Screen Shots from Screen Shots from 2010 CQS Internet Instrument (DRAFT)

Attachment B

The U.S. Census Bureau Estimates that, for the average household, this form will take about 10 minutes to complete, including
the time for reviewing the instructions and answers. Send comments regarding this burden estimate or any other aspect of this
burden to: Paperwork Reduction Project xxxx-xxxx-C, U.S. Census Bureau, AMSD-3K138, 4600 Silver Hill Road, Washington, DC
20233. You may e-mail comments to Paperwork@census.gov; use “Paperwork Project xxxx-xxxx-C” as the subject.

Attachment B

If YES
YES: they
h are taken
k to ADDRESS (page
(
3).
3)
If NO: they are asked to re-enter the access code and shown the address that
matches that access code. If it is still not the correct address, they go to NO
COMPLETE (p
(page
g 27).
)

CONFIRM

2

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If YES
YES: they
h are taken
k to RIGHT REST (page
(
4).
4)
If NO: they are taken to TIME (page 5).

ADDRESS

3

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All options go to PIN (page 7).

RIGHT RESP

4

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If YES
YES: they
h are taken
k to PIN (page
(
7).
7)
If NO: they are taken to ADDAWAY (page 6).

TIME

5

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If YES
YES: they
h are taken
k to PIN (page
(
7).
7)
If NO: they are taken to NO COMPLETE (page 27).

ADDAWAY

6

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PIN

7

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PEOPLE

8

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If YES: they are taken to STAY (page 10).
If NO: they are taken to COMPLETED (page 11).

MISS

9

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STAY

10

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COMPLETED

11

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If O
Option
i 1 or O
Option
i 11: Th
They go to OWNER – OWNS (page
(
13) with
i h “owns”
“
”
text filled in.
If Option 3: They go to OWNER-RENTS (page 14) with “rents” text filled in.
If Option 4: They go to RELATION (page 15).

HOME

12

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OWNER - OWNS

13

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OWNER - RENTS

14

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RELATION

15

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SEX

16

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AGE

17

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ORIGIN

18

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RACE

19

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If NO: They are taken to REVIEW2 (page 24).
If only one YES: They are taken to FULLSTAY (page 21) to collect the address.
If multiple YES answers: They are taken to REVIEW2 (page 24).

ELSEWHERE

20

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FULLSTAY

21

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Option
O
i 1 is
i the
h address
dd
that
h the
h survey invitation
i i i was mailed
il d to.
Option 2 is the address provided on the FULLSTAY screen (page 21).
If Option 1, 2, or 3: They go to WHERE (page 23).
If Option 4: They go to REVIEW2 (page 24).

MOST

22

Attachment B

Option
O
i 1 is
i the
h address
dd
that
h the
h survey invitation
i i i was mailed
il d to.
Option 2 is the address provided on the FULLSTAY screen (page 21).
All options go to REVIEW2 (page 24).

WHERE

23

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SUBMIT button submits the survey and takes them to the THANKYOU (page 26).
REVIEW takes them to REVIEW3 (page 25).

REVIEW2

24

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REVIEW3

25

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THANK YOU

26

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NO COMPLETE

27