2017 Census Test - Self Response

This document provides the specifications for the English, self-administered version of the Internet instrument for the 2017 Census Test. The dashboard will direct respondents to complete the necessary sections of the instrument.

Translations and help text will be provided in a separate document.

Input Variables

Variable

Possible Values

Default Value

INTERNET_TE

1 = One question (enrolled)

2 = Two questions (enrolled and corporation)

3 = Three questions (two enrolled and corporation)

n/a

Standard Fills

<ADDRESS>	Partial address from RESIDENCE screen if available. Partial address from APT_RESIDENCE screen if available. Partial address from URB_RESIDENCE screen if available. Partial address from AREANM_RESIDENCE screen if available. Partial address from GEN_RESIDENCE screen if available. If PR_STATE=”PR”, then <ADDRESS> comes from the *_RESIDENCE screen, if available. Else, partial reference address from input file (street address and apt/bldg number)
<REFDATE>	April 1, 2017
<FULL ADDRESS>	Full address from the input file
<OMB STATEMENT>	The U.S. Census Bureau estimates that, for the average household, this survey 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 ####-####, U.S. Census Bureau, DCMD-2H174, 4600 Silver Hill Road, Washington, DC 20233. You may e-mail comments to 2020.census.paperwork@census.gov; use “Paperwork Project ####-####” as the subject. You are not required to respond to this collection of information if it does not display a valid approval number from the Office of Management and Budget (OMB). The eight-digit OMB number is ####-####.
<WARNING MESSAGE>	US Census Bureau Notice and Consent Warning You are accessing a United States Government computer network. Any information you enter into this system is confidential and may be used by the Census Bureau for statistical purposes, as well as for other uses, such as improving the efficiency of our programs. If you want to know more about the use of this system, and how your privacy is protected, visit our online privacy webpage at http://www.census.gov/about/policies/privacy/privacy-policy.html. Use of this system indicates your consent to us collecting, monitoring, recording, and using the information that you provide. So that our website remains accurate and available to you and all other visitors, we monitor network traffic to identify unauthorized attempts to upload or change information or otherwise cause damage to the web service. Your usage of this system is likely to be monitored, recorded, and subject to audit. If you are not using the network connection for authorized purposes, then it is a violation of Federal law and can be punished with fines or imprisonment (PUBLIC LAW 99-474).

Instructions

The instructions, provided from a link on the Dashboard, should include the following:

#1	Who Should Complete the Survey: This survey should be completed by the person who owns or rents the living quarters, or any other person who is at least 15 years of age with knowledge of the household.
#2	Navigation: Use only the “Next” or “Previous” buttons on the bottom of each screen. Do NOT use the Forward or Back buttons on your browser. MOBILE: Use only the forward or back arrows…
#3	Changing Responses: For questions where you must choose a single response from a list, clicking another response will change your answer to that response. If it is a “check all that apply” question, you may click on a selected check box to unselect the box and remove it as one of your answers.
#4	Session Time Limits and Login/Logout: For your security, you will be logged out after 30 minutes of inactivity. If you need to leave the survey for more than 30 minutes, please click “Save and Log Out” so you may return to the survey at a later time. All of your information will be saved. You will need to enter your PIN to resume the survey. Your PIN will be provided to you during the survey.
#5	Help with Survey Questions: If you need assistance on a specific survey question, use the “Help” link that appears with that question.
#6	Submitting your Survey: Once your survey is submitted, you will not be able to access your information or change any of your responses. After you submit your survey and are shown the confirmation page you may close the web browser.

FAQs

Frequently Asked Questions (FAQs), provided from a link on the Dashboard, should include the following:

#1	Q. What is the 2017 Census Test? The 2017 Census Test is a survey that the U.S. Census Bureau is conducting in preparation for the 2020 Census. The goal of this survey is to develop new methods that will make the next census easier, more convenient, and less costly for taxpayers.
#2	Q. Do I have to complete this survey? This survey is mandatory, but will only take about 10 minutes to complete. We are conducting this survey under the authority of Title 13 United States Code Section 193. This survey has been approved by the Office of Management and Budget (OMB). For this survey, the OMB approval number is ####-####.
#3	Q. Why was I selected for this survey? The U.S. Census Bureau chose your address, not you personally, as part of a randomly selected sample. Your address was selected to represent a cross section of households in your community.
#4	Q. Who should complete the survey? This survey should be completed by the person who owns or rents the living quarters or any other person who is at least 15 years of age with knowledge of the household.
#5	Q. How do I change my answers? For questions where you must choose a single response from a list, clicking another response will change your answer to that response. If it is a “check all that apply” question, you may click on a selected check box to unselect the box and remove it as one of your answers.
#6	Q. How long will it take to complete this survey? The U.S. Census Bureau estimates that, for the average household, this survey 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 ####-####, U.S. Census Bureau, DCMD-2H174, 4600 Silver Hill Road, Washington, DC 20233. You may e-mail comments to 2020.census.paperwork@census.gov; use “Paperwork Project ####-####” as the subject. Respondents are not required to respond to any information collection unless it displays a valid approval number from the Office of Management and Budget. The OMB approval number for this survey is ####-####.
#7	Q. What types of questions will I be asked? In this survey, you will be asked if the housing unit is rented or owned and for the names of everyone living in the household. For each person living in the household, you will be asked for the name, relationship to householder, sex, age/date of birth, race or origin and whether or not the person sometimes lives or stays somewhere else.
#8	Q. Do you share my data with other agencies such as Immigration and Customs Enforcement, the Federal Bureau of Investigations, the Internal Revenue Service, courts, or the police? No, individual responses are not shared with anyone, including these government agencies or private organizations. It is against the law to disclose or publish any private information (names, telephone numbers, etc.) that identifies an individual or business. We use your information to produce statistics. The personal information you provide here cannot be used against you by any government agency or court.
#9	Q. How does the Census Bureau protect my survey data? Federal law protects your information, and we have developed policies and statistical safeguards to help us follow the law and further ensure the confidentiality of your information. Federal Law: Title 13 of the United States Code protects the confidentiality of all your information. Violating this law is a crime with severe penalties. Privacy Principles: Our Privacy Principles are guidelines that cover all of our activities. These principles encompass both our responsibilities to protect your information and your rights as a respondent. They apply to the information we collect and the statistics we publish. Statistical Safeguards: Statistical methods ensure that the statistics we release do not identify individuals or businesses. These methods include extensive review and analysis of all our data products, as well as disclosure avoidance methodologies such as data suppression and modification. Your information is confidential and we will never identify you individually. For more information, visit the Census Bureau’s Data Protection and Privacy Policy webpage (http://www.census.gov/privacy/).
#10	Q. Is it safe to complete this survey online? Yes, for more information, please refer to the FAQ question link, "How does the Census Bureau protect my survey data?" for guidelines on Federal Law, Privacy Principles, and Statistical Safeguards. Additionally, the following policies apply to personally identifiable information provided in an online survey. More information on this topic can be found on the Data Protection and Privacy Policy webpage (http://www.census.gov/privacy/). For each online survey, we are required to provide an explanation to respondents about the confidentiality of the data and the laws that protect those data (e.g., Title 13, United States Code Section 9 (a)). All web data submissions are encrypted in order to protect your privacy, even in the remote chance that your survey responses are intercepted.
#11	Q. Will the results be published? The Census Bureau plans to make results of this study available to the general public. Results will be presented in aggregate form and no personally identifiable information will be published. Information quality is an integral part of the pre-dissemination review of the information disseminated by the Census Bureau (fully described in the Census Bureau’s Information Quality Guidelines at http://www.census.gov/quality/guidelines/index.html). Information quality is also integral to the information collection conducted by the Census Bureau and is incorporated into the clearance process by the Paperwork Reduction Act.

