TABLE OF CONTENTS

CE-305 (3-1-2006)

Page

Hispanic origin 

Race 

Asian origin

Education

Armed Foreces

Section 1B — General Housing Characteristics

Section 1C — Major Household Appliances

Section 3 — Types of Owned Real Estate

2

3

4

5

6

7

8

9—15

Closing Costs

Costs for Selling a Property

Mortgage Definitions

Mortgage Payment Items

19—20 Section 5 — Construction, Repairs, Alterations, and

Maintenance of Owned and Rented Property

21—27 Section 6 — Household Appliances and Other Selected Items

28 Section 7 — Household Equipment Repairs and Service Contracts

29—34 Section 8 — Home Furnishings and Related Household Items

35—40 Section 9 — Clothing and Sewing Materials

41 Sections 10 and 11 — Rented, Leased, and Owned Vehicles

42—45 Section 12 — Vehicle Operating Expenses

46 Section 13 — Insurance Other than Health

48—50 Section 15 — Medical and Health Expenditures

51 Section 16 — Educational Expenses

54—58 Section 18 — Trips and Vacations

Section 19 — Miscellaneous Expenses

Section 20 — Expense Patterns For Selected Services and Goods

Section 22 — Occupations 

Section 22 — Work Experience and Income

59—62

63

65

Homeowner’s Associations or Condominiums Fees

69 Section 24 — Total CU Income

47 Section 14 — Hospitalization and Health Insurance

Section 4 — Utilities and Fuels for Owned and Rented Properties

Section 21 — Credit Liability

2006 Calendar

2007 Calendar

Privacy Act Statement and Introductions

16—18

64

70

Fees for Cooperatives

CARD A

CARD B

CARD C

66—68

Page 1

Section 17 — Subscriptions, Memberships, Books, and 

Entertainment Expenses

52—53

Fraction Conversion Chart

71

73

72
02 — Mexican-American

03 — Chicano

04 — Puerto Rican

05 — Cuban-American

06 — Central or South American

07 — Other

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2 — Black or African American

3 — American Indian or Alaskan Native

4 — Asian

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5 — Native Hawaiian or Other Pacific Islander
2 — Filipino

3 — Japanese

4 — Korean

5 — Vietnamese

6 — Asian Indian

7 — Other group not listed

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01 — 11 — 1st grade through 11th grade

38 — 12th grade, no diploma

39 — High school graduate — high school diploma,

or the equivalent (For example: GED)

40 — Some college but no degree 

41 — Associate degree in college — Occupational/Vocational

program

42 — Associate degree in college — Academic program

43 — Bachelor’s degree (For example: BA, AB, BS)

44 — Master’s degree (For example: MA, MS, MEng,

MEd, MSW, MBA)

45 — Professional School Degree (For example: MD,

DDS, DVM, LLB, JD)

46 — Doctorate degree (For example: PhD, EdD)
in any branch of the U.S. military. This includes the Army,

Navy, Marine Corps, Air Force and Coast Guard, their Reserve

components and the Air and Army National Guard.

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2 — Row or townhouse — inner unit (2, 3, or 4 story structure with 2 walls

in common with other units and a private ground level entrance; it may

have a rental unit as part of the structure)

3 — End row or end townhouse (one common wall)

4 — Duplex (detached two unit structure with one common wall between

the units)

5 — 3-plex or 4-plex (3 or 4 unit structure with all units occupying the same

level or levels)

6 — Garden (a multi-unit structure, usually wider than it is high, having 2, 3,

or possibly 4 floors; characteristically the units not only have common

walls but are also stacked on top of one another)

7 — High-rise (a multi-unit structure which has 4 or more floors)

8 — Apartment or flat (a unit not described above; could be located in the

basement, attic, second floor or over the garage of one of the units

described above)

9 — Mobile home or trailer

10 — College dormitory

Fuels

1 — Gas (underground pipes)

2 — Electricity

3 — Fuel oil 

4 — Other

5 — No fuel used

Included with this housing unit

1 — Swimming pool

2 — Off-street parking

3 — Porch, terrace, patio, or balcony 

4 — Apartment or guest house

5 — Central air conditioning

6 — Window air conditioning
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8 — Clothes washer

9 — Clothes dryer

10 — Television

11 — Home computer

3 — Refrigerator

4 — Home freezer

12 — Sound components, component systems, or 

13 — VCRs, DVD players, or digital video 

recorders

compact disc sound systems

5 — Built-in dishwasher

6 — Portable dishwasher

7 — Garbage disposal
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1 — A home in which you used to live

2 — Property for business or investment purposes only

3 — A second home, vacation home, or recreational property 

4 — Unimproved land with no buildings on it

5 — Other property
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Property survey charges

Title search

Recording fees

Transfer taxes

Escrow payment

Points paid by buyer

Deed preparation

Lawyer’s fees

Advertising costs

Real estate listing fees
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Commission to Realtor 

Closing costs

Points for financing

Mortgage penalties

Property inspection

Lawyer’s fees

Advertising costs

Deferred mortgage interest payment

Real estate listing fees
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MORTGAGE DEFINITIONS

1 — Fixed rate mortgage (Conventional Mortgage, Fully Amortized

Payment Mortgage)

2 — Rate of interest is not fixed and can go up or down over the life of

the loan depending on the current interest rate (Variable Rate

Mortgage, Adjustable Rate Mortgage, ARM)

3 — Payments start out low but increase later (Graduated Payment

Mortgage)

4 — Interest and required payment are renegotiated on a regular basis

through the life of the loan (Rollover or Renegotiable Mortgage)

5 — Initial interest and required payments are lower than usual

mortgage rates. The lender receives the deferred interest plus a

fee when the property is sold (Deferred Interest Mortgage)

6 — Other (Specify)
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MORTGAGE PAYMENT ITEMS

1 — Principal and interest

2 — Property taxes

3 — Property insurance

4 — Life insurance

5 — Mortgage guarantee insurance

6 — Any other payments (Specify)

7 — Interest only (no principal)
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1 — Repayment of loans owed by cooperative 

2 — Property taxes

3 — Property insurance

4 — Management

5 — Repairs and maintenance, including lawn care and snow removal

6 — Improvements

7 — Recreational, incuding swimming, golf, and tennis facilities

8 — Security, including guards and alarm systems

9 — Utilities: such as gas, electricity, water, heat

10 — Trash collection

11 — Other (Specify)
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1

2

3

4

5

6

7

8

9

10

11

— Management

— Repairs and maintenance, including lawn care and snow removal

— Improvements

— Utilities: such as gas, electricity, water, heat

— Parking

— Recreational, including swimming, golf, and tennis facilities

— Security, including guards and alarm systems

— Maid service

— Medical services

— Trash collection

— Other (Specify)
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1 — Residential Service

