[USA] 2011 Preference Parameters Study of Osaka University

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Shaping the Future with Your Opinions

222240Dear MySurvey Member,
Would you please give this questionnaire to the person in your household whose age and sex are
indicated above (this may be you)? Thank you!
TO THE HOUSEHOLD MEMBER HELPING WITH THIS STUDY:
Today's survey covers a wide variety of topics, such as your current lifestyle and choices you would
make given different situations. You may remember doing a similar survey last year.
I would like to assure you that your answers will be completely confidential. Your answers will betabulated with information from thousands of other participants and only the total results will be used
for academic research purposes.
The survey is lengthy. To pace yourself, you can answer the booklet in sections if you like. Most of
the questions can be easily answered by simply placing an “X” in the appropriate box or boxes. In thequestions that ask you to write in your answers, please be as specific as possible. Please take yourtime to read each question thoroughly and be sure to answer all the questions. Remember that there
are no right or wrong answers to this survey. We are just interested in your opinions.
Once you have finished, please return the questionnaire to me in the enclosed postage-paid envelope.
As a token of my appreciation, I have enclosed a $5 bill.
Thank you for your continued cooperation.
Sincerely,
Carol Adams

[USA] 2011 Preference Parameters Study of Osaka University

Section A
1.

2.

How true for you are each of the following statements? Answer for each on a scale from 1 to 5, where “1” means it
is particularly 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
For MeTrue For Me
2345My daily life is fulfilling............................................................................. 1
I plan to spend a lot of money or plan to purchase expensive
23
45
items in the future ................................................................................ 12345
I don’t feel uncomfortable borrowing money ........................................... 12345I am so occupied with my daily life that I cannot save much money ...... 12345I have anxieties about my health ............................................................ 12345I am deeply religious................................................................................ 12345I have been feeling stressed lately ........................................................ 12345I have been feeling depressed lately ...................................................... 12345I haven’t been sleeping well lately .......................................................... 1
I have been feeling lonely lately.............................................................. 12
3
4
5
I want to bequeath as much of my inheritance as possible
23
4
5
to my spouse........................................................................................ 1
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
DisagreeSince the future is uncertain, it is a waste to think about it ..................... 1
It is OK to receive social security, even if you are ineligible. .................. 1
In general, most people are trustworthy.................................................. 1
In a recession, it is better to preserve men's jobs than it isto preserve women's jobs. ................................................................... 1
Although an economy regulated by market forces widens theincome gap between the rich and the poor, it makes people
wealthier in general; so in total, they are better off ............................ 1

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

2

3

4

5

A mother's job holding has a negative impact on
the development of primary school children ........................................ 1

2

3

4

5

It is more important for a wife to help her husband’s career thanto pursue her own career..................................................................... 1

2

3

4

5

When the competition is greater, illegal activity and cheating increase . 1
It is the government’s responsibility to take care of those who cannot
take care of themselves financially...................................................... 1
I feel happy when I do a good deed that I think benefits
others (such as picking up trash in a park) ........................................ 1
We have to take control of our own destinies ......................................... 1
Being poor is due to unfairness rather than laziness.............................. 1
The most important factor for success in life is hard work
rather than luck and personal connections.......................................... 1
Difficulties in life make people stronger and better than before.............. 1
Our destinies are pre-determined by God or fate even
before we are born............................................................................... 1
It is unacceptable that the number of poor people increases further...... 1
It is unacceptable that income inequalities increase further ................... 1
If a husband has sufficient income, his wife should not work ................. 1
Husbands should work outside the home, and wives should
keep the household ............................................................................. 1

3.

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” 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)
Receiveor
Receive
7
days
today
Option “A”
Option “B”
from today$30.xx5$30.01$30.08$30.02$30.08$30.09$30.03$30.00$30.05$30.34$31.78$30.14$29.96$30.67$31.27$32.97$30.00$59.51

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

222240[USA] 2011 Preference Parameters Study of Osaka University

4.

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
97
Receive 90
or
days
days
Option “A”
Option “B”
from today
from today$30.02$30.081
2$30.00$30.291
2$30.07$59.551
2$30.07$33.021
2$30.06$30.001
2$30.06$30.651
2$30.07$31.251
2$30.00$31.761
2$30.01$30.01
1
2

5.

Let’s assume that you are required to spend two hours every week cleaning a park. Today is your assigned workday. It seems that the park will have less litter than expected, so you can reduce the amount of your work time.
You have the choice of shortening your work hours either today or on the next assigned day, which is 7 days fromtoday. 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?
(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
90 Minutes reduction
1
2
58 Minutes reduction
58 Minutes reduction
1
2
61 Minutes reduction
55 Minutes reduction
1
2
58 Minutes reduction
67 Minutes reduction
1
2
60 Minutes reduction
80 Minutes reduction
1
2
59 Minutes reduction
63 Minutes reduction
1
2
59 Minutes reduction
73 Minutes reduction
1
2
58 Minutes reduction
48 Minutes reduction
1
2

6.

Now, let’s assume that you are required to spend two hours every week cleaning a park, starting 90 days from today.
It seems that the park will have less litter than expected, so you can reduce the amount of your work time. You havethe choice to shorten the work hours either on that day, 90 days from today, or on the next assigned day, which is 97
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?
(X ONE Box For EACH Row)
Reduce my working
Reduce my working
ortime 97 days fromtime 90 days from
Option “A”
Option “B”
today
today
58 Minutes reduction
48 Minutes reduction
1
2
59 Minutes reduction
68 Minutes reduction
1
2
58 Minutes reduction
87 Minutes reduction
1
2
59 Minutes reduction
59 Minutes reduction
1
2
58 Minutes reduction
53 Minutes reduction
1
2
58 Minutes reduction
77 Minutes reduction
1
2
59 Minutes reduction
73 Minutes reduction
1
2
61 Minutes reduction
66 Minutes reduction
1
2

7.