Global Requirements

Breadcrumbs

Breadcrumbs will be provided through out the demographic section of the survey. The breadcrumbs will provide links back to pages the respondent navigated through to get to their current page.

Checkpoints/Saving Data

Data will be save each time a respondent chooses “Next” or “Previous” and each time a respondent navigates from their current screen using the breadcrumbs.

Timeouts

The instrument will time out if a respondent is inactive for 30 minutes. After 28 minutes of inactivity, display a warning: “Your session is about to expire. Press Ok to keep working or you will be logged out.”

Dashboard

There will be a dynamic Dashboard that the respondent will return to throughout the survey. It will display different content depending on where you are in the survey and what survey questions have previously been answered.

Once an address is verified or collected, the dashboard will prompt respondents to complete the questions about the household. There will be a “Start” button that will go to the RESPONDENT screen if you entered the survey with and ID or to the RESIDENCE screen if you did not use an ID. If some Household information has been entered, but has not been completed, there will be a “Resume” button.

Household Dashboard

Pressing “Start”/”Resume” on the Dashboard will take you through several questions that will be used to build the Household Roster. Once the names are collected, each person’s name will be displayed on the Dashboard. Each name will a have a corresponding “Start” button that will allow the respondent to begin the Demographics section for that person.

There will also be a “Delete” option. There will not be an option to delete the Reference Person.

If the questions for that person are completed, there will be an “Edit” button instead of a start button. If the demographics are started, but not completed, for that person, there will be a “Resume” button.

There will also be an option to add additional people below the list of names.

Once data is collected for each name, a “Submit” button will appear.

CQA Login Screens

CQA ADMIN LOGIN

Screen Name	CQA ADMIN LOGIN
Field Names
Data Needed	List of CQA ADMIN user names and passwords
Universe	CQA URL cases
Question Wording	CQA Login Username: ________ Password: _______ [Login Button]
Question Wording Fills
Response Options	Username: ________ (8 digit alphanumeric) Password: _______ (15-digit alphanumeric)
Response Options Fills	N/A
Edits/Errors	Incorrect login entered: Display error message “Failed login. Please try again.”
Branching	Goto CQA LOGIN
Help Text link	N/A
Special Instructions

CQA WELCOME/ LOGIN

Screen Name	CQA LOGIN
Field Names	RESP_USER_ID: NUM 12
Data Needed
Universe
Question Wording	Welcome to the 2017 Census Test Interviewer Instructions, in faded text: Use the example below to help the respondent locate their User ID Keep in mind that not all respondents will have a User ID. If the respondent does not have or is unable to provide a User ID, use the “click here” link under the LOGIN button. <Example User ID image> This interview may be recorded for quality assurance purposes. Do I have your permission to record this interview? Please give me your 12-digit User ID. This ID can be found below the barcode on the materials we mailed you. User ID: _____ - _____ - ____ [Login Button] If you do not have a User ID, click here.
Question Wording Fills
Response Options	User ID: _____-_____-____ (three 4-digits numeric text boxes, separated by a hyphen. Include auto-tabbing between fields.)
Response Options Fills	N/A
Edits/Errors	If invalid ID entered, display: Login Failed. Please try again.
Branching	If valid, previously used User ID, and complete, goto COMPLETED. If valid User ID, goto CONFIRM If blank, goto CQA NONID LOGIN.
Help Text link	N/A
Special Instructions

CQA CONFIRM

Screen Name	CQA CONFIRM
Field Names	RESP_FOR_QUEST_ADR_YES_IND: NUM 1 (0=not selected and 1=selected) RESP_FOR_QUEST_ADR_NO_IND: NUM 1 (0=not selected and 1=selected)
Data Needed	<FULL ADDRESS>
Universe	CQA LOGIN = valid ID
Question Wording	Are you completing the 2017 Census Test for <FULLADDRESS>? (Help) <FULL ADDRESS>
Question Wording Fills	N/A
Response Options	Radio Buttons Yes No
Response Options Fills	N/A
Branching	If second time at CONFIRM and “No,” goto DASHBOARD (to start as if no email) If new ID and “Yes” or blank, goto CQA QUESTIONS If previously used ID and “Yes,” goto DASHBOARD (to start where left off) If “No”, goto CQA NONID LOGIN
Help Text link	CONFIRM
Special Instructions	No “Previous” button on this screen. If CQA CONFIRM = “No,” create a new ID and goto REGISTER

VERIFYID

Screen Name	VERIFY
Field Names	RESP_VERIFIED_USER_ID: NUM 12
Data Needed	List of valid USER IDs
Universe	CONFIRM=no
Question Wording	Please give me your 12-digit USER ID again so that we can verify that you need to complete this survey.
Question Wording Fills	N/A
Response Options	USER ID: _____-_____-____ (three 4-digits numeric text boxes, separated by a hyphen. Include auto-tabbing between fields.)
Response Options Fills	N/A
Edits/Errors	N/A
Branching	If VERIFY is blank, goto LOGIN If VERIFY is invalid, goto LOGIN If VERIFY = LOGIN, goto OTHER_COMPLETE If VERIFY <> LOGIN, goto CONFIRM.
Help Text link	N/A
Special Instructions	No “Previous” button on this screen.

