San Francisco Upcoming Paid Study - Household Finances September 2011

Thank you for taking the time to answer these brief questions. As always, we appreciate your input as a valuable Plaza Research respondent. Plaza Research San Francisco is currently looking for Males & Females ages 30-48 for a two hour in-home interview taking place in your home on September 13 or September 14. You will receive a $150-$200 honorarium for your time.

IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone.

Please note that all responses will be returned on a first come, first served basis until the studies are full.

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* 1. Contact information

Name:

Company:

Email Address:

Phone Number:

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* 2. Exact Age

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* 3. Employment

Not employed

Stay at home mom/dad

Employed part-time

Employed full-time

Retired

Other

Other (please specify)

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* 4. Employment Information (if not employed, please write "n/a")...

Job Title

Company

Industry

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* 5. Ethnic background

African American

Asian

Caucasian

Hispanic

Other (please specify)

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* 6. What is your household income?

$39k or less

$40k-$50k

$51k-$60k

$61k-$70k

Over $71k

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* 7. What is the highest level of education you have completed?

Less than High school

High school graduate

Technical/ Trade school

Some college

College graduate

Some Post graduate

Post graduate degree

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* 8. Which of the following do you currently have? (check all that apply)

Checking account

Saving account

Credit Card

None of the above

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* 9. Which of the following, if any, do you currently own or have and have used or accessed in the past 30 days? (check all that apply)

Debit Card

Prepaid Cell Phone (Plastic card that you must add minutes to)

Prepaid Card (Plastic credit cards that you can add money to and use wherever the brand of the card is accepted or to get cash out of an ATM)

None of the above

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* 10. In the past 60 days, which of the following services, if any, have you used? (check all that apply)

A money order purchased from a company other than a bank

A money order purchased from a bank

A check cashing company other than a bank

A bank for cashing a check

A payday loan

None of the above

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* 11. Which of the following BEST describes your current financial situation?

I am doing well financially and do no anticipate any financial issues in the future

I feel OK about my current financial situation, but am optimistic about the future

I am struggling financially, but am optimistic about the future

I am struggling financially and am not feeling positive about my financial future

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* 12. Do you currently have children living at home?

Yes

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* 13. Which of the following describes your current marital status?

Single, not living with a significant other

Single, but living with a significant other

Married

Divorced/Separated

Widower/Widow

**IMPORTANT: PLEASE PUSH THE "DONE" BUTTON AT THE BOTTOM OF THIS SCREEN. YOUR ANSWERS WILL NOT BE SAVED WITHOUT DOING SO!**

Thank you for participating in our survey. IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone. Please note that all responses will be returned on a first come, first served basis until the studies are full.

*****REFERRALS ARE GREATLY APPRECIATED!*****

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* 1. Contact information

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* 2. Exact Age

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* 3. Employment

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* 4. Employment Information (if not employed, please write "n/a")...

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* 5. Ethnic background

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* 6. What is your household income?

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* 7. What is the highest level of education you have completed?

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* 8. Which of the following do you currently have? (check all that apply)

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* 9. Which of the following, if any, do you currently own or have and have used or accessed in the past 30 days? (check all that apply)

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* 10. In the past 60 days, which of the following services, if any, have you used? (check all that apply)

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* 11. Which of the following BEST describes your current financial situation?

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* 12. Do you currently have children living at home?

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* 13. Which of the following describes your current marital status?

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* 14. FOR COMPANY USE ONLY
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