T. Wills And Life Insurance

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Module T. Wills And Life Insurance of HRS 2018

item label	type	description
T001		Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed?
T002		Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]?
T003		Does that include any of your children or step-children?
T004		(Which child is that?)
T005		Does that document provide for all your children about equally?
T006		Does that document include any grandchild directly?
T007		(Which of your children are the parents of those grandchildren?)
T008		Have you made provisions for any charities in your will or trust?
T011		Do you have any life insurance, including individual or group policies?
T012		How many different life insurance policies do you have?
T013		What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die?
T016		Does it amount to less than $____ , more than $____ , or what?
T018		[Is this a life insurance policy that builds/Are any of these life insurance policies ones that build] up a cash value that you can borrow against, or that you would receive if the policy were to be cancelled?
T019		(How many such policies do you have?)
T020		What is the current face value of [these policies/this policy]?
T023		Does it amount to less than $____ , more than $____ , or what?
T028		Does it amount to less than $____ per month, more than $____ per month, or what?
T025		(Altogether,) about how much in total do you pay for this policy each month or year?
T029		Who are the beneficiaries of this policy?
T031		[Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies?
T032		What is the total face value of (this policy/all of these policies)?
T035		Does it amount to less than $____ , more than $____ , or what?
T036		[Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled?
T037		What was the total face value of (this policy/all of these policies)?
T040		Does it amount to less than $____ , more than $____ , or what?
T041		Was this lapse or cancellation something you chose to do, or was it done by the provider, your employer, or someone else?
T043		Did you receive any cash when the policy was cancelled or allowed to lapse?
T044		About how much cash did you receive? $ ________ .00
T252		Now we would like to ask you some questions about healthcare decisions that might need to be made for you in the future, if you are unable to make them yourself. [INSTR: PRESS 1 TO CONTINUE.]
T245		Have you ever discussed with anyone the care or medical treatment you would want to receive if you were to become seriously ill in the future?
T247M		Who has that authority, (that is, what is their relationship to you)?
T248		(Which child was that?)
T250		(Z275_CareArrangements=1 or 5):Have you provided written instructions about the care or medical treatment that you want to receive if you cannot make those decisions yourself?
T251		Do these instructions express a desire to limit the care or medical treatment that you receive in certain situations?
T254		We are also interested in arrangements your [mother/father/parents] may have made regarding [her/his/their] future medical care.
T255		Has your mother made any legal arrangements for a specific person or persons to make decisions about her care or medical treatment if she cannot make those decisions herself?
T256		Who is that -- what is that person's relationship to your mother?
T257		Has your father made any legal arrangements for a specific person or persons to make decisions about his care or medical treatment if he cannot make those decisions himself?
T258		Who is that -- what is that person's relationship to your father?
T047		T ASSIST [INSTR: HOW OFTEN DID R RECEIVE ASSISTANCE WITH ANSWERS IN SECTION T - WILLS AND TRUSTS?]
T101		Please, let me confirm, did R's FIRST NAME still own that home when [he/she] (died/passed away)?
T066		Did R's FIRST NAME ever own it?
T102		What happened to that home - did R's FIRST NAME sell it, give it to someone, or what?
T104		To whom did [he/she] give the house, that is, what was their relationship to R's FIRST NAME)?
T105		Which child is the parent of that grandchild?
T107		What was the selling price?
T110		Did it amount to a total of less than $____ , more than $____ , or what?
T111		Do you own it now, was it sold, was it inherited by someone else, has it not yet been disposed of, or what?
T113		Who inherited the house, (that is, what was their relationship to R's FIRST NAME)?
T055		(Which child is that?)
T116		What was the selling price?