2 — Mobile/Cellular Service

OTHER TELEPHONE AND NON-TELEPHONE SERVICE ITEMS

1 — Internet access (including broadband, DSL, or dial-up)

2 — Cable or satelite television services

3 — Non-telephone related rentals or purchases such as a modem
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1 — CABLE OR SATELLITE TV OR SATELLITE RADIO SERVICES 

Cable TV

TiVo

DirecTV

Satellite XM Radio

Dish TV

2 — INTERNET CONNECTION OR INTERNET SERVICE PROVIDERS 

AOL Earthlink ISPs

3 — LISTENING TO OR DOWNLOADING MUSIC OR AUDIO FILES

Napster iTunes

4 — VIEWING OR DOWNLOADING VIDEO FILES

5 — ONLINE GAMES OR OTHER INTERNET ENTERTAINMENT SITES

6 — INTERNET SERVICES AWAY FROM HOME SUCH AS WEB CAFES

OR INTERNET KIOSKS

Comcast Verizon

Sony Connect
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3 — Fuel oil

4 — Bottled or tank gas

5 — Other fuels including wood

6 — Piped-in water

7 — Sewerage maintenance

8 — Trash/garbage collection including — 

hazardous waste collection waste disposal 

recyclable material collection

9 — Water softening service

10 — Septic tank cleaning

2 — Natural or utility gas
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2 — Building an addition to the house or a new structure, such as a

porch, garage, or new wing

3 — Finishing a basement or an attic or enclosing a porch

4 — Remodeling one or more rooms in the house

5 — Landscaping the ground or planting new shrubs or trees

6 — Building outdoor patios, walks, fences, or other enclosures,

driveways, or permanent swimming pools

7 — Repairing outdoor patios, walks, fences, driveways, or

permanent swimming pools (including permanent above

ground swimming pools) 

8 — Inside painting or papering, spackling, sanding

9 — Outside painting, caulking, sanding, or surface repairs

14 — Flooring repair or replacement, including inlaid linoleum or

vinyl tile

15 — Insulation

16 — Roofing, gutters, or downspouts

17 — Siding

18 — Installation, repair, or replacement of window panes, screens,

storm doors, awnings, and the like

19 — Masonry, brick, or stucco work

are hard-wired into the home)

20 — Other improvements or repairs (include security systems which

10 — Plastering or paneling

11 — Plumbing or water heating installations and repairs

12 — Electrical work

13 — Heating or air conditioning jobs
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2 — Gas cooking stove, range, or oven

3 — Microwave oven

6 — Home freezer

7 — Dishwasher — built-in

8 — Dishwasher — portable

14 — Trash compactor

15 — Window air conditioner

4 — Other cooking stove, range, or oven including wood, coal, or

peat burning stoves

5 — Refrigerator

16 — Portable cooling and heating equipment, including portable

dehumidifiers, humidifiers, fans, and space heaters; excluding

window air conditioners 

17 — Other major home appliances and equipment

9 — Garbage disposal

10 — Clothes washer

11 — Clothes dryer

12 — Range hood

13 — Smoke alarms and detectors
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5 — RANGE HOOD

3 — GAS STOVE, RANGE, OR OVEN

7 — HOME FREEZER

8 — BUILT-IN DISHWASHER

9 — PORTABLE DISHWASHER

4 — OTHER STOVE RANGE, OR OVEN 

(such as a wood burning stove)

6 — REFRIGERATOR 

(including refrigerator/freezer combinations)

2 — ELECTRIC STOVE, RANGE, OR OVEN 

(including convection oven)

10 — GARBAGE DISPOSAL

12 — CLOTHES DRYER

11 — CLOTHES WASHER 

 (including washer/dryer combinations)
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g 

2 — ELECTRICAL PERSONAL CARE APPLIANCES, including —

3 — SMOKE DETECTORS, including —

4 — ELECTRIC FLOOR CLEANING EQUIPMENT, including —

blender

breadmaker

coffee grinder

coffee maker

corn popper

crockpot

deep fat fryer

electric barbecue

electric can opener

electric grill

electric fondue set

electric fry pan

electric iron

electric knife

electric timer

electric wok

food processor

hot plate

ice cream maker

juicer

mixer

pizza oven

rice cooker

sandwich grill

slow cooker

smoothie maker

toaster

toaster oven 

waffle iron

curling iron

denture cleaner

electric hair trimmer

electric razor

powered scale

wired

vacuum cleaner

powered toothbrush

facial sauna

foot bath

hair dryer

heating pad

make-up mirror

massager

water-pik

battery-operated ionization chamber type photo-cell type

hand vacuum rug shampooer floor polisher

5 — OTHER HOUSEHOLD APPLIANCES, including —

trash compactor

air purifier 

home security device (burglar alarm) including

console, control modules, burglar alarm console, 

door and window transmitters

6 — SEWING MACHINES (with or without cabinet)

7 — OTHER OFFICE MACHINES INCLUDING TYPEWRITERS AND 

CALCULATORS, including —

8 — PERSONAL DIGITAL ASSISTANT OR PDAS

typewriter

calculator

copy machine

fax machine

adding machine

water filters 

carbon monoxide detector

palm

iPaq
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computer printers

remote terminals

modems

monitors

mouse

CRT units for computer use only

interface equipment

cables

10 — COMPUTER SOFTWARE AND ACCESSORIES FOR NON-BUSINESS

USE, including —

software floppy disks

mouse pads

printer cartridges

13 — PHOTOGRAPHIC EQUIPMENT, including —

filters

winder

enlarger

projector

camera

digital camera

lens

tripod

projection screen

electro flash

strobe light

(for photographs)

battery pack for camera flash

motor driven film advancer

memory cards for digital

 cameras

Do not include film, film processing, or other photographic supplies.

fax modems

zip drive

memory

USB flash drives

laptops

joy sticks

home computers with or 

without CRT’s

11 — TELEPHONES AND ACCESSORIES, including —

telephones

beepers

cell phone covers

headsets

cordless telephones

pagers

chargers

phone jacks and cords

car chargers

cell phones

12 — TELEPHONE ANSWERING DEVICES

MUSICAL INSTRUMENTS, SUPPLIES, AND ACCESSORIES

14 — PIANOS, ORGANS, OR KEYBOARDS

15 — OTHER MUSICAL INSTRUMENTS, SUPPLIES, AND ACCESSORIES, 

including –

guitar

valve oil

woodwinds

brass instruments

trombone

reeds saxophone drums

sheet music

strings for musical

instruments

stringed

instruments

music stand

clarinet

picks

rosin

music books

trumpet

any other musical

accessories 

carrying case

zip disk

combinations of telephone/answering machines
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electric lawn

trimmer

17 — POWER TOOLS, including —

electric drill

electric saw

router

cordless drill

lathe

electric polisher 

electric swimming pool 

cleaning equipment

TOOLS FOR HOME USE

18 — NONPOWER TOOLS, including —

wrench

socket

hammer pliers

saw

plane

axe

screwdriver level trouble light

tractor (farm,

garden, etc.)