CQA SEC QUESTIONS

Screen Name	CQA SEC QUESTIONS
Field Names
Data Needed	Randomly generated PIN Full list of verification questions
Universe	CONFIRM = “Yes” NONID LOGIN = valid email
Question Wording	To maintain the confidentiality of your data, you will need this PIN to return to the survey incase you leave the survey before submitting. This survey will take approximately 10 minutes. You will be automatically logged off if your computer is idle for 15 minutes. Please make a not of the 6-digit PIN below. PIN: xxxxxx
Question Wording Fills	N/A
Response Options
Response Options Fills	N/A
Edits/Errors	N/A
Branching	Goto DASHBOARD.
Help Text link	N/A
Special Instructions	No “Previous” button on this screen.

Security Screens

SECURITY (If you do not know your PIN)

Screen Name	SECURITY
Field Names	RESP_SEC_QUEST_RESP_TEXT: VARCHAR2(50)
Data Needed	USER IDs from input file Email addresses that respondents have provided. Verification questions/responses for USER IDs and email addresses.
Universe	LOGIN2 = invalid PIN. LOGIN2 = “Click here” and verification question available.
Question Wording	Please provide the answer to the following verification question to return to your survey. <VERIFICATION QUESTION> If correct response provided, display a pop-up: Your new PIN is:_____ Please log in using your new PIN to access your account. Return to Login
Question Wording Fills
Response Options	Response:_____________________
Response Options Fills	N/A
Branching	If correct response entered, display new PIN and goto LOGIN2. If the respondent selects “Cancel”, goto LOGIN
Help Text link	N/A
Special Instructions	No “Previous” button.

Verify Address Screens

VERIFY ADDRESS

Screen Name	VERIFY ADDRESS
Field Names	RESP_AT_MAFADR_OCD_YES_IND: NUM1 (0=not selected and 1=selected) RESP_AT_MAFADR_OCD_NO_IND: NUM1 (0=not selected and 1=selected) RESP_AT_MAFADR_OCD_DK_IND: NUM1 (0=not selected and 1=selected) RESP_AT_MAFADR_OCD_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe
Question Wording	On <REFDATE>, <FILL1> living or staying at <ADDRESS>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will you be” If current date is on or after REFDATE, then <FILL1> = “were you”
Response Options	Radio Buttons Yes No Don’t know Refused
Response Options Fills	N/A
Branching	If “Yes,” goto SECURITY If “No,” “Don’t know,” or “Refused,”, goto ANYONE
Help Text link	VERIFY ADDRESS
Special Instructions	If “Previous” button is selected, goto CONFIRM

ANYONE

Screen Name	ANYONE
Field Names	H_OCC_YES_IND: NUM1 (0=not selected and 1=selected) H_OCC_NO_IND: NUM1 (0=not selected and 1=selected) H_OCC_DK_IND: NUM1 (0=not selected and 1=selected) H_OCC_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe	VERIFY ADDRESS=no
Question Wording	<FILL1> at < ADDRESS> on <REFDATE>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “Will anyone be living” If current date is on or after REFDATE, then <FILL1> = “Did anyone live”
Response Options	Radio Buttons Yes No Don’t know Refused
Response Options Fills	N/A
Branching	If “No,” goto VACANCY Else, goto OTHER_COMPLETE
Help Text link	ANYONE
Special Instructions

VACANCY

Screen Name	VACANCY
Field Names	H_VAC_FORRENT_IND: NUM1 (0=not selected and 1=selected) H_VAC_RENTNOTOCC_IND: NUM1 (0=not selected and 1=selected) H_VAC_FORSALE_IND: NUM1 (0=not selected and 1=selected) H_VAC_SOLDNOTOCC_IND: NUM1 (0=not selected and 1=selected) H_VAC_SEASON_IND: NUM1 (0=not selected and 1=selected) H_VAC_MIGRANT_IND: NUM1 (0=not selected and 1=selected) H_VAC_OTHER_IND: NUM1 (0=not selected and 1=selected) H_VAC_DK_IND: NUM1 (0=not selected and 1=selected) H_VAC_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe	VACANCY = no
Question Wording	What is the primary reason why no one <FILL1> living or staying at <ADDRESS> on <REFDATE>? The unit <FILL1> – (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” If current date is on or after REFDATE, then <FILL1> = “was”
Response Options	Radio Buttons For rent Rented, not occupied For sale only Sold, not occupied For seasonal, recreational, or occasional use For migrant workers Other Don’t know Refuse
Response Options Fills	N/A
Branching	Goto OTHER_COMPLETE
Help Text link	VACANCY
Special Instructions

OTHER_COMPLETE

Screen Name	OTHER_COMPLETE
Field Names	RESP_OTHERID_YES_IND: NUM1 (0=not selected and 1=selected) RESP_OTHERID_NO_IND: NUM1 (0=not selected and 1=selected) RESP_OTHERID_DK_IND: NUM1 (0=not selected and 1=selected) RESP_OTHERID_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	<FILL1> <REFDATE>
Universe	ANYONE = yes or don’t know VACANCY
Question Wording	Thank you for providing accurate information for <address>. Since you did not live or stay at this address on Census day, you do not need to provide any additional information for it. Do you have another USER ID for the place <FILL1> living or staying on <REFDATE>?
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “you will be” If current date is on or after REFDATE, then <FILL1> = “you were”
Response Options	Radio Buttons Yes No Don’t know Refused
Response Options Fills	N/A
Branching	If “Yes,” goto LOGIN If “No,” goto REGISTER (NonID)
Help Text link	OTHER_COMPLETE
Special Instructions