T119		Did it amount to a total of less than $____ , more than $____ , or what?
T120		Is that home now vacant, or is someone living there?
T121		Who lives in the house, (that is, what was their relationship to R's FIRST NAME)?
T122		(Which child is that?)
T124		Remind me, did [he/she] still own that home when [he/she] (died/passed away)?
T125		Did R's FIRST NAME ever own it?
T240		What happened to that home? Did R's FIRST NAME sell it, give it to someone, or what?
T128		To whom did [he/she] give the house, (that is, what was their relationship to R's FIRST NAME)?
T129		Which child is the parent of that grandchild?
T131		What was the selling price?
T134		Did it amount to a total of less than $____ , more than $____ , or what?
T135		Do you own it now, was it sold, was it inherited by someone else, has it not yet been disposed of, or what?
T137		Who inherited the house, (that is, what was their relationship to R's FIRST NAME)?
T138		(Which child is that?)
T140		What was the selling price?
T143		Did it amount to a total of less than $____ , more than $____ , or what?
T144		Is that home now vacant, or is someone living there?
T145		Who lives in the house, (that is, what was their relationship to R's FIRST NAME)?
T146		(Which child is that?)
T148		What were the total expenses associated with the death for things of that type?
T151		Did it amount to less than $____ , more than $____ , or what?
T153		How much did insurance pay? $ _______ .00 OR _______ %
T155		Before [his/her] death, had R's FIRST NAME put any of [his/her] assets into a trust?
T156		In addition to the trust, did R's FIRST NAME have a will that was written and witnessed?
T157		Has [his/her] will been probated?
T158		In what state was it probated? ______STATE
T160		In what county was it probated? ________COUNTY
T161		Have they been divided up among the heirs, have they not yet been distributed, was there nothing of much value to distribute, or what?
T164		(Again,) excluding any life insurance, were any of [his/her] possessions or assets left to any of [his/her] [children or grandchildren (or great-grandchildren)/children/grandchildren (or great-grandchildren)]?
T165		Did R's FIRST NAME provide equally for all of [his/her] children and their families?
T166		Did [he/she] leave the same amount to each of [his/her] grandchildren?
T168		(Excluding any life insurance,) did [he/she] make provisions in [either the trust or the will/the trust/the will] for charities?
T169		(Excluding any life insurance,) did [he/she] make provisions in [either the trust or the will/the trust/the will] for any of [his/her] brothers or sisters?
T170		(Excluding any life insurance,) did [he/she] make provisions in [either the trust or the will/the trust/the will] for any other of [his/her] relatives?
T171		(Excluding any life insurance,) did [he/she] make provisions in [either the trust or the will/the trust/the will] for any of [his/her] friends?
T172		(Excluding any life insurance,) did [he/she] make provisions in [either the trust or the will/the trust/the will] for anyone else or anything else that we have not yet listed?
T173		Excluding any life insurance, altogether what was the value of [his/her] total estate? $________.00
T176		Did it amount to a total of less than $____ , more than $____ , or what?
T242		Does that include the value of the home?
T177		Is any part of [his/her] estate still held in any type of a trust?
T178		Who is currently the trustee of this trust?
T180		(Which child is that?)
T181		In addition to what you have just told me about [his/her] estate did anyone receive a settlement from life insurance?
T182		Who were the beneficiaries of that life insurance?
T184		Did each of [his/her] children and their families receive the same amount from life insurance?
T906		Was it more than 90 percent of [his/her] life insurance settlement?
T907		Was it more than 25 percent of [his/her] life insurance settlement?
T902_11		Altogether, how much did [you/[[his/her] [husband/wife/partner]]] receive from [his/her] life insurance?
T904_11		Was it more than half of [his/her] life insurance settlement?
T905_11		Was it more than 75 percent of [his/her] life insurance settlement?
T906_11		Was it more than 90 percent of [his/her] life insurance settlement?
T907_More		25Was it more than 25 percent of [his/her] life insurance settlement?
T908_11		Was it more than 10 percent of [his/her] life insurance settlement?
T902		Altogether, how much did [his/her] other relatives receive from [his/her] life insurance?
