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Diary of Consumer Payment Choice
Memory Aid & Instructions
Please read before you begin!

****Place sticker here that contains the following information:****
OCTOBER X—the night before Day 1
Log on to the Diary website to record information about cash,
checking account balances, and prepaid card balances.
OCTOBER X, OCTOBER X, AND OCTOBER X—Diary Days 1, 2, & 3
1. Use this diary to record all payments (purchases, bills, and other
payments) and cash activity.
2. Log on to the Diary website every night, even if you do not make
any payments on a given day.
USERNAME and PASSWORD for website
WEBSITE URL ADDRESS

This booklet contains…
Instructions for the night before your Diary begins
Instructions for Diary Days 1, 2, & 3
Memory Aid for recording payments and other activity

Page
2
4
10

Your responses will remain anonymous and confidential and will be used for
research purposes only.

The night before Day 1
Complete the Survey of Consumer
Payment Choice

If you have not already done so, use the link we sent you
and complete the Survey before logging on to your Diary
website.

Count your paper cash
Do not count coins.
Count cash held by you, but not by other members of your household.
Enter zero (0) in Total Dollar Amount if you do not have any cash.
Bills

Pocket, purse, or wallet

Elsewhere
(Home, car, office, etc.)

Number
of bills

Dollar ($)
amount

Number
of bills

Dollar ($)
amount

$1 bills

_____

$_____

_____

$_____

$2 bills

_____

$_____

_____

$_____

$5 bills

_____

$_____

_____

$_____

$10 bills

_____

$_____

_____

$_____

$20 bills

_____

$_____

_____

$_____

$50 bills

_____

$_____

_____

$_____

$100 bills

_____

$_____

_____

$_____

Total dollar
($) amount

2 — Diary of Consumer Payment Choice

$_____

$_____

The night before Day 1
Record your current account balances

Report the exact balance of the account as of the end of the night
before Day 1—that is, before you begin your Diary.
Go online to check balances.
If you cannot go online, check your current balance the way you usually
do.
Include accounts owned by you or jointly with someone else.
Balance as of
Date
Time
am
____pm

$____.__

General-purpose prepaid cards are accepted
anywhere you can use a credit or debit card. They
have an AmEx, Discover, MasterCard, or Visa logo.

am
____pm

$____.__

Primary PayPal Account

am
____pm

$____.__

Account or card used most often to make payments

Primary Checking Account
Primary General-Purpose Prepaid Card

Balance

Record information about income

Types of income: employment, retirement, self-employment, Social
Security, interest and dividends, rental income, government assistance,
alimony, child support, etc.
Record information about income received by you, but not by other
members of your household.
Date

Dollar amount
received

__/__/2016

$_____.__

When did you last receive income?

__/__/2016

$_____.__

When do you next expect to receive
income?

__/__/2016

$_____.__

Did you receive income the day before
Diary Day 1?
If yes, provide date and amount.

Log on to the Diary website
Diary of Consumer Payment Choice — 3

Diary Days 1, 2, & 3
Log on at the end of every Diary day
• Log on to the Diary website, even if you did not
make any payments during the day.
• Record all payments you pay yourself, not
payments by other members of your household.

Record all payments, no matter how small
• Remember to include small payments for items like coffee, snacks,
•

tolls, cigarettes, convenience store purchases, fast food.
Record dollars and cents, for example, $2.33.

Record all payments, including bills

•
•

Remember to include any bills scheduled to be paid electronically
on all 3 of your Diary days.
Refer to your bank or credit card records to gather information
about bills and other payments.

Record all deposits and withdrawals
•
•

When recording withdrawals, do not include paper cash and coins
received back as change from a cash purchase.
If you receive cash back from a refund or exchange, record it in the
“Receiving or getting cash” box.

Count your cash at the end of every day
•
•

Record the amount of cash in your pocket, wallet, or purse at the
end of every Diary day.
On Day 3, record how much cash you have stored elsewhere, for
example, in your home, office, or car.

4 — Diary of Consumer Payment Choice

Bill Payments
•
•

A bill payment is a payment for goods or services that you received in the
past or that you will receive in the future.
Record all bills you paid. Do not record bills paid by other members of your
household.

When is a bill paid?
•
•
•
•

Automatically or electronically: paid on the day the payment is specified to
be made.
By mail: paid on the day you mail the payment.
In person: paid on the day you hand over the payment.
By phone: paid on the day you call to make the payment.

