.
¨Recibi¢ [fill S_TEMPNAME] alg£n pago de pensi¢n para menores
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWCSMTH-
In which month did [fill TEMPNAME] last receive
Child Support payments?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
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-PWCSMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ pagos de pensi¢n para menores?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-CSYR1-
When did [fill TEMPNAME] last receive
Child Support payments?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-CSYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ pagos de pensi¢n para menores?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-ALIYN-
Did [fill TEMPNAME] receive any
alimony payments[fill TEMP2+] [fill TEMP3+]
(1) Yes
(2) No
@
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-ALIYN.2-
¨Recibi¢ [fill S_TEMPNAME] algunos
pagos de pensi¢n alimenticia del c¢nyuge divorciado
[fill TEMP2+] [fill TEMP3+]
(1) S¡
(2) No
@
[#------------------------------------------------------------
-PWALIYN-
Last time I recorded that [fill TEMPNAME] received
Alimony payments.
Did [fill TEMPNAME] receive any Alimony
payments at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
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-PWALIYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢ pagos de pensi¢n alimenticia
del c¢nyuge divorciado.
¨Recibi¢ [fill S_TEMPNAME] alg£n pago de pensi¢n alimenticia del c¢nyuge divorciado
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWALIMTH-
In which month did [fill TEMPNAME] last receive
Alimony payments?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
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-PWALIMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ pagos de pensi¢n alimenticia del c¢nyuge divorciado?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-ALIYR1-
When did [fill TEMPNAME] last receive
Alimony payments?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-ALIYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ pagos de pensi¢n alimenticia del c¢nyuge divorciado?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------------------------
-FSYN-
[fill C_WASWERE] [fill TEMPNAME] [fill TEMP2+]
authorized to receive food stamps?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-FSYN.2-
¨Estaba [fill S_TEMPNAME] [fill TEMP2+]
autorizado(a) a recibir cupones de alimentos?
(1) S¡
(2) No
@
[#------------------------------------------------------------
-PWFSYN-
Last time I recorded that [fill TEMPNAME] [fill TEMP2+]
[fill WASWERE] authorized to receive Food Stamps.
Did [fill TEMPNAME] receive any Food Stamps
at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWFSYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
cupones de alimentos.
¨Recibi¢ [fill S_TEMPNAME] algunos cupones de alimentos
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWFSMTH-
In which month did [fill TEMPNAME] last receive
Food Stamps?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
------------------------------------------------------------------------------
-PWFSMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ cupones de alimentos?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-FSYR1-
When did [fill TEMPNAME] last receive
Food Stamps?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-FSYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ cupones de alimentos?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-WICYN-
[fill C_AREIS] [fill TEMPNAME] on WIC, the Womens,
Infants, and Children's nutrition program?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-WICYN.2-
¨Participa [fill S_TEMPNAME] en el programa WIC, el
Programa de Asistencia de Alimentos para Mujeres,
Ni¤os e Infantes?
(1) S¡
(2) No
@
[#------------------------------------------------------------
-PWWICYN-
Last time I recorded that [fill TEMPNAME] [fill WASWERE]
on WIC, the Womens, Infants, and Children's nutrition program.
[fill C_WASWERE] [fill TEMPNAME] on WIC
at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWWICYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] participa en el programa WIC, el
Programa de Asistencia de Alimentos para Mujeres, Ni¤os e Infantes.
¨Particip¢ [fill S_TEMPNAME] en el programa WIC, el Programa de Asistencia de
Alimentos para Mujeres, Ni¤os e Infantes, en alg£n momento durante el per¡odo de
tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWWICMTH-
In which month did [fill TEMPNAME] last receive
WIC benefits?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
------------------------------------------------------------------------------
-PWWICMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ beneficios de WIC?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-WICYR1-
When did [fill TEMPNAME] last receive
WIC benefits?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-WICYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ beneficios de WIC?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-PATYN-
Did [fill TEMPNAME] [fill TEMP2+] any welfare or public
assistance payments?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PATYN.2-
¨Recibi¢/Recibieron [fill S_TEMPNAME] [fill TEMP2+] Ayuda
a Familias con Hijos Dependientes (AFDC), ayuda de bienestar,
o asistencia p£blica?