wheelbarrow

rake

spreader

caulking gun

drill

sander

electric plane

cordless circular saw

HEATING AND COOLING EQUIPMENT

fan dehumidifier humidifier

19 — WINDOW AIR CONDITIONERS

20 — PORTABLE COOLING AND HEATING EQUIPMENT, including —

space heater
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21 — TELEVISIONS, ALL TYPES INCLUDNG COMBINATIONS OF TVs

WITH DVD/VIDEO PLAYERS

video cassette player

video disc player

video cassette recorder/player

combination VCR/DVD player

video tape recorder/player

video laser disc player

DVD player

TIVO unit

22 — VCR, VIDEO CAMERA, VIDEO DISC PLAYER, CAMCORDER, including —

25 — RADIO, ALL TYPES, including —

CB (not permanently

mounted in an

automobile)

clock radio

console

short-wave

walky-talky

audio tape decks

reel-to-reel tape decks

27 — SOUND COMPONENTS, COMPONENT SYSTEMS, AND COMPACT DISC SOUND

SYSTEMS

speakers

mixer

stereo

tuner

amplifier

turntable

receiver

equalizer

tape deck (not specified)

compact disc players

stereo rack system

28 — OTHER SOUND AND VIDEO EQUIPMENT, including —

earphones/headphones

power converter

base station CB

antenna

power booster

headset

microphone

adapter for sound equipment

UHF video converter

antenna (TV, radio, etc.)

VCR tape rewinder

transistor/portable

Walkman (radio

only)

26 — TAPE RECORDERS AND PLAYERS (not permanently mounted in an automobile), 

including —

audio cassette players/recorders

Walkman (cassette/radio combination or cassette only)

battery packs

23 — SATELLITE DISHES, including —

satellite accessories

flat screen TV

plasma TV

high definition TV

24 — HANDHELD PERSONAL MUSIC PLAYERS

lpod

jukebox music player

Sonic Blue RIO

IRiver

personal mp3 players
CE-305 (3-1-2006) Page 26

roller blades baseball bat

29 — GENERAL SPORTS EQUIPMENT, including —

30 — HEALTH AND EXERCISE EQUIPMENT, including —

trampoline

exercycle

treadmill

ab roller

tent

kerosene lamp

frame packs and

other camping packs

32 — HUNTING AND FISHING EQUIPMENT, including —

fishing rod and tackle knife

33 — WINTER SPORTS EQUIPMENT, including —

snow skis

ski boots

snowboard 

snowboard equipment

ski poles

ice skates

ice boat

sledding equipment

31 — CAMPING EQUIPMENT, including —

sleeping bag

sleeping pad

air mattress

canteen

table tennis

equipment

lawn games

badminton set

camping stove

camping cookware

portable heater

scopes (not specified) 

toboggan

sled

34 — WATER SPORTS EQUIPMENT, including —

water skis

life jacket

wake board

snorkel

water ski vest

diving equipment

surf board

raft

wind surf board

35 — OUTBOARD MOTORS

Include specialized athletic shoes such as for football, baseball, soccer, biking, 

and bowling, except if included in the rental or activity fee for the sport.

sports shoes

tennis racket

bowling ball

baseball glove 

skateboard

football

basketball

racquetball

racquetball racket

volleyball

frisbee

boxing equipment 

karate equipment

soccer ball

sports protective

equipment/gear

golf clubs

basketball hoop

sports uniform

rowing machine

exercise mat

home gym

weight bench

weights

BB/pellet gun

bow and arrow ammunition

crossbow

rifle

shotgun
CE-305 (3-1-2006) Page 27

bicycle parts locks rack supplies

37 — TRICYCLES AND BATTERY POWERED RIDERS, including —

38 — PLAYGROUND EQUIPMENT, including —

portable swimming pool swing set

39 — OTHER SPORTS AND RECREATION EQUIPMENT

telescope

paintball equipment

golf cart (non-riding)

metal detector

stand tires tubes

sand box

bicycle helmets

big wheels

gym set
CE-305 (3-1-2006) Page 28

washer

refrigerator

range/oven

portable heating equipment

portable air conditioning equipment (window air conditioner)

portable fans

dehumidifiers

sewing machines

typewriters

vacuum cleaners

3 — Televisions, radios, video and sound equipment, except those installed

in automobiles or other vehicles

5 — Lawn and garden equipment (including lawn mower repair, snowblower 

repair)

6 — Musical instruments and accessories (including professional tuning)

4 — Computers, computer systems, and related equipment for non-business use

7 — Hand or power tools

8 — Photographic equipment

9 — Sport and recreational equipment (including bicycles)

10 — Termite or pest control treatment

11 — Heating or air conditioning equipment, such as —

central air conditioners

central coolers

furnaces

Include any services provided under service contracts. Do not include repairs.
CE-305 (3-1-2006) Page 29

sofabed

1 SOFAS, including 

2 — LIVING ROOM CHAIRS, including —

modular

loveseat

recliner

bean bag chair

rocker

swivel

3 — LIVING ROOM TABLES, including —

coffee table

TV table

end tables

lamp table

4 — MODULAR WALL UNITS, SHELVES, OR CABINETS including —

shelves

bookcase

curio cabinet

5 — PING-PONG TABLES, POOL TABLES, AND OTHER SIMILAR

RECREATION ROOM ITEMS

6 — OTHER LIVING ROOM, FAMILY, OR RECREATION ROOM FURNITURE,

including —

room divider

coat rack

card table/chairs

bar stools

foot stool (ottoman)

bar or porta bar

desk/chair

gun cabinet

7 — LIVING ROOM FURNITURE COMBINATIONS, including —

sofa, chair, and table combinations or suites

DINING ROOM AND KITCHEN FURNITURE

8 — ALL DINING ROOM AND KITCHEN FURNITURE, including —

dinette set

dining table and chairs

serving table or cart

kitchen chairs

buffet

china closet

BEDROOM FURNITURE

9 — MATTRESSES AND SPRINGS INCLUDING ROLLAWAYS

10 — BEDROOM FURNITURE OTHER THAN MATTRESSES AND SPRINGS

headboard

brass bed

frames

bunk bed

chest

dresser

vanity

cedar chest

night tables

mirrors

chairs

armoire

water bed

entertainment center

convertible chair
CE-305 (3-1-2006) Page 30

crib

playpen

highchair

portable crib

11 INFANTS FURNITURE, including 

mattress

12 — INFANTS EQUIPMENT, including —

carriage

car seat

baby backpack

baby bottle sterilizer

13 — PATIO, PORCH, OR OUTDOOR FURNITURE

14 — OUTDOOR EQUIPMENT, including —

barbecue grill patio lanterns patio umbrella

OFFICE FURNITURE FOR HOME USE

15 — ALL OFFICE FURNITURE FOR HOME USE, including —

file cabinet

safe

office chairs

drawing table

computer furniture

OUTDOOR FURNITURE AND EQUIPMENT

Do not include any furniture used exclusively for business.