In which of the following two ways would you prefer to receive your monthly income? 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)
1

7a.

1

2

Your monthly income has a 50% chance of
doubling, but also has a 50% chance of
decreasing by 30% Æ (Answer Q. 7a)Of the following two jobs, which would you
prefer? (X ONE Box)
A job that has a 50% chance of the monthly
income doubling, but also a 50% chance ofthe monthly income being cut in half
A job for which your monthly income isguaranteed to increase by 0.5%

3

or

2

7b.

1

2

Your monthly income is guaranteed toincrease by 0.5% Æ (Answer Q. 7b)
Of the following two jobs, which would you
prefer? (X ONE Box)
A job that has a 50% chance of the monthly
income doubling, but also a 50% chance ofthe monthly income decreasing by 10%
A job for which your monthly income isguaranteed to increase by 0.5%222240[USA] 2011 Preference Parameters Study of Osaka University

8.

In which of the following two ways would you prefer to receive your monthly income? 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)Your monthly income has a 50% chanceof increasing by 60%, but also has a 50%
chance of decreasing by 10% Æ (Answer
Q. 8a)

1

8a.
1

2

9.

Of the following two jobs, which would you
prefer? (X ONE Box)
A job that has a 50% chance of the monthly
income increasing by 30%, but also has a
50% chance of decreasing by 10%
A job for which your monthly income isguaranteed to increase by 0.5%

10¢
$20
$40
$80
$150
$250
$350
$500

2

1

2

Of the following two jobs, which would you
prefer? (X ONE Box)
A job that has a 50% chance of the monthly
income increasing by 200%, but also has a
50% chance of decreasing by 10%
A job for which your monthly income isguaranteed to increase by 0.5%

Which ONE do you prefer?
(X ONE Box For EACH Row)
Option “A”(buy the “speed lottery” Option “B” (DO NOT buy
the “speed lottery” ticket)
ticket)
1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

I would choose a “speed lottery”. (If you win, you get the prize right away).

I would choose a “3-year lottery”. (If you win, you get the prize 3 years later)

How much would you spend to buy a “3-year lottery” ticket? 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 “3-year
lottery” ticket
10¢
$20
$40
$80
$150
$250
$350
$500

12.

8b.

Your monthly income is guaranteed toincrease by 0.5% Æ (Answer Q. 8b)

Suppose that there is another lottery called a “3-year lottery”. This also has a 50% chance of winning $1000 justlike the “speed lottery”. If you win, you get the prize 3 years later. If you lose, you get nothing. If you were
given the choice of which one you prefer, a “speed lottery” or a “3-year lottery”, which lottery would you choose?
(X ONE Box)
1

11.

2

Suppose that there is a “speed lottery” with a 50% chance of winning $1000. 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.

or

Which ONE do you prefer?
(X ONE Box For EACH Row)
Option “A”(buy the “3-year lottery” Option “B” (DO NOT buy
ticket)the “3-year lottery” ticket)
1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

Assume that you know there is a 50% chance of losing $1000 on a given day. You can take out insurance tocover 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. Please indicate
which option you prefer for each of the nine insurance prices.

Price of the insurance
$10
$50
$150
$300
$375
$400
$425
$450
$500

Which ONE do you prefer?
(X ONE Box For EACH Row)
Option “A”(purchase the
Option “B” (NOT
insurance)purchase the insurance)
1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

4

222240[USA] 2011 Preference Parameters Study of Osaka University

13.

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

14.

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
2
About the same as 1 year ago
3Less happy than 1 year ago
4
Don't know

15.

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

15a.

In Q.15, 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

16.

How do you feel about leaving an inheritance to your children? If you do not have any children, please respondon the assumption that you actually do have children. (X ONE Box)
1
I plan to leave an inheritance to my child(ren) no matter what.
2
I plan to leave an inheritance to my child(ren) only if they provide care (including nursing care) during
old age.
3
I plan to leave an inheritance to my child(ren) only if they provide financial assistance during old age.
4
I plan to leave an inheritance to my child(ren) only if they carry on the family business.
5
I do not plan to make special efforts to leave an inheritance to my child(ren) but will leave whatever isleft over.
6
I do not plan to leave an inheritance to my child(ren) under any circumstances because doing so may
reduce their will to work.
7
I do not plan to leave an inheritance to my child(ren) under any circumstances because I want to use
my wealth myself.
8
I want to leave an inheritance to my child(ren) but I won’t because I don’t have the financial capacity
to do so.

16a.

16b.

(X ONE Box)

If you answered 1 to 5 for Q.16, please continue. Otherwise, skip to Q.17.
How do you plan to divide your inheritance among your children? (X ONE Box)
1
I plan to divide my inheritance equally among my children.
2
I do not plan to divide my inheritance equally among my children.
3
I have only one child so there is no need to divide my inheritance among my children.
If you answered 2 for Q.16a, please continue. Otherwise, skip to Q.17.
Then how do you plan to divide your inheritance among your children? (X ALL That Apply)
01
I plan to leave more or all to the child (children) who lives with me.
02
I plan to leave more or all to the child (children) who lives near me.
03
I plan to leave more or all to the child (children) who helps me with housework.
04
I plan to leave more or all to the child (children) who provides nursing care.
05
I plan to leave more or all to the child (children) who provides financial assistance.
06
I plan to leave more or all to the child (children) who carries on the family business.
07
I plan to leave more or all to my eldest son or daughter even if he/she does not live with me, does notlive near me, does not help me with housework, does not provide nursing care, does not provide
financial assistance, and does not carry on the family business.
08
I plan to leave more or all to the child (children) who has less earnings capacity.
09
I plan to leave more or all to the child (children) who has greater needs.
10
I plan to leave more or all to the child (children) whom I like more.

