Program cash payments (generally includes basis of payment—whether weekly, monthly, quarterly, etc.; number of payments; who in household received; reasons for receipt)
State or federal unemployment compensation
Supplemental unemployment benefits
Union unemployment or strike benefits
Worker's compensation payments
Social Security payments last year and month
Social Security received for children last year and month
Supplemental Security Income
SSI received for children
Public assistance or welfare payments from state or local welfare office; type of assistance (AFDC, other, both)
Veterans' payments by type
Survivors' benefits by type (e.g., private or public widows' pensions, estates, trusts, annuities; excluding Social Security or VA)
Disability benefits by type (excluding Social Security or VA)
Pension or retirement benefits by type (excluding Social Security or VA)
Asset income (generally includes who owns, basis of payment, number of payments)
Interest income
Dividend income
Property income (including rent, royalties, income from estates or trusts)
Other Income
Child support payments
Alimony payments
Regular financial assistance from friends or relatives
Income from hobbies, home businesses, or farms not already covered
Income from unemployment compensation, severance pay, welfare, foster child payments, or other money income not already covered
Educational assistance from Pell Grants; from other sources
In-Kind Program Participation
Number of children who ate lunch at school; number who qualified for free or reduced price lunch
Whether live in public housing project or have subsidized rent
Whether household received food stamps; who covered; monthly amount; number of months
Receipt of heating assistance; amount
[Note: There are no questions on welfare program participation prior to the previous year.]
Health problem that prevents or limits work
Ever retired or left a job for health reasons
Self-assessment of health status (poor to excellent)
Health insurance coverage from current or former employer or union; policyholders; who covered; whether current or former employer or union paid all, part, or none of premium
Health insurance coverage purchased directly; policyholders; who covered
Health insurance coverage from non-household member; who covered Medicare coverage; who covered
Medicaid coverage; who covered; number of months covered
CHAMPUS or CHAMPVA coverage; who covered
Coverage by any other state health insurance plan or any other coverage (plans in 26 states listed as possibilities); who covered
[Note: Above questions are for coverage any time during previous year; type of coverage last week also ascertained. There are no questions on reasons for lack of coverage.]