dresser

toy chest

changing table

chest

bassinet

stroller

guard rail

swing 

baby carriers

baby monitor

baby travel systems

baby jogger
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6 COCS

18 — OTHER HOUSEHOLD DECORATIVE ITEMS, including —

painting

mirror

17 — LAMPS AND OTHER LIGHTING FIXTURES, including chandeliers

vase

book ends

fireplace equipment and

accessories

seasonal decorations 

(Christmas)

wall hangings

plant stand

wreaths

baskets

silk flowers

garment bag

19 — STORAGE ITEMS, including —

CLOSET STORAGE AND TRAVEL ITEMS

shoe bag shoe rack

20 — TRAVEL ITEMS, including —

suitcases

travel garment bags

luggage

trunk

portable luggage carriers

attaché cases
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22 — CHINA AND OTHER DINNERWARE

23 — STAINLESS, SILVER, AND OTHER FLATWARE, EXCEPT PLASTIC

24 — GLASSWARE, including crystal

25 — SERVING PIECES OTHER THAN SILVER

26 — NONELECTRIC COOKWARE, including —

skillet

teakettle

27 — SILVER SERVING PIECES, including —

tray

pitcher

bowl

pressure cooker

pans

pots

saucepan

casserole dishes

roaster
CE-305 (3-1-2006) Page 33

sheets

pillowcases

pillows

blanket/cover

28 BEDROOM LINENS, including 

comforter

mattress pad

quilt

bedspread

baby blanket

electric blanket

29 — BATHROOM LINENS, including —

towels shower curtain bath mat

tub mat

30 — KITCHEN AND DINING ROOM LINENS, including —

31 — OTHER LINENS, including —

32 — SLIPCOVERS, DECORATIVE PILLOWS AND CUSHIONS, CUSTOM OR

tablecloths

dish cloths

covers for living room tables

cloth napkins

doilies

small appliance cover

dish towels

toilet cover

face cloths bath rug

chair pads

furniture protectors

placemats

READY-MADE
CE-305 (3-1-2006) Page 34

33 — ORIGINAL WALL-TO-WALL CARPET (original)

34 — WALL-TO-WALL CARPET (replacement)

35 — ROOM-SIZE RUGS AND OTHER NON-PERMANENT FLOOR COVERINGS,

including carpet squares

37 — VENETIAN BLINDS, WINDOW SHADES, AND OTHER WINDOW

COVERINGS (either custom or ready-made)

36 — CURTAINS AND DRAPES (either custom or ready-made)

WALL-TO-WALL CARPETING FOR ONE OR MORE ROOMS
CE-305 (3-1-2006) Page 35

outerwear

jacket

2 — SPORT COATS AND TAILORED JACKETS, including blazers

3 — SUITS, including —

4 — VESTS (purchased separately, not with a suit), excluding sweater vests

and down vests

5 — SWEATERS AND SWEATER SETS, including —

cardigan

formal suit

man’s suit (of

two or more

pieces)

woman’s suit (of two

or more pieces)

pullover

6 — PANTS, SLACKS, AND JEANS, including —

jump suit

dress pants

7 — SHORTS AND SHORT SETS, including men’s and boys’ dress and 

casual shorts and women’s and girls’ shorts and short sets.

jumpers

8 — DRESSES, including —

sundress

9 — SKIRTS, including short and skirt combination

overalls 

Do not include any athletic shorts.

Do not include any tennis skirts, golf skirts, or other athletic skirts.

windbreaker

fur coat

down vest

sweater vest ski sweater

V-neck sweater

dress slacks

blue jeans

casual pants 

maternity pants

formals or

semi-formals

two-piece

dresses wedding gown

winter coat
CE-305 (3-1-2006) Page 36

11 — UNDERGARMENTS, including —

bras

girdles

12 — HOSIERY, including —

socks knee-highs

13 — NIGHTWEAR AND LOUNGEWEAR, including —

14 — ACCESSORIES, including —

pajamas night shirt thermal sleeping

garments

ties

thermal underwear

gloves

15 — ACTIVE SPORTSWEAR, including—

athletic shorts tennis outfit sweatshirt

16 — UNIFORMS, other than sport, for which the cost is not reimbursed,

including shirts, pants, suits, service apparel, such as: medical, barber,

boy or girl scout, mechanic, waiter/waitress, plumber and lab smocks,

and military apparel

dress shoes

17 — COSTUMES, including costumes for dance, ballet, Halloween, etc.

sandals sneakers, jogging, aerobic,

18 — FOOTWEAR, including —

Do not include any sports uniforms.

Do not include specialized athletic shoes such as for football, soccer,

bowling, biking, or baseball.

tights pantyhose

night gown

apron

bridal headpiece

undershirts

robe house coat

umbrella

belt

scarves wallet

purse

mittens ear muffs

handkerchief

fold-up rain accessories

snow and ski suit

swimwear

jogging suit swimwear accessories

hunting wear leotards

athletic shirt

boots bedroom slippers basketball, tennis shoes

bandannas

prescription sunglasses

hair accessories

slips

underwear

T-shirt

Do not include any sweat shirts or athletic shirts.

dress shirt knit blouse

casual shoes
CE-305 (3-1-2006) Page 37

bathing suits sweater

jogging suit

crawler

2 — DRESSES AND OTHER OUTERWEAR, including —

jeans

T-shirts

tops

short set

pants set

pants

shirt

overalls

romper

playsuit

vest

jumpsuit

sunsuit

3 — UNDERWEAR AND DIAPERS, including disposable 

Do not include diaper service.