(1) S¡
(2) No
@
[#------------------------------------------------------------
-PATYP-
Did [fill HESHE] receive:
READ ALL CATEGORIES. ENTER (N) FOR NONE/NO MORE
(1) Public Assistance Payments-formerly known as AFDC or ADC
(2) General Assistance or General Relief
(3) Energy Assistance Program
(4) Other
@1 @2 @3 @4
------------------------------------------------------------------------------
-PWADCYN-
Last time I recorded that [fill TEMPNAME] received public
assistance payments formerly know as AFDC or ADC?
Did [fill TEMPNAME] receive any such assistance
at any time between [fill MONTH1+] and today?
NOTE FOR FR: DO NOT INCLUDE ANY ENERGY ASSISTANCE
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWADCYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
pagos de AFDC.
¨Recibi¢ [fill S_TEMPNAME] alg£n pago de AFDC
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWADCMTH-
In which month did [fill TEMPNAME] last receive
AFDC?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
------------------------------------------------------------------------------
-PWADCMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ pagos de AFDC?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-ADCYR1-
When did [fill TEMPNAME] last receive
this assistance?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-ADCYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ pagos de AFDC?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-PWGAYN-
Last time I recorded that [fill TEMPNAME] [fill TEMP2+]
received General Assistance.
Did [fill TEMPNAME] receive any General Assistance
at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWGAYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
Asistencia General.
¨Recibi¢ [fill S_TEMPNAME] alguna Asistencia General
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWGAMTH-
In which month did [fill TEMPNAME] last receive
General Assistance?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
------------------------------------------------------------------------------
-PWGAMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ Asistencia General?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-GAYR1-
When did [fill TEMPNAME] last receive
General Assistance?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-GAYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ Asistencia General?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-PWEAYN-
Last time I recorded that [fill TEMPNAME] [fill TEMP2+]
received Energy Assistance.
Did [fill TEMPNAME] receive any Energy Assistance
at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWEAYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
Asistencia para Pago de Energ¡a.
¨Recibi¢ [fill S_TEMPNAME] alguna Asistencia para Pago de Energ¡a
durante el per¡odo de tiempo desde el 1ro. de [fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWEAMTH-
In which month did [fill TEMPNAME] last receive
Energy Assistance?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
------------------------------------------------------------------------------
-PWEAMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ Asistencia para Pago de Energ¡a?
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-EAYR1-
When did [fill TEMPNAME] last receive
Energy Assistance?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-EAYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ Asistencia para Pago de Energ¡a?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-PATYP2-
Since [fill MONTH1+] 1st, did [fill TEMPNAME]
[fill TEMP2+] any:
[bold]ENTER (N) FOR NONE/NO MORE[n]
[fill TEMP3+]
[fill TEMP4+]
[fill TEMP5+]
(4) Other
@1 @2 @3 @4
------------------------------------------------------------------------------
-PATYP2.2-
Desde el 1ro. de [fill S_MONTH1+], ¨recibi¢/recibieron [fill S_TEMPNAME]
[fill TEMP2+] alguna asistencia p£blica de:?
[bold]ENTER (N) FOR NONE/NO MORE[n]
[fill TEMP3+]
[fill TEMP4+]
[fill TEMP5+]
(4) Otro
@1 @2 @3 @4
------------------------------------------------------------------------------
-PAOTHR-
What was the specific "other" source of
public assistance income?
@
------------------------------------------------------------------------------
-PSSTHRU-
Did [fill TEMPNAME] receive ANY
child support as a bonus or pass thru
from a public assistance agency?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWPSYN-
Last time I recorded that [fill TEMPNAME] received
child support as a bonus or pass thru from a public
assistance agency?
Did [fill TEMPNAME] receive any Pass Thru Child Support
payments of this type at any time between [fill MONTH1+] and today?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-PWPSYN.2-
Anteriormente, yo anot‚ que [fill S_TEMPNAME] recibi¢
pensi¢n para menores como bono o pago de pensi¢n para menores por medio de AFDC.