T904		Was it more than half of [his/her] life insurance settlement?
T905_12		Was it more than 75 percent of [his/her] life insurance settlement?
T906_12		Was it more than 90 percent of [his/her] life insurance settlement?
T907_12		Was it more than 25 percent of [his/her] life insurance settlement?
T908		Was it more than 10 percent of [his/her] life insurance settlement?
T902_13		Altogether, how much did other non-relatives receive from [his/her]
T904_13		Was it more than half of [his/her] life insurance settlement?
T905		Was it more than 75 percent of [his/her] life insurance settlement?
T906_13		Was it more than 90 percent of [his/her] life insurance settlement?
T907_13		Was it more than 25 percent of [his/her] life insurance settlement?
T908_13		Was it more than 10 percent of [his/her] life insurance settlement?
T186		Altogether, what was the value of the life insurance settlement?
T189		Did it amount to a total of less than $____ , more than $____ , or what?
T190		Did R's FIRST NAME provide written instructions about the treatment or care [he/she] wanted to receive during the final days of [his/her] life?
T192		About when were these written instructions dated (approximately)?
T191		MONTH:
T193		Did these instructions express a desire to receive all care possible under any circumstances in order to prolong life?
T194		Did these instructions express a desire to limit care in certain situations?
T195		Did these instructions express a desire to have any treatment withheld?
T196		(Did these instructions express a desire to) keep [him/her] comfortable and pain free but to forego extensive measures to prolong life?
T197		Were these instructions applicable to the actual situation?
T198		Were you consulted about whether these instructions should be followed?
T199		Were any (other) family members or other persons consulted?
T200		Who was consulted, (that is, what was their relationship to R's FIRST NAME)?
T202		(Which child was that?)
T204		Did any problems come up in trying to follow these written instructions?
T205		Did the physician or any other health care worker have problems following the written instructions?
T206		Did R's FIRST NAME (also) make any legal arrangements for a specific person or persons to make decisions about [his/her] care or medical treatment if [he/she] could not make those decisions [himself/herself]?
T207M		Who had that authority, (that is, what was their relationship to R's FIRST NAME)?
T209		(Which child was that?)
T212		When was the Durable Power of Attorney for Health Care made (approximately)?
T211		MONTH:
T213		Did R's FIRST NAME ever discuss with you or anyone else the treatment or care [he/she] wanted to receive in the final days of [his/her] life?
T214		With whom did [he/she] discuss it, (that is, what was their relationship to R's FIRST NAME)?
T216		(Which child was that?)
T218		Did any decisions have to be made about the care and treatment of R's FIRST NAME during the final days of [his/her] life?
T219		Who was actually involved in making decisions about the care and treatment of R's FIRST NAME during the final days of [his/her] life, (that is, what was their relationship to R's FIRST NAME)?
T221		(Which child was that?)
T223		Was R's FIRST NAME able to participate in decisions about [his/her] medical care during the final days of [his/her] life?
T224		For about how long before R's FIRST NAME (died/passed away) was [he/she] unable to participate in decisions about [his/her] medical care?
T227		Who was the main decision-maker (that is, what was their relationship to R's FIRST NAME)?
T228		(Which child was that?)
T230		Did those last decisions involve a desire to give all care possible unconditionally in order to prolong life?
T231		Did those last decisions involve limiting care in certain situations?
T232		Did those last decisions involve withholding any treatment?
T233		Did those last decisions rest largely on keeping R's FIRST NAME comfortable and pain free without taking extensive measures to prolong life?
T234		Did any doctor(s) recommend any care or treatment that the family or other decision-maker(s) ultimately refused?
T235		Did R's FIRST NAME receive this treatment anyway?
T236		Did cost enter into the decisions about what care or treatment [he/she] would receive in the final days of [his/her] life?
T259		On a scale of zero to 10, where zero is the worst possible and 10 is the best possible, in your opinion, how would you rate the overall quality of [deceased R's] last week of life?