NONID

REGISTER

Screen Name	REGISTER
Field Names	RESP_USERNAME_TEXT: CHAR 20
Data Needed	N/A
Universe	Cases from Non ID Welcome page. LOGIN = “Click here” if no ID link selected. VERIFY = LOGIN CONFIRM = “No” twice
Question Wording	If you would like to return to the survey later, you must create a username. Your username is a unique identifier, assigned to you, that lets you re-enter the survey. If you leave the survey before finishing it and have not created a username, your responses will NOT be saved for you to return and finish. The username you create must be between 8 and 20 characters long and contain at least one number. Why do I need to create a username?
Question Wording Fills	N/A
Response Options	Please provide a username Must be between 8 and 20 characters long and include only letters and numbers. [20 character text box] qI [[ ] I do not want to create a username
Response Options Fills	N/A
Edits	Username field must contain between 8 and 20 characters, including only letters and numbers. “A valid user name must be between 8 and 50 characters and include only letters and numbers." If a username has already been used, display next to the username text box, "Username already exists" If the ‘I do not want to create a username" is checked, display in green a message box: If you leave the survey before finishing it and have not created a username, your responses will be not be saved for you to return and finish.
Branching	If valid, new username, goto SECURITY. If valid, previously used email and survey has been completed, goto COMPLETED. Else if valid, previously used email, goto LOGIN2. If no email address box selected, goto STATE.
Help Text link	NONIDLOGIN
Special Instructions	No “Previous” button on this screen. Usernames must be unique. The “Submit” button is disabled until the respondent creates a username OR selects the "I do not want to create a username" check box AND successfully passes the Captcha. Create an ID for spawned NONID cases.

STATE

Screen Name	STATE
Field Names	ADR_STATE_TEXT: varchar2 (2) ADR_STATE_DK_IND: numeric (1 if selected, 0 if not selected) ADR_STATE_REF_IND: numeric (1 if selected, 0 if not selected)
Data Needed
Universe	Cases from REGISTER screen
Question Wording	In order to collect your address, we first need to know in which state you <FILL1> living on <REFDATE>. Where <FILL2> living on <REFDATE>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” If current date is on or after REFDATE, then <FILL1> = “were” If current date is before REFDATE, then <FILL2> = “will you be” If current date is on or after REFDATE, then <FILL2> = “were you”
Response Options	State/PR: drop down menu with alphabetical states, District of Columbia, and Puerto Rico (Radio buttons) Don’t know Refused
Response Options Fills	N/A
Branching	If no State is selected or State <> PR, goto RESIDENCE via HOUSEHOLD DASHBOARD (NONID Address Collection). If State = PR, goto PR_URB via HOUSEHOLD DASHBOARD (PR NONID Address Collection)
Help Text link	STATE
Special Instructions	State names, District of Columbia, and Puerto Rico will be abbreviated.

NONID Address Collection

RESIDENCE

Screen Name	RESIDENCE
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE (1=Street, 2=Rural Route, 3=Other) Respondent-Provided Street Address Fields ADR_STNU_TEXT: varchar2 (20) ADR_STNM_LINE1_TEXT: varchar2 (100) ADR_UNIT_TEXT: varchar2 (52) Respondent-Provided General Address Fields for Street Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5)
Data Needed
Universe	NONID Respondents who are state-side.
Question Wording	Please provide the address where you <FILL> on <REFDATE>.(Help) If you have a street address associated with your residence, such as one you would provide to have a package delivered to your home, then please provide it here.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “will be living” If the current data is on or after REFDATE, then <FILL1>= “lived”
Response Options	Address Number: Ex:101 20-character text box Street Name: Ex: N Main St 100-character text box Apt/Unit: Ex: Apt 23 52-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box *I do not have a street address (check box)
Edits/Errors	If (ADR_STNU_TEXT is nonblank and ADR_STNM_LINE1_TEXT is blank) OR (ADR_STNU_TEXT is blank and ADR_STNM_LINE1_TEXT is nonblank) OR [ADR_STNU_TEXT is blank and ADR_STNM_LINE1_TEXT is blank and (ADR_CITY_TEXT = nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT=nonblank)], and the respondent selects the “Next” button First time: “Please provide your full address. 2. Second time: “In order to continue, you must provide an address number, street name and city and state or ZIP code. 3. Third time: End the survey and display NOCOMPLETE. Address boxes should be highlighted, so the respondent is alerted to where information is invalid or missing.
Branching	Else if, third time all address fields are blank, or “Next” is selected with an invalid address, goto NOCOMPLETE. If valid address provided and GEO Standardizer is (stalled or disabled or otherwise inaccessible), goto RESPONDENT If valid address provided and GEO Standardizer is functional, goto STAN_RESIDENCE If a respondent selects “I do not have a street address”, goto RURAL_ROUTE
Help Text link	RESIDENCE
Special Instructions	If the Address Type is Street Address, display the Address Number, Street Name, and Apt/Unit only (e.g., “5007 N Maple Ave Apt. A”). If the response is valid (according to the parameters above), then all subsequent actions will be based on that value when “Next” is pressed.

RURAL_ROUTE

Screen Name	RURAL_ROUTE
Field Names	ADR_IS_RURAL_YES_IND: NUM 1 (0=not selected and 1=selected) ADR_IS_RURAL_NO_IND: NUM 1 (0=not selected and 1=selected) ADR_IS_RURAL_DK_IND: NUM 1 (0=not selected and 1=selected) ADR_IS_RURAL_REF_IND: NUM 1 (0=not selected and 1=selected)
Data Needed
Universe	Respondents who selected “I do not have a street address” on the RESIDENCE screen.
Question Wording	Do you have a rural route address? (Help)
Question Wording Fills
Response Options	Radio Buttons Yes No Don’t know Refused
Response Option Fills
Branching	If “Yes”, goto RR_ADDRESS If “No” “Don’t know/refused,” or blank, goto HOMELESS
Help Text link	RURAL_ROUTE
Special Instructions