¨Recibi¢ [fill S_TEMPNAME] alg£na pensi¢n para menores como bono o pago de
pensi¢n para menores por medio de AFDC durante el per¡odo de tiempo desde el 1ro. de
[fill S_MONTH1+] hasta hoy?
(1) S¡
(2) No
@
------------------------------------------------------------
-PWPSMTH-
In which month did [fill TEMPNAME] last receive
pass thru child support payments?
(1) [fill I_MONTH1+]
(2) [fill I_MONTH2+]
(3) [fill I_MONTH3+]
(4) [fill I_MONTH4+]
(5) [fill MONTH1+]
(6) [fill MONTH2+]
(7) [fill MONTH3+]
(8) [fill MONTH4+]
(9) Other
(N) Never Received
@
------------------------------------------------------------------------------
-PWPSMTH.2-
¨Cu l fue el £ltimo mes en el cual [fill S_TEMPNAME]
recibi¢ pensi¢n para menores como bono o pago de pensi¢n para menores por medio de
AFDC.
(1) [fill I_MONTH1]
(2) [fill I_MONTH2]
(3) [fill I_MONTH3]
(4) [fill I_MONTH4]
(5) [fill MONTH1]
(6) [fill MONTH2]
(7) [fill MONTH3]
(8) [fill MONTH4]
(9) Otro
(N) Nunca Recibido
@
------------------------------------------------------------
-PSYR1-
When did [fill TEMPNAME] last receive
pass thru child support payments?
MONTH: @MON
YEAR: @YEAR
------------------------------------------------------------------------------
-PSYR1.2-
¨Cu ndo fue la £ltima vez que [fill S_TEMPNAME]
recibi¢ pensi¢n para menores como bono o pago de pensi¢n para menores por medio de
AFDC?
MES: @MON
A¥O: @YEAR
------------------------------------------------------------
-NOINC-
Did [fill TEMPNAME] receive any non-job
income from some source we have not covered,
such as financial help from someone outside
this household, payments from the government,
or anything else?
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-INCLIST- I have recorded that, between [fill MONTH1+] 1st and today,
[fill TEMPNAME] had the following sources of non-job income:
(READ NAMES OF INCOME SOURCES)
PRESS "SHIFT-F6" TO ACCESS INCOME SOURCES LISTED IN BOX
BELOW. PRESS "SHIFT-F6" AGAIN TO RETURN TO THIS POINT.
Have I listed anything that SHOULD NOT be there?
(1) Yes
(2) No @
------------------------------------------------------------------------------
-ERRSRC-
Which of these?
(N) None/No more
@1 @2 @3
@4 @5 @6
------------------------------------------------------------------------------
-ANYOTH-
Did [fill TEMPNAME] receive income from any
source, such as financial help from someone
outside the household, payments from the government,
or any other program income?
NOTE TO FR: DO NOT ANSWER 'YES' FOR ANY TYPES OF
ASSET-BASED INCOME, WHICH WILL BE COVERED IN THE NEXT SECTION.
(1) Yes
(2) No
@
------------------------------------------------------------------------------
-OTHSRCE- PRESS "SHIFT-F6" TO ACCESS INCOME SOURCES LISTED IN BOX
BELOW. PRESS "SHIFT-F6" AGAIN TO RETURN TO THIS POINT.
What kind of income did [fill TEMPNAME] receive?
ENTER NUMERIC CODE OF INCOME SOURCE REPORTED
ANYTHING ELSE? (N) None/No more
@1 @2 @3 @4
------------------------------------------------------------------------------
-H_SSIYN-
SSI pays monthly benefits to aged, disabled,
and blind people who have limited income and
assets regardless of age. Note: a person may
be eligible for SSI payments even if they have never worked.