4 — SLEEPING GARMENTS

5 — LAYETTES

6 — ACCESSORIES, including —

boots

mittens/gloves

slippers

socks

shoes

booties

bibs

caps/hats

bonnets
CE-305 (3-1-2006) Page 38

costume jewelry, rings, and infants jewelry

9 — HAIRPIECES, WIGS, OR TOUPEES
CE-305 (3-1-2006) Page 39

3 — WATCH OR JEWELRY REPAIR, including cleaning

4 — CLOTHING RENTAL, including formal wear

5 — CLOTHING STORAGE
CE-305 (3-1-2006) Page 40

interfacing fiberfill

foam

3 — SEWING NOTIONS, including —

4 — OTHER SEWING MATERIALS, including —

sewing basket patterns

snaps

zipper

2 — SEWING MATERIALS FOR MAKING CLOTHES, including any fabric 

used for making clothing

crochet hooks

seam binding

embroidery thread

crochet thread

sewing kit knitting needles,

equipment

thread

needles/pins

scissors

measuring tapes

buttons

embroidery

hoops

stuffing

felt or felt square

quilt pad

rug material

beads, glitter,

sequins
CE-305 (3-1-2006) Page 41

2 — TRUCK, MINIVAN, VAN, AND SUV

3 — MOTORIZED CAMPER-COACH

4 — TRAILER-TYPE CAMPER

5 — OTHER ATTACHABLE-TYPE CAMPER

7 — BOAT, WITH A MOTOR. INCLUDE JET SKIS

6 — MOTORCYCLE, MOTOR SCOOTER AND MOPED (MOTORIZED BICYCLE)

such as for a boat, or cycle — includes trailer for snowmobile or for 

moving, hauling, etc.

such as a snowmobile, dunebuggy, go-cart or riding golf cart (except 

charges for rental of golf carts included in golfing fees)

9 — TRAILER OTHER THAN CAMPER

10 — PRIVATE PLANE

11 — ANY OTHER VEHICLE

8 — BOAT, WITHOUT A MOTOR SUCH AS CANOES, KAYAKS, AND ROWBOATS
CE-305 (3-1-2006) Page 42

adjust ignition

timing or mixture

2 — MOTOR TUNE-UP, including —

air/fuel filters

breather/vapor/air

filter element

computer sensor

distributor cap, rotor

emission controls

ignition wires

pcv valve

spark plugs

anti-lock brake

bleed brake 

system

brake

adjustment

3 — BRAKE WORK, including —

machine drums/

rotors

parking brake

wheel calipers

wheel cylinder

adjust valve

4 — BATTERY PURCHASES AND INSTALLATION

5 — TIRE PURCHASES AND MOUNTING

6 — TIRE REPAIRS

7 — FRONT END ALIGNMENT, WHEEL BALANCING, WHEEL ROTATION

axle bearing/

seals

axle shafts

ball joints

8 — STEERING OR FRONT-END WORK, including —

bushings

CV joints/boots

idler arms

power steering

fluid/filter

rack and pinion

steering box/

linkage

studs, lug nuts

tie rods

wheel hubs

alternator belt

alternator/

generator

battery

charging

9 — ELECTRICAL SYSTEM WORK, including —

car computer

coil

gauges/

instruments

ignition system

starter motor

switches

voltage-regulator

wiring

hydraulic system

master cylinder

shoes or pads
CE-305 (3-1-2006) Page 43

compressor

11 — AIR CONDITIONING WORK, including —

condenser motor/switch recharging

coolant or filter

cooling fan/

controls

cooling fan relay

12 — ENGINE COOLING SYSTEM WORK, including —

fan or water pump

belt

fan switch or motor

heater core

hoses

pressure cap

radiator

thermostat

water pump

catalytic converter

exhaust pipe

13 — EXHAUST SYSTEM WORK, including —

hanger/clamps

manifold gasket

muffler resonator

clutch cable

clutch fork

flywheel

14 — CLUTCH OR TRANSMISSION WORK, including —

hydraulic system

master cylinder

pilot bearing

rebuilt

transmission

safety switch

shaft seal

transaxle

transmission filter

convertible top

crash repairs

15 — BODY WORK AND PAINTING, including —

doors

glass replaced

rust proofing

sanding

T-roof

vinyl top

16 — SHOCK ABSORBER REPLACEMENT, including MacPherson struts

window repair/

replacement
CE-305 (3-1-2006) Page 44

antenna

CB antenna

19 — AUDIO EQUIPMENT AND INSTALLATION, including —

CB radio

radio

speakers

stereo equipment

tape player

alarm system

bike/ski racks

bumper guards

20 — VEHICLE ACCESSORIES AND CUSTOMIZING, including —

carpeting

fender skirts

luggage rack

running boards

seat covers

spoilers

steering wheel 

covers

car washes

cleaning mitts

wheel cleaning 

supplies

21 — VEHICLE CLEANING SERVICES AND CLEANING SUPPLIES, including —

vehicle detailing services

boat cleaning services

upholstery sprays

vacuuming

waxes

protective coating

televisions and combinations of 

TVs with VCRs and/or DVD players

satellite receiver, In-Motion Satellite receiver

18 — VIDEO EQUIPMENT AND INSTALLATION, including —

G.P.S. navigational system w/screen

Video game consoles

battery cables

brake lights

charcoal canisterfilters

22 — OTHER VEHICLE SERVICES, PARTS, AND EQUIPMENT, including —

gas cable/cap/can

gasket sets

headlights

heater repair

hub caps

jack

light bulbs

speedometer cable

tire pressure gauge

tire/wheel

 combination

vent filters

wheel lugs

wheels

windshieldwipers
CE-305 (3-1-2006) Page 45

2 — Vehicle inspection

3 — State vehicle registration

4 — Local vehicle registration

emissions inspection safety inspections
CE-305 (3-1-2006) Page 46

Term Insurance

Whole-Life Insurance

Cash Benefits

Mortgage Insurance

Veterans Insurance

Annuities

Income or Disability Insurance

Group-Life Insuance

Straight-Life Insurance

Flight Insurance

Life Endowments

Burial Insurance

2 — LIFE INSURANCE OR OTHER POLICES WHICH PROVIDE BENEFITS IN

CASE OF DEATH OR DISABILITY, including —

3 — HOMEOWNERS INSURANCE, including any insurance covered in

mortgage payments or flood insurance

5 — AUTOMOBILE OR OTHER VEHICLE INSURANCE, including —

HOME INSURANCE

FLOOD INSURANCE

FIRE AND EXTENDED COVERAGE

Bodily Injury Insurance

Property Damage Insurance

No-Fault Insurance

Liability Insurance

Collision Insurance

Comprehensive Insurance

HOME INSURANCE

Insurance protecting your home, furniture, personal effects, or other property

against fire, theft, loss, natural disasters, or damage from other means.

4 — TENANTS’ INSURANCE

6 — OTHER TYPES OF NONHEALTH INSURANCE, including —

Credit Card Insurance

Personal Liability Insurance

Mortgage Guarantee Insurance

Ambulance

Umbrella policies

Do not include malpractice insurance.
CE-305 (3-1-2006) Page 47

2 — FEE FOR SERVICE PLAN

In a fee for service type of plan you or your insurance company is

generally billed after each visit. In a traditional fee for service plan you

may go to any doctor or hospital you choose. In a Preferred Provider

Organization (PPO) you are provided with a list of doctors from which

you may choose. If you choose to go to one of the doctors on the PPO

list, the amount of expenses covered is higher than if you go to a

doctor not on the list.

3 — COMMERCIAL MEDICARE SUPPLEMENT

A Commercial Medicare Supplement is a voluntary contributory private

insurance plan available to Medicare recipients, to cover the costs of

deductibles, coinsurance, physician services and other medical and

health services.