RR_ADDRESS

Screen Name	RR_ADDRESS
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE(1=Street, 2=Rural Route, 3=Other) Respondent-Provided Rural Route Address Fields ADR_RR_DESC_TEXT: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) ADR_STNU_TEXT: varchar2 (10) ADR_POBOX_TEXT: varchar2 (10) Respondent-Provided General Address Fields for Rural Route Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5) Physical Description Field ADR_LOC_DESC_TEXT: varchar2 (250)
Data Needed
Universe	RURAL_ROUTE = “Yes”
Question Wording	Please provide the rural route address where you <FILL1> on <REFDATE>. (Help) <> After the respondent provides a valid rural route address, read the following:<> Please describe the physical location of where you <FILL1> on <REFDATE>. Please provide as much information as possible. For example: a location description such as "The apartment over the gas station in Selma, CA" or "The brick house with the screened porch on the northeast corner of Farm Road and HC 46 in Suitland, MD 20746“.
Question Wording Fills	FILLS: If the current date is before REFDATE then FILL1 = will be living If the current date is on or after REFDATE then FILL1 = lived
Response Options	RR Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box Physical Location Description: 250-character text area
Response Option fills
Edits/Errors	If (ADR_RR_DESC_TEXT = blank OR ADR_STNU_TEXT= blank OR ADR_POBOX_TEXT = blank), and (ADR_CITY_TEXT = nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT =nonblank)] and the respondent selects the “Next” button: 1. First time: “Please provide your full address.” 2. Second time: “In order to continue, you must provide a Rural Route Descriptor, Number, and, Box ID#. Any address you provide should also include a City and State or a ZIP Code.’ 3. Third time: End the survey and display NOCOMPLETE. because Physical Location is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto STAN_RR_ADDRESS, if a valid RR address is provided. Address boxes and Physical Location Description box should be highlighted, so the respondent is alerted to where information is invalid or missing.
Branching	Else if, third time all address fields are blank, or “Next” is selected with an invalid address, goto NOCOMPLETE. If valid address provided and GEO Standardizer is (stalled or disabled or otherwise inaccessible), goto RESPONDENT If valid address provided and GEO Standardizer is functional, goto STAN_RR_ADDRESS.
Help Text link	RR_ADDRESS
Special Instructions	For all rural route addresses, the applications must process the existing fields (ADR_RR_DESC_TEXT, ADR_STNU_TEXT, and ADR_POBOX_TEXT) into one 40-character VARCHAR2 field called RT_RR_INFO. This field will combine the input from ADR_RR_DESC_TEXT (RR or HC or SR or PSC or RTE), then include one single space as a delimiter, then include the input from ADR_STNU_TEXT, then include one single space as a delimiter, then add the word “Box”, then include one single space delimiter, then include the input from ADR_POBOX_TEXT. The new field RT_RR_INFO will be stored in the application database during address collection, then transferred with the rest of the data at the end of data collection per case. If the Address Type is Rural Route, display the Rural Route Descriptor, Rural Route Number, and Box Number (e.g., RR 15 Box 24).

HOMELESS

Screen Name	HOMELESS
Field Names	TBD
Data Needed
Universe	RURAL_ROUTE = “No” or blank
Question Wording	<FILL1> experiencing homelessness on <REFDATE>?
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = Will you be If the current data is on or after REFDATE, then <FILL1>= Were you
Response Options	Yes No Don’t know Refused (Radio buttons)
Branching	Goto OTHER_ADDRESS_PHYS
Help Text link	HOMELESS
Special Instructions

OTHER_ADDRESS_PHYS

Screen Name	OTHER_ADDRESS_PHYS
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE(1=Street, 2=Rural Route, 3=Other) Respondent-Provided General Address Fields for P.O. Box Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5) Physical Description Field ADR_LOC_DESC_TEXT: varchar2 (250)
Data Needed
Universe	HOMELESS
Question Wording	In order to complete your survey, we need as much information as possible about where you <FILL1> on <REFDATE>. Please describe the physical location of where you <FILL2> living on <REFDATE>. You must provide at least city and state, or ZIP code.(Help) For example: a location description such as The apartment over the gas station” or “The brick house with the screened porch on the northeast corner of Farm Road and HC 46 ;” or a name of a park, street intersection or shelter, if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example:, “Friendship Park”
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = will be living If the current data is on or after REFDATE, then <FILL1>= lived If the current date is before REFDATE, then <FILL2> = will be If the current data is on or after REFDATE, then <FILL2>= were
Response Options	Physical Location Description: 250-character text area City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box
Edits/Errors	If (ADR_CITY_TEXT= nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT=nonblank)], and the respondent selects the “Next” button: 1. First time: Please provide your full address. Any address that you provide should also include a City and State, or a ZIP Code. 2. Second time: You must provide a City and State, or a ZIP Code. 3. Third Time: End the survey and display NOCOMPLETE screen. because Physical Location is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto RESPONDENT. Address boxes and Physical Location Description box should be highlighted, so the respondent is alerted to where information is invalid or missing.
Branching	Else if, third time all address fields are blank, or “Next” is selected with an invalid address, goto NOCOMPLETE. If valid address provided and GEO Standardizer is (stalled or disabled or otherwise inaccessible), goto RESPONDENT If valid address provided and GEO Standardizer is functional, goto STAN_OTHER_ADDRESS
Help Text link	OTHER_ADDRESS_PHYS
Special Instructions	If respondents provide an address on this screen, this address should be the fill for the “<ADDRESS>” that is referenced on the remaining screens. If a P.O. Box is not provided, display: “the location associated with <city> <state> <zip> (e.g., “the location in Any City, MD”)

