ASSETS. Sampling Note: No sampling in this module.

ASSETS Sassets 11-16-05 Page 1 of 10 Sampling Note: No sampling in this module. HOMES >pintro< The next section covers different types of assets that you or your spouse may have, such as real estate, motor vehicles and financial investments. >p814m< Do you own your own home, or are you renting? own Rent/other dkr >p814s< How much do you think your home would sell for now? //bracketed// >p814z< How much, if anything, do you owe on your home? //bracketed// Is the home worth less than $70,000? yes No >pu815< Is this a MOBILE home? >pu815a< Do you live in a retirement community? >pu815b< Would you be allowed to continue living in your current residence even if you needed substantial care? No dkr

of 10 FARMS >p818< Do you own a business or farm? N / DK >p818f< How much do you think this business or farm would sell for now? //bracketed// >p818z< How much, if anything, do you owe on your business or farm? //bracketed// OTHER REAL ESTATE >pu816f< Do you own any other real estate, (such as a second home, land, rental real estate, a real estate partnership, or money owed to you on a land contract or mortgage)? N / DK >p816m< How much do you think this other real estate would sell for now? //bracketed// >p816z< How much, if anything, do you owe on your other real estate? //bracketed//

of 10 VEHICLES >pu818s< Next, we would like to know about any motor vehicles you may have. These would include cars, trucks, campers, boats, airplanes, and other RVs. Thinking of all your motor vehicles together, would you say they are worth more than $1,000 or less than $1,000? Less/D K/R More >p820m< Altogether how much do you think these vehicles would sell for now? //bracketed// >p820z< How much, if anything, do you owe on these vehicles? //bracketed// OTHER DEBTS >p820n< Do you owe a total of $5,000 or more for anything other than what we have already talked about? (such as,for credit cards, installment loans, overdue bills, and personal loans for schooling or other purposes.) N / DK >p820s< Altogether how much do you owe on all your debts other than mortgages, car, and business loans? //bracketed//

of 10 SAVINGS & INVESTMENTS >pu822a1< The next questions ask about a number of different kinds of savings or investments you may have. First we will ask you about retirement savings, then about banking accounts, next about saving bonds and certificates of deposit, and finally about your stock or bond market investments. >pu822b< Some people have retirement plans that accumulate an ACCOUNT BALANCE -- these are things like IRA's, 401k's and profit sharing plans. Do you (or your husband/wife) have any plans like this? N / DK >pu822c< If you added up all such accounts, about how much would they amount to right now? //bracketed// CHECKING/SAVINGS: R (and Spouse) >pu822a3< Do you (or your husband/wife) have more than $1,000 or less than $1,000 in checking accounts, savings accounts, or money market funds? More Less/D K/R >pu822a3a< If you added up all such accounts, about how much would they amount to right now? //bracket//

of 10 CDs, Government Savings Bonds... R (and Spouse) >pu822a4< Aside from anything you have already told me about, do you (or your husband/wife) have any money in CDs, Government Savings Bonds, or Treasury Bills? N / DK >pu822a4a< If you added up all such accounts, about how much would they amount to right now? //bracketed// Stocks, Mutual Funds: R (and Spouse) >pu822f1< (Aside from anything you have already told me about, do you (or your husband/wife) have any money in/what about) stocks, bonds, or shares in a mutual fund? N / DK >pu822f1a< If you sold all of these and paid off anything you owed on them, about how much would you have? //bracketed//

of 10 Other Assets: R (and Spouse) >pu822f3< (Aside from anything you have already told me about, do you (or your husband/wife) have any money in/what about) any other savings or assets? (Such as jewelry, money owed to you by others, a collection for investment purposes, rights in a trust or estate where you are the beneficiary, or an annuity.) N /DK >pu822f3a< If you sold all that and paid off any debts on it, about how much would you have? //bracketed//

of 10 Life Insurance: R >pu823< Do you, yourself, have any life insurance, including individual or group policies? N /DK go to >pu823g< >pu823b< How much money would your beneficiaries receive from these policies if you were to die? //bracketed// Is R included in the non-normative sample? No es >pu823c< Who are the beneficiaries of (this policy/all these policies)? ENTIREL TO SPOUSE SPOUSE AND KIDS EQUALL TO ALL CHILDREN OR ONL CHILD OTHER [specify] dk/r primarily to one Child >pu823d< Which child is that? [display the roster of living kids]

Sassets_12-14-04 Page 8 of 10 >pu823e< Is the face value less than $50,000? N es go to >pu823g< >pu823ee< Are any of these life insurance policies that build up a cash value (that you can borrow against, or that you would receive if the policy were to be canceled)? NO dkr >pu823f< What is the total CASH VALUE of these policies? (The CASH VALUE of a policy is what the insurance company would pay if the policy were canceled before death.) //bracketed// Is R married? N go to end

of 10 Life Insurance:Spouse >pu823g< Does your (husband/wife) have any life insurance, including individual or group policies? N / DK go to >pwho< >pu823i< How much money would (his/her) beneficiaries receive from these policies if your (husband/wife) were to die? //bracketed// Is R included in the non-normative sample? No es >pu823cs< Who are the beneficiaries of these policies? ENTIREL TO SPOUSE SPOUSE AND KIDS EQUALL TO ALL CHILDREN OR ONL CHILD OTHER [specify] dk/r primarily to one Child >pu823ds< Which child is that? [display the roster of living kids]

of 10 Life Insurance: Spouse >pu823l< Is the face value less than $50,000? N es go to >pwho< >pu823ll< Are any of these life insurance policies that build up a cash value (that your (husband/wife) can borrow against, or that (he/she) would receive if the policy were to be canceled)? es >pu823f< What is the total CASH VALUE of these policies? NO dkr (The CASH VALUE of a policy is what the insurance company would pay if the policy were canceled before death.) //bracketed// Is R married? es >pwho< Who in your family knows the most about your assets, debts and retirement plans? Would you say it is you or your (husband/wife)? END OF MODULE