Section A
A1.

How true for you is each of the following statements? Answer for each on a scale from 1 to 5, where “1” means it isparticularly true for you and “5” means “it doesn't hold true at all for you. (X ONE Box For EACH)
Doesn’t Hold
Particularly
True At All
True For Me
For MeMy daily life is fulfilling .............................................................................. 12345I plan to spend a lot of money or plan to purchase expensive
items in the future ................................................................................. 1 □
2 □
3 □
4 □
5 □
I don’t feel uncomfortable borrowing money ............................................ 1 □
2 □
3 □
4 □
5 □
I am so occupied with my daily life that I cannot save much money ....... 1 □
2 □
3 □
4 □
5 □
Even if I make plans, I end up procrastinating ......................................... 1 □
2 □
3 □
4 □
5 □
If there is something that I want, I need to buy it ..................................... 1 □
2 □
3 □
4 □
5 □
I always plan things before I actually do them ......................................... 1 □
2 □
3 □
4 □
5 □
If I have work that can wait to be done tomorrow,
I wait until tomorrow to do it ................................................................ 1 □
2 □
3 □
4 □
5 □
I have anxieties about my health ............................................................. 1 □
2 □
3 □
4 □
5 □
I am deeply religious................................................................................. 1 □
2 □
3 □
4 □
5 □
I have been feeling stressed lately ......................................................... 1 □
2 □
3 □
4 □
5 □
I have been feeling depressed lately ....................................................... 1 □
2 □
3 □
4 □
5 □
I haven’t been sleeping well lately ........................................................... 1 □
2 □
3 □
4 □
5 □
I have been feeling lonely lately ............................................................... 1 □
2 □
3 □
4 □
5 □
I have anxieties about my ‘life after I am 65 years old’*(For those who are already aged 65 or above, ‘life in future’) ............ 1 □
2 □
3 □
4 □
5 □
I want to bequeath as much of my inheritance as possible
to my spouse......................................................................................... 1 □
2 □
3 □
4 □
5 □
Behaving similarly to people around me makes me feel comfortable .... 1 □
2 □
3 □
4 □
5 □
When I am faced with a problem, I usually act before I think .................. 1 □
2 □
3 □
4 □
5 □
I never cut into a line of people ................................................................ 1 □
2 □
3 □
4 □
5 □
I always keep my promise ........................................................................ 1 □
2 □
3 □
4 □
5 □
I am never late for appointments/deadlines ........................................... 1 □
2 □
3 □
4 □
5 □
Work is something to live for .................................................................... 1 □
2 □
3 □
4 □
5 □
Work is for making money........................................................................ 1 □
2 □
3 □
4 □
5 □
I enjoy competing with others................................................................... 1 □
2 □
3 □
4 □
5 □
I plan tasks carefully................................................................................. 1 □
2 □
3 □
4 □
5 □
I plan trips well ahead of time .................................................................. 1 □
2 □
3 □
4 □
5 □
I exercise self-control ............................................................................... 1 □
2 □
3 □
4 □
5 □
I am an observant thinker......................................................................... 1 □
2 □
3 □
4 □
5 □
I plan for job security ................................................................................ 1 □
2 □
3 □
4 □
5 □
I say things without thinking ..................................................................... 1 □
2 □
3 □
4 □
5 □
I take nutritional content into account when choosing foods ................... 1 □
2 □
3 □
4 □
5 □
I take the time to properly chew my food ................................................. 1 □
2 □
3 □
4 □
5 □
I always eat my meals at the same time .................................................. 1 □
2 □
3 □
4 □
5 □

□

□

□

□

□

A2. To what extent do you agree with each of the following statements? Answer on a scale from 1 to 5, where “1” means
you agree completely and “5” means you disagree completely. Of course, you may choose any number in between.
(X ONE Box For EACH)
Completely
Completely
Agree
DisagreeIn general, most people are trustworthy. .................................................. 1 □

2

□

3

□

4

□

5

□

2

□

3

□

4

□

5

□

2

□

3

□

4

□

5

□

2

□

3

□

4

□

5

□

2

□

3

□

4

□

5

□

I feel happy when I do a good deed that I think benefits
others (such as picking up trash in a park)............................................. 1 □It is the government’s responsibility to take care of those who cannot
take care of themselves financially ....................................................... 1 □Child(ren) should take care of their parents when they requirelong-term care ....................................................................................... 1 □If I have child(ren), I would like my child(ren) to take care of me
when I require long-term care................................................................. 1 □A3. Suppose that you are to receive money from someone. You can either choose to receive the money today, or 7days from today, but the amounts will be different. Compare the amounts and dates below in Option “A” andOption “B”, and indicate which option you prefer for each of the nine choices.
Option “A”
Option “B”
Which ONE do you prefer?
(X
ONE Box For EACH Row)
Receiveor
Receive
7
days
today
Option “A”
Option “B”
from today¥3,005¥3,0141□
2□¥3,003¥3,2971□
2□¥3,008¥3,0371□
2□¥3,000¥3,0001□
2□¥3,005¥5,951
1□
2□¥3,009¥3,0681□
2□¥3,001¥3,1191□
2□¥3,002¥2,9961□
2□¥3,008¥3,011
1□
2□

1

A4. Now, suppose that you are to receive money from someone and you can choose either to receive the money 90
days from today, or 97 days from today, but the amounts will be different. Compare the amounts and dates
below in Option “A” and Option “B” and indicate which option you prefer for each of the nine choices.
Option “A”
Option “B”
Which ONE do you prefer?
(X ONE Box For EACH Row)
Receive 90
Receive
97
or
days
days
Option “A”
Option “B”
from today
from today¥3,000¥3,1181□
2□¥3,006¥3,0001□
2□¥3,000¥3,0091□
2□¥3,007¥3,301
1□
2□¥3,006¥3,0351□
2□¥3,002¥3,0051□
2□¥3,007¥5,9551□
2□¥3,001¥3,001
1□
2□¥3,007¥3,066
1□
2□

A5. Now, suppose that you are to receive money from someone and you can choose either to receive the money today,or 28 days from today, but the amounts will be different. Compare the amounts and dates below in Option “A” andOption “B” and indicate which option you prefer for each of the nine choices.
Option “A”
Option “B”
Which ONE do you prefer?
(X ONE Box For EACH Row)
Receive 28
or
Receive today
days
Option “A”
Option “B”
from today¥3,004¥3,2401□
2□¥3,000¥3,0001□
2□¥3,005¥3,0171□
2□¥3,001¥14,7691□
2□¥3,006¥3,1221□
2□¥3,007¥3,4791□
2□¥3,002¥2,9781□
2□¥3,009¥4,1871□
2□¥3,007¥3,042
1□
2□

A6.
Let’s assume that you are required to spend 3 hours (=180 Minutes) once a year cleaning a park. Today is yourassigned work day, but it seems that the park has less litter than expected. Now you have the choice to shorten yourwork hours either today or on the next available day, which is 7 days from today. Please look at Option “A” andOption “B” below for the work date and minutes you can choose, and indicate which you prefer for each of the eightchoices.
Option “A”
Option “B”
Which ONE do you prefer?
(X ONE Box For EACH Row)or
Reduce my working time
Reduce my working time 7
todaydays from today
Option “A”
Option “B”
60 Minutes reduction
74 Minutes reduction
1□
2□
59 Minutes reduction
61 Minutes reduction
1□
2□
58 Minutes reduction
48 Minutes reduction
1□
2□
60 Minutes reduction
90 Minutes reduction
1□
2□
59 Minutes reduction
59 Minutes reduction
1□
2□
58 Minutes reduction
64 Minutes reduction
1□
2□
59 Minutes reduction
68 Minutes reduction
1□
2□
61 Minutes reduction
55 Minutes reduction
1□
2□
A7. Now, let’s assume that you are required to spend 3 hours (=180 Minutes) once a year cleaning a park. Your assigned
work day is 90 days from today, but it seems that the park will have less litter than expected. You now have thechoice to shorten the work hours either on that day, 90 days from today, or on the next available day, which is
97 days from today. Please look at Option “A” and Option “B” below for the work date and minutes you canchoose, and indicate which you prefer for each of the eight choices.
Option “A”
Option “B”
Which ONE do you prefer?
(X ONE Box For EACH Row)or
Reduce my working time
Reduce my working time
90 days from today
97 days from today
Option “A”
Option “B”
61 Minutes reduction
63 Minutes reduction
1□
2□
60 Minutes reduction
90 Minutes reduction
1□
2□
58 Minutes reduction
48 Minutes reduction
1□
2□
59 Minutes reduction
65 Minutes reduction
1□
2□
60 Minutes reduction
54 Minutes reduction
1□
2□
58 Minutes reduction
72 Minutes reduction
1□
2□
59 Minutes reduction
59 Minutes reduction
1□
2□
60 Minutes reduction
69 Minutes reduction
1□
2□

2

A8.