STAN_RESIDENCE

Screen Name	STAN_RESIDENCE
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE(1=Street, 2=Rural Route, 3=Other) Standardized Street Address Fields ADR_STNU_PRI_STD_TEXT: varchar2 (20) ADR_STNM_BASE_STD_NAME: varchar2 (100) ADR_UNIT_DESC_STD_TEXT: varchar2 (40) General Address Fields for Standardized Street Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5) ADR_COUNTY_TEXT: varchar2 (16) Geocode BCU Fields for ADR_MAF_STATUS_CODE=1 Cases: ADR_BCU_STATE_MTCH_TEXT: varchar2 (2) ADR_BCU_COUNTY_MTCH_TEXT: varchar2 (3) ADR_BCU_TRACT_MTCH_ID: varchar2 (6) ADR_BCU_MTCH_ID: varchar2 (8) Geocode BCU Fields for ADR_MAF_STATUS_CODE=2 Cases: ADR_BCU_STATE_MTCH_TEXT: varchar2 (2) ADR_BCU_COUNTY_MTCH_TEXT: varchar2 (3) ADR_BCU_TRACT_MTCH_ID: varchar2 (6) ADR_BCU_MTCH_ID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (ADR_MAF_STATUS_CODE=3 or 5): ADR_BCU_STATE_AGEO_TEXT: varchar2 (2) ADR_BCU_COUNTY_AGEO_TEXT: varchar2 (3) ADR_BCU_TRACT_AGEO_ID: varchar2 (6) ADR_BCU_AGEO_ID: varchar2 (8) ADR_MAF_STATUS_CODE: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode ADR_MAF_ID: NUM (9) ADR_MAF_QUALITY_CODE: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match ADR_MAF_PREF_CODE: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record ADR_MAF_EXCL_CODE: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	All Respondents who provided a valid address on the RESIDENCE and GEO Standardizer is functional
Question Wording	<>Review the address information provided for errors. Make sure the information displayed matches the information provided by the respondent. Make any corrections that are necessary. <>
Response Options	Address Number: Ex: 101 20-character text box Street Name: Ex: N Main St 100-character text box Apt/Unit: Ex: Apt 23 52-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box
Edits/Errors	If (ADR_STNU_PRI_STD_TEXT is nonblank and ADR_STNM_BASE_STD_NAME is blank) OR (ADR_STNU_PRI_STD_TEXT is blank and ADR_STNM_BASE_STD_NAME is nonblank) OR [ADR_STNM_BASE_STD_NAME is blank and ADR_STNM_BASE_STD_NAME is blank and (ADR_CITY_TEXT = nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT=nonblank)], and the respondent selects the “Next” button: 1. First time: Please provide your full address. 2. Second time: In order to continue, you must provide an address number, street name and city and state or ZIP code. 3. Third time: End the survey and display NOCOMPLETE.
Branching	Branching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives ADR_MAF_STATUS_CODE=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; ADR_MAF_ID ADR_MAF_STATUS_CODE ADR_MAF_QUALITY_CODE ADR_MAF_PREF_CODE ADR_MAF_EXCL_CODE; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives ADR_MAF_STATUS_CODE =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives ADR_MAF_STATUS_CODE=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a ADR_MAF_STATUS_CODE of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a ADR_MAF_STATUS_CODE of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a ADR_MAF_STATUS_CODE of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).
Help text	STAN_RESIDENCE
Special Instructions	Fields are editable and pre-filled with the standardized version of the address. The final address on this screen should be the fill for the “<ADDRESS>” that is referenced on the remaining screens unless the match status = 0,5. There is no need to display the county field called “HCCOUNTY.” However, the internet application must populate that field when GEO returns the value for HC_ COUNTY.

STAN_RR_ADDRESS

Screen Name	STAN_RR_ADDRESS
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE(1=Street, 2=Rural Route, 3=Other) Standardized Street Address Fields ADR_RR_DESC_STD_TEXT: varchar2 (20) ADR_STNU_PRI_STD_TEXT: varchar2 (10) ADR_POBOX_STD_TEXT: varchar2 (10) General Address Fields for Standardized Street Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5) ADR_COUNTY_TEXT: varchar2 (16) Geocode BCU Fields for ADR_MAF_STATUS_CODE=1 Cases: ADR_BCU_STATE_MTCH_TEXT: varchar2 (2) ADR_BCU_COUNTY_MTCH_TEXT: varchar2 (3) ADR_BCU_TRACT_MTCH_ID: varchar2 (6) ADR_BCU_MTCH_ID: varchar2 (8) Geocode BCU Fields for ADR_MAF_STATUS_CODE=2 Cases: ADR_BCU_STATE_MTCH_TEXT: varchar2 (2) ADR_BCU_COUNTY_MTCH_TEXT: varchar2 (3) ADR_BCU_TRACT_MTCH_ID: varchar2 (6) ADR_BCU_MTCH_ID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (ADR_MAF_STATUS_CODE=3 or 5): ADR_BCU_STATE_AGEO_TEXT: varchar2 (2) ADR_BCU_COUNTY_AGEO_TEXT: varchar2 (3) ADR_BCU_TRACT_AGEO_ID: varchar2 (6) ADR_BCU_AGEO_ID: varchar2 (8) ADR_MAF_STATUS_CODE: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode ADR_MAF_ID: NUM (9) ADR_MAF_QUALITY_CODE: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match ADR_MAF_PREF_CODE: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record ADR_MAF_EXCL_CODE: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	All Respondents who provided a valid address on the RR_ADDRESS and GEO Standardizer is functional
Question Wording	<>Review the address information provided for errors. Make sure the information displayed matches the information provided by the respondent. Make any corrections that are necessary. <>
Response Options	RR Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box
Edits/Errors	If (ADR_RR_DESC_STD_TEXT = blank OR ADR_STNU_PRI_STD_TEXT= blank OR ADR_POBOX_STD_TEXT= blank), and (ADR_CITY_TEXT = nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT =nonblank)] and the respondent selects the “Next” button: First time: Please provide your full address. Second time: In order to continue, you must provide a Rural Route Descriptor, Number, and Box ID#. Any address you provide should also include a City and State or a ZIP Code. Third time: End the survey and display NOCOMPLETE.
Branching	Branching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives ADR_MAF_STATUS_CODE=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; ADR_MAF_ID ADR_MAF_STATUS_CODE ADR_MAF_QUALITY_CODE ADR_MAF_PREF_CODE ADR_MAF_EXCL_CODE; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives ADR_MAF_STATUS_CODE =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives ADR_MAF_STATUS_CODE=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto RR_ADDRESS2 screen so the respondent can provide additional address information. If the respondent updated address receives a ADR_MAF_STATUS_CODE of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto RR_ADDRESS2 screen so the respondent can provide additional address information. If the respondent updated address receives a ADR_MAF_STATUS_CODE of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a ADR_MAF_STATUS_CODE of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).
Help text	STAN_RR_ADDRESS
Special Instructions	Fields are editable and pre-filled with the standardized version of the address. The final address on this screen should be the fill for the “<ADDRESS>” that is referenced on the remaining screens unless the match status = 0,5. There is no need to display the county field called “HCCOUNTY.” However, the internet application must populate that field when GEO returns the value for HC_ COUNTY.

