2016 Regional EITC Free Tax Preparation Site Survey For Filers (2015 Tax Year)
https://www.surveymonkey.com/r/okivita2016
Site Location:
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Your participation in this survey helps us improve our program! Your participation is completely voluntary, and
you do not have to answer any questions that you do not want to answer. Your individual answers will not be
shared with others. Thank you for taking the time to complete the survey! FILL OUT 1 PER PERSON
1. How did you find out about us? (Choose 1)
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Returning from previous year
Friend/Family Member
Agency/Church/School/Employer
United Way 211
Flyer/Poster at library or business
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Radio/Television Ad
Facebook, Twitter, other Social Media
Email, Website
Newspaper Ad
Bus Ad
2. Who prepared your taxes last year? (Choose 1)
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This site
 Paid tax preparer (H&R Block, Liberty Tax,
Another free tax site
Jackson Hewitt, etc.)*
Friend or family member
 Car dealer or furniture store
I did my own taxes (paper or tax
 I did not file last year
software)
 Other:
*If you paid to have your taxes done last year, approximately how much did you pay? $_______
3. If you receive a refund this year how are you planning to use it? (check top 3 that apply)
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Utility bills
Medical expenses/bills
Credit card bills/ repay loans
Rent/Mortgage/Housing
Child Care
Groceries
Clothes/Family gifts
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Appliances, electronics or furniture
New car or car repair
Home repair/improvement
Education: tuition, books, student loan
Vacation/party
Savings/Investment/Rainy day fund
I don’t expect a refund
4. If you receive a refund this year will you save some of it for later?
 Yes, bank account
 Yes, savings bond
 Yes, other
 Not this year.
5. Would you be interested in learning to do your own taxes?
 Yes
 No
6. Would you be interested in financial education classes, workshops or coaching on credit,
budgeting, saving, etc.?
 Yes
 No
** TURN OVER **
7. What is your employment status: (person completing survey)
 Employed, Full time
 Employed, Part time
 Employed, Temp or Seasonal
 Not Employed
 Self Employed
 Retired
8. Which of the following financial services have you used in last 12 months: (check all that apply)
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Bank /Savings/Checking Account
Retirement/Investment Account
Credit Card/Debit Card
Pre-Paid Card/Gift Card
Money Order
Car Title Loan
Rent to Own
Pay Day Loan/Cash Advance
Refund Anticipation Loan
Pawn Shop
Student Loan
Housing Line of Credit
Bank Loan
Bankruptcy
9. What is your gender (person completing survey)
 Female
 Male
10. Age: ____ years (person completing survey)
11. Race/ethnicity? (check one) (person completing survey)
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African-American
Asian
Caucasian
Native American/Alaskan Native
Native Hawaiian/Other Pacific Islander
 Multi-racial
 Other
Are you Hispanic?
 Yes
 No
12. Do you or a member of your household have a disability?
 Yes
 No
13. Did you or a member of your household serve in the military (active or past)?
 Yes
 No
14. What is your education level? (person completing survey)
 Less than High School
 High School or GED
 Some College/Technical School
 Two Year College Degree
 Four Year College Degree
 Graduate School
15. What is your current household size? (number of family members on your return) #_____ people
16. What is your current combined household income?
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$0-9,999
$10, 000-19,999
$20,000-29,999
$30,000-39,999
$40,000 - $49,999
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$50,000 - $59,000
$60,000 - $70,000
$70.000 - $80,000
$80,000+
Thank you for completing this survey...it helps us to better serve you!!!