Let’s assume that you are required to spend 3 hours (=180 Minutes) once a year cleaning a park. Today is yourassigned day, but it seems that the park has less litter than expected. Now you have the choice to shorten thework hours either today or on the next available day, which is 28 days from today. Please look at Option“A” and Option “B” below for the work date and minutes you can choose, and indicate which you prefer for each of
the eight choices.
Option “A”
Option “B”
Which ONE do you prefer?
Reduce my working(X ONE Box For EACH Row)or
Reduce my working
time 28 days fromtime today
Option “A”
Option “B”
today
61 Minutes reduction
99 Minutes reduction
1□
2□
60 Minutes reduction
36 Minutes reduction
1□
2□
58 Minutes reduction
58 Minutes reduction
1□
2□
59 Minutes reduction
177 Minutes reduction
1□
2□
60 Minutes reduction
67 Minutes reduction
1□
2□
58 Minutes reduction
82 Minutes reduction
1□
2□
61 Minutes reduction
119 Minutes reduction
1□
2□
59 Minutes reduction
18 Minutes reduction
1□
2□

A9. In which of the following two ways would you prefer to receive your monthly salary? Assume that your job
assignment is the same for each scenario. If you are a dependent (e.g. student, housewife, etc.) and not working,please answer based on the assumption that your monthly income equals your current actual living expenses.
(X ONE Box)
Option “A”

Option “B”

or

A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 60%
A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 50%
A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 45%
A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 30%
A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 10%
A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 5%
A 50% chance of the salary doubling, butalso a 50% chance of the salarydecreasing by 1%

Which ONE do you prefer?
(X ONE Box For Each ROW)

Option “A”

Option “B”

Guaranteed to the salary
increase by 0.5%

1

□

2

□

Guaranteed to the salary
increase by 0.5%

1

□

2

□

Guaranteed to the salary
increase by 0.5%

1

□

2

□

Guaranteed to the salary
increase by 0.5%

1

□

2

□

Guaranteed to the salary
increase by 0.5%

1

□

2

□

Guaranteed to the salary
increase by 0.5%

1

□

2

□

Guaranteed to the salary
increase by 0.5%

1

□

2

□

A10. In which of the following two ways would you prefer to receive your monthly salary? Assume that your job
assignment is the same for each scenario. If you are a dependent (e.g. student, housewife, etc.) and not working
please answer based on the assumption that your monthly income equals your current actual living expenses.
(X ONE Box)
Option “A”

Option “B”

orWhich ONE do you prefer?
(X ONE Box For Each ROW)

Option “A”
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 19%
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 17%
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 15%
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 13%
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 12%
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 11%
A 50% chance of the salary decreasing by
30%, but also a 50% chance of the salarydecreasing by 10%

Option “B”

Guaranteed to the salarydecrease by 20%

1

□

2

□

Guaranteed to the salarydecrease by 20%

1

□

2

□

Guaranteed to the salarydecrease by 20%

1

□

2

□

Guaranteed to the salarydecrease by 20%

1

□

2

□

Guaranteed to the salarydecrease by 20%

1

□

2

□

Guaranteed to the salarydecrease by 20%

1

□

2

□

Guaranteed to the salarydecrease by 20%

1

□

2

□

3

A11. In which of the following two ways would you prefer to receive your monthly salary? Assume that your job
assignment is the same for each scenario. If you are a dependent (e.g. student, housewife, etc.) and not working
please answer based on the assumption that your monthly income equals your current actual living expenses.
(X ONE Box)
Option “A”
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 10.5%
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 11%
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 13%
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 14%
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 15%
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 16%
A 50% chance of the salary increasing by
30%, but also a 50% chance of the salary
increasing by 18%
A12.

Which ONE do you prefer?
(X ONE Box For Each ROW)

Option “B”

orOption “A”

Option “B”

Guaranteed to the salary
increase by 20%

1

□

2

□

Guaranteed to the salary
increase by 20%

1

□

2

□

Guaranteed to the salary
increase by 20%

1

□

2

□

Guaranteed to the salary
increase by 20%

1

□

2

□

Guaranteed to the salary
increase by 20%

1

□

2

□

Guaranteed to the salary
increase by 20%

1

□

2

□

Guaranteed to the salary
increase by 20%

1

□

2

□

Overall, how happy would you say you are currently? Using a scale from 0 - 10 where “10” is “very happy” and “0”is “very unhappy”, how would you rate you current level of happiness? (X ONE Box)
Very Happy
Very Unhappy
10

□

09

□

08

□

07

□

06

□

05

□

04

□

03

□

02

□

01

□

00

□

A13.

Compared to 1 year ago, do you think that you are happier now than you were then? (X ONE Box)
1 □Happier than 1 year ago
3 □Less happy than 1 year ago
2 □About the same as 1 year ago
4 □Don't know

A14.

How does your standard of living compare with that of the people around you? (X ONE Box)
1 □ Theirs is much lower than mine
4 □ Theirs is somewhat higher than mine
2 □ Theirs is somewhat lower than mine
5 □ Theirs is much higher than mine
3 □ Theirs is about the same as mine

A14-1. In A14, with whom did you compare your standard of living? (X ONE Box)
01 □ Neighbor
02 □ Your own classmates when you were in school
03 □ Relatives
04 □ Families of your children’s classmates
05 □ Worker in your company who is in your age group, has similar academic background, or who started
working in the same year
06 □ Worker in your company who is assigned to a similar job as yours, regardless of their age, academic
background, year in which he or she joined the company.
07 □ Worker in another company in the same industry who belongs to the same age group, has similar
academic background, or who started working in the same year
08 □ Worker in another company in the same industry who is assigned to a similar job as yours, regardlessof his or her age, academic background, and year in which he or she joined a company
09 □ Average person in the US
10 □ Average person in the world
11 □ Friend or acquaintance excluding above choices
12 □ Others (Specify): _________________________
13 □ I don’t know
A15.

Suppose that there is a “speed lottery” with a 50% chance of winning ¥100,000. If you win, you get the prize rightaway. If you lose, you get nothing. How much would you spend to buy a ticket for this lottery? Choose Option “A”
if you would buy it at that price, and choose Option “B” if you would not buy the ticket at that price.
(X ONE Box For EACH Row)
Price of the “speed
lottery” ticket¥10¥2,000¥4,000¥8,000¥15,000¥25,000¥35,000¥50,000

Which ONE do you prefer?
(X ONE Box For EACH Row)
Option “A”
Option “B”(buy the “speed lottery” (DO NOT buy the “speed
ticket)lottery” ticket)

□
□
1 □
1 □
1 □
1 □
1 □
1 □

□
□
2 □
2 □
2 □
2 □
2 □
2 □

1

2

1

2

4

A16.

Assume that you know there is a 50% chance of losing ¥100,000 on a given day. You can take out insurance
to cover this amount in case of loss. If an insurance policy is sold as listed below, would you purchase it? You
may choose Option “A”, to purchase the insurance, or Option “B”, not to purchase the insurance. Pleaseindicate which option you prefer for each of the nine insurance prices.
Which ONE do you prefer?
(X ONE Box For EACH Row)
Option “A”
Option “B”(purchase the(NOT purchase theinsurance)
insurance)

Price of the insurance

□
□
1 □
1 □
1 □
1 □
1 □
1 □
1 □

¥1,000¥5,000¥10,000¥15,000¥20,000¥30,000¥40,000¥45,000¥50,000
A17.

How satisfied are you with each of the following?
SatisfiedYour life overall
The place you live inYour non-work activities
The current financial situation ofyour household
Relationships with your friends
Work
Relationship with your spouse
Relationships with your family
member(s), except for your
spouse

□
□
1□
1□
1□
1□
1□

□
□
2 □
2 □
2 □
2 □
2 □
2 □
2 □

1

2

1

2

(X ONE Box)
Unsatisfied

□
□
2□
2□
2□
2□
2□

□
□
3□
3□
3□
3□
3□

□
□
4□
4□
4□
4□
4□

□
□
5□
5□
5□
5□
5□

1

2

3

4

5

1

2

3

4

5

1

□

2

□

3

□

4

□

5

□

□ Don’t work
□ Don’t have spouse
6 □ Don’t have any family
6
6

except for spouseA18. Imagine that you have just found out that something you said carelessly hurt a friend’s feelings.
feel? (X ONE Box)
1 □ I would feel guilty but would not feel very ashamed
2 □ I would feel guilty and would feel somewhat ashamed
3 □ I would feel both guilty and ashamed
4 □ I would feel ashamed and somewhat guilty
5 □ I would feel ashamed but would not feel very guilty
6 □ I would feel neither guilty nor ashamed

How would you

A19.

