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* 1. Contact Information

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* 2. What is your gender?

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* 3. What is your age?

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* 4. Which of the following specific items, do you, yourself, pay for on a regular basis?

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* 5. Which of the following financial institutions do you currently do business or have an account with?

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* 6. How many of the following personal accounts or products do you currently have yourself or jointly in total? (Please include all banks you have that account/ product with)

  0 1 2 3 4 or more
Checking account
Savings account
Credit card
Debit card
Mortgage or Home equity line of credit
Auto or personal loan

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