Types of bills
Household or utility payments
•
Rent
•
Mortgage
•
Home equity loan
•
Home Equity Line of Credit
(HELOC) (do not include any
payment made as part of your
mortgage payment)
•
Yard maintenance (Landscaping,
tree service, or snow removal,
etc.)
•
Housing maintenance (Maid,
cleaning, laundry service,
plumber, handyman, etc.)
•
Electricity
•
Water/sewer
•
Natural gas, propane, heating
fuel, other energy
•
Homeowner’s association or
condo fees
•
Trash collection
Phone, cable, or internet payments
•
Telephone (landline and mobile)
•
Cable
•
Internet
Credit card or loan payments
•
Credit card bill
•
Car, truck, motorcycle, boat, or
other vehicle loan payments
•
Student loan
•
Other types of loans

Insurance payments
•
Health insurance
•
Vehicle insurance
•
Homeowner’s or renter’s
insurance
•
Life insurance
•
Umbrella insurance
Miscellaneous
•
Tuition, daycare, babysitting
•
Medical or dental payments not
covered by insurance
•
Parking (buying a weekly,
monthly, or annual pass)
•
Public transportation (buying a
weekly or monthly pass for bus,
subway, ferry, etc.)
•
Memberships or subscriptions
(Gym, Netflix, social or
professional club dues,
magazines, etc.)
•
Religious contributions
•
Alimony/child support
Tax payments (not including payroll
deductions from income)
•
Federal taxes
•
State taxes
•
Local taxes
•
Property taxes
•
Car/vehicle taxes

Diary of Consumer Payment Choice — 5

Payment Codes
Payment method

P0: Multiple payment methods

P7: Online banking bill payment

P1: Cash
P2: Check
P3: Credit card
P4: Debit card
P5: Prepaid/Gift/EBT card
P6: Bank account number payment

P8: Money order
P9: Traveler’s check
P10: PayPal
P11: Account-to-account transfer
P12: Mobile phone payment
P13: Other payment method

(When you go online, we will ask about
each method separately.)

(You give your bank routing number and
account number to a third party to
authorize a deduction from your
account.)

D1: Computer

(You initiate a payment at your bank’s
online banking website.)

(Examples: Remittances; EZPass or other
electronic toll; bitcoin or other virtual
currency)

Device you used (if any)

(Laptop or desktop computer)

D2: Tablet

(Examples: iPad or Kindle)

D3: Mobile phone

(Includes text message payments, apps,
mobile web browsing, voice call on
mobile phone)

D4: Landline phone

(Voice call on a landline phone)

D5: Mail

(Examples: USPS, FedEx, UPS)

D6: No device

Type of business, organization, or person you paid
T1: Financial services provider
T7: Retail store or online retailer
(Examples: banks, credit card
•
Gas stations
companies, insurance companies,
•
Coffee shops
mortgage companies, mutual funds,
•
Convenience stores
brokerages)
•
Fast food stores
T2: Education provider
•
Restaurants and bars
(Examples: schools, colleges, childcare)
•
Grocery stores/supermarkets
T3: Medical care provider
•
Pharmacies (Example: Walgreens)
(Examples: hospital, doctor, dentist,
•
Large retailer (Example: Walmart)
physical therapy)
•
Home improvement
T4: Government
•
Online retailer (Examples:
(Examples: federal/state/local taxes,
Amazon.com, Ebay.com)
fees, fines, licenses, utilities)
•
Liquor store
T5: Nonprofit/charity
•
Pet store/pet grooming
(Examples: religious groups, United
•
Other store or online retailer
Way, American Cancer Society)
T8: Other service business
T6: A person
Utilities, repair services,
(Examples: friends, family, co-workers,
communications, entertainment,
other people)
casinos, hairdresser, dry cleaning, etc.
6 — Diary of Consumer Payment Choice

Income Codes

How income is received
I1: Direct deposit to Checking
I5: Paper check
Account #1
I6: Payroll card
I2: Direct Deposit to checking
I7: General-purpose reloadable

account #2
I3: Direct deposit to another
checking or savings account
I4: Cash

prepaid card #1
I8: Another prepaid card
I9: Other

Deposit Codes
Source of deposit

SD1: Cash
SD2: Check
SD3: Transfer from an account I
own
L1: ATM
L2: Bank teller

SD4: Direct deposit
SD5: Transfer from an account I do
not own

For cash deposits, location of cash deposit

L3: Other

A1: Checking account #1
A2: Checking account #2

Account deposited into

A3: General-purpose prepaid card #1
(“reloading”)
A4: Other account

Cash Withdrawal Codes
Location of cash withdrawal

C1: ATM
C2: Cash back at a retail store
C3: Bank teller
C4: Family or friend
C5: Check cashing store

C6: Employer
C7: Cash refund from returning
goods
C8: Payday lender
C9: Other location

Source of cash withdrawal

SW1: Checking account
SW2: Savings or other bank account
SW3: Salary/wages/tips
SW4: Cashing a check

SW5: Credit card cash advance
SW6: Prepaid card cash withdrawal
SW7: Another person
SW8: Other source

Diary of Consumer Payment Choice — 7

Examples: Daily Payments
1.
2.
3.
4.
5.

