Per Diem, Travel and Transportation Allowance Committee
Living Pattern Survey for Military COLA
RCS DD-P&R(AR)-2125

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Living Pattern Survey for Military COLA

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Living Pattern Survey for Military COLA

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PRIVACY ACT STATEMENT
In accordance with the Privacy Act of 1974 (public Law 93-579), this notice informs you of the purpose of the survey and how the findings will be used. Please read it carefully.

Authority:	10 USC 136, 1782 and 2358; 37 USC 405

Principal Purpose(s):	Information collected in this survey will be used to determine Cost-of-Living Allowances (COLA) for uniformed Service members in overseas locations

Routine Use(s):	None.

Disclosure:	Voluntary. Failure to respond will not result in any penalty to the respondent. However, maximum participation is encouraged so that data will be complete and representative. Your survey questionnaire will be treated as confidential. Any identifiable information will be used only by persons engaged in, and for the purposes of, the survey. Only group statistics will be reported.

Living Pattern Survey for Military COLA

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PURPOSE OF DATA COLLECTION

The Cost of Living Allowance, COLA, is an allowance paid to Service members stationed in high cost overseas locations. COLA helps maintain purchasing power so you can purchase about the same level of goods and services overseas as in the United States.

The questionnaire is designed to identify where and how you purchase goods and services. The information obtained from this questionnaire is used in planning and completing a separate Retail Price Data Collection that forms the basis for prescribing your COLA.

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TIME TO COMPLETE

Please take about 30 minutes to complete this survey.

Please answer all of the questions that apply. If you do not purchase a particular product, select 'Not purchased' or 'Not Applicable'. All of the requested information is necessary to compute a cost-of-living index for your location.

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PART I. GENERAL INFORMATION (1 of 2)

Country
{COUNTRY}

Duty Station
{DUTYLOC}

Branch of Service

DoD Agency/Command

Pay Grade

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PART I. GENERAL INFORMATION (2 of 2)

Number of family
members living with you.

Months at this duty station:

On-Base or Off-Base Housing

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (1 of 14)

INSTRUCTIONS

Select the Primary and Secondary retail outlets most frequently used by you and your household in the local economy.
Use the drop down lists to select the name and location for each retail outlet.
If you do not purchase a product, select "Not purchased" instead of selecting a name and location.
If you use an outlet that is not in the list, please select the 'Other' button next to the list. You will then be able to supply your own outlet name and location.

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (2 of 14)

INSTRUCTIONS

Exclude any military facilities or any other government owned or operated facilites.

Please report OFF BASE Retail Outlets only.

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (3 of 14)

I. Meat and Dairy Products

Local Off Base Retail Outlets

Meat (beef/pork/lamb)

Primary

Secondary

Seafood

Primary

Secondary

Poultry

Primary

Secondary

Dairy Products

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (4 of 14)

II. Groceries

Local Off Base Retail Outlets

Groceries
(including cereal, bread, soda)

Primary

Secondary

III. Tobacco and Alcohol

Cigarettes

Primary

Secondary

Alcoholic Beverages

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (5 of 14)

IV. Fruits and Vegetables

Local Off Base Retail Outlets

Fresh Fruits/Vegetables

Primary

Secondary

Frozen Fruits/Vegetables

Primary

Secondary

Canned Fruits/Vegetables

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (6 of 14)

V. Clothing

Local Off Base Retail Outlets

Men's Clothing

Primary

Secondary

Woman's Clothing

Primary

Secondary

Children's Clothing

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (7 of 14)

VI. Personal Care Items

Local Off Base Retail Outlets

Toiletries (including
toothpaste and shampoo)

Primary

Secondary

Dry Cleaning

Primary

Secondary

Laundry

Primary

Secondary

Hair Services

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (8 of 14)

VII. Household Goods

Local Off Base Retail Outlets

Household Appliances
(including microwave, toaster, and coffee maker)

Primary

Secondary

Housekeeping Supplies
(including detergent, toilet paper, and diapers)

Primary

Secondary

Major Appliances

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (9 of 14)