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Up to survey overview
Start of T. Wills And Life Insurance

T001 Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed? view item details » NEXT WE HAVE SOME QUESTIONS ABOUT WILLS, TRUSTS AND LIFE INSURANCE.DO YOU CURRENTLY HAVE A WILL THAT IS WRITTEN AND WITNESSED? 1 YES, WILL 2 [VOL] YES, WILL AND TRUST 3 [VOL] NO WILL, BUT HAVE TRUST 5 NO WILL

If Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed? view item details » != 5 and Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed? view item details » was not answered »

	T002 Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]? view item details » HAVE YOU MADE PROVISIONS IN YOUR [WILL/WILL OR TRUST/TRUST] FOR ANY FAMILY MEMBERS [OTHER THAN YOUR [HUSBAND/WIFE/PARTNER/SPOUSE]]? 1 YES 5 NO

	If Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]? view item details » != 5 and Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]? view item details » was not answered »

		If A101 > 0 »

			T003 Does that include any of your children or step-children? view item details » DOES THAT INCLUDE ANY OF YOUR CHILDREN OR STEP-CHILDREN? 1 YES 5 NO

			If Does that include any of your children or step-children? view item details » = 1 YES 5 NO »

				T004M1

				If (T004M1 != 993 and T004M1 > 1) or (T004M1 = 1 and T004M1 != 996) »

					If A101 > 1 »

						T005 Does that document provide for all your children about equally? view item details » DOES THAT DOCUMENT PROVIDE FOR ALL YOUR CHILDREN ABOUT EQUALLY? 1 YES 5 NO 8 DK 9 RF

		If NZ114 > 0 and NZ114 != 95 »

			T006 Does that document include any grandchild directly? view item details » DOES THAT DOCUMENT INCLUDE ANY GRANDCHILD DIRECTLY? 1 YES 2 [VOL] ONLY THROUGH THEIR PARENTS 5 NO 8 DK 9 RF

			If Does that document include any grandchild directly? view item details » = 1 YES 2 [VOL] ONLY THROUGH THEIR PARENTS 5 NO 8 DK 9 RF »

				T007M1

	T008 Have you made provisions for any charities in your will or trust? view item details » HAVE YOU MADE PROVISIONS FOR ANY CHARITIES IN YOUR WILL OR TRUST? 1 YES 5 NO 8 DK 9 RF

T011 Do you have any life insurance, including individual or group policies? view item details » DO YOU HAVE ANY LIFE INSURANCE, INCLUDING INDIVIDUAL OR GROUP POLICIES? 1 YES 5 NO 8 DK 9 RF

If Do you have any life insurance, including individual or group policies? view item details » != 5 and Do you have any life insurance, including individual or group policies? view item details » !was not answered »

	T012 How many different life insurance policies do you have? view item details » HOW MANY DIFFERENT LIFE INSURANCE POLICIES DO YOU HAVE? 2 TWO 3 THREE 4 FOUR 5 FIVE OR MORE

	T013 What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die? view item details » WHAT IS THE TOTAL FACE VALUE OF THIS POLICY, THAT IS, THE AMOUNT OF MONEY THE BENEFICIARY WOULD GET IF YOU WERE TO DIE?

	If What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die? view item details » = 9999998 or What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die? view item details » = 9999999 »

		T014

	T017

	T018 [Is this a life insurance policy that builds/Are any of these life insurance policies ones that build] up a cash value that you can borrow against, or that you would receive if the policy were to be cancelled? view item details » [IS THIS A LIFE INSURANCE POLICY THAT BUILDS/ARE ANY OF THESE LIFE INSURANCE POLICIES ONES THAT BUILD] UP A CASH VALUE THAT YOU CAN BORROW AGAINST, OR THAT YOU WOULD RECEIVE IF THE POLICY WERE TO BE CANCELLED? 1 YES 5 NO 8 DK 9 RF

	If [Is this a life insurance policy that builds/Are any of these life insurance policies ones that build] up a cash value that you can borrow against, or that you would receive if the policy were to be cancelled? view item details » = 1 YES 5 NO 8 DK 9 RF »

		If How many different life insurance policies do you have? view item details » != 1 »

			T019 (How many such policies do you have?) view item details » (HOW MANY SUCH POLICIES DO YOU HAVE?) 2 TWO 3 THREE 4 FOUR 5 FIVE OR MORE

			T020 What is the current face value of [these policies/this policy]? view item details » WHAT IS THE CURRENT FACE VALUE OF [THESE POLICIES/THIS POLICY]?

