Income Level Survey Questionnaires
Please complete this questionnaire to share non-sensitive information about your income level and household situation for survey purposes.
Respondent Profile
Age range
*
18–24
25–34
35–44
45–54
55–64
65+
Prefer not to say
Employment status
*
Please Select
Employed full-time
Employed part-time
Self-employed
Unemployed and looking for work
Unemployed and not looking for work
Student
Retired
Homemaker
Prefer not to say
Household size
*
Education level
*
Please Select
Less than high school
High school diploma or equivalent
Some college, no degree
Associate degree
Bachelor's degree
Master's degree
Professional degree
Doctorate
Prefer not to say
Income and Household Situation
Annual household income range
*
Less than $25,000
$25,000–$49,999
$50,000–$74,999
$75,000–$99,999
$100,000–$149,999
$150,000 or more
Prefer not to say
Primary source of household income
*
Employment wages or salary
Self-employment or business
Retirement benefits
Government assistance
Investment or rental income
Pension or annuity
Multiple sources equally
Prefer not to say
Other
Number of income earners in household
*
Monthly housing cost range
*
Less than $500
$500–$999
$1,000–$1,499
$1,500–$1,999
$2,000–$2,499
$2,500 or more
Prefer not to say
How comfortable are you with your savings covering unexpected expenses?
*
Not at all comfortable
1
2
3
4
Very comfortable
5
1 is Not at all comfortable, 5 is Very comfortable
Survey Rating and Comments
How would you rate your overall financial stability?
*
Very unstable
1
2
3
4
5
6
7
8
9
Very stable
10
1 is Very unstable, 10 is Very stable
Additional comments or context
Submit
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