5222240[USA] 2011 Preference Parameters Study of Osaka University

17.

Suppose that in 5 years, the inheritance tax will be charged at a rate of 20 % for the entire amount of inheritance toall inheritors, in addition to the current inheritance tax. How would this affect you? (If you do not have any
children, please answer on the assumption that you actually do have children.) (X ONE Box)
1
I would try to increase the amount of inheritance, so that the after-tax amount would be the same as it
is now.
2
I would try to increase the amount of inheritance, but the after-tax amount would be lower than it isnow.
3
I would not change the amount of inheritance.
4
I would reduce the amount of inheritance and would use more money for my old age.
5
I would reduce the amount of inheritance and would donate some money to charity organizations or
schools.
6
I would reduce the amount of inheritance and, instead, would use more money for my child(ren)’s
education and living expenses during my life.
7
I do not plan to leave any inheritance to my child(ren) anyway.

18.

Please answer the following questions regarding your life during retirement. (The question asks about
inheritances to your children. If you do not have any children, please respond on the assumption thatyou actually do have children.）Please assume that you have won $100,000 in a lottery and that you can spend your prize money only on private
long-term care (LTC) or on an inheritance to your children. You must immediately decide how much of the prize
money to spend on a high-quality nursing home with private room and how much to leave to your children as aninheritance, and once you make your decision, you cannot make any changes at a later time. Furthermore,
please assume that you cannot tell your children how much you will leave to them as an inheritance. How muchof your prize money would you choose to spend on private long-term care (LTC)? (X ONE Box)1

19a.

Zero (I will leave all of my prize money($100,000) to my children as an inheritanceand will either not seek private long-termcare (LTC) or will bear the cost using myown funds)

2$1 to less than $20,000

3$20,000 to less than $40,000

4$40,000 to less than $60,000

5$60,000 to less than $80,000

6$80,000 - $99,999

7$100,000 (I will spend all of my prize
money on private long-term care
(LTC)

Please answer the following questions concerning how you want to spend the final year of your life. Pleaseassume that you are currently 85 years old and in need of long-term care (LTC) but have absolutely no long-termcare insurance. You know that you have exactly one year left to live and need to spend it in a long-term care
(LTC) facility. Also, you have sold your home and have a total wealth of $200,000 at today’s prices.
If you had to choose between Option 1 and Option 2 below, which option would you choose? (X ONE Box)
: Use Medicaid funded long-term care (LTC). The government will pay for your long-term care (LTC),
Option 1
allowing you to leave all $200,000 as an inheritance. However, using Medicaid restricts your choice of facility,
which, on average, results in inferior care, and requires you to surrender all income to the government,: Pay $50,000 for private long-term care (LTC). You would only leave $150,000 as an inheritance, but
Option 2
would have your choice of facility and would be able to keep your income to spend as you wish during that year
(unspent income is forfeited).

19b.

Up to how much of your $200,000 in wealth would you be willing to pay to stay in a private long-term care (LTC)
facility rather than use Medicaid-funded long-term care (LTC). (X ONE Box)
1
I would be willing to live in a private long-term care (LTC) facility only if I did not need to pay anything out of
my own pocket (i.e., I want to leave all of my $200,000 in wealth to my children as an inheritance.)2
I would be willing to pay up to $25,000 out of my own pocket to live in a private long-term care (LTC) facility
3
I would be willing to pay up to $50,000 out of my own pocket to live in a private long-term care (LTC) facility
4
I would be willing to pay up to $100,000 out of my own pocket to live in a private long-term care (LTC)
facility.
5
I would be willing to pay up to $125,000 out of my own pocket to live in a private long-term care (LTC)
facility.
6
I would be willing to pay up to $150,000 out of my own pocket to live in a private long-term care (LTC)
facility.
7
I would be willing to pay up to $175,000 out of my own pocket to live in a private long-term care (LTC)
facility
8
I would be willing to pay all of my assets ($200,000) to live in a private long-term care (LTC) facility.

20.

Have you received any inheritance (or transfers of wealth before death) from your parents or your spouse’s
parents in the past? (X ALL That Apply)

Received inheritance (or transfers of wealth before
death) in the past from your parents.
Received inheritance (or transfers of wealth before
death) in the past from your spouse's parents.

6

YES

NO

1

2

3

4

NO SPOUSE

5222240[USA] 2011 Preference Parameters Study of Osaka University

21.

Do you expect that you will receive any inheritance (or transfers of wealth before death) from your parents or your
spouse’s parents in the future? (X ALL That Apply)

Expect to receive inheritance (or transfers of wealthbefore death) in the future from your parents.
Expect to receive inheritance (or transfers of wealthbefore death) in the future from your spouse’s parents.

YES

NO

1

2

3

4

NO SPOUSE

5

Section B - The following questions are about you and your family.
1.

Your gender:

2.

Please answer about your marital status. (X ONE Box)
1
I have a spouse (husband or wife, including common-law marriage) Æ (Continue)
2
I am currently unattached, having divorced or separated Æ (Continue)
3
I am an unattached widow or widower Æ (Continue)
4
I have never married Æ (Skip to Q.2b)

2a.

When did you marry your spouse? (Write In #)Month __________ Year ____________________ or when I was __________ years old Æ (Skip to Q.3)

2b.