Thinking about when you were a child and were given an assignment during school vacation, how early did you
usually finish up the assignment? (X ONE Box)
1 □ Got it done right away
5□ Got it done at the last time
2 □ Tended to get it done early, before the6□ Got it done after the deadline
due date
7□ Did not get it done
3 □ Worked on it daily up until the due date8□ There weren’t any assignments
4 □ Tended to get it done toward the end

A20.

Thinking about when you were a child and were given an assignment during school vacation, how early did youplan to finish the assignment? (X ONE Box)
1 □ I planned to get it done right away
6□ I planned to do get it done after the last minute2 □ I planned to get it done rather early, before the7□ I did not plan to get it done
due date
8□ I had no particular plans
3 □ I planned to work it daily up until the due date9□ There weren’t any assignments
4 □ I planned to get it done rather toward the end
5 □ I planned to get it done at the last minute

A21.

Thinking about when you were a child and were given an assignment during school vacation, when did you think
was the ideal time to finish up the assignment? (X ONE Box)
1 □ To get it done right away
5□ To get it done at the last minute2 □ To get it done early, before the due date6□ To get it done after the deadline
3 □ To work on it daily up until the due date7□ Not to get it done
4 □ To get it done rather toward the end

A22.

How high does the chance of rain have to be before you will bring an umbrella with you when you go out?
(Write In Number From 0 - 100)
%

5

A23.

During the last year (in 2012), how much money did you donate? Please choose a number from the box below tochoose the most appropriate category and write in the number to indicate the total amount of donation you made.
Please also choose numbers from the box below to indicate the portion of your donation for disaster relief, religious
purposes, and other purposes.
Last year
Total value of annual donation（Of the total value）
A：Disaster relief(for example, donations to disaster victims and disaster relief
organizations)
B：Religious purposes(for example, donations to religious organizations such as
churches, synagogues, mosques, etc. Please do NOT
include payments for services.)
Other (Neither A nor B)□ I did not donate for any purpose3 □ ¥5,000 to less than ¥10,000
5 □ ¥50,000 to less than ¥100,000
7 □ ¥500,000 to less than ¥1,000,0001□ ¥1 to less than ¥5,000
4 □ ¥10,000 to less than ¥50,000
6 □ ¥100,000 to less than ¥500,000
8 □ More than ¥1,000,000
2

A24.

Have you received any inheritances (including real estate and financial assets) with a total value of ¥5,000,000 or
more from your parents or your spouse’s parents in the past? (X ALL That Apply)YES
NONO SPOUSE
Received an inheritance with a total value of
1 □2 □¥5,000,000 or more in the past from my parents.
Received an inheritance with a total value of¥5,000,000 or more in the past from my spouse's
parents.

3

A25.

□

4

□

5

□

Have you received any monetary transfers (including real estate and financial assets) or financial support (forexample, for educational expenses in college/graduate school, housing purchase, marriage expenses, etc.) with a
total value of ¥5,000,000 or more from your parents or your spouse’s parents in the past? (X ALL That Apply)YES
NONO SPOUSE
Received a monetary transfer or financial support witha total value of ¥5,000,000 or more in the past
1 □2 □from my parents.
Received a monetary transfer or financial support witha total value of ¥5,000,000 or more in the past
3 □
4 □
5 □
from my spouse's parents.

6

A26.

What is the purpose of your savings and financial assets? Please circle “1” if the stated purpose applies and “2” if
it does not. In addition, have you accumulated these savings, or have you used them in the past year? Circle “1” if
the savings increased, “2” if they decreased, and “3” if they neither increased nor decreased.

Do you have any
savings for thismotive?
YES
No
Using in case of unexpected emergency
such as illness, disasters, etc.
Paying for my children’s educational
expenses
Budgeting for my wedding
Budgeting for my children’s wedding(s)For building, extending or renovating myhome or for purchasing land
Using after retirement
Preparing for when I need nursing care(e.g., if I am bedridden)
Purchasing durable consumer goods(e.g., automobiles, furniture, household
appliances)
Paying for leisure activities (e.g., vacation,
sports)Leaving an inheritance for my children
Objectives other than those listed above
I have no objective in particular, justsecurity.
I do not have any savings

A27

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Do you think going through hard times helps you (i.e., improves your personality)? Please choose the mostaccurate percentage of usefulness for you. For example, if you think the experience is absolutely useless, circle
0%, if you think it may be useful, circle 50%, and if you think it is definitely useful, circle 100%.
Useless00

A28

neither

Useful

□0% 10 □10% 20 □20% 30 □30% 40 □40% 50 □50% 60 □60% 70 □70% 80 □80% 90 □90% 100 □100%

Suppose that there are 10 red balls and 10 white balls in a bag. You can choose either Option "A", to take a ballfrom the bag and receive ¥1,000 if the ball is red, or Option “B”, to take a certain amount of money without taking aball. Which would you choose: option "A" or "B"? Please look at Option “A” and Option “B” below and indicate
which you prefer for each of the seven choices.
Option “A”
Receive if you pick a
red ball¥1,000¥1,000¥1,000¥1,000¥1,000¥1,000¥1,000

Option “B”
orCertainly receive
¥50
¥200
¥400
¥600
¥800
¥1,000¥2,0007Which ONE do you prefer?
(X ONE Box for EACH Row)
Option “A”
Option “B”

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A29

Suppose that there is a total of 20 red and white balls in a bag. You do not know how many balls of each color are
there. You can choose either Option "A", to take a ball from the bag and receive ¥1,000 if the ball is red, or Option“B”, to take a certain amount of money without taking a ball. Which would you choose: option "A" or "B"? Pleaselook at Option “A” and Option “B” below and indicate which you prefer for each of the seven choices.
Option “A”
Receive if you pick a
red ball¥1,000¥1,000¥1,000¥1,000¥1,000¥1,000¥1,000

A30

Option “B”
orWhich ONE do you prefer?
(X ONE Box for EACH Row)
Option “A”
Option “B”

Certainly receive

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¥1,000¥2,000

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2

What kind of lessons did you take during your preschool years and/or during elementary school, including lessons
from your parents? (X ALL That Apply for Each)
During yourpreschool years
Swimming ................................................................................................ 01
Baseball, football, tennis ......................................................................... 02
Marital arts (karate, fencing, judo, etc.) ................................................... 03
Gymnastics Training with gym equipment .............................................. 04
Dancing (ballet, folk dancing, ballroom dancing, etc.) ............................ 05
Musical instruments (guitar, piano, violin, etc.) ....................................... 06
Singing or chorus .................................................................................... 07
Painting, sculpture, handicrafts ............................................................. 08
Calligraphy .............................................................................................. 09
Game of go.............................................................................................. 10
Chess ...................................................................................................... 11
Foreign language .................................................................................... 12
Math problems and language dectation .................................................. 13
Cram school for entrance examincluding standardized examinations .................................................... 14
Cram school for supplementary lesson ................................................... 15
Correspondence courses with periodic delivery of course materials ...... 16
Other () .................................................................................... 17

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Section B - The following questions are about you and your family.

□ Male□ Female

B1.

Your gender:

B2.

Please answer about your marital status. (X ONE Box)12

□ I have a spouse (husband or wife, including common-law marriage)  (Continue)□ I am not currently married, having divorced or separated  (Continue)
3 □ I am an unattached widow or widower  (Continue)
4 □ I have never married  (Skip to B2-2)
5 □ I am currently separated in the process of divorce  (Continue)
6 □ I am not married but living with significant other*  (Skip to B2-2)
12*Please do not answer questions involving a spouse
B2-1.

When did you marry your spouse? (Write In #)Month __________ Year ____________________ or when I was __________ years old

B2-2.

Do you have plans to marry, or want to marry in the future? (X ONE Box)
1 □ I already have plans to marry.
2 □ I do not have any plans to marry but would like to.
3 □ I do not have any plans to marry and do not want to.
4 □ I already have married.

B3.

What is your height and weight? (Write In #)Height:feet
inches,
Weight:poundsPlease answer the following questions for you and your spouse (if applicable)
B4.
When were you born? (Write In Number for Month and Year)
You, yourself: Month _____ _____ Year _____ _____ _____ _____Your spouse:Month _____ _____ Year _____ _____ _____ _____+ □ No spouse

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If you got married within the last one year, please answer the following questions.

Otherwise, skip to B6.