			If What is the current face value of [these policies/this policy]? view item details » = 9999998 or What is the current face value of [these policies/this policy]? view item details » = 9999999 »

				T021

		T024

		If T024 > 0 and T024 was answered »

			T025 (Altogether,) about how much in total do you pay for this policy each month or year? view item details » (ALTOGETHER,) ABOUT HOW MUCH IN TOTAL DO YOU PAY FOR THIS POLICY EACH MONTH OR YEAR?

			If (Altogether,) about how much in total do you pay for this policy each month or year? view item details » = 8 or (Altogether,) about how much in total do you pay for this policy each month or year? view item details » = 9 »

				T026

		T029 Who are the beneficiaries of this policy? view item details » WHO ARE THE BENEFICIARIES OF THIS POLICY?

	T031 [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies? view item details » [SINCE R'S LAST IW MONTH, YEAR/IN THE LAST 2 YEARS], HAVE YOU OBTAINED ANY NEW LIFE INSURANCE POLICIES? 1 YES 5 NO

	If [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies? view item details » != 5 and [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies? view item details » !was not answered »

		T032 What is the total face value of (this policy/all of these policies)? view item details » WHAT IS THE TOTAL FACE VALUE OF (THIS POLICY/ALL OF THESE POLICIES)?

		If What is the total face value of (this policy/all of these policies)? view item details » = 9999998 or What is the total face value of (this policy/all of these policies)? view item details » = 9999999 »

			T033

T036 [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled? view item details » [SINCE R'S LAST IW MONTH, YEAR/IN THE LAST 2 YEARS], HAVE YOU ALLOWED ANY LIFE INSURANCE POLICIES TO LAPSE OR HAVE ANY BEEN CANCELLED? 1 YES 5 NO

If [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled? view item details » != 5 and [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled? view item details » !was not answered »

	T037 What was the total face value of (this policy/all of these policies)? view item details » WHAT WAS THE TOTAL FACE VALUE OF (THIS POLICY/ALL OF THESE POLICIES)?

	If What was the total face value of (this policy/all of these policies)? view item details » = 9999998 or What was the total face value of (this policy/all of these policies)? view item details » = 9999999 »

		T038

	T041 Was this lapse or cancellation something you chose to do, or was it done by the provider, your employer, or someone else? view item details » WAS THIS LAPSE OR CANCELLATION SOMETHING YOU CHOSE TO DO, OR WAS IT DONE BY THE PROVIDER, YOUR EMPLOYER, OR SOMEONE ELSE? 1 R'S CHOICE 2 PROVIDER/EMPLOYER/ SOMEONE ELSE CHOSE

	If Was this lapse or cancellation something you chose to do, or was it done by the provider, your employer, or someone else? view item details » != 2 »

		T042

		T043 Did you receive any cash when the policy was cancelled or allowed to lapse? view item details » DID YOU RECEIVE ANY CASH WHEN THE POLICY WAS CANCELLED OR ALLOWED TO LAPSE? 1 YES 5 NO

		If Did you receive any cash when the policy was cancelled or allowed to lapse? view item details » != 5 and Did you receive any cash when the policy was cancelled or allowed to lapse? view item details » !was not answered »

			T044 About how much cash did you receive? $ ________ .00 view item details » ABOUT HOW MUCH CASH DID YOU RECEIVE? $ ________ .00

End of T. Wills And Life Insurance

Start of T. Wills And Life Insurance

========================================================================

T001

Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed?

NEXT WE HAVE SOME QUESTIONS ABOUT WILLS, TRUSTS AND LIFE INSURANCE.DO YOU CURRENTLY HAVE A WILL THAT IS WRITTEN AND WITNESSED?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES, WILL
2 [VOL] YES, WILL AND TRUST
3 [VOL] NO WILL, BUT HAVE TRUST
5 NO WILL

If Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed? (T001) != 5 and Next we have some questions about wills, trusts and life insurance.Do you currently have a will that is written and witnessed? (T001) was not answered »

| ========================================================================

T002

Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]?