Do you have plans to marry, or want to marry in the future?
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.

3.

What is your height and weight? (Write In #)Height: __________ feet__________ inches, Weight: _______________ pounds

4.

How much did you weigh when you were born? (X ONE Box)
1
Less than 5.5 pounds
2
5.5 - 6.9 pounds
4
8.5 - 9.9 pounds
5
10 pounds or more

1

Male

2

Female36

7.0-8.4 pounds
Don’t know

Please answer the following questions for you and your spouse (if applicable)
5.
When were you born? (Write In Number for Month and Year)
You, yourself: Month _____ _____ Year _____ _____ _____ _____Your spouse: Month _____ _____ Year _____ _____ _____ _____+
No spouse
6.
You:

How many brothers and sisters do you have who are now living? (Write In Number For EACH)
Older brothers ..................._______
Younger brothers .............. _______
Older sisters ........................_______
Younger sisters ................. _______Your spouse: Older brothers ..................._______
Older sisters ........................_______

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

7.

Please indicate the highest level of education (or equivalent) completed by you and by your spouse. If you arestill in school, “X” the one you are in now. (X ONE Box For EACH)
Your Spouse
Yourself
No spouse ...................................................................................................................................... +Grade School .......................................................................................... 1
1
Some High School .................................................................................. 2
2
Graduated from High School................................................................... 33
Some College - no degree ...................................................................... 4
4
Graduated from College - Associate's Degree (2 year) ........................ 5
5
Graduated from College - Bachelor's Degree (4 year) .......................... 66
Some post graduate studies - no degree................................................ 77
Master's Degree - MS, MA, MBA, etc. .................................................. 88
Doctoral Degree - DVM, Ph.D, DDS, etc. ............................................. 998.

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)
Don’t work
You_______________ hours per week+
No spouse
Doesn’t work
Your spouse_______________ hours per week

8a.

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.
Don’t work
You_______________ hours per weekYour spouse_______________ hours per week+
No spouse
Doesn’t work

8b.

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.)You_______________ hours per week
- Don’t work
Your spouse_______________ hours per week
+ No spouse- Doesn’t work

Please answer if you don’t work.
9.

If you were working, what do you estimate you would be making per hour? (Write In)$_______________ per hour
7222240[USA] 2011 Preference Parameters Study of Osaka University

All respondents should answer the following question.
10.

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

11.

+

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”.
(X ONE Box And Write In Number For EACH Row)
You
Your spouse12.

_______________ 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) ................................. 1010Unemployed (excluding housewives/househusbands).................... 11
11
Other (Specify): _______________________________________ ........
If you answered 1 to 7 for yourself and your spouse for Q.12, please continue. Otherwise, skip to Q.13.

12a.

What is the type of employment of you and of your spouse?

(X ONE Box)
Yourself
Your SpouseNo spouse ...................................................................................................................................... +1
Employee of private company or organization........................................ 1
2
Government employee............................................................................ 2
3
Management position.............................................................................. 3
4
Self-employed ......................................................................................... 4
5
Family employee (in self-employed business) ........................................ 5

12b.

What is your employment status, and what is your spouse’s employment status? (X ONE Box)
Yourself
Your SpouseNo spouse ...................................................................................................................................... +1
Full-time employee.................................................................................. 1
2
Part-time employee ................................................................................. 23
Student part-time employee .................................................................... 3
Temporary work (sent to a company from a temporary job agency,
4internship, specific project for a company, etc.).................................. 45
Contract worker....................................................................................... 5
Other (Specify): ＿＿＿＿＿＿..................................................................

12c.

Have you and your spouse worked for a job introduced by a temporary staffing agency in the past two years? (XONE Box that best describes the type of work.)
Yourself
Your SpouseNo spouse ...................................................................................................................................... +1
Mostly jobs lasting one day ..................................................................... 1
2
Mostly jobs lasting two to less than ten days .......................................... 2
3
Mostly jobs lasting ten days to less than three months .......................... 3
4
Mostly jobs lasting three months or more ............................................... 4
5
I did not take any dispatched employment.............................................. 512d.

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 ...................................................................................................................................... +1Less than a year...................................................................................... 1
2
A year to less than 5 years...................................................................... 2
3
5 years to less than 10 years .................................................................. 3
4
10 years to less than 20 years ................................................................ 4
5
20 years to less than 30 years ................................................................ 5
6
30 years to less than 40 years ................................................................ 6
7
More than 40 years ................................................................................. 78222240[USA] 2011 Preference Parameters Study of Osaka University

12e.

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)Your Spouse
Yourself
No spouse ...................................................................................................................................... +1
1 to 5 people ........................................................................................... 1
2
6 to 29 people ......................................................................................... 2
3
30 to 99 people ....................................................................................... 34100 to 299 people ................................................................................... 45300 to 499 people ................................................................................... 56500 to 999 people ................................................................................... 671,000 to 4,999 people ............................................................................. 785,000 or more people .............................................................................. 8
9Government employee............................................................................ 912f.

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 ...................................................................................................................................... +01
Agriculture and related industries .......................................................... 01
02
Mining..................................................................................................... 02
03
Construction ........................................................................................... 03
04
Manufacturing ........................................................................................ 04
05
Wholesale trade/Retail trade.................................................................. 05
06
Finance and insurance........................................................................... 06
07
Real estate ............................................................................................. 07
08
Transportation/Telecommunications...................................................... 08
09
Utilities.................................................................................................... 09
10
Professional and business services....................................................... 10
11
Others..................................................................................................... 1112g.