4 — SPECIAL PURPOSE PLAN

A special purpose plan is one which covers only specific health needs.

Examples of special purpose health insurance plans are —

Dental Insurance

Vision Insurance

Prescription Drug Insurance

Mental Health Insurance

Dread Disease Policy

The first is the group/staff type in which you go to a central facility

(group health center) to receive care.

The second type is an independent practice association (IPA) in which

providers work from their individual offices and are referred to as

primary care physicians.

•

•

Do not include Medicare Prescription Drug plans.
CE-305 (3-1-2006) Page 48

eye glasses

kits and equipment

fittings

contact lenses

warranty expenses

2 — PURCHASE OF EYE GLASSES OR CONTACT LENSES, such as —

DENTAL CARE

4 — HOSPITAL ROOMS OR SERVICES including —

FROM FACILITIES SUCH AS —

3 — DENTAL CARE, such as —

INPATIENT HOSPITAL CARE

general care hospitals

psychiatric hospitals

operating room

oxygen

recovery room

therapy

X-rays

anesthetics

blood tranfusions

drugs and medicine

examinations

any other services

injections

intensive care unit

laboratory tests

nursing services

treatment rooms

bridges

orthodontic work

fillings

caps or crowns

examinations

cleanings

X-rays

dentures

root canals

any other dental services

teeth whitening in a dental 

office

insurance

substance abuse hospitals and centers

birthing centers
CE-305 (3-1-2006) Page 49

chiropractor

acupuncturist

homeopath

physical therapist

PHYSICIAN SERVICES

7 — LAB TESTS OR X-RAYS

8 — CARE IN CONVALESCENT OR NURSING HOME

6 — ALL SERVICES PROVIDED AND BILLED BY PHYSICIANS, such as —

podiatrist

midwife

naturopath

nurse practitioners

OTHER MEDICAL CARE SERVICES

Include all services provided and billed by a convalescent 

or nursing home.

X-rays blood tests

internist

dermatologist

psychiatrist

surgeon

general practitioner

gynecologist

urologist

osteopath

plastic surgeon

pediatrician

any other type of physicians

psychologist

substance abuse professionals

marriage counselor

medical massage therapist 

(certified)

other types of lab tests

Do not include services received in a hospital as an

inpatient or services for eye and dental care.

ambulance services

rescue services

9 — OTHER MEDICAL CARE, such as —

outpatient hospital care

emergency room services

If medical care is given in outpatient department or

emergency room, include —

injections

allergy shots

cardiology test

cardiogram

skin treatment

hearing test

cancer treatment

baby shots

physicians check up

broken/sprained bones

blood pressure check

blood donation
CE-305 (3-1-2006) Page 50

13 — PURCHASE OF SUPPORTIVE OR CONVALESCENT MEDICAL

EQUIPMENT, such as —

ice bags

hot water bottles

heating pads

14 — RENTAL OF MEDICAL OR SURGICAL EQUIPMENT FOR GENERAL

USE, such as —

12 — RENTAL OF SUPPORTIVE OR CONVALESCENT MEDICAL EQUIPMENT,

such as —

sinus masks

blood pressure kits

vaporizers

splints

cervical collars

wheelchairs

braces

crutches

canes

walkers

whirlpools

slings

ace bandages

thermometers

ice bags

hot water bottles

heating pads

pollen masks

15 — PURCHASE OF MEDICAL OR SURGICAL EQUIPMENT FOR GENERAL

USE, such as —

sinus masks

insulin needles

syringes

blood pressure kits

vaporizers

home defibrillator

Do not include purchases of items such as band aids, gauze, cotton

roll, and cotton balls.

11 — PRESCRIBED MEDICINES OR PRESCRIBED DRUGS

splints

cervical collars

wheelchairs

braces

crutches

canes

walkers

whirlpools

slings

ace bandages

sun lamps

therapeutic heat lamps

sun lamps

therapeutic heat lamps

ostomy supplies

oxygen

orthopedic appliances

(supports)
CE-305 (3-1-2006) Page 51

2 — NURSERY SCHOOL OR CHILD DAY CARE CENTERS, including

noninstructional day camps

3 — TUITION, including —

student dormitory

fraternity

4 — HOUSING WHILE ATTENDING SCHOOL, including —

sorority

sewing

needlepoint

horse riding

swimming

skydiving

cooking

instructional day camps

any other recreational lessons

driving lessons

5 — FOOD OR BOARD WHILE ATTENDING SCHOOL

Include only those expenses paid directly to the school or

to other educational facility.

business school

secretarial school

technical school

vocational school

college or university

high school

seminary

preparatory school

elementary school

parochial school

adult education

housing for married students

Include only those expenses paid directly to the school or

to other educational facility.

Include only those expenses paid directly to the school or

to other educational facility.

6 — PRIVATE SCHOOL BUS

text books

microscopes

technical books

slide rule

art supplies

cap and gown

drafting equipment

laboratory equipment

7 — PURCHASE OF ANY SCHOOL BOOKS, SUPPLIES, OR EQUIPMENT, 

WHICH HAS NOT ALREADY BEEN REPORTED, including —

laboratory fees matriculation fees

8 — OTHER SCHOOL RELATED EXPENSES NOT ALREADY REPORTED,

including the rental of any school books or expenses

laundry fees

registration fees

student union fees

health fees transportation fees

athletic fees

cap and gown rentals

rental of school books

rental of school equipment

administration fees exam preparation fees

conferences and seminars

tutoring
CE-305 (3-1-2006) Page 52

2 — Books purchased from book club

3 — Season tickets to theater, concert series, opera, other musical series, or

amusement parks

4 — Season tickets to sporting events

5 — Encyclopedias or other sets of reference books

6 — Golf courses, country clubs and other social organizations

7 — Health clubs, fitness centers, swimming pools, weight loss centers, or 

other sports and recreational organizations

8 — Civic, service, or fraternal organization

9 — Credit card membership fees

10 — Shopping club memberships such as COSTCO and SAM’S

11 — Global positioning services, or GPS, such as OnStar

12 — Direct or online dating services
CE-305 (3-1-2006) Page 53

Purchase of video tapes, or DVD’s other than through a mail-order club

Rental of video tapes or DVDs, including —

mail delivery DVD rentals

gg g

Single admissions to spectator sporting events, including —

football

basketball

baseball hockey soccer

Single admissions to performances, including —

movies operas plays concerts

Books not purchased through book clubs, including —

paperbacks hardcover

Exclude reference books or school books

Single copies of newspapers, magazines, periodicals (non-subscription)

Compact discs, audio tapes, or records

Photographic film, including —

Photo processing

audio

disposable cameras

digital photo processing video film processing

Single admissions to other entertainment activities, including —

museums

historic sites

amusement parks zoos state parks

auto racing
CE-305 (3-1-2006) Page 54

1 — Visit friends or or relatives

2 — Business trips

3 — Recreational trips, such as –

Sightseeing

Sports events

Club or organizational meetings

Outdoor recreation

4 — Any other trips that occur overnight or longer

5 — Any day trips at least 75 miles away
CE-305 (3-1-2006) Page 55

1 — local (taxi, etc.)