Fast food purchase
Using mobile phone to pay a person
Paying a bill online
Automatic bill payment
Two or more payment methods

Time

Amount
Spent

Payment
Method

Did you
pay in
person?

Business, organization, or person you
paid
Device

Type

Name

1: Fast food purchase

At 7:30 a.m., Ethan picks up coffee on the way to work. He pays cash.
7:30
$ 2.49
P1
Y /N
D6
T7
Dunkin’ Donuts
am

2: Using mobile phone to pay a person

While with his roommate in their apartment, Jackson uses his phone to send his
roommate his share of the rent. (He does not need to record his roommate’s name.)
9 am

$450.00

P12

Y /N

D3

T6

Roommate

3: Paying a bill online

Mike goes online to pay his credit card bill. At 12:15 pm, he uses his computer and
authorizes a payment using his bank account number.
12:15
$ 50.34
P6
D1
T1
Chase Visa
Y/ N
pm

4: Automatic bill payment

Emma checks her credit card and sees that her electric bill paid automatically. (She
doesn’t specify a time, which is OK for automatic bills.)
$ 112.45

P3

Y/ N

D6

T8

DTE Energy

5: Two or more payment methods

At 6pm, Isabella ate at her favorite restaurant and paid for the $40.95 dinner with her
debit card. She paid the $8 tip with cash. (When she goes online, Isabella will be able
to describe the two payment methods.)
6 pm

$ 48.95

P0

Y /N

8 — Diary of Consumer Payment Choice

D6

T7

Olive Garden

Examples: Income, Deposits, Withdrawals, Cash

1.
2.
3.
4.

Cash back at retail store
Cash withdrawal from general purpose prepaid card using ATM
Direct deposit of salary or wages to primary checking account
Transfer from your savings account to secondary checking account

1: Cash back at retail store

At 7am, Linda shopped at her neighborhood grocery store. She paid $60.92 for her
groceries with a debit card and got $40 cash back. (She records both the grocery
purchase and “receiving or getting cash.”)

Time

Amount
Spent

Payment
Method

Did you
pay in
person?

7 am

$ 60.92

P4

Y /N

Business, organization, or person you
paid
Device

Type

D6

T7

Name

Kroger

Time

Cash Amount

Cash Location

Cash Source

Did you pay a
fee?

7 am

$ 40.00

C2

SW 1

Y/ N

2: Cash withdrawal

At 10 am, Ryan stopped at an out-of-network ATM and withdrew $20.00 cash using
his general-purpose prepaid card.
10
C1
SW 6
Y /N
$ 20.00
am

3: Direct deposit or salary

It’s payday, and Jennifer’s salary was automatically deposited into her primary
checking account (Checking Account #1).
Amount of income

How income was received

$888.75

I1

4: Transfer from savings to checking

Jose transfers $100 from his savings account to his secondary checking account
(Checking Account #2).
Amount of deposit

$100.00

Source of
deposit

SD3

If cash deposit,
location

L

Account deposited into

A2

Diary of Consumer Payment Choice — 9

Day 1: Daily Payments
Please go online to complete the survey, even if you did not make any
payments on Day 1.
Payments for (date):
_____/______/________
What payment methods
did you carry or have
available to make
payments on Diary Day 1?

P1

P2

P10

Amount Spent

P11

P3

P4

P12

P5

P6

P7

P8

P13

Did you
Payment pay in
Method person? Device

Business, organization, or person
you paid

Time
am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

Type

Name

Reminders
•
•
•
•

Record all payments, no matter how small or large
Record all payments, including bills
Record all deposits and withdrawals
Count your cash at the end of every day

10 — Diary of Consumer Payment Choice

P8

Day 1: Income, Deposits, Withdrawals, Cash
Please go online to complete the survey, even if you did not have any activity
on Day 1.
Activity for (date): _____/______/________

Did you receive income on Day 1? If yes…
Amount of income

How income was received

$_______.__ I
$_______.__ I

Deposits, Day 1
Amount of deposit

Source of deposit If cash deposit, location

Account deposited into

$_______.__

SD

L

A

$_______.__

SD

L

A

$_______.__

SD

L

A

Cash withdrawals, Day 1
Time

Cash amount

Location of cash
withdrawal

Source of cash
withdrawal

Did you pay a
fee?

am
______pm

$_______.__

C

SW

Y/N

am
______pm

$_______.__

C

SW

Y/N

am
_____pm

$_______.__

C

SW

Y/N

Cash amount, end of Day 1 (pocket, purse, or wallet)
How many bills of each type?
Bills

$1 bills
$2 bills
$5 bills
$10 bills

Pocket, purse, or wallet
Number
$ amount

_____
_____
_____
_____

$_____
$_____
$_____
$_____

Bills

$20 bills
$50 bills
$100 bills
Total $

Pocket, purse, or wallet
Number
$ amount

_____
_____
_____

$_____
$_____
$_____
$_____

Diary of Consumer Payment Choice — 11

Day 2: Daily Payments
Please go online to complete the survey, even if you did not make any
payments on Day 2.
Payments for (date):
_____/______/________
What payment methods
did you carry or have
available to make
payments on Diary Day 2?