STAN_OTHER_ADDRESS

Screen Name	STAN_OTHER_ADDRESS
Field Names	Address Type Fields ADR _HUNIT_TYPE_CODE (1=Street, 2=Rural Route, 3=Other) Respondent-Provided General Address Fields for P.O. Box Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5) Geocode BCU Fields for ADR_MAF_STATUS_CODE=1 Cases: ADR_BCU_STATE_MTCH_TEXT: varchar2 (2) ADR_BCU_COUNTY_MTCH_TEXT: varchar2 (3) ADR_BCU_TRACT_MTCH_ID: varchar2 (6) ADR_BCU_MTCH_ID: varchar2 (8) Geocode BCU Fields for ADR_MAF_STATUS_CODE=2 Cases: ADR_BCU_STATE_MTCH_TEXT: varchar2 (2) ADR_BCU_COUNTY_MTCH_TEXT: varchar2 (3) ADR_BCU_TRACT_MTCH_ID: varchar2 (6) ADR_BCU_MTCH_ID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (ADR_MAF_STATUS_CODE=3 or 5): ADR_BCU_STATE_AGEO_TEXT: varchar2 (2) ADR_BCU_COUNTY_AGEO_TEXT: varchar2 (3) ADR_BCU_TRACT_AGEO_ID: varchar2 (6) ADR_BCU_AGEO_ID: varchar2 (8) ADR_MAF_STATUS_CODE: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode ADR_MAF_ID: NUM (9) ADR_MAF_QUALITY_CODE: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match ADR_MAF_PREF_CODE: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record ADR_MAF_EXCL_CODE: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed
Universe	If respondent provides a valid address on OTHER_ADDRESS_PHYS and GEO Standardizer is functional.
Question Wording	<>Review the address information provided for errors. Make sure the information displayed matches the information provided by the respondent. Make any corrections that are necessary. <>
Question Wording Fills
Response Options	City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box
Edits/Errors	If (ADR_CITY_TEXT= nonblank OR ADR_STATE_TEXT= nonblank OR ADR_ZIP_TEXT=nonblank)], and the respondent selects the “Next” button: 1. First time: Please provide your full address. Any address that you provide should also include a City and State, or a ZIP Code. 2. Second time: You must provide a City and State, or a ZIP Code. 3. Third Time: End the survey and display NOCOMPLETE. Text boxes should be highlighted, so the respondent is alerted to where information is invalid or missing. Address boxes should be highlighted, so the respondent is alerted to where information is invalid or missing.
Branching	Branching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives ADR_MAF_STATUS_CODE=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; ADR_MAF_ID ADR_MAF_STATUS_CODE ADR_MAF_QUALITY_CODE ADR_MAF_PREF_CODE ADR_MAF_EXCL_CODE; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives ADR_MAF_STATUS_CODE =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives ADR_MAF_STATUS_CODE=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto RR_ADDRESS2 screen so the respondent can provide additional address information. If the respondent updated address receives a ADR_MAF_STATUS_CODE of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives ADR_MAF_STATUS_CODE=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto RR_ADDRESS2 screen so the respondent can provide additional address information. If the respondent updated address receives a ADR_MAF_STATUS_CODE of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a ADR_MAF_STATUS_CODE of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).
Help Text link	STAN_OTHER_ADDRESS.
Special Instructions	If respondents provide an address on this screen, this address should be the fill for the “<ADDRESS>” that is referenced on the remaining screens. If a P.O. Box is not provided, display: “the location associated with <city> <state> <zip> (e.g., “the location in Any City, MD”)

RESIDENCE2

Screen Name	RESIDENCE2
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE(1=Street, 2=Rural Route, 3=Other) Respondent-Provided Street Address Fields ADR_STNU_PRI_STD_TEXT: varchar2 (20) ADR_STNM_BASE_STD_NAME: varchar2 (100) ADR_UNIT_DESC_STD_TEXT: varchar2 (52) Respondent-Provided General Address Fields for Street Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5)
Data Needed
Universe	Respondents who provided a valid address on the STAN_RESIDENCE screens and RTNP ADR_MAF_STATUS_CODE = 0 or 5.
Question Wording	We want to make sure that we have the best address possible for our records. (Help) I am going to read the address to you using standard abbreviations and formatting. (Help) Please listen for common errors, such as misspelled street name, missing apartment numbers, or an incorrect ZIP Code and identify any changes that need to be made. <>Read back the complete address and spell out all words. Make any corrections the respondent might have. <>
Question Wording Fills
Response Options	Address Number: Ex: 101 20-character text box Street Name: Ex: N Main St 100-character text box Apt/Unit: Ex: Apt 23 52-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box
Edits/Errors	If (ADR_STNU_PRI_STD_TEXT is nonblank and ADR_STNM_BASE_STD_NAME is blank) OR (ADR_STNU_PRI_STD_TEXT is blank and ADR_STNM_BASE_STD_NAME is nonblank) OR [ADR_STNU_PRI_STD_TEXT is blank and ADR_STNM_BASE_STD_NAME is blank and (ADR_CITY_TEXT = nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT=nonblank)], and the respondent selects the “Next” button: 1. First time: “Please provide your full address.” 2. Second time: “In order to continue, you must provide an address number, street name, and city and state or ZIP code. 3. Third time: End the survey and display NOCOMPLETE. Address boxes should be highlighted, so the respondent is alerted to where information is invalid or missing.
Branching	Else if, third time all address fields are blank, or “Next” is selected with an invalid address, goto NOCOMPLETE. If valid address provided and GEO Standardizer is (stalled or disabled or otherwise inaccessible), goto RESPONDENT If <valid address provided> and<GEO Standardizer is functional> and <ADR_MAF_STATUS_CODE = 2,3,4,5,0 goto WEBMAP INTERFACE If <valid address provided> and<GEO Standardizer is functional> and <ADR_MAF_STATUS_CODE = 1 goto RESPONDENT
Help Text link	RESIDENCE2
Special Instructions	If the respondent changes any of the fields on this screen, the address will be standardized behind the scenes and then sent to RTNP. If respondents provide an address on this screen, this address should be standardized and used as the fill for the “<ADDRESS>” that is referenced on the remaining screens. If the Address Type is Street Address, display the Address Number, Street Name, and Apt/Unit only (e.g., “5007 N Maple Ave Apt. A”). If the response is valid (according to the parameters above), then all subsequent actions will be based on that value when “Next” is pressed.