2 — airplane

3 — train

4 — bus

5 — ship

(COMMERCIAL)

6 — car, jeep

7 — truck, van

8 — motorcycle, moped

9 — private plane

(RENTED)

13 — car owned by CU

14 — vehicle leased by CU

15 — other vehicle owned by CU

16 — vehicle owned by someone else

(PRIVATE)

17 — other transport

10 — boat, trailer

11 — camper

12 — other vehicles
CE-305 (3-1-2006) Page 56

Golf clubs

Skis/snowboards

Fishing equipment

Boat

Scuba/snorkeling equipment

Other sports equipment
CE-305 (3-1-2006) Page 57

Golf

Fishing

Swimming

Tennis

Skiing/snowboarding

Bowling

Exercise classes 

Scuba/snorkeling

Other sports
CE-305 (3-1-2006) Page 58

Movies

Theater

Concerts

Museums

Tours

Sports events

Other entertainment events
CE-305 (3-1-2006) Page 59

4 — FRESH FLOWERS OR POTTED PLANTS

burial plans during funeral)

bridal showers

weddings

anniversaries

3 — CATERED AFFAIRS, including —

parties

graduations

confirmations

Bar Mitzvah

Bat Mitzvah

income tax

preparation

7 — ACCOUNTING FEES, including —

trust management estate management

fertilize lawn, etc.

tree removal

planting

HOME SERVICES PROVIDED BY NON-CU MEMBER

lawn cutting

tilling

plowing

hedge trimming

tree pruning

9 — GARDENING OR LAWN CARE SERVICES, including —

will

divorce

bails bonds

estate settlement

6 — SERVICES OF LAWYERS AND OTHER LEGAL PROFESSIONALS, including —

civil litigation, includng lawsuits, 

bankruptcies, etc.

contracts

arbitration services

criminal litigation, 

including traffic 

citations

mediation

Do not include fees for business purposes or those related to closing 

costs for the purchase of real estate.

Do not include fees for business purposes.

Include any services provided under service contracts.

Do not include services which are covered by management or 

maintenance fees.

clergy

8 — OCCUPATIONAL EXPENSES, such as union dues or professional licenses.

5 — PROFESSIONAL PHOTOGRAPHY FEES

funeral transcript
Page 60 CE-305 (3-1-2006)

TV computer game

hardware

Game cube

18 — VIDEO AND COMPUTER GAME HARDWARE, SOFTWARE, GAMEBOYS

AND ACCESSORIES

video game hardware

video games

games

infant toys

19 — TOYS AND GAMES

stuffed animals

action figures

trucks

16 — CARE FOR INVALIDS, CONVALESCENTS, HANDICAPPED, OR ELDERLY 

PERSONS IN THE HOME

Do not include institutional or medical care.

17 — ADULT DAY CARE CENTERS

dart board

dolls

trains

14 — BABYSITTING, NANNY SERVICES, OR OTHER CHILD CARE IN YOUR HOME

Do not include nursery school care or care in a day care center.

15 — BABYSITTING, NANNY SERVICES, OR OTHER CHILD CARE IN SOMEONE

ELSE’S HOME

Do not include nursery school care or care in a day care center.

12 — OTHER HOME SERVICES AND SMALL REPAIR JOBS AROUND THE

HOUSE, NOT PREVIOUSLY REPORTED

Include diaper service.

11 — HOME SECURITY SYSTEM SERVICE FEES

13 — MOVING, STORAGE, AND FREIGHT

Do not include expenses that are reimbursed by employer or

other persons outside of the CU.

moving companies

self storage units

mini-warehouses

cargo shipping

Playstation

X box
Page 61 CE-305 (3-1-2006)

g pp

24 — PET SERVICES, including —

aquarium

hamster cage

dog

bird

tropical fish

pet toys

guinea pig

hamster

dog house

bird cage

cat

gerbil

23 — PURCHASE OF PETS, PET SUPPLIES, AND MEDICINE FOR PETS, 

including —

25 — VETERINARIAN EXPENSES FOR PETS

grooming

pet resorts

kennels license

collars

22 — LOTTERIES AND GAMES OF CHANCE

21 — STAMP AND COIN COLLECTING

vet insurance

stamp albums coin albums first day covers

pet daycare
CE-305 (3-1-2006) Page 62

2 — ANY OTHER PEOPLE NOT IN YOUR CU, such as — 

4 — ALIMONY

3 — CHILD SUPPORT

6 — POLITICAL ORGANIZATIONS

5 — EDUCATIONAL INSTITUTIONS 

7 — RELIGIOUS ORGANIZATIONS, INCLUDING CHURCHES, TEMPLES AND

MOSQUES, BUT NOT INCLUDING PAROCHIAL SCHOOLS

Paid any of the following —

Given any money by cash, checks, money orders or credit cards to benefit —

8 — CHARITIES AND ALL OTHER ORGANIZATIONS

y py p

clothing, and entertainment expenses

friends

street musicians

cash gifts at the office

co-workers

birthday money

wedding money

homeless persons

money to assist others

alumni funds

scholarship funds

educational endowments

school fund-raisers

political parties political candidates Political Action 

Committees (PACs)

tithes and offerings

building funds

religious funds raisers

religious television/radio ministries

Red Cross

United Way

Humane Society

civic organizations

social service

organizations

public television/radio

American Cancer Society

American Heart Association

fine arts and literary

organizations

9 — STOCKS, BONDS, MUTUAL FUNDS

Include only funds given to persons or organizations outside of

your CU
CE-305 (3-1-2006) Page 63

2 — LAUNDRY OR DRY CLEANING SERVICES

4 — OTHER TOBACCO PRODUCTS

3 — CIGARETTES

7 — CHARGES OR FEES FOR PERSONAL FINANCIAL SERVICES SUCH AS ATM

FEES OR ACCOUNT SERVICE CHARGES FROM FINANCIAL INSTITUTIONS

SUCH AS BANKS, CREDIT UNIONS, AND FINANCE COMPANIES —

5 — HAIRCUTTING, STYLING, MANICURES, MASSAGES AND OTHER 

SALON SERVICES

8 — TAXI OR LIMOUSINE SERVICE

9 — MASS TRANSPORTATION SERVICES SUCH AS A BUS, SUBWAY,

MINI-BUS OR TRAIN

clothing

coats

quilts

rugs

linens

drapes

cigars pipe tobacco chewing tobacco

hair coloring

waxing

pedicures

tanning salons

facials

6 — SAFE DEPOSIT BOX LOCATED IN A BANK OR SIMILAR FINANCIAL

INSTITUTION

ATM fees

certified check fee

check cashing fee

regular service charges

money order fee

below minimum balance fee

check order fee

online banking and 

bill payment fee

fees for personal loans, excluding those for real estate management fee for

trust, custodial or escrow accounts
CE-305 (3-1-2006) Page 64

2 Store credit cards Department, Speciality, Electronic, or Sporting Goods

3 — Major credit cards — Visa, MasterCard, American Express, Discover, or

other revolving credit accounts

4 — Store installment credit accounts

5 — Financial institutions — Banks, brokerages, savings and loans, credit

unions, or insurance companies

Do not include insurance premium payments

6 — Doctors, dentists, hospitals, or other medical practitioners for expenses not