HAVE YOU MADE PROVISIONS IN YOUR [WILL/WILL OR TRUST/TRUST] FOR ANY FAMILY MEMBERS [OTHER THAN YOUR [HUSBAND/WIFE/PARTNER/SPOUSE]]?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO

| If Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]? (T002) != 5 and Have you made provisions in your [will/will or trust/trust] for any family members [other than your [husband/wife/partner/spouse]]? (T002) was not answered »

| | If A101 > 0 »

| | | ========================================================================

| | |

T003

Does that include any of your children or step-children?

DOES THAT INCLUDE ANY OF YOUR CHILDREN OR STEP-CHILDREN?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO

| | | If Does that include any of your children or step-children? (T003) = 1 YES 5 NO »

| | | | ========================================================================

| | | |

T004M1

| | | | If (T004M1 != 993 and T004M1 > 1) or (T004M1 = 1 and T004M1 != 996) »

| | | | | If A101 > 1 »

| | | | | | ========================================================================

| | | | | |

T005

Does that document provide for all your children about equally?

DOES THAT DOCUMENT PROVIDE FOR ALL YOUR CHILDREN ABOUT EQUALLY?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO
8 DK
9 RF

| | If NZ114 > 0 and NZ114 != 95 »

| | | ========================================================================

| | |

T006

Does that document include any grandchild directly?

DOES THAT DOCUMENT INCLUDE ANY GRANDCHILD DIRECTLY?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
2 [VOL] ONLY THROUGH THEIR PARENTS
5 NO
8 DK
9 RF

| | | If Does that document include any grandchild directly? (T006) = 1 YES 2 [VOL] ONLY THROUGH THEIR PARENTS 5 NO 8 DK 9 RF »

| | | | ========================================================================

| | | |

T007M1

| ========================================================================

T008

Have you made provisions for any charities in your will or trust?

HAVE YOU MADE PROVISIONS FOR ANY CHARITIES IN YOUR WILL OR TRUST?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO
8 DK
9 RF

========================================================================

T011

Do you have any life insurance, including individual or group policies?

DO YOU HAVE ANY LIFE INSURANCE, INCLUDING INDIVIDUAL OR GROUP POLICIES?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO
8 DK
9 RF

If Do you have any life insurance, including individual or group policies? (T011) != 5 and Do you have any life insurance, including individual or group policies? (T011) !was not answered »

| ========================================================================

T012

How many different life insurance policies do you have?

HOW MANY DIFFERENT LIFE INSURANCE POLICIES DO YOU HAVE?

- - - - - - - - - - - - - - - - - - - - - - - - -
2 TWO
3 THREE
4 FOUR
5 FIVE OR MORE

| ========================================================================

T013

What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die?

WHAT IS THE TOTAL FACE VALUE OF THIS POLICY, THAT IS, THE AMOUNT OF MONEY THE BENEFICIARY WOULD GET IF YOU WERE TO DIE?

| If What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die? (T013) = 9999998 or What is the total face value of this policy, that is, the amount of money the beneficiary would get if you were to die? (T013) = 9999999 »

| | ========================================================================

| |

T014

| ========================================================================

T017

| ========================================================================

T018

[Is this a life insurance policy that builds/Are any of these life insurance policies ones that build] up a cash value that you can borrow against, or that you would receive if the policy were to be cancelled?

[IS THIS A LIFE INSURANCE POLICY THAT BUILDS/ARE ANY OF THESE LIFE INSURANCE POLICIES ONES THAT BUILD] UP A CASH VALUE THAT YOU CAN BORROW AGAINST, OR THAT YOU WOULD RECEIVE IF THE POLICY WERE TO BE CANCELLED?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO
8 DK
9 RF

| If [Is this a life insurance policy that builds/Are any of these life insurance policies ones that build] up a cash value that you can borrow against, or that you would receive if the policy were to be cancelled? (T018) = 1 YES 5 NO 8 DK 9 RF »

| | If How many different life insurance policies do you have? (T012) != 1 »

| | | ========================================================================

| | |

T019

(How many such policies do you have?)