VIII. Phone Services

Local Off Base Retail Outlets

Telephone, Local

Primary

Secondary

Telephone, Long Distance

Primary

Secondary

Internet Service Provider

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (10 of 14)

IX. Medical

Local Off Base Retail Outlets

Non-Prescription Drugs

Primary

Secondary

Doctor

Primary

Secondary

Dentist

Primary

Secondary

Hospital

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (11 of 14)

X. Entertainment

Local Off Base Retail Outlets

Audio and Visual Supplies
(including VCR's, video tapes, CD's)

Primary

Secondary

Photographic Supplies
(including film & development)

Primary

Secondary

Recreational Equipment
(including bicycles)

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (12 of 14)

X. Entertainment: Recreational Activities

Local Off Base Retail Outlets

Movie Theater

Primary

Secondary

Professional Performing Arts

Primary

Secondary

Professional Sporting Events

Primary

Secondary

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (13 of 14)

XI. Personally Owned Vehicle

Local Off Base Retail Outlets

Auto Maintenance
(including oil changes & tune up)

Primary

Secondary

Gasoline

Primary

Secondary

Auto Tires

Primary

Secondary

Auto Insurance

Primary

Secondary

Living Pattern Survey for Military COLA

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PART II. LOCAL OFF BASE RETAIL OUTLET PURCHASES (14 of 14)

XII. Restaurants

Local Off Base Retail Outlets

Lunch

Primary

Secondary

Dinner

Primary

Secondary

XII. Daycare

Daycare
(excluding pre-school)

Primary

Secondary

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (1 of 11)

INSTRUCTIONS

Estimate the percentage of where you purchase the given items since your arrival at the base.
Base your estimates on the percentage of total volume you buy from each source, not the percentage of total cost.
Indicate percentage of use; do not report outlet names.
For items that you do not use, check the N/A box.
Fields left blank will be considered 0%.

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (2 of 11)

SOURCES OF SUPPLY DEFINITIONS

Local Market - purchases from outlets on the local economy.
Military Commissary/Exchange - purchases made on local base.
Supplies Brought to Base - purchases made prior to assignment to this location for use at your new duty location.
Catalogs/Mail Orders/Internet/Export Companies - purchases made from catalogs, online, or export houses, i.e., Peter Justesen.
Other - purchases made from other overseas military installations, and U.S. or foreign non-military retail facilities.

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (3 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Supplies Brought to Base	Catalogs/ Mail Orders/ Internet/ Export Companies	Other	Required Total
Meat		%	%	%	%	%	100%
Seafood		%	%	%	%	%	100%
Poultry		%	%	%	%	%	100%
Dairy Products		%	%	%	%	%	100%

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (4 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Supplies Brought to Base	Catalogs/ Mail Orders/ Internet/ Export Companies	Other	Required Total
Groceries (including cereal, bread, & cola)		%	%	%	%	%	100%
Cigarettes		%	%	%	%	%	100%
Alcoholic Beverages		%	%	%	%	%	100%

Living Pattern Survey for Military COLA

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (5 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Supplies Brought to Base	Catalogs/ Mail Orders/ Internet/ Export Companies	Other	Required Total
Fresh Fruits/ Vegetables		%	%	%	%	%	100%
Frozen Fruits/ Vegetables		%	%	%	%	%	100%
Canned Fruits/ Vegetables		%	%	%	%	%	100%

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (6 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Supplies Brought to Base	Catalogs/ Mail Orders/ Internet/ Export Companies	Other	Required Total
Men's Clothing		%	%	%	%	%	100%
Women's Clothing		%	%	%	%	%	100%
Children's Clothing		%	%	%	%	%	100%
Toiletries		%	%	%	%	%	100%

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (7 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Supplies Brought to Base	Catalogs/ Mail Orders/ Internet/ Export Companies	Other	Required Total
Household Appliances		%	%	%	%	%	100%
Household Supplies		%	%	%	%	%	100%
Medicine		%	%	%	%	%	100%
Audio/Visual Supplies		%	%	%	%	%	100%