B5. If you got married within the last one year, please indicate your spouse’s highest level of education (orequivalent) completed. If he/she is still in school, “X” the one he/she is in now. (X ONE Box)Your spouse
Graduated from elementary/ junior high school …………………………………………………………….1 □Some High School – no degree ………………………………………………………………………………2 □Graduated from High School ………………………………………………………………………………….3 □Some College (including Technical College) - no degree ………………………………………………….4 □Graduated from College (including Technical College) - Associate's Degree (2 year) …………………5 □Some university (including old-education-system high school) – no degree …………………………….6 □Graduated from University (including old-education-system high school) - Bachelor's Degree (4 year)…………………………………………………………………………………………………………………………………………………………………………………………………….7□

Some post graduate studies - no degree …………………………………………………………………….8 □Graduated from graduate school - Master's Degree - MS, MA, MBA, etc. ……………………………….9 □Some doctoral studies – no degree ………………………………………………………………………… 10 □Graduated from graduate school - Doctoral Degree - DVM, Ph.D, DDS, etc. .......................................11 □If you answered 1-5 for B5, please go to B5-2, if you answered 6-11 for B5, please go to B5-1.
B5-1.

In case you and/or your wife attended college, what is you/your spouse’s major?
Your Spouse
Law .......................................................................................................... 01 □Economics ............................................................................................... 02 □Business/Management ............................................................................ 03 □International Relations/ Sociology ........................................................... 04 □Humanities/Literature .............................................................................. 05 □Education ................................................................................................ 06 □Medicine .................................................................................................. 07 □Dentistry .................................................................................................. 08 □Pharmacology ......................................................................................... 09 □Nursing ..................................................................................................... 10 □Health ...................................................................................................... 11 □Science.................................................................................................... 12 □Engineering ............................................................................................. 13 □Agriculture ............................................................................................... 14 □Home Economics .................................................................................... 15 □Art ............................................................................................................ 16 □Athletics ................................................................................................... 17 □Other ....................................................................................................... 18 □B5-2.

When are your spouse's parents’ birth years? (Write The Year For EACH)
Your spouse’s father____________________Your spouse’s mother ____________________

B5-3.

Please indicate the highest level of education (or equivalent) completed by your spouse’s parents.
(X ONE Box For EACH)
Your Spouse’s Father Your Spouse’s Mother
Graduated from elementary/ junior high school ................................………….1 □1 □Some High School – no degree …………………………………………………..2 □2 □Graduated from High School ……………………………………………………...3 □3 □Some College (including Technical College) - no degree .................………….4 □4 □Graduated from College (including Technical College) - Associate's Degree (2 year)…………………………………………………………………………………..........5 □5 □Some university (including old-education-system high school) – no degree ...6 □6 □Graduated from University (including old-education-system high school) - Bachelor's Degree (4 year)………………………………………………………………………………...………7 □7 □Some post graduate studies - no degree ..........................................………….8 □8 □Graduated from graduate school - Master's Degree - MS, MA, MBA, etc…….9 □9 □Some doctoral studies – no degree ............................................... ………….10 □10 □Graduated from graduate school - Doctoral Degree - DVM, Ph.D, DDS, etc. .11 □
11 □

B5-4.

Are your spouse’s parents alive? (X ONE Box) If they are alive, indicate their age. If they are deceased, indicate
their age of death. (Write In For EACH)
Your spouse’s father

12Your spouse’s mother

1
2

B5-5.

Alive
Deceased__________ years old__________ years old

Alive
Deceased__________ years old__________ years old(X ONE Box For Each)How many brothers and sisters does your spouse have who are now living? (Write In Number For EACH)

Your spouse: Older brothers ................... _______
Older sisters ........................ _______

Younger brothers .............. _______
Younger sisters ................. _______

9

B5-6.
You:

Please indicate the type of the school you and your spouse attended (Write In Number For EACH)
Elementary School ............ _______High School ......................... _______

Junior High School ............ _______
University .......................... _______Your spouse: Elementary School ............ _______High School ......................... _______

Junior High School ............ _______
University .......................... _______

0: Did not attend
1: Private school
2: Public school (not-national)
3: National school
All respondents should answer the following question.
B6.

About how many hours per week do you and your spouse usually work including overtime work? If you don’t
work outside the home, X “don’t work”. If you don’t have a spouse, X “no spouse” and if your spouse doesn’t
work outside the home, X “doesn’t work”. (Write In A Number For EACH Row)
You_______________ hours per week-□Don’t work
Your spouse_______________ hours per week+□No spouse-□Doesn’t work

B6-1.

About how many hours per week in paid overtime do you and your spouse work? (Write in a number in each row)
If you or your spouse do not work overtime, please write zero.
You
Your spouse

B6-2.

_______________ hours per week_______________ hours per week-

□Don’t work
□No spouse+-□Doesn’t work

About how many hours per week in unpaid overtime do you and your spouse work? (Write in a number in eachrow. If you or your spouse do not work overtime please write zero.)YouYour spouse_______________ hours per week_______________ hours per week-□Don’t work+□No spouse-□Doesn’t work

Please answer if you don’t work.
B7.

If you were working, what do you estimate you would be making per hour? (Write In)¥_______________ per hour

All respondents should answer the following question.
B8.

About how many days in a year do you and your spouse work? If you don’t work outside the home, X “don’t work”.
If you don’t have a spouse, X “no spouse” and if your spouse doesn’t work outside the home, X “doesn’t work”.
(Write In Number For EACH Row)
You
Your spouse

B9.

-□Don’t work
□No spouse+-□Doesn’t work

To what age do you and your spouse plan to work? If you are already retired, write in your age at the time ofretirement. If you haven’t worked outside the home, X “haven’t worked”. If you don’t have a spouse, X “nospouse” and if your spouse hasn’t worked outside the home, X “hasn’t worked”.
(Write In Number For EACH Row)
You
Your spouse

B10.

_______________ days per year_______________ days per year_______________ years old_______________ years old□Haven’t worked□No spouse+-□Hasn’t worked

What is your occupation and what is your spouse's occupation (Including part-time work)?
(X ONE Box For EACH)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Office and administrative support ............................................................ 01 □01 □Sales and related occupations ................................................................. 02 □02 □Management, business, and financial operations .................................... 03 □03 □Professional and related occupations ...................................................... 04 □04 □Service occupations (healthcare support/protective service,or food preparation and serving-related, security guards, etc.) ........... 05 □05 □Construction, extraction, and maintenance .............................................. 06 □06 □Farming, fishing, and forestry................................................................... 07 □07 □Housewives/Househusbands ................................................................. 08 □08 □Student ..................................................................................................... 09 □09 □Retired (excluding housewives/househusbands) ................................... 10 □10 □Unemployed (excluding housewives/househusbands)...................... 11 □11 □Other (Specify): ...................................................................................... 12 □
12 □

10

If you answered 1 to 7 for yourself and/or your spouse for B10, please continue.

Otherwise, skip to B11

B10-1. What is the type of employment of you and of your spouse?

(X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Employee of private company or organization .......................................... 1 □1 □Government employee .............................................................................. 2 □2 □Management position ................................................................................ 3 □3 □Self-employed ........................................................................................... 4 □4 □Family employee (in self-employed business) .......................................... 5 □5 □B10-2. What is your employment status, and what is your spouse’s employment status? (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Full-time employee .................................................................................... 1 □
1 □Part-time employee ................................................................................... 2 □2 □Student part-time employee ...................................................................... 3 □3 □Temporary work (sent to a company from a temporary job agency,
internship, specific project for a company, etc.) .................................... 4 □4 □Contract worker ......................................................................................... 5 □5 □Other (Specify): ....................................................................................... 6 □6 □B10-3. Have you and your spouse worked for a job introduced by a temporary staffing agency in the past two years?
(X ONE Box that best describes the type of work.)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Mostly jobs lasting one day ....................................................................... 1 □1 □Mostly jobs lasting two to less than ten days ............................................ 2 □2 □Mostly jobs lasting ten days to less than three months ............................ 3 □3 □Mostly jobs lasting three months or more ................................................. 4 □4 □I did not take any dispatched employment ................................................ 5 □5 □B10-4. For how many years have you been working for your present employer? And for how many years has your spousebeen working for his or her present employer? (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Less than a year ........................................................................................ 1 □1 □A year to less than 5 years........................................................................ 2 □2 □5 years to less than 10 years .................................................................... 3 □3 □10 years to less than 20 years .................................................................. 4 □4 □20 years to less than 30 years .................................................................. 5 □5 □30 years to less than 40 years .................................................................. 6 □6 □More than 40 years ................................................................................... 7 □7 □B10-5. Approximately how many employees are working for the company that employs you, and how many are working
for the company that employs your spouse? Indicate the approximate numbers including the head office, allbranch offices, branch stores, sales offices and factories. If the employer is a government organization, select"Government employee." (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □1 to 5 people ............................................................................................. 1 □1 □6 to 29 people ........................................................................................... 2 □2 □30 to 99 people ......................................................................................... 3 □3 □100 to 299 people ..................................................................................... 4 □4 □300 to 499 people ..................................................................................... 5 □5 □500 to 999 people ..................................................................................... 6 □6 □1,000 to 4,999 people ............................................................................... 7 □7 □5,000 or more people ................................................................................ 8 □8 □Government employee .............................................................................. 9 □9 □B10-6. Which one of the following best describes the industry in which you work, and which one best describes theindustry in which your spouse works? (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Agriculture and related industries ............................................................ 01 □01 □Mining ....................................................................................................... 02 □02 □Construction ............................................................................................. 03 □03 □Manufacturing .......................................................................................... 04 □04 □Wholesale trade/Retail trade .................................................................... 05 □05 □Finance and insurance ............................................................................. 06 □06 □Real estate ............................................................................................... 07 □07 □Transportation/Telecommunications ........................................................ 08 □08 □Utilities ...................................................................................................... 09 □09 □Services.................................................................................................... 10 □10 □Education ................................................................................................. 11 □11 □Others....................................................................................................... 12 □
12 □