covered by insurance

7 — Other credit — School loans, personal loans, or loans from retirement

plans
CE-305 (3-1-2006) Page 65

registered nurse

computer systems analyst

engineer

accountant

social worker

physician

computer programmer

lawyer

clergy

cashier

motor vehicle salesperson

05 — SALES, RETAIL

commodity salesperson

door to door salesperson

apparel salesperson

mining sales representative

financial services

manufacturing sales representative

real estate sales person

wholesale sales representative

insurance salesperson

health technician

drafting

06 — SALES, BUSINESS GOODS AND SERVICES

practical nurse

electronic technician

clinical laboratory technician

07 — TECHNICIAN

secretary

computer assistant

04 — ADMINISTRATIVE SUPPORT, INCLUDING CLERICAL

bookkeeper

receptionist

clerk

typist

private guard

08 — PROTECTIVE SERVICE

police officer firefighter

nanny

09 — PRIVATE HOUSEHOLD SERVICE

household worker

janitor

food preparer

child care worker

cook

food counter/fountain worker

hairstylist

waiter/waitress

orderly

maid/houseman

10 — OTHER SERVICE

machine operator

11 — MACHINE OPERATOR, ASSEMBLER, INSPECTOR

assembler inspector

truck driver

12 — TRANSPORTATION OPERATOR

bus driver tractor operator

stock handler

construction laborer

13 — HANDLER, HELPER, LABORER

freight handler

packager

material handler

automobile mechanic

sheet metal worker

14 — MECHANIC, REPAIRER, PRECISION PRODUCTION

machine repairer

meat cutter

machinist

tailor

carpenter

plumber

15 — CONSTRUCTION, MINING

electrician

mining worker

painter

farmer

16 — FARMING

farm worker

forestry worker

animal caretaker

17 — FORESTRY, FISHING, GROUNDSKEEPING

fisher groundskeeper

armed forces

18 — ARMED FORCES
CE-305 (3-1-2006) Page 66

1. $0 — $4,999

2. $ 5,000 — $ 9,999

3. $10,000 — $14,999

4. $15,000 — $19,999

5. $20,000 — $29,999

6. $30,000 — $39,999

7. $40,000 — $49,999

8. $50,000 — $69,999

9. $70,000 — $89,999

10. $90,000 — $119,999

11. $120,000 and over
CE-305 (3-1-2006) Page 67

ess ta$300

2. $ 300 — $ 399

3. $ 400 — $ 499

4. $ 500 — $ 599

5. $ 600 — $ 699

6. $ 700 — $ 799

7. $ 800 — $ 899

8. $ 900 — $ 999

9. $ 1,000 — $ 1,499

10. $ 1,500 and over
CE-305 (3-1-2006) Page 68

1. $0 — $999

2. $ 1,000 — $ 1,999

3. $ 2,000 — $ 2,999

4. $ 3,000 — $ 3,999

5. $ 4,000 — $ 4,999

6. $ 5,000 — $ 9,999

7. $10,000 — $14,999

8. $15,000 — $19,999

9. $20,000 — $29,999

10. $30,000 — $39,999

11. $40,000 — $49,999

12. $50,000 and over
CE-305 (3-1-2006) Page 69

2. Under $3,000

3. $ 3,000 — $ 5,999

4. $ 6,000 — $ 7,499

5. $ 7,500 — $ 9,999

6. $10,000 — $12,999

7. $13,000 — $14,999

8. $15,000 — $19,999

9. $20,000 — $24,999

10. $25,000 — $29,999

11. $30,000 — $34,999

12. $35,000 — $49,999

13. $50,000 — $74,999

14. $75,000+
CE-305 (3-1-2006) Page 70

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25

5

12

19

26

1

8

15

22

29

6

13

20

27

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

MARCH

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

1

8

15

22

29

6

13

20

27

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

6

13

20

27

8

15

22

29

DECEMBER

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29
CE-305 (3-1-2006) Page 71

AUGUST

MAY

OCTOBER

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

1

8

15

22

29

6

13

20

27

SEPTEMBER

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

FEBRUARY

NOVEMBER

APRIL

JUNE

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

SMTWT F S

7

14

21

28

2

9

16

23

3

10

17

24

4

11

18

25

5

12

19

26

1

8

15

22

6

13

20

27

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

7

14

21

28

9

16

23

30

10

17

24

31

11

18

25

12

19

26

13

20

27

8

15

22

29

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

4

11

18

25

5

12

19

26

1

8

15

22

29

6

13

20

27

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29

MARCH

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

1

8

15

22

29

6

13

20

27

14

21

28

9

16

23

30

10

17

24

31

11

18

25

12

19

26

13

20

27

8

15

22

29

DECEMBER

SMTWT F S

7

14

21

28

2

9

16

23

30

3

10

17

24

31

4

11

18

25

5

12

19

26

6

13

20

27

1

8

15

22

29
CE-305 (3-1-2006) Page 72

1/3

2/3

1/4

2/4

3/4

1/5

2/5

3/5

4/5

1/6

2/6

3/6

4/6

5/6

2/7

3/7

4/7

5/7

6/7

1/8

2/8

3/8

4/8

5/8

6/8

7/8

1/9

2/9

4/9

5/9

6/9

7/9

8/9

33.33

66.67

25.00

50.00

75.00

20.00

40.00

60.00

80.00

16.67

33.33

50.00

66.67

83.33

1/10

2/10

3/10

4/10

5/10

6/10

7/10

8/10

9/10

28.57

42.86

57.14

71.42

85.71

12.50

25.00

37.50

50.00

62.50

75.00

87.50

11.11

22.22

44.44

55.55

66.67

77.78

88.89

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00
CE-305 (3-1-2006) Page 73

update the Consumer Price Index (CPI). All survey information will

be used for statistical purposes only.

Any information you provide for this survey is confidential, by law,

under title 13, United States Code. Participation in this survey is

voluntary and there are no penalties for refusing to answer any

question(s). However, your cooperation is extremely important to

help insure the completeness and accuracy of these data.