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 ...................................................................................................................................... +1
The wage is based almost entirely on performance ............................... 1
2
The wage is based mostly on performance ............................................ 2
3
The wage is based slightly on performance............................................ 3
4
The wage is not at all based on performance ......................................... 4

12h.

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 ...................................................................................................................................... +1
Could not work any harder than currently ............................................... 1
2
Work hard and continuously.................................................................... 2
3
Work continuously but not hard .............................................................. 3
4
Work but have some downtime............................................................... 4
5Work but have a lot of downtime............................................................. 5

12i.

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 ...................................................................................................................................... +1
Strong possibility ..................................................................................... 1
2
Some possibility ...................................................................................... 2
3
Little possibility ........................................................................................ 3
4
Don't know............................................................................................... 49222240[USA] 2011 Preference Parameters Study of Osaka University

13.

Please tell us about all your children ever born.
associated with each question in the box below.

For columns G through J, please use the number codes

G: 0=Preschool, 1=First grade; 2=Second grade; 3=Third grade; 4=Fourth grade; 5=Fifth
grade; 6=Sixth grade;
7=Seventh grade;
8=Eighth grade;
9=Ninth grade;
10=Tenth grade;
11=Eleventh grade; 12=Twelfth grade; 13=Diploma/certificate course; 14=College (undergraduate):
15=Graduate school; 16=others.
H: 17= Junior high (intermediate) school; 18=High school; 19=College - Associate's Degree (2year);
20=College - Bachelor's Degree (4 year);
21=Master's degree - MS, MA, MBA, etc;
22=Doctoral degree - DVM, Ph.D, DDS. etc; 23=no idea.
I: 24=not working/no plans to work; 25=Office and administrative support;
26=sales and related occupations; 27=management, business, and financial operations;
28= professional and related occupations;
29=service occupations (healthcare support/protective
service, or food preparation and serving-related, security guard, etc.); 30= Construction, extraction,and maintenance;
31= Farming, fishing, and forestry; 32= Housewives / Househusbands
J: 33=not attending/no plans to enroll; 34=public school; 35=private school (secular); 36=private
school (parochial); 37=other (specify).

A. Birth date
ID

Birth
month

Birth
year

B.
Still
alive?
If Not,fill intheyearof
death.

Year
of
death

D. Marital
StatusC. Sex(1=male,2=female)

1=married,

E. Living
together inthe samehousehold?

2=widow/
widower,(1=yes,0=no)(0=nevermarried,F
Currently
attendingschool?
(1=yes,0=noÎ
skip toH)
G.
Current
class(code)

3=divorced/
separated)F

G

H. Completed
educationlevel(if have not alreadycompleted, enter
the code forwhich grade towhich you expect
the child to study)

1=alreadycompleted
2=expectto complete(code)

I. Occupation(if the child is a
student, enter thecode for theoccupation you
expect the child tochoose)1=actual
occupation
2=expectedoccupation(code)

J. Type of
secondary school(Class X to XII)
(If not alreadyattending, enter
the code for which
type do you expect
the child to enter)

1=actuallyattending2=expect
to attend

1
2
3
4
5
6
7
8

If you do not already have children, please answer Q.14. Otherwise, skip to Q.15.
14.

Do you want to have children in the future?
1
Yes
2
No

15.

How many children do you want (including the children you already have)?
0
I don’t want any children
1
One child2
Two children
3
Three children
4
Four children
5
Five or more children

16.

Approximately how much was your salary or hourly wage in 2010 (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 $_____ _____

10222240(code)

[USA] 2011 Preference Parameters Study of Osaka University

17.

Approximately how much was the annual earned income of you and your spouse before taxes, including bonuses
and business income in 2010? (X ONE Box)
Yourself
Your SpouseNo spouse ............................................................................................................................ +01
None............................................................................................. 01
02
Less than $10,000........................................................................ 02
03$10,000 to less than $20,000....................................................... 03
04$20,000 to less than $40,000....................................................... 04
05$40,000 to less than $60,000....................................................... 05
06$60,000 to less than $80,000....................................................... 06
07$80,000 to less than $100,000..................................................... 07
08$100,000 to less than $120,000................................................... 08
09$120,000 to less than $140,000................................................... 09
10$140,000 or more......................................................................... 1017a.

Of your annual income above, what is the percentage of non-labor income (income other than earned income orbusiness earnings)? This consists of income from assets, payments from the government, age-related benefits
such as Medicare, disability insurance payments, and pensions, money provided from your relatives, and extra
income from lotteries or gambling. Also, do you think your non-labor income will increase in the future?
(Write In)_____ _____% of your total income isnon-labor income(X ONE Box)

You

18.

Your Spouse(X ONE Box)1

It will increase in the future1

It will increase in the future2

It will decrease in the future2

It will decrease in the future3

It will remain the same3

It will remain the same

Are you or your spouse currently seeking jobs? (Please answer regardless of whether you presently have a job.)(X ONE Box For EACH Row)
You
Your spouse

19.

1

No spouse

1

Seeking a job
Seeking a job

2
2

Not seeking a job
Not seeking a job

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;

20.

week ends: ____hours______minutes
week ends: ____hours______minutes

How long does it take for you, and for your spouse, to commute? (Write In)
You:Your spouse:

21.

(Write In)_____ _____% of your spouse’s total
income is non-labor income____hours______minutes;____hours______minutes

1

Don't work

1

Doesn't work

Which of the following best describes your current household? (X ONE Box)
Single2
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)7You, your spouse, your children and your (or your spouse's) parent(s)8You, your spouse, your children and your (or your spouse's) parent(s)/sibling(s)9You and your friend(s)Others (Specify):__________________
1

22.

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

23.