SSI is NOT the same as Social Security. Person can
get SSI in addition to Social Security.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_STSSIYN-
The SSI program is issued by the Social Security
Administration. Each state may add to the Federal
payment from its own funds. This additional money
may be included in the Federal payment or it may be
received as a separate check. If it is combined with
the Federal payment, the words "STATE PAYMENT INCLUDED"
will appear on the Federal check. A few states make
SSI payments to individuals who do not receive a
Federal payment.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_LIFEYN-
Many life insurance policies allow a person to
covert the policy to an annuity at retirement
or at age 65. Thereafter, rather than the person
paying a premium, the policy pays the person a
regular income for life or for a specified number of years.
Annuities are purchased by people at retirement or
during the person's working years to guarantee a
regular income after retirement.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_DISTYP-
Workers' Compensation - payments are generally made
under state laws set up to compensate workers for loss
of pay because of accidents or illnesses caused by or
happening on the job.
Payments from a sickness, accident, or disability insurance
policy - An individual who is sick or disabled may receive
income from private disability insurance that he/she purchased
on his/her own. Policies may cover cases where either a
short-term or long-term illness has forced an individual to
stop working in his/her regular job.
Employer disability payments - This privately run program
(established by either an employer or union) pays benefits
to persons with temporary sickness or disability. This
program is not connected with any government program.
Pension from company or union - A private retirement pension
is received by a retired or disabled person from a former
employer or labor union, either directly or through an
insurance company.
Federal Civil Service - Federal employee retirement pensions
are payments by the Federal Government to its retired and/or
disabled civilian employees. Do not use this category for
military retirement pensions.
U.S. Military retirement pay - Military retirement pay is
received by persons are former career members of the
U.S. Armed Forces. Payments are based on a percentage of
the active duty basic pay which is adjusted by semiannual
cost of living changes. Do not include payments from the
Veterans' Administration of disabled or aged veterans.
State government retirement pension - State government
retirement pensions include payments by state government
agencies such as colleges or universities or state hospitals
to their retired former employees, and to employees who
retired early because of disability.
Local government retirement pension - Local government
retirement pensions are paid to those retired person who
were former employees or the city, county or other local
government agencies such as police and fire departments,
libraries and public schools and hospitals and to employees
who retired early because of disability.
U.S. Government Railroad Retirement - Railroad Retirement
Benefits are based on a person's long-term employment in the
railroad industry.
Black Lung payments - Miners who are disabled by black lung
disease are entitled to payment under this program. Payment
amounts increase with the number of dependents. Most of the
payments are administered by the Social Security Administration.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_FSYN-
Food Stamps are coupons that can be used to purchase food.
The food stamp program is a joint federal-state program
which is administered by state and local governments.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_SSYN-
Social Security payments are received by person who have
worked long enough in employment which Social Security
deductions were made from a person's salary in order to
be entitled to payments.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_SSCLDYN-
Social Security payments are received by person who
have worked long enough in employment which SS deductions
were made from a person's salary in order to be entitled
to payments. SS payments may be made to the spouse or
dependent children of covered workers. SS also pays
benefits to student dependents (under 19 years of age)
of eligible social security annuitants who are disabled
or deceased.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
-H_PATYP-
AFDC or ADC - Aid to Families with Dependent Children
(AFDC) or Aid for Dependent Children (ADC) is a
program that is state or locally administered. Eligibility
for AFDC/ADC is based on (1) the incapacity or death of a
parent; (2) a parent's continued absence from the home; or
(3) the unemployment of a parent.
General Assistance or General Relief - State and local programs
provide cash assistance to persons not eligible for AFDC or SSI,
and to persons awaiting enrollment in AFDC or SSI. These
programs are also available to persons out of work who cannot
qualify for unemployment insurance or whose benefits under that
program are inadequate or have been exhausted. General
assistance or general relief programs are often called by other
names.
WIC - The Supplemental Food Program for Women, Infants and
Children (WIC) provides food, and/or vouchers which can be
exchanged for food. Pregnant women without children may also
qualify for this program.
PRESS "ENTER" TO EXIT HELP.
@
------------------------------------------------------------------------------
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Page Last Modified: May 12, 2006