P1

P2

P9

P10

Amount Spent

P3
P11

P4

P5

P12

Did you
Payment pay in
Method person? Device

P6

P7

P8

P13

Business, organization, or person
you paid

Time
am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

Type

Name

Reminders
•
•
•
•

Record all payments, no matter how small or large
Record all payments, including bills
Record all deposits and withdrawals
Count your cash at the end of every day

12 — Diary of Consumer Payment Choice

P8

Day 2: Income, Deposits, Withdrawals, Cash
Please go online to complete the survey, even if you did not have any activity
on Day 2.
Activity for (date): _____/______/________

Did you receive income on Day 2? If yes…
Amount of income

How income was received

$_______.__ I
$_______.__ I

Deposits, Day 2
Amount of deposit

Source of deposit If cash deposit, location

Account deposited into

$_______.__

SD

L

A

$_______.__

SD

L

A

$_______.__

SD

L

A

Cash withdrawals, Day 2
Time

Cash amount

Location of cash
withdrawal

Source of cash
withdrawal

Did you pay a
fee?

am
______pm

$_______.__

C

SW

Y/N

am
______pm

$_______.__

C

SW

Y/N

am
_____pm

$_______.__

C

SW

Y/N

Cash amount, end of Day 2 (pocket, purse, or wallet)
How many bills of each type?
Bills

$1 bills
$2 bills
$5 bills
$10 bills

Pocket, purse, or wallet
Number
$ amount

_____
_____
_____
_____

$_____
$_____
$_____
$_____

Bills

$20 bills
$50 bills
$100 bills
Total $

Pocket, purse, or wallet
Number
$ amount

_____
_____
_____

$_____
$_____
$_____
$_____

Diary of Consumer Payment Choice — 13

Day 3: Daily Payments
Please go online to complete the survey, even if you did not make any
payments on Day 3.
Payments for (date):
_____/______/________
What payment methods
did you carry or have
available to make
payments on Diary Day 3?

P1

P2

P9

P10

Amount Spent

P3
P11

P4

P5

P12

Did you
Payment pay in
Method person? Device

P6

P7

P8

P13

Business, organization, or person
you paid

Time
am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

am
_____pm

$________.___

P

Y/N D

T

Type

Name

Reminders
•
•
•
•

Record all payments, no matter how small or large
Record all payments, including bills
Record all deposits and withdrawals
Count your cash at the end of every day

14 — Diary of Consumer Payment Choice

P8

Day 3: Income, Deposits, Withdrawals, Cash
Please go online to complete the survey, even if you did not have any activity
on Day 3.
Activity for (date): _____/______/________

Did you receive income on Day 3? If yes…
Amount of income

How income was received

$_______.__ I
$_______.__ I

Deposits, Day 3
Amount of deposit

Source of deposit If cash deposit, location

Account deposited into

$_______.__

SD

L

A

$_______.__

SD

L

A

$_______.__

SD

L

A

Cash withdrawals, Day 3
Time

Cash amount

Location of cash
withdrawal

Source of cash
withdrawal

Did you pay a
fee?

am
______pm

$_______.__

C

SW

Y/N

am
______pm

$_______.__

C

SW

Y/N

am
_____pm

$_______.__

C

SW

Y/N

Cash amount, end of Day 3 (pocket, purse, or wallet)
How many bills of each type?
Bills

$1 bills
$2 bills
$5 bills
$10 bills

Pocket, purse, or wallet
Number
$ amount

_____
_____
_____
_____

$_____
$_____
$_____
$_____

Bills

$20 bills
$50 bills
$100 bills
Total $

Pocket, purse, or wallet
Number
$ amount

_____
_____
_____

$_____
$_____
$_____
$_____

Diary of Consumer Payment Choice — 15

Thank you for completing the Diary of Consumer Payment Choice.
Purpose: Improve understanding and operation of the U.S. payment system by
tracking the spending habits and cash activity of consumers

Your diary responses will remain anonymous and confidential and will
be used for research purposes only.

16 — Diary of Consumer Payment Choice