LRC SAVINGS REGISTRATION SURVEY Question Title * 1. What is your first name? Question Title * 2. What is your email address? Question Title * 3. In what state or U.S. territory do you live? I don't live in the U.S.A. Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia (DC) Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming Question Title * 4. In what country do you live? Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte D'Ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea Bissau Guyana Haiti Holy See Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka State of Palestine Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom of Great Britain and Northern Ireland United Republic of Tanzania United States of America Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Vietnam Yemen Zambia Zimbabwe Question Title * 5. Gender? Male Female I don't identify with either Question Title * 6. What is your race/ethnicity? White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another race Other (please specify) Question Title * 7. Which category below includes your age? 17 or younger 18-24 25-34 35-44 45-54 55-64 65 or older Question Title * 8. What is the highest level of school you have completed or the highest degree you have received? Less than high school degree High school degree or equivalent (e.g., GED) Some college but no degree Associate degree Bachelor degree Graduate degree Question Title * 9. Do you own a business? Yes No Question Title * 10. Which of the following categories best describes your employment status? Self employed Employed, working 40 or more hours per week Employed, working 1-39 hours per week Not employed, looking for work Not employed, NOT looking for work Retired Disabled, not able to work Question Title * 11. How much money did YOU personally earn each year? Please choose the total amount of money you earned - do not subtract the amount you paid in taxes or any deductions listed on your tax return. $0 - $9,999 $10,000 - $19,999 $20,000 - $29,999 $30,000 - $39,999 $40,000 - $49,999 $50,000 - $59,999 $60,000 - $69,999 $70,000 - $79,999 $80,000 - $89,999 $90,000 - $99,999 $100,000 - $124,999 $125,000 - $149,999 $150,000 - $199,999 More than $200,000 I earned my income outside of the U.S. in a different currency. Question Title * 12. Which of the following best describes your current relationship status? Married Widowed Divorced Separated In a domestic partnership or civil union Single, but cohabiting with a significant other Single, never married Question Title * 13. How many children are you parent or guardian for and live in your household (aged 17 or younger only)? None 1 2 3 4 More than 4 Question Title * 14. What are your financial obstacles? The primary reason you joined the LIVE RICHER Challenge. (choose all that apply) Excessive spending An inability to budget Difficulty paying bills A struggle to save Student loan debt Credit card debt Utility debt Medical bill debt Poor spending habits Poor credit score Living paycheck-to-paycheck Limited or non-existent understanding of investing Limited/No retirement plan Poor money management (regardless of salary) Difficulty paying my mortgage Other (please specify) Question Title * 15. What are your financial goals? (choose ALL that apply) Decrease excessive spending Build and stick to a budget Pay all of my bills on time Automate bill payments Develop and utilize a savings account Develop a savings plan Open and use a savings account Decrease/Eliminate debt Control spending Make a major purchase (home/condo/auto) Develop a student loan/debt repayment plan Learn how to invest Increase credit score Better understand credit Develop a healthy relationship with money Increase savings Travel /vacations Developing an emergency fund Other (please specify) Done! Grab Your Free Resources!