Living Pattern Survey for Military COLA

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (8 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Supplies Brought to Base	Catalogs/ Mail Orders/ Internet/ Export Companies	Other	Required Total
Photographic Supplies		%	%	%	%	%	100%
Reading Materials		%	%	%	%	%	100%
Recreational Equipment		%	%	%	%	%	100%
Auto Tires		%	%	%	%	%	100%

Living Pattern Survey for Military COLA

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (9 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Other	Required Total
Dry Cleaning		%	%	%	100%
Hair Services, Men's		%	%	%	100%
Hair Services, Women's		%	%	%	100%
Hair Services, Children's		%	%	%	100%

Living Pattern Survey for Military COLA

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (10 of 11)

	N/A	Local Market	Military Commissary/ Exchange	Other	Required Total
Movie Theater		%	%	%	100%
Gasoline (note coupon use in column 2)		%	%	%	100%
Auto Maintenance (including oil changes and tune up)		%	%	%	100%
Daycare		%	%	%	100%

Living Pattern Survey for Military COLA

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PART III. SOURCES OF SUPPLY OF GOODS AND SERVICES (11 of 11)

If you reported purchasing products from catalogs, mail orders, export companies or from other sources, list your most important suppliers below. Otherwise, click next.

Catalogs, Mail Orders, Internet, Export

Retail Outlets

US Catalogs and Mail Orders
(including Internet purchases)

Primary

Secondary

Export Companies

Primary

Secondary

Other Overseas Military Installations

Primary

Secondary

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Do you employ Household Help?

Yes

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PART IV. HOUSEHOLD HELP (1 of 2)

	N/A	Hours Worked Per Week	Hourly Wage (in local currency)	Currency Used (Example: Euro, Yen)	Social Security Tax (Example: 5.00%)	Other Expenses	Other Expenses Description
Housekeeper
Cook

Living Pattern Survey for Military COLA

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PART IV. HOUSEHOLD HELP (2 of 2)

Household Help Necessary for:
(check all that apply)

Security

Language Difficulties

Shopping/Food Preparation

Extra Cleaning/Laundry Due to Climate

Other (specify in comments below)

Comments:

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PART V. RELATIVE USE OF GOODS AND SERVICES (1 of 4)
Based on volume (not cost), approximate the proportion of the following goods used in preparing meals at home:

	N/A	Fresh	Canned	Required Total
Fruits		%	%	100%

	N/A	Fresh	Canned	Frozen	Required Total
Vegetables		%	%	%	100%

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PART V. RELATIVE USE OF GOODS AND SERVICES (2 of 4)
Based on volume (not cost), approximate the proportion of the following goods used in preparing meals at home:

	N/A	Fresh	Dried	Required Total
Milk		%	%	100%

	N/A	Beef/Veal	Pork	Lamb	Seafood	Poultry	Required Total
Meats/Fish		%	%	%	%	%	100%

Living Pattern Survey for Military COLA

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PART V. RELATIVE USE OF GOODS AND SERVICES (3 of 4)

Estimate you and your family's usage of transportation:

	Personally Owned Vehicle	Government Transportation	Taxi	Municpal Bus	Subway/ Commuter Transit	Other:	Required Total
Transportation	%	%	%	%	%		100%

Living Pattern Survey for Military COLA

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PART IV. RELATIVE USE OF GOODS AND SERVICES (4 of 4)

Estimate you and your family's usage of meal facilities:

	N/A	Local Restaurant	On-Base Restaurant	Home	Required Total
Breakfast		%	%	%	100%
Lunch		%	%	%	100%
Dinner		%	%	%	100%

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PART VI. REMARKS

Use this section to briefly describe any other unusual cost-of-living expenses for your household that were not already covered in this report.

Do not address concerns about housing, utilities, and other housing related costs. This information is collected in a separate questionnarie.

(You have 250 characters for your remarks)

Living Pattern Survey for Military COLA

100% of Survey Completed

Thank you for completing the Survey.

If you completed this survey via floppy disk or email, please return the survey data file to your locality POC as instructed.

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