RR_ADDRESS2

Screen Name	RR_ADDRESS2
Field Names	Address Type Fields ADR_HUNIT_TYPE_CODE(1=Street, 2=Rural Route, 3=Other) Respondent-Provided Rural Route Address Fields ADR_RR_DESC_STD_TEXT: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) ADR_STNU_PRI_STD_TEXT: varchar2 (10) ADR_POBOX_STD_TEXT: varchar2 (10) Respondent-Provided General Address Fields for Rural Route Addresses ADR_CITY_TEXT: varchar2 (16) ADR_STATE_TEXT: varchar2 (2) ADR_ZIP_TEXT: varchar2 (5) Physical Description Field ADR_LOC_DESC_TEXT: varchar2 (250)
Data Needed
Universe	Respondents who provided a valid address on the STAN_RR_ADDRESS screens and RTNP ADR_MAF_STATUS_CODE = 0 or 5.
Question Wording	We want to make sure that we have the best address possible for our records. (Help) I am going to read the address to you using standard abbreviations and formatting. Please listen for common errors, such as misspelled street name, missing apartment numbers, or an incorrect ZIP Code and identify any changes that need to be made. <>Read back the complete address and spell out all words, Make any corrections the respondent might have.<>
Response Options	RR Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box Physical Location Description: 250-character text area
Response Option fills
Edits/Errors	If [(ADR_RR_DESC_STD_TEXT = blank OR ADR_STNU_PRI_STD_TEXT= blank OR ADR_POBOX_STD_TEXT = blank), and (ADR_CITY_TEXT = nonblank OR ADR_STATE_TEXT = nonblank OR ADR_ZIP_TEXT=nonblank)], and the respondent selects the “Next” button: 1. First time: “Please provide your full address.” 2. Second time: “In order to continue, you must provide a Rural Route Descriptor, Number, and Box ID#. Any address you provide should also include a City and State or a ZIP Code.’ 3. Third time: End the survey and display NOCOMPLETE. Because Physical Location is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto STAN_RR_ADDRESS, if a valid RR address is provided. Address boxes and Physical Location Description box should be highlighted, so the respondent is alerted to where information is invalid or missing.
Branching	Else if, third time all address fields are blank, or “Next” is selected with an invalid address, goto NOCOMPLETE. If valid address provided and GEO Standardizer is (stalled or disabled or otherwise inaccessible), goto RESPONDENT If <valid address provided> and<GEO Standardizer is functional> and ADR_MAF_STATUS_CODE = 2,3,4,5,0 goto WEBMAP INTERFACE If <valid address provided> and<GEO Standardizer is functional> and ADR_MAF_STATUS_CODE = 1 goto RESPONDENT
Help Text link	RR_ADDRESS2
Special Instructions	For all rural route addresses, the application must process the existing fields (ADR_RR_DESC_STD_TEX, ADR_STNU_PRI_STD_TEXT, and ADR_POBOX_STD_TEXT) into one 40-character VARCHAR2 field called RT_RR_INFO. This field will combine the input from RR_DESC (RR or HC or SR or PSC or RTE), then include one single space as a delimiter, then include the input from ADR_STRNUM_PRI_TEXT, then include one single space as a delimiter, then add the word “Box”, then include one single space delimiter, then include the input from RES_BOXNUM. The new field RT_RR_INFO will be stored in the application database during address collection, then transferred with the rest of the data at the end of data collection per case. If respondents provide an address on this screen, this address should be standardized and used as the fill for the “<ADDRESS>” that is referenced on the remaining screens. If the Address Type is Rural Route, display the Rural Route Descriptor, Rural Route Number, and Box Number (e.g., RR 15 Box 24).

PR_NONID

APT

Screen Name	APT
Field Names	APT_YES: NUM 1 (0=not selected and 1=selected) APT_NO: NUM 1 (0=not selected and 1=selected)
Data Needed
Universe	USER IDs flagged as PR Respondents in STATE who chose “Puerto Rico” in the State drop-down menu.
Question Wording	<FILL1> in an apartment, condominium, or residencial público? (Help)
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “Will you be living” If the current data is on or after REFDATE, then <FILL1>= “Did you live”
Response Options	Radio Buttons Yes No
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If “Yes”, go to APT_RESIDENCE. If “No” or blank, go to URB.
Help Text link	APT
Special Instructions

URB

Screen Name	URB
Field Names	URB_YES: NUM 1 (0=not selected and 1=selected) URB_NO: NUM 1 (0=not selected and 1=selected)
Data Needed
Universe	Respondents, where APT =”No” or blank.
Question Wording	<FILL1> in an urbanización? (Help)
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “Will you be living” If the current data is on or after REFDATE, then <FILL1>= “Did you live”
Response Options	Radio Buttons Yes No
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If “Yes”, go to URB_RESIDENCE. If “No” or blank, go to AREANM
Help Text link	URB
Special Instructions

AREANM

Screen Name	AREANM
Field Names	AREANM_YES: NUM 1 (0=not selected and 1=selected) AREANM_NO: NUM 1 (0=not selected and 1=selected)
Data Needed
Universe	Respondents, where URB =”No” or blank.
Question Wording	<FILL1> some place where it’s necessary to know your barrio, barriada, sector, community, or parcela? (Help) This is common in rural areas.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “Will you be living” If the current data is on or after REFDATE, then <FILL1>= “Did you live”
Response Options	Radio Buttons Yes No
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If “Yes”, go to AREANM_RESIDENCE. If “No” or blank, go to GEN_RESIDENCE.
Help Text link	AREANM
Special Instructions

APT_RESIDENCE

Screen Name	APT_RESIDENCE
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Respondent-Provided PR Condominium/Residencial Address Fields RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_APTCOMPLEX: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Physical Description Field ADDR_DESC_LINE1: varchar2 (250)
Data Needed
Universe	APT = “Yes”
Question Wording	Where <FILL1> on <REFDATE>? (Help) Please provide any information associated with your address. Do not include your P.O. Box or Rural Route address.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “will you be living” If the current data is on or after REFDATE, then <FILL1>= “did you live”
Response Options	Name of Apartment/Condominium Building or Residencial Público: 100-character text box Ex: COND Ponce de León or RES Los Jardines de Ponce Building/Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box Please provide nearby points of reference (describing how to reach your home. Points of Reference: 250-character text area
Edits/Errors	Required Fields APTCOMPLEX (Name of Condominium, Apartment Building, or Residencial) AND PR_LOCWSID (Apt Unit Information; may include Building Identifier) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (PR_APTCOMPLEX is nonblank and PR_LOCWSID is blank) OR (PR_APTCOMPLEX is blank and PR_LOCWSID is nonblank) OR [PR_APTCOMPLEX is blank and PR_LOCWSID is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide a condominium or residencial address. If you do not live in this type of address, then please click ‘Previous’.” Second time: “In order to continue, you must provide at least the name of your condominium or residencial, an apartment number and Municipio or ZIP Code. If you live on a named street, then include that as well. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto STAN_APT_RESIDENCE.
Branching	If valid