11

B10-7. To what extent is your salary or wage based on your work performance, and to what extent is your spouse’s salaryor wage based on his or her work performance? (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □The wage is based almost entirely on performance ................................. 1 □1 □The wage is based mostly on performance .............................................. 2 □2 □The wage is based slightly on performance.............................................. 3 □3 □The wage is not at all based on performance ........................................... 4 □4 □B10-8. About how hard do you work each day, and about how hard does your spouse work each day? Please answer
based on the amount of work done per hour. (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Could not work any harder than currently ................................................. 1 □1 □Work hard and continuously...................................................................... 2 □2 □Work continuously but not hard ................................................................ 3 □3 □Work but have some downtime ................................................................. 4 □4 □Work but have a lot of downtime ............................................................... 5 □5 □B10-9. What is the possibility that you or your spouse will be unemployed (or in the case of running your own business,
will discontinue the business) within the next two years? (X ONE Box)
Yourself
Your SpouseNo spouse ........................................................................................................................................ + □Strong possibility ....................................................................................... 1 □1 □Some possibility ........................................................................................ 2 □2 □Little possibility .......................................................................................... 3 □3 □Don't know................................................................................................. 4 □4 □All respondents should answer the following question
B11. What is the occupation of the longest job in your career and what is the occupation of the longest job in your spouse’s
career? (X ONE Box For EACH) Please do not regard "Housewife/Househusband," "Student," "Retired (except
Housewife/Househusband)," "Unemployed (except Housewife/Househusband)” as occupations for the purposes ofthis question.
Yourself
Your SpouseNo spouse ............................................................................................................................................. + □Office and administrative support ................................................................. 01 □01 □Sales and related occupations...................................................................... 02 □02 □Management, business, and financial operations ........................................ 03 □03 □Professional and related occupations ........................................................... 04 □04 □Service occupations (healthcare support/protective service,or food preparation and serving-related, security guards, etc.) .................... 05 □05 □Construction, extraction, and maintenance .................................................. 06 □06 □Farming, fishing, and forestry ....................................................................... 07 □07 □Have/Has never worked .............................................................................. 08 □08 □Other (Specify): ............................................................................................. 09 □09 □If you answered 1 to 7 for yourself and/or your spouse for B11, please continue.

Otherwise, skip to B12.

If you have had more than one employer in the occupation of your longest job, please answer about the one in which
you worked/have worked the longest.
B11-1. What is the type of employment of you and of your spouse in the occupation of your/his/her longest job?
(X ONE Box)
Yourself
Your SpouseNo spouse ............................................................................................................................................. + □Employee of private company or organization .............................................. 1 □1 □Government employee .................................................................................. 2 □2 □Management position .................................................................................... 3 □3 □Self-employed ................................................................................................ 4 □4 □Family employee (in self-employed business)............................................... 5 □5 □B11-2. What is your employment status, and what is your spouse’s employment status in the occupation of your/his/herlongest job? (X ONE Box)
Yourself
Your SpouseNo spouse ............................................................................................................................................. + □Full-time employee ........................................................................................ 1 □
1 □Part-time employee ........................................................................................ 2 □2 □Student part-time employee........................................................................... 3 □3 □Temporary work (sent to a company from a temporary job agency,
internship, specific project for a company, etc.) ............................................ 4 □4 □Contract worker.............................................................................................. 5 □5 □Other (Specify): ............................................................................................ 6 □6 □12

B11-3. For how many years did you work (have you been working) in the occupation of your longest job? And for how
many years did your spouse work (or has your spouse been working) in the occupation of his/her longest job?
(X ONE Box)
Yourself
Your SpouseNo spouse ............................................................................................................................................. + □Less than a year ............................................................................................ 1 □1 □A year to less than 5 years ............................................................................ 2 □2 □5 years to less than 10 years ......................................................................... 3 □3 □10 years to less than 20 years ....................................................................... 4 □4 □20 years to less than 30 years ....................................................................... 5 □5 □30 years to less than 40 years ....................................................................... 6 □6 □More than 40 years ........................................................................................ 7 □7 □B11-4. Approximately how many employees were/are working for the company of the occupation of your longest job, andhow many were/are working for the company of the occupation of your spouse’s longest job? Indicate theapproximate numbers including the head office, all branch offices, branch stores, sales offices and factories. If
the employer is a government organization, select "Government employee." (X ONE Box)
Yourself
Your SpouseNo spouse ............................................................................................................................................. + □1 to 5 people .................................................................................................. 1 □1 □6 to 29 people ................................................................................................ 2 □2 □30 to 99 people .............................................................................................. 3 □3 □100 to 299 people .......................................................................................... 4 □4 □300 to 499 people .......................................................................................... 5 □5 □500 to 999 people .......................................................................................... 6 □6 □1,000 to 4,999 people .................................................................................... 7 □7 □5,000 or more people ..................................................................................... 8 □8 □Government employee .................................................................................. 9 □9 □B11-5. Which one of the following best describes the industry in which you worked/work in the occupation of yourlongest job, and which one best describes the industry in which your spouse worked/works in the occupation of
his/her longest job? (X ONE Box)
Yourself
Your SpouseNo spouse ............................................................................................................................................. + □Agriculture and related industries ................................................................. 01 □01 □Mining ........................................................................................................... 02 □02 □Construction .................................................................................................. 03 □03 □Manufacturing ............................................................................................... 04 □04 □Wholesale trade/Retail trade ........................................................................ 05 □05 □Finance and insurance ................................................................................. 06 □06 □Real estate .................................................................................................... 07 □07 □Transportation/Telecommunications ............................................................ 08 □08 □Utilities .......................................................................................................... 09 □09 □Professional and business services ............................................................. 10 □10 □Education ...................................................................................................... 11 □11 □Others ........................................................................................................... 12 □12 □All respondents should answer the following question
B12.

How many sons and daughters do you have?
boxes. (Write In Number)
Son

B13.

If you do not have any children, please indicate 0 in the following
DaughterApproximately how much was your salary or hourly wage in 2012 (including business income if you are
self-employed), and approximately how much was your spouse’s salary or hourly wage? (Write In)

You:

Salary per month ¥_____ _____ _____ _____or Wage per hour ¥_____ _____Your spouse:

Salary per month ¥_____ _____ _____ _____or Wage per hour ¥_____ _____

B14.

Approximately how much was the annual earned income of you and your spouse before taxes, including bonuses
and business income in 2012? (X ONE Box)
Yourself
Your SpouseNo spouse .............................................................................................................................. + □None ............................................................................................... 01 □01 □Less than ¥1,000,000 .................................................................... 02 □02 □¥1,000,000 to less than ¥2,000,000............................................... 03 □03 □¥2,000,000 to less than ¥4,000,000............................................... 04 □04 □¥4,000,000 to less than ¥6,000,000............................................... 05 □05 □¥6,000,000 to less than ¥8,000,000............................................... 06 □06 □¥8,000,000 to less than ¥10,000,000............................................. 07 □07 □¥10,000,000 to less than ¥12,000,000........................................... 08 □08 □¥12,000,000 to less than ¥14,000,000........................................... 09 □09 □¥14,000,000 or more ...................................................................... 10 □
10 □

13

B15.