How much were the average food expenses of your entire family per month in 2010? (Write In For EACH Row)
Approximate food expenses (excluding expenses of eating out). $____________________ per month
Approximate expenses of eating out ............................................ $____________________ per month24.

How much did you spend on durable consumer goods such as housing, cars, and expensive electronic products
for your entire family in 2010? (Write In)
Approximate expense in 2010 for entire family $______________________________

25.

How much were the average expenditures of your entire family per month in 2010? 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 expense in 2010 for entire family $_________________________ per month

25a.

Please answer this question if there are members in your household besides yourself. Of all the money spent by
your household per month, what percentage do you spend? What percentages do the other members of yourhousehold spend? Please write in the average percentage of money spent by you, by your spouse and by othermembers, and the average percentage allocated to common use, so that the percentages add up to be 100% foryour entire household. (Write In)
1. You_____%
2. Your spouse_____%
3. Other members_____%
4. Common use_____%
Total
100 %
11

222240[USA] 2011 Preference Parameters Study of Osaka University

25b.

Please answer this question if you have a spouse. Who mainly decides on expenditures, savings and investments
for your household? (X ONE Box For EACH Row)
Discuss together Discuss together
Your Spousebut you mainly but your spouse
You decide
decides
decidemainly decides
1. Decision on expenditures
12
3
4
2. Decision on savings and investments
1
2
3
4

25c.

If you and your spouse both decide on expenditures, savings and investments, do the following statements holdtrue for you and for your spouse? (X ONE Box For EACH Row)
Hold true for you
Hold true for
Doesn’t hold true
Hold true forbut not for your your spouse butforboth of you
spousenot for you
either of you
1. Careful when making decisions
1
2
3
4
2. Gather information before deciding
1
2
3
4

26.

In 2010 what was the approximate percentage change in your family’s total annual expenditures compared with
2009? 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
7%
5%
3%
1%
than 1%1%
3%
5%
7%
Decreased
Increasedby at least but less but less but less but less in either but lessbut lessbut lessbut less by at least
than 9% than 7% than 5% than 3% direction than 3%
than 5%than 7%than 9%
9%
9%
10

09

08

07

06

05

04

03

02

01

00

27.

In 2011 what will be the approximate percentage change in your family’s total annual expenditures compared with
2010? 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%
10

09

08

07

06

05

04

03

02

01

00

28.

By what percentage do you expect consumer prices will change in 2011, compared with the previous year?
(X ONE Box)
Increase Increase Increase Increase
Decrease Decrease Decrease Decrease
by at
by at
by at
by at
by at
by at
by at
by at
Change
least
least
least
least
least
least
least
least
by less
3.5%
2.5%
1.5%
0.5%
0.5%
1.5%
2.5%
3.5%
Decrease
Increase
than
but less but less but less but less 0.5% in but less but less but less but less
by at
by at
than
than
than
than
than
than
than
than
either
least
least
4.5%
3.5%
2.5%
1.5%
1.5%
2.5%
3.5%
4.5%
4.5%
4.5%
direction
10

09

08

07

06

05

04

03

02

01

00

29.

Please indicate the highest level of education (or equivalent) completed by your parents and by your spouse's
parents. (X ONE Box For EACH)
Your
Your
Your Spouse’s Your Spouse’s
MotherFatherMotherFather+No spouse……………………………………………………………………………………. +1
1
1
Grade School ................................................................ 12
2
2
Some High School ........................................................ 2
3
3
3
Graduated from High School......................................... 34
4
4
Some College - no degree ............................................ 45
5
5
Graduated from College - Associate's Degree (2 year) 5
6
6
6
Graduated from College - Bachelor's Degree (4 year) 67
7
7
Some post graduate studies - no degree...................... 788
8Masters Degree - MS, MA, MBA, etc. ......................... 899
9Doctoral Degree - DVM, Ph.D, DDS, etc. ................... 930.

Was your mother working when you were 15 years old? Was your spouse’s mother working when your spousewas 15 years old? (X ONE Box for Yourself and ONE Box for Your Spouse)Your Spouse
Yourself
Mother had passed away already or lived separately from respondent. 1
1
2
2
Full-time worker
33Part-time worker
44Mother was not working then.

31.

When are your (and your spouse's) parents’ birth years? (Write In Number For EACH)
Your father ______________________________Your mother_____________________________Your spouse’s father ____________________Your spouse’s mother ____________________

12222240[USA] 2011 Preference Parameters Study of Osaka University

31a.

Are your parents alive? (X ONE Box) If they are deceased, indicate their age at death. (Write In For EACH)
Your father
1
Alive
2
DeceasedÆ __________ years oldYour mother1
2Your spouse’s father

12Your spouse’s mother

1
2

31b.

Alive
DeceasedÆ

__________ years old

Alive
DeceasedÆ

__________ years old

Alive
DeceasedÆ

__________ years old

In which state do your parents live? If they are living in a foreign country, indicate the name of the country. If yourparents are deceased, indicate the place where they lived the longest. (Write In)
Your Parents:
Name of a State in the United States: _____________________________Name of a Country: ___________________________________________Your Spouse’s Parents: Name of a State in the United States: _____________________________Name of a Country: ___________________________________________

32.

