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Income Survey Form Template

Gather essential data on income levels easily

Struggling to collect reliable income data from your target group? This Income Survey Form Template is designed for researchers, nonprofits, and businesses who need accurate insights into income levels. It helps you effectively gauge income ranges, identify trends in income brackets, assess financial needs, and better understand your audience's economic landscape-all while being user-friendly and compliant with accessibility standards. Try out the live template to experience its simplicity for yourself.

Do you consent to take part in this survey?
Yes
No
May we contact you about your responses?
Yes
No
What is your age?
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to say
What is your gender?
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
If you prefer to self-describe your gender, you may enter it here
What is the highest level of education you have completed?
Less than high school
High school or equivalent
Some college or technical certificate
Bachelor's degree
Postgraduate or professional degree
Prefer not to say
Including yourself, how many people live in your household?
1
2
3
4
5
6 or more
Prefer not to say
Country of residence
How many dependent children live in your household?
0
1
2
3
4
5 or more
Prefer not to say
What is your current employment status?
Please Specify:
How many hours do you typically work per week?
0 (not working)
1-19
20-34
35-40
41-50
51 or more
Not applicable
Prefer not to say
What is your primary currency?
What is your total personal income before tax in the last 12 months (in your primary currency)?
What is your total household income before tax in the last 12 months (in your primary currency)?
Which of the following are your sources of income? Select all that apply.
Please Specify:
Which benefits or assistance do you currently receive, if any? Select all that apply.
Please Specify:
Compared with 12 months ago, how has your income changed?
Decreased a lot
Decreased a little
No change
Increased a little
Increased a lot
Prefer not to say
How easy or difficult is it to meet your monthly expenses?
Very difficult
Difficult
Neutral
Easy
Very easy
How often do you have money left over at the end of the month?
Very rarely
Rarely
Sometimes
Often
Very often
Do you have an emergency fund that covers at least three months of expenses?
Yes
No
Not sure
Prefer not to say
Full name (optional)
Email (optional)
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Paper art illustration depicting an income survey form in a creative layout for a financial article

When to use this form

Use this template when you need clean, comparable income data to segment audiences, qualify leads, or assess eligibility. Marketers use it to size markets, test price sensitivity, and personalize offers. Nonprofits and schools estimate sliding-scale fees and aid without asking for exact dollars. Researchers pair it with the Political survey form to analyze opinions by income bracket. If you want a responsive, branded layout, start from the Bootstrap form. To trial question wording and skip logic with a small group, try the Demo questions and answers form. The outcome: standardized ranges, less respondent friction, and a dataset you can analyze quickly across locations, household sizes, and job types.

Must Ask Income Survey Questions

  1. Which range best describes your household's annual income before taxes?

    Using ranges reduces drop-off and protects privacy while still giving you clear segments. It enables straightforward analysis for pricing tiers and market sizing.

  2. How many people does this income support in your household?

    Household size normalizes income so you can compare across families and individuals. It prevents misleading conclusions that ignore dependents.

  3. What is your primary source of income?

    Source of income signals stability and constraints, which affect spending and credit risk. It also helps tailor messaging, benefits, or support.

  4. How often do you receive your income?

    Pay frequency reveals cash flow patterns that drive payment plan uptake and churn. It guides how you schedule billing, reminders, or outreach.

  5. What is your employment status?

    Employment status is a strong predictor of income changes and eligibility. It lets you filter results and track trends over time.

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