(HOW MANY SUCH POLICIES DO YOU HAVE?)

- - - - - - - - - - - - - - - - - - - - - - - - -
2 TWO
3 THREE
4 FOUR
5 FIVE OR MORE

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T020

What is the current face value of [these policies/this policy]?

WHAT IS THE CURRENT FACE VALUE OF [THESE POLICIES/THIS POLICY]?

| | | If What is the current face value of [these policies/this policy]? (T020) = 9999998 or What is the current face value of [these policies/this policy]? (T020) = 9999999 »

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T021

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T024

| | If T024 > 0 and T024 was answered »

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T025

(Altogether,) about how much in total do you pay for this policy each month or year?

(ALTOGETHER,) ABOUT HOW MUCH IN TOTAL DO YOU PAY FOR THIS POLICY EACH MONTH OR YEAR?

| | | If (Altogether,) about how much in total do you pay for this policy each month or year? (T025) = 8 or (Altogether,) about how much in total do you pay for this policy each month or year? (T025) = 9 »

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T026

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T029

Who are the beneficiaries of this policy?

WHO ARE THE BENEFICIARIES OF THIS POLICY?

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T031

[Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies?

[SINCE R'S LAST IW MONTH, YEAR/IN THE LAST 2 YEARS], HAVE YOU OBTAINED ANY NEW LIFE INSURANCE POLICIES?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO

| If [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies? (T031) != 5 and [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you obtained any new life insurance policies? (T031) !was not answered »

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| |

T032

What is the total face value of (this policy/all of these policies)?

WHAT IS THE TOTAL FACE VALUE OF (THIS POLICY/ALL OF THESE POLICIES)?

| | If What is the total face value of (this policy/all of these policies)? (T032) = 9999998 or What is the total face value of (this policy/all of these policies)? (T032) = 9999999 »

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| | |

T033

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T036

[Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled?

[SINCE R'S LAST IW MONTH, YEAR/IN THE LAST 2 YEARS], HAVE YOU ALLOWED ANY LIFE INSURANCE POLICIES TO LAPSE OR HAVE ANY BEEN CANCELLED?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO

If [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled? (T036) != 5 and [Since R's LAST IW MONTH, YEAR/In the last 2 years], have you allowed any life insurance policies to lapse or have any been cancelled? (T036) !was not answered »

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T037

What was the total face value of (this policy/all of these policies)?

WHAT WAS THE TOTAL FACE VALUE OF (THIS POLICY/ALL OF THESE POLICIES)?

| If What was the total face value of (this policy/all of these policies)? (T037) = 9999998 or What was the total face value of (this policy/all of these policies)? (T037) = 9999999 »

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| |

T038

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T041

Was this lapse or cancellation something you chose to do, or was it done by the provider, your employer, or someone else?

WAS THIS LAPSE OR CANCELLATION SOMETHING YOU CHOSE TO DO, OR WAS IT DONE BY THE PROVIDER, YOUR EMPLOYER, OR SOMEONE ELSE?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 R'S CHOICE
2 PROVIDER/EMPLOYER/ SOMEONE ELSE CHOSE

| If Was this lapse or cancellation something you chose to do, or was it done by the provider, your employer, or someone else? (T041) != 2 »

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T042

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T043

Did you receive any cash when the policy was cancelled or allowed to lapse?

DID YOU RECEIVE ANY CASH WHEN THE POLICY WAS CANCELLED OR ALLOWED TO LAPSE?

- - - - - - - - - - - - - - - - - - - - - - - - -
1 YES
5 NO

| | If Did you receive any cash when the policy was cancelled or allowed to lapse? (T043) != 5 and Did you receive any cash when the policy was cancelled or allowed to lapse? (T043) !was not answered »

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| | |

T044

About how much cash did you receive? $ ________ .00

ABOUT HOW MUCH CASH DID YOU RECEIVE? $ ________ .00

End of T. Wills And Life Insurance

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T. Wills And Life Insurance