Please reply concerning your own parents and your spouse’s parents.
(A) 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)
1=Currently necessary
2=Alive but not currently necessary
3=Already passed away but necessary
while alive
4=Already passed away and notnecessary while alive

Your own
motherYour own father

Your spouse’s
fatherYour spouse’s
mother

1

2

1

2

1

2

1

2

3

4

3

4

3

4

3

4

If you answered 1, 2 or 3 for Q.32 (A), please continue. Otherwise, skip to Q.33.
(B) Who is, or was, the primary caregiver for that parent? Please pick one choice from among choices 1 through 8
for each parent. If you picked choice 2 in part (A), please indicate whom you expect to be the primary caregiver
when that parent requires care. If are still single, please answer on the assumption that you will have a spouse.
(X ONE Box For EACH)
1=You
2=Your spouse
3=Your brother/sister or your spouse’s
brother / sister
4=The spouse of the parent requiring care
5=Other family member
6=Nursing home or assisted living home
7=Home helper
8=OtherYour own
motherYour own father

Your spouse’s
fatherYour spouse’s
mother

1

1

1

1

2

2

2

2

3

3

3

3

4

4

4

4

5

5

5

5

6

6

6

6

7

7

7

7

8

8

8

8

If you answered 1, 2 or 3 for Q.32 (A), please continue. Otherwise, skip to Q.33.
(C) For all of the six items shown below, please indicate which role(s), if any, that you and your spouse are playing
with respect to each parent. Please circle 1 if “yes” and 2 if “no.” If you picked choice 2 in part (A), pleaseindicate what role(s), if any, that you and your spouse expect to play when that parent requires care. If
you are still single, please answer on the assumption that you will have a spouse. (X ONE Box For EACH)
1＝Yes 2＝No

Your own
motherYour own father

Your spouse’s
fatherYour spouse’s
motheri) Live(lived) together

1

2

1

2

1

2

1

2

ii) Live (lived) nearby

1

2

1

2

1

2

1

2

iii) Help (helped) with housework

1

2

1

2

1

2

1

2

iv) Provide (provided) care

1

2

1

2

1

2

1

2

v) Provide (provided) financial assistance

1

2

1

2

1

2

1

2

vi) None of the above

1

2

1

2

1

2

1

2

33.

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. Are you ... (X ONE Box)
1
2
3

34.

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

What is the nature of your residence?
1
2
3
4(X ONE Box)Your own house (a single-family house)Your own condominium
Private rented house (a single house or an apartment)
Supplied house (a company house or an official residence)
13

5
6
7
8

Government-owned housing
Lodgings (Hotels, Motels, etc.)
Dormitory, Group Quarters, etc.
Others222240[USA] 2011 Preference Parameters Study of Osaka University

35.

Approximately how much was the annual earned income before taxes and with bonuses included of your entire
household for 2010? (If you are a student, please indicate the income of your parents' entire household.)(X ONE Box)
01
Less than $10,000
07$100,000 to less than $120,000
02$10,000 to less than $20,000
08$120,000 to less than $140,000
03$20,000 to less than $40,000
09$140,000 to less than $160,000
04$40,000 to less than $60,000
10$160,000 to less than $180,000
05$60,000 to less than $80,000
11$180,000 to less than $200,000
06$80,000 to less than $100,000
12$200,000 or more

36.

Approximately how much household income is your goal? (If you are a student, please indicate the income of yourparents’ entire household.) (X ONE Box)
01
Less than $10,000
07$100,000 to less than $120,000
02$10,000 to less than $20,000
08$120,000 to less than $140,000
03$20,000 to less than $40,000
09$140,000 to less than $160,000
04$40,000 to less than $60,000
10$160,000 to less than $180,000
05$60,000 to less than $80,000
11$180,000 to less than $200,000
06$80,000 to less than $100,000
12$200,000 or more

37.

About how much household income is common for people around you? (X ONE Box)
01
Less than $10,000
07$100,000 to less than $120,000
02$10,000 to less than $20,000
08$120,000 to less than $140,000
03$20,000 to less than $40,000
09$140,000 to less than $160,000
04$40,000 to less than $60,000
10$160,000 to less than $180,000
05$60,000 to less than $80,000
11$180,000 to less than $200,000
06$80,000 to less than $100,000
12$200,000 or more

38.

In 2010 what was the approximate percentage change in your family’s total annual income compared with 2009?
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
7%
5%
3%
1%
1%
3%
5%
7%
Decreased
Increasethan 1%by atd by at but less but less but less but less in either but less but less but less but lessleast 9% than 9% than 7% than 5% than 3% direction than 3% than 5% than 7% than 9% least 9%
10

09

08

07

06

05

04

03

02

01

00

39.

In 2011 what will be the approximate percentage change in your family’s total annual income compared with
2010? 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 Change
least
least
least
least by less Decrease Decrease Decrease Decrease
7%
5%
3%
1%
than 1% by at
by at
by at
by at
but
but
but
but
in
least
least
least
least
Increase
less
less
less
less
either
by at
1%
3%
5%
7%
Decrease
than
than
than
than directio but less but less but less but less by at
least
9%
7%
5%
3%
n
than 3% than 5% than 7% than 9% least 9%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
Spouse40.

What do you estimate will be the change in total annual income of your household in 2015 compared to 2010?
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 Change
Decrease Decrease Decrease
least
least
least
least by less Decrease by at
by at
by at
15%
10%
6%
2%
than
least
least
least
by at
but
but
but
but
2% in
least
6%
10%
15% Decrease
Increase
less
less
less
less
either2%
but less but less but less by at
by at
than
than
than
than directio but less
than
than
than
least
least
20%
15%
10%
6%
n
than 6%
10%
15%
20%
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
Spouse41.

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)
01
Do not possess housing or properties
06$200,000 to less than $300,000
02
Less than $50,000
07$300,000 to less than $400,000
03$50,000 to less than $100,000
08$400,000 to less than $500,000
04$100,000 to less than $150,000
09$500,000 to less than $1,000,000
05$150,000 to less than $200,000
10$1,000,000 or more
14222240[USA] 2011 Preference Parameters Study of Osaka University

42.