Are you or your spouse currently seeking jobs? (Please answer regardless of whether you presently have a job.)(X ONE Box For EACH Row). If you and your spouse are seeking jobs, please indicate the duration of yoursearch. If it is more than one month, please write in a specific duration
You□ Seeking a job□ Not seeking a job

1.Less than a month 2.More than a month (___year/s ___month/s)□ No spouse1□ Seeking a job
2□ Not seeking a job

1.Less than a month 2.More than a month (___year/s___month/s)

12Your spouse

B16.

+

How much time do you and your spouse spend doing housework everyday? Please answer an average amount oftime per day for weekdays and weekends. (Write In)
You:
week days: ____hours______minutes;Your spouse: week days: ____hours______minutes;

B17.

week ends: ____hours______minutes
week ends: ____hours______minutes

How long does it take for you, and for your spouse, to commute? If you or your spouse do/does not work, pleaseindicate 0 (Write In Number).
You:
Your spouse:

B18.

____hours______minutes;____hours______minutes□ Don't work
1 □ Doesn't work
1

Which of the following best describes your current household? (X ONE Box)

□ Single□ You and your parent(s)3 □You and your spouse
4 □You, your spouse and your children
5 □You and your children (no spouse)
6 □You, your spouse, and your (or your spouse's) parent(s)7 □You, your spouse, your children and your (or your spouse's) parent(s)8 □You, your spouse, your children and your (or your spouse's) parent(s)/sibling(s)9 □You and your friend(s)10 □Others (Specify):__________________
1
2

B19.

How many people are currently living in your household including yourself?
# of people: _____ _____

B20.

How much did you spend on durable consumer goods such as housing, cars, and expensive electric products foryour entire family in 2012? (Write In)
Approximate expense in 2012 for entire family ¥_____________________

B20-1.

Did your household purchase a house (or condo) in 2012? (X ONE Box)
1

B21.

□ Yes

2

(Write In)□ No

How much were the average food expenses of your entire family per month in 2012?

(Write In For EACH Row)

Approximate food expenses (excluding expenses of eating out) . ¥__________________ per month
Approximate expenses of eating out ............................................ ¥____________________ per month
B22.

How much were the average expenditures of your entire family per month in 2012? Exclude durable consumer
goods purchased such as housing, cars, expensive electronic products, taxes, insurance premiums, andmortgage interest. Include costs of public utilities and energy bills. (Write In)
Approximate monthly expense in 2012 for entire family¥_______________________ per month

In 2012 what was the approximate percentage change in your family’s total annual expenditures compared with
2011? Select the most appropriate response from the following list. (X ONE Box)
Increased Increased Increased Increased
by at
by at
by at
by at
Changed Decreased Decreased Decreased Decreased
least
least
least
least
by less by at least by at least by at least by at least
Increased
7%
5%
3%
1%
than 1%1%
3%
5%
7%
Decreasedby at least but less but less but less but less in either but lessbut lessbut lessbut less by at least
9%
than 9% than 7% than 5% than 3% direction than 3%
than 5%than 7%than 9%
9%
B23.

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03

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02

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01

□

00

In 2013 what will be the approximate percentage change in your family’s total annual expenditures compared with
2012? Select the most appropriate response from the following list. (X ONE Box)
Increase Increase Increase Increase
by at
by at
by at
by at
Change Decrease Decrease Decrease Decrease
least
least
least
least
by less
by at
by at
by at
by at
Increase
7%
5%
3%
1%
than 1% least 1% least 3% least 5% least 7% Decreaseby at
but less but less but less but less in either but less but less but less but lessby atleast 9% than 9% than 7% than 5% than 3% direction than 3% than 5% than 7% than 9% least 9%

B24.

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05

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14

04

□

03

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02

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01

□

00

□

□

B25.

By what percentage do you expect consumer prices will change in 2013, compared with the previous year?
(X ONE Box)
Increase Increase Increase Increase
Decrease Decrease Decrease Decrease
by at
by at
by at
by at
Change
by at
by at
by at
by at
least
least
least
least
by less
least
least
least
least
Increase
3.5%
2.5%
1.5%
0.5%
than
0.5%
1.5%
2.5%
3.5%
Decreaseby at
but less but less but less but less 0.5% in but less but less but less but less
by at
least
than
than
than
than
either
than
than
than
than
least
4.5%
4.5%
3.5%
2.5%
1.5%
direction
1.5%
2.5%
3.5%
4.5%
4.5%
10

□

B26.

09

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08

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07

□

06

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05

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04

□

□

03

02

□

01

□

00

□

Now, we would like to ask you about dependents in your family. Here, a dependent(one supported) is anyone
claimed as such on the last tax return. (X ONE Box)

You are ….

□ Supporting someone in the family□ Supported by someone in your family
3 □ Neither supporting nor being supported (single-person household included)
1
2

B27.

What is the nature of your residence?

(X ONE Box)

□ Your own house (a single-family house)□ Your own condominium
3 □ Private rented house (a single house or an apartment)
4 □ Supplied house (a company house or an official residence)
B28.

5

2

6

Approximately how much was the annual earned income before taxes and with bonuses included of your entire
household for 2012? (If you are a student, please indicate the income of your parents' entire household.)(X ONE Box)

□ Less than ¥1,000,000□ ¥1,000,000 to less than ¥2,000,000
03 □ ¥2,000,000 to less than ¥4,000,000
04 □ ¥4,000,000 to less than ¥6,000,000
05 □ ¥6,000,000 to less than ¥8,000,000
06 □ ¥8,000,000 to less than ¥10,000,000
B29.

□ ¥10,000,000 to less than ¥12,000,000□ ¥12,000,000 to less than ¥14,000,000
09 □ ¥14,000,000 to less than ¥16,000,000
10 □ ¥16,000,000 to less than ¥18,000,000
11 □ ¥18,000,000 to less than ¥20,000,000
12 □ ¥20,000,000 or more

01

07

02

08

Approximately how much household income is your goal? (If you are a student, please indicate the income of yourparents’ entire household.) (X ONE Box)

□ Less than ¥1,000,000□ ¥1,000,000 to less than ¥2,000,000
03 □ ¥2,000,000 to less than ¥4,000,000
04 □ ¥4,000,000 to less than ¥6,000,000
05 □ ¥6,000,000 to less than ¥8,000,000
06 □ ¥8,000,000 to less than ¥10,000,000
B30.

□ Government-owned housing□ Lodgings (Hotels, Motels, etc.)
7 □Dormitory, Group Quarters, etc.
8 □Others1□ ¥10,000,000 to less than ¥12,000,000□ ¥12,000,000 to less than ¥14,000,000
09 □ ¥14,000,000 to less than ¥16,000,000
10 □ ¥16,000,000 to less than ¥18,000,000
11 □ ¥18,000,000 to less than ¥20,000,000
12 □ ¥20,000,000 or more

01

07

02

08

About how much household income is common for people around you? (X ONE Box)
01 □ Less than ¥1,000,000
07 □ ¥10,000,000 to less than ¥12,000,000
02 □ ¥1,000,000 to less than ¥2,000,000
08 □ ¥12,000,000 to less than ¥14,000,000
03 □ ¥2,000,000 to less than ¥4,000,000
09 □ ¥14,000,000 to less than ¥16,000,000
04 □ ¥4,000,000 to less than ¥6,000,000
10 □ ¥16,000,000 to less than ¥18,000,000
05 □ ¥6,000,000 to less than ¥8,000,000
11 □ ¥18,000,000 to less than ¥20,000,000
06 □ ¥8,000,000 to less than ¥10,000,000
12 □ ¥20,000,000 or more

In 2012 what was the approximate percentage change in your family’s total annual income compared with 2011?
Select the most appropriate response from the following list. (If you are a student, please answer for the incomeof your parents' entire household.) (X ONE Box)
Increased Increased Increased Increased
Decreased Decreased Decreased Decreased
by at
by at
by at
by at
Changed
by at
by at
by at
by at
least
least
least
least
by less
least
least
least
least
Increased
7%
5%
3%
1%
than 1%1%
3%
5%
7%
Decreasedby at
but less but less but less but less in either but less but less but less but lessby atleast 9% than 9% than 7% than 5% than 3% direction than 3% than 5% than 7% than 9% least 9%

B31.

10

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03

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02

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01

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00

□

In 2013 what will be the approximate percentage change in your family’s total annual income compared with
2012? Select the most appropriate response from the following list. Please answer your entire household, for you
and for your spouse. (If you are a student, please answer for the income of your parents' entire household.)(X ONE Box for EACH Row)
Increase Increase Increase Increase
by at
by at
by at
by at
least
least
least
least
Decrease Decrease Decrease Decrease
7%
5%
3%
1%
Change
by at
by at
by at
by at
Increase
but
but
but
but
by less
least
least
least
least
by at
less
less
less
less
than 1%1%
3%
5%
7%
Decrease
least
than
than
than
than in either but less but less but less but less
by at
9%
9%
7%
5%
3%
direction than 3% than 5% than 7% than 9% least 9%
Entire
10 □
09 □
08 □
07 □
06 □
05 □
04 □
03 □
02 □
01 □
00 □
Household
You
10 □
09 □
08 □
07 □
06 □
05 □
04 □
03 □
02 □
01 □
00 □
Your
10 □
09 □
08 □
07 □
06 □
05 □
04 □
03 □
02 □
01 □
00 □
Spouse

B32.

B33.

What do you estimate will be the change in total annual income of your household in 2017 compared to 2012?
Please circle ONE applicable number for your entire household, ONE for you, and ONE for your spouse. (If you
are a student, please answer for the income of your parents' entire household.) (X ONE Box for EACH Row)
Increase Increase Increase Increase
by at
by at
by at
by at
Decrease Decrease Decrease
least
least
least
least
Decrease by at
by at
by at
15%
10%
6%
2%
Change
by at
least
least
least
Increase
but
but
but
but
by less
least
6%
10%
15% Decrease
by at
less
less
less
less
than 2%
2%
but less but less but less by at
least
than
than
than
than
in either but less
than
than
than
least
20%
20%
15%
10%
6%
direction than 6%
10%
15%
20%
20%
Entire
10 □
09 □
08 □
07 □
06 □
05 □
04 □
03 □
02 □
01 □
00 □
Household
You
10 □
09 □
08 □
07 □
06 □
05 □
04 □
03 □
02 □
01 □
00 □
Your
10 □
09 □
08 □
07 □
06 □
05 □
04 □
03 □
02 □
01 □
00 □
Spouse

B34.

After you are retired, what proportion of the living expenses of you and your spouse do you think you will be able
to cover using Social Security income? (X ONE Box)
01□0~9%06□50~59%02□10~19%07□60~69%
03□20~29%08□70~79%04□30~39%09□80~89%05□40~49%
10□90% or more

B35.

Approximately how much is the present appraised value of all housing and property owned by your entire
household? (If you are a student, please answer about the housing and property owned by your parents' entire
household.) (X ONE Box)

□ Do not possess housing or properties□ Less than ¥5,000,000
03 □ ¥5,000,000 to less than ¥10,000,000
04 □ ¥10,000,000 to less than ¥15,000,000
05 □ ¥15,000,000 to less than ¥20,000,000
B36.

□ ¥20,000,000 to less than ¥30,000,000□ ¥30,000,000 to less than ¥40,000,000
08 □ ¥40,000,000 to less than ¥50,000,000
09 □ ¥50,000,000 to less than ¥100,000,000
10 □ ¥100,000,000 or more

01

06

02

07

Approximately how much is the balance of financial assets (savings, stocks, bonds, insurance, etc.) of your entire
household? (If you are a student, please indicate the balance of financial assets of your parents' entire
household.) (X ONE Box)

□ Less than ¥2,500,000□ ¥2,500,000 to less than ¥5,000,000
03 □ ¥5,000,000 to less than ¥7,500,000
04 □ ¥7,500,000 to less than ¥10,000,000
05 □ ¥10,000,000 to less than ¥15,000,000
B37.

□ ¥15,000,000 to less than ¥20,000,000□ ¥20.000,000 to less than ¥30,000,000
08 □ ¥30,000,000 to less than ¥50,000,000
09 □ ¥50.000,000 to less than ¥100,000,000
10 □ ¥100,000,000 or more

01

06

02

07

Please indicate which of the following financial assets you own. (X ALL That Apply)□ Bank savings (including cooperative banks, credit unions and other associations)□ Corporate bonds
03 □ Life insurance
04 □ Stocks
05 □ Investment Trusts
06 □ Foreign currency deposits
07 □ Futures / Options
08 □ U.S. Government bonds
09 □ Government bonds of foreign countries
10 □ Private individual pensions (from life insurance companies, etc.)
11 □ Company pensions
12 □ Cash
13 □ None  (Skip To B38)
01
02

(Continue)

B37-1. What percentage of the financial assets of your entire household are in the following ... (Write In % For EACH)
Bank savings, Postal savings, cash, Japanese government bonds ............................... __________%
Investment trusts, stocks, futures/options, corporate bonds,
foreign currency deposits, government bonds of foreign countries……………………….__________%

16

All respondents should answer the following question
B38.

Does your household have a saving plan for the next one year?
1 □ Have plans for each month2 □ Have plans for each 3 month period
3 □ Have plans for each 6 month period
4 □ Have plans for the whole year
5 □ Don’t have any saving plans for the next year

B39.

Do you currently have any debts? Debts here include housing loans, car loans and any other installment
payments on which you have to pay interest charges. (X ONE Box)
1
2

If so, how detailed is the plan? (X ONE Box)

□ No debts → (Skip To B40)
□ Yes, have debts
If you answered 2 for B39, please continue.

Otherwise, skip to B40.

B39-1. If you are paying off housing loan(s), what is the current balance of your housing loan(s)?

(X ONE Box)

□ Less than ¥2,500,000
2 □ ¥2,500,000 to less than ¥5,000,000
3 □ ¥5,000,000 to less than ¥7,500,000
4 □ ¥7,500,000 to less than ¥10,000,000
5 □ ¥10,000,000 to less than ¥15,000,000
6 □ ¥15,000,000 to less than ¥20,000,000
7 □ ¥20,000,000 to less than ¥30,000,000
8 □ ¥30,000,000 or more
9 □ No housing loans1

B39-2. Do you have any debts other than housing loan(s), including car loans and any other installment payments on
which you have to pay interest charges (X ONE Box)

□ No loans other than housing loans (Skip to B40)
□ Less than ¥500,000
3 □ ¥500,000 to less than ¥1,000,000
4 □ ¥1,000,000 to less than ¥2,000,000
5 □ ¥2,000,000 to less than ¥3,000,000
6 □ ¥3,000,000 to less than ¥5,000,000
7 □ ¥5,000,000 to less than ¥7,500,000
8 □ ¥7,500,000 to less than ¥10,000,000
9 □ ¥10,000,000 or more
12

B39-3. What debts do you currently have? (X ALL That Apply)□ Car loan(s)□ Installment payment(s) for consumption
3 □ Education loan(s)4 □ Borrowing for living and/or medical expenses□ Borrowing for business fund(s)□ Borrowing for entertainment expenses
7 □ Borrowing to pay off debts
8 □ Other

1

5

2

6

17

All respondents should answer the following question
B40.

Do you use credit cards? If you do, how do you use them? (X ALL That Apply)□ For payments in full
□ For payments in installments with no interest
3 □ For payments in installments with interest charges
4 □ For revolving payments
5 □ I have a credit card or cards but do not use it or them
6 □ I do not have a credit card
1
2

B41.

Have you ever been rejected for a loan application (excluding housing loans)? (X ALL That Apply)
1 □ Yes2 □ No, but I did not get approved for the full amount for which I applied, only for a reduced amount3 □ Did not apply because I did not think I would be approved
4 □ No, I have always been able to borrow the amount I applied for5 □ I have never attempted to borrow money

B42.

On a scale of 0-10 with “10” being “Highest” and “0” being “Lowest”, please indicate what you think your standardof living is. (X ONE Box)
HighestLowest
10

B43.

09

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□

07

□

06

□

05

□

04

□

03

□

02

□

01

□

00

□

How would you describe your current health status: Is it excellent, very good, good, fair, or poor? (X ONE Box)
1
2

B44.

□

□ Excellent□ Very good3
4

□ Good□ Fair5□ Poor

Do you visit a doctor on a regular basis either in a hospital or clinic (including dental clinics) because of a chronic
disease or injury? This also includes a home visit by a doctor. (X ONE Box)
1 □ Yes  Continue
2 □ No  Skip to B45

B44-1. On average, how many times do you go to a hospital or clinic as an out-patient within a one month period?
(Write in)____________times in a monthB44-2. About how much did you pay for out-of-pocket medical expenses per outpatient visit for doctor or clinic visits,
including medicine? (Write in)¥____________
B45.

During the last 12 months, have you been in a hospital or clinic as an in-patient overnight or longer? This includes
childbirth. (X ONE Box)
1 □ Yes2 □ NoB45-1. Have you had any health check-ups (excluding prenatal check, dental check-up, and medical treatment) within thepast year? (X ALL That Apply)□ Health check organaized by local municipality□ Health check organized by your employee or labor union of your employee
3 □ Health check organized by your school
4 □ Medical check-up (other than above 1-3)
5 □ Health check (Cancer check only)
6 □ Other7 □ I haven’t taken any health check in the last one year
1
2

B46.

Do you smoke?

(X ONE Box)

□ Never smoked  Skip to B47□ Hardly smoke
03 □ Occasionally smoke
04 □ I smoke about 1 to 5 cigarettes a day
05 □ I smoke about 6 to 10 cigarettes a day□ I smoke about 11 to 20 cigarettes a day□ I smoke about 21 to 30 cigarettes a day
08 □ I smoke about 31 to 40 cigarettes a day
09 □ I smoke 41 cigarettes or more a day
10 □ I used to smoke, but I quit

01

06

02

07

If you answered 2 to 10 for B.46, please continue.
B46-1.

How long does it take to get to a smoking area in your work place? If you are not working, please answer aboutsmoking at the place you spend most of the day. (X ONE Box)

□ 0 minutes (I can smoke right at my seat)□ 1-2 minutes
3 □ 3-5 minutes
B46-2.

Otherwise, skip to B.47.

□ 6-10 minutes□ 11 minutes or more
6 □ Smoking is not allowed at all at my workplace

1

4

2

5

Do you want to quit smoking? Would you like to quit smoking? (X ONE Box)
1 □ Yes, I want to quit smoking
2 □ I want to reduce the amount of cigarettes I smoke
3 □ No, I don’t want to quit smoking
4 □ I don’t know
5 □ I don’t smoke

18

All respondents should answer the following question
B47. Do you exercise? (X ONE Box)
1 □ Almost everyday
2 □ A few times a week
3 □ About once a week
B48.

4
5

Do you drink alcoholic beverages?

□ About once a month□ Don't exercise at all(X ONE Box)

□ Don't drink at all□ Hardly drink (a few times a month or less)3 □ Drink sometimes (a few times a week)
4 □ A can of beer (12 oz.) or its equivalent a day, almost everyday
5 □ 3 cans of beer (12 oz. x 3) or its equivalent a day, almost everyday
6 □ 5 cans of beer (12 oz. x 5) or its equivalent a day, almost everyday
1
2

B49.

Do you gamble in lotteries or at casinos or bet on sporting events or horse races?
1 □ Don't gamble at all
5 □ Once a month or so
2 □ I used to gamble, but I quit
6 □ Once a week or so
3 □ Hardly gamble
7 □ Almost everyday
4 □ Several times a year or so

B50.

Please indicate if you are affiliated with any of the following religions. (X ONE Box)

□ None□ Catholic
3 □ Protestant
B51.

□ Other Christian□ Judaism
6 □
Islam

□ Hinduism□ Buddhism
9□
Others

1

4

7

2

5

8

Do you have breakfast, lunch, and dinner on weekdays? (X ONE Box)
AlmosteverydayBreakfast
Lunch
Dinner

B52.

(X ONE Box)

Do not havefor a few days

1
1
1

Do not havefor four to five
days
3
3
3

2
2
2

Hardly eat

444What time do you usually wake up, have breakfast, have lunch, have dinner, and go to bed?

Wake
up

Break
fast

Lunch

Dinner

Go to
bed

Wake
up

Break
fast

Lunch

Dinner

Go to
bed

0:00

１

１

１

１

１

12:00

25

25

25

25

25

0:30

２

２

２

２

２

12:30

26

26

26

26

26

1:00

３

３

３

３

３

13:00

27

27

27

27

27

1:30

４

４

４

４

４

13:30

28

28

28

28

28

2:00

５

５

５

５

５

14:00

29

29

29

29

29

2:30

６

６

６

６

６

14:30

30

30

30

30

30

3:00

７

７

７

７

７

15:00

31

31

31

31

31

3:30

８

８

８

８

８

15:30

32

32

32

32

32

4:00

９

９

９

９

９

16:00

33

33

33

33

33

4:30

10

10

10

10

10

16:30

34

34

34

34

34

5:00

11

11

11

11

11

17:00

35

35

35

35

35

5:30

12

12

12

12

12

17:30

36

36

36

36

36

6:00

13

13

13

13

13

18:00

37

37

37

37

37

6:30

14

14

14

14

14

18:30

38

38

38

38

38

7:00

15

15

15

15

15

19:00

39

39

39

39

39

7:30

16

16

16

16

16

19:30

40

40

40

40

40

8:00

17

17

17

17

17

20:00

41

41

41

41

41

8:30

18

18

18

18

18

20:30

42

42

42

42

42

9:00

19

19

19

19

19

21:00

43

43

43

43

43

9:30

20

20

20

20

20

21:30

44

44

44

44

44

10:00

21

21

21

21

21

22:00

45

45

45

45

45

10:30

22

22

22

22

22

22:30

46

46

46

46

46

11:00

23

23

23

23

23

23:00

47

47

47

47

47

11:30

24

24

24

24

24

23:30

48

48

48

48

48

In themorning

In theafternoon

19

B53.

Indicate the care levels of your and your spouse’s parents. If you and your spouse’s parents already passed away,
choose their care level when they were alive. (Write In Number for EACH)
Your father
Your motherYour spouse’s father
Your spouse’s mother________________________________________________________□ No spouse□ No spouse++

1. Supportt Level 1 or 2
2. Care Level 1 or 2
3. Care Level 3, 4, or 5
4. He or she has a care level, but I don’t know which level he/she has.
5. He or she applied the use of the long-term care insurance, but the application was rejected.
6. He or she does not need any care, so he or she has not applied for use of long-term care insurance.
7. Although he or she needs care, he or she has not applied for use of long-term care insurance.
8. I don’t know.
B54.

Who do your parents or your spouse’s parents live with? Please check all appropriate answer(s). If your parents
and your spouse’s parents have passed away, please circle the number 5, “No one.”Your father

Your mother

Your

Your

spouse’s

spouse’sfathermotherNo spouse0

You or your spouse

1

1

1

1

Your brother/ sister or your spouse’s

2

2

2

2

The spouse of the parent requiring care

3

3

3

3

Other family member

4

4

4

4

No one5555brother/ sisterB54-1. Who do your parents or your spouse’s parents live near? Please check all appropriate answer(s). If your parents
and your spouse’s parents have passed away, please circle the number 5, “No one.”Your father

Your mother

Your

Your

spouse’s

spouse’sfathermotherNo spouse0

You or your spouse

1

1

1

1

Your brother/ sister or your spouse’s

2

2

2

2

The spouse of the parent requiring care

3

3

3

3

Other family member

4

4

4

4

No one5555brother/ sisterB54-2. Do (did) your parents or your spouse’s parents receive financial assistance from someone? Please check all
appropriate answer(s).

Your father

Your mother

Your

Your

spouse’s

spouse’sfathermotherNo spouse0

You or your spouse

1

1

1

1

Your brother/ sister or your spouse’s

2

2

2

2

The spouse of the parent requiring care

3

3

3

3

Other family member

4

4

4

4

No one5555brother/ sister

20

B55

Do your parents or your spouse’s parents require (or did they require) physical care or help with housework?
Please choose one response from among choices 1 through 4 for each parent. (X ONE Box For EACH)

Your father

No spouse
Currently necessary
Alive but not currently necessary
Already passed away but necessary
Already passed away and not necessary
while alive

Your

Your

Your

motherspouse’s

spouse’sfathermother
0

1

1

1

1

2

2

2

2

3

3

3

3

4

4

4

4

If you answered 1, 2, or 3 for B55, please continue.
B55-1. Who is, or was, the primary caregiver for that parent? Please pick one choice from among choices 1 through 8 foreach parent. If you picked choice 2 in part (A), please indicate whom you expect to be the primary caregiver whenthat parent requires care. In addition, please indicate whether your parents or your spouse’s parents live (lived)with you, live near your house, and receive financial assistance from you, respectively. (X ONE Box For EACH)
Your father

Your mother

Your

Your

spouse’s

spouse’sfathermotherNo spouse

0

You

1

1

1

1

Your spouse

2

2

2

2

Your brother/ sister or your spouse’sbrother/

3

3

3

3

The spouse of the parent requiring care

4

4

4

4

Other family member

5

5

5

5

Nursing home or assisted living home

6

6

6

6

Home helper

7

7

7

7

Other

8

8

8

8

Live with you

Yes/ No

Yes/ No

Yes/ No

Yes/ No

Live near with you

Yes/ No

Yes/ No

Yes/ No

Yes/ No

Receive financial assistance from you

Yes/ No

Yes/ No

Yes/ No

Yes/ No

sisterThank you for your help with this study. Please return your completed
questionnaire in the enclosed postage-paid envelope as soon as possible.

21