C

FI (2

-

-

-

-

-

-

-

-

-

-

-

I

a.

T.

ONFlDENTlAl_ - This survey is conducted under the provisions of Title 13, U.S. Code. The information you provide cannot be used BUDGET BUREAUNO. 416309

for purposes of taxation, investigation,or regulation. APPROVAL EXPIRES DECEMBER 31,1963

p yFp 0-2 U.S. DEPARTMENT OF COMMERCE - BUREAU OF THE CENSUS Sample Control Number _- - FOR THE BOARD OF GOVERNORS OF THE

FEDERAL RESERVE SYSTEM Name of interviewer

SURVEY OF FINANCIAL CHARACTERISTICS Code

1963

1. RECORD OF INTERVIEW

Interview time Interview Person interviewed made at

Date of (f) ---- -------- _---

interview Arrived Departed 1 Result of interview

for from Home Office P e1scJn Title interview interview

(a) (b) (c) (d) (e) I (d I I I i I

I I

Name of head

!

I

I !

I

I I

2. FIELD CONTROL JNFORMATION c. Name of head (if different from Line “a”)

d. Home telephone number

h. Comments

1

Home address e. Home telephone number (if different from Line “d” above)

f. Office address

g. Office telephone number

C

I c

L

i -

d ; -

d d 3 2

-

-0 -0 -cl -0 -0 -0

4l 4-l “0 -u -0 -0 -cl

.

. : :

:n 52 JI

PAGE 2

*)

Section II - GENERAL BACKGROUND INFORMATION ABOUT FAMILY UNIT ON DECEMBER 31, 1960 (About 2ti years aqo)

DESCRIPTION OF PRESENT FAMILY UNIT WORK EXPERIENCE DURING 1960

Line No.,from Se&on I,of each Marital status on Home address on Occupation and industry Name and location of principal employer family member December 31, 1960 December 31, 1960 of longest job (name, city, and State) 14 yrs. and over

(1) (2) (3) (4) (5)

1 0 Unchanged 0 Same 0 Same 0 Same -_______-_

2 0 Married

s 0 WIdowed

4 0 Divorced

I 0 Unchanged 0 Same 0 Same 0 Same -------_--

2 0 Married

s 0 Widowed

4 a Divorced

I 0 Unchanged 0 Same 0 Same 0 Same _----------.

z 0 Married

s 0 Widowed

4 0 Divorced

I 0 Unchanged 0 Same 0 Same 0 Same --___----_

z 0 Married

a n Widowed

4 0 Divorced

1 OUnchanged 0 Same 0 Same 0 Same ----___--^_

2 0 Married

3 0 Widowed

4 0 Divorced

1 0 Unchanged 0 Same 0 Same 0 Same ----_-_----

z 0 Married

s 0 Widowed

4 0 Divorced

NOTES

S 39Vd

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(P “w*enb 02 peeoold)

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538nlN383a t10 saN08 ~3t-uo

STOCKS

12. Now we would like to discuss common stocks, preferred stocks and shares in mutual funds that con be bought by the general public. Did o,ny member of your family

own any publicly troded stocks or any shares in mutual funds and investment clubs at ony time during 1962?

I DNo 2OYes c

a. We ore interested in making very occurote estimates of the market value of people’s holdings of stocks which as you know change in value more

then other types of securities. The best way of doing this is to ask for a list of your individual issues. What are the companies, mutual funds,

or investment clubs in which you held stock at the end of 1962? Remember that we ore talking only about stock of componies that could be pur-

chased by the general public.

+ 1

I 0 No stocks held on December 31, 1962. 2 0 Otherwise, complete (Proceed to (Proceed to Question 12~)

I

Table C for each issue. Question 13)

Table C \ Records used. . . . . . . . . . 1 0 No 2 IJ Yes

Ask number of shares Ask only if “No” co Column (e)

Family Type of Is the stock

member issue ’ Total market listed in most owning Full name of issuing corporation or fund (“X” one) newspapers? value on That would make

(issues held on December 31, 1962) What was the total number Whot was the December 31, the market value

3 - Head (c) (If ‘rYc3s.r go price per 1962

(If preferred stock, enter dividend rate) about - -

V - Wife _ of shares held December to next issue. share on

1 - Other 31, 1962? If “NO,” ask

: December 31, (rduftipty(d) by(5) Does that seem 1962?

(Specify) -z (5, through (h).) and enter in (g) correct? 8 f EA icy g ;; E” ;gu Qs

(4 (b) G $5 =!A 59 ‘2

,cu (4 (e) (0 (g) (h)

I OYes 2 ONo s 1 OYes 2 ONo (correct (s))

, OYes 2 ONo S 1 OYes z ONo (correct (B))

1 OYes I OYes 2 ONo $ 2 ONo (correct (g))

tOYes 2(7No 91 1 OYes 2 DNo (correct (@)

1 OYes , OYes 2 ONo sa z ONo (correct [a)

1 DYes tOYes 2DNo $ 2 ONo (correct (s))

I OYes 2 ONo (B 1 OYes 2 (-JNo (correct (B))

I OYes I OYes 2 ONo $ 2 ONo (correct (s))

1 OYes , OYes 2 ONo $ 2 ONo (correct (&)

1 OYes I OYes 2 ONo 31 z ONo (correct (&)

1 OYes I C]Yes 2 ONo s 2 ONo (correct(&)

I OYes 2 ONo 91 1 OYes 2 ONo (correct (B))

I OYes 2 ONo $ 1 OYes 2 ONo (correct f&j

(a) 6) Cc) Cd) (e) (0

I OYes ZUNO

1 OYes 2aNo

lOYes 213No

1 OYes 20No

I OYes 210

1 OYes 20No

2 I OYes 20No

cl . m

t I OYes 20No

1 OYes 20No

1 OYes 2/o

I OYes 2[0

1OYes 210

I OYes 20No

I (If more space is needed, use “Notes” space at end of schedule or attach individual sheers.)

No (Correct (g))

No (correct (g))

B 1 OYes 20No (Correct (g))

$ 1 IJYes

2 l---JNo (Correct tg))

B I OYes

2 ONo (Correct (g))

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t

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-(sp=P!A!P YSV) SahOZ

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