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)
01
Less than $25,000
06$150,000 to less than $200,000
02$25,000 to less than $50,000
07$200,000 to less than $300,000
03$50,000 to less than $75,000
08$300,000 to less than $500,000
04$75,000 to less than $100,000
09$500,000 to less than $1,000,000
05$100,000 to less than $150,000
10$1,000,000 or more

43.

Please indicate which of the following financial assets you own. (X ALL That Apply)
01
Bank savings (including cooperative banks, credit unions and other associations)02
Corporate bonds
03
Life insurance
04
Stocks05
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.)
11Company pensions
12
Cash
13
None Æ (Skip To Q.44)

Æ(Continue)

43a.

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

43b.

What would you say is the average annual rate of return on financial assets available on the market?
+
Cannot say______.______% (e.g. 3.5%)

44.

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. Please circle only ONE. (X ONE Box)1
No debts
2
Yes, have debts(Write In)

If you answered 2 for Q.44, please continue. Otherwise, skip to Q.45.
44a.

If you are paying off housing loan(s), what is the current balance of your housing loan(s)?
(X ONE Box)
1
Less than $25,000
6$150,000 to less than $200,000
2$25,000 to less than $50,000
7$200,000 to less than $300,000
3$50,000 to less than $75,000
8$300,000 or more
4$75,000 to less than $100,0009No housing loans
5$100,000 to less than $150,000

44b.

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)1
No loans other than housing loans
6$30,000 to less than $50,000
2Less than $5,000
7$50,000 to less than $75,000
3$5,000 to less than $10,000
8$75,000 to less than $100,000
4$10,000 to less than $20,000
9$100,00 or more
5$20,000 to less than $30,000
If you answered 2 to 9 for Q.44b, please continue. Otherwise, skip to Q.45.

44c.

What debts do you currently have? (X ALL That Apply)1
Car loan(s).
2Installment payment(s) for consumption.
3
Education loan(s).
4Borrowing for living and/or medical expenses.

5
6
7
8

Borrowing for business fund(s).
Borrowing for entertainment expenses.
Borrowing to pay off debts.
Other.

45.

Do you use credit cards? If you do, how do you use them? (X ALL That Apply)1
For payments in full.
2
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.

46.

Have you ever been rejected for a loan application (excluding housing loans)? (X ALL That Apply)
1
Yes
2
No, but I did not get approved for the full amount for which I applied, only for a reduced amount.
3
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 for.
5
I have never attempted to borrow money.

47.

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

09

08

07

06

05

15

04

03

02

01

00

222240[USA] 2011 Preference Parameters Study of Osaka University

48.

How would you describe your current health status: Is it excellent, very good, good, fair, or poor? . (X ONE Box)
1
Excellent
3
Good
5
Poor
2
Very good
4
Fair

49.

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 Æ Continue
2
No Æ Skip to Q.50

49a.

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 month49b.

About how much did you pay for out-of-pocket medical expenses per outpatient visit for doctor or clinic visits,
including medicine? (Write in)$____________

50.

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
Yes
2
No

51.

Do you fasten your seatbelt when you sit in the back seat of a car? (X ONE Box)
1
Always4Hardly2
Usually5
I never fasten my seat belt when I sit in the back seat of a car
3
Only on a highway
6
I do not sit in the back seat of a car

52.

Do you smoke? (X ONE Box)
Never smoked Î Skip to Q.53
Hardly smoke
Occasionally smoke
I smoke about 1 to 5 cigarettes a day
I smoke about 6 to 10 cigarettes a day

01
02
03
04
05

06
07
08
09
10

I smoke about 11 to 20 cigarettes a day
I smoke about 21 to 30 cigarettes a day
I smoke about 31 to 40 cigarettes a day
I smoke 41 cigarettes or more a day
I used to smoke, but I quit

If you answered 2 to 10 for Q.52, please continue. Otherwise, skip to Q.53.
52a.

How old were you when you started smoking?
Around ____________years old(Write in)

52b.

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)1
0 minutes (I can smoke right at my seat)4
6-10 minutes
2
1-2 minutes
5
11 minutes or more
3
3-5 minutes
6
Smoking is not allowed at all at my workplace
If you answered 10 for Q.52, please continue. Otherwise, skip to Q.53.

52c.

When is the last time you smoked? (approximately) (Write in)MM

YYaround (_______) / (_______)
52d.

How long did it take for you to quit smoking once you decided to quit? (Write in number)about ____________days about ____________months about ____________years

53.

Do you exercise? (X ONE Box)
1
Almost everyday
2
A few times a week3
About once a week4
5

About once a month
Don't exercise at all

54.

Do you drink alcoholic beverages? (X ONE Box)
1
Don't drink at all
2
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

55.

Do you gamble in lotteries or at casinos or bet on sporting events or horse races? (X ONE Box)
1
Don't gamble at all3
Several times a year or so 5
Once a week or so
2
Hardly gamble
4
Once a month or so
6
Almost everyday

56.

Please indicate if you are affiliated with any of the following religions. (X ONE Box)
01
Baptist07
Other Protestant
13
Islam
02
Episcopalian08
Roman Catholic
14
Judaism
03
Evangelical09
Orthodox Christian15
Scientology
04
Lutheran
10
Other Christian16
Some other affiliation not listed above05
Presbyterian
11
Buddhism
17
None
06
United Methodist
12
Hinduism18
Prefer not to answer
Thank you for your help with this study. Please return your completed
questionnaire in the enclosed postage-paid envelope as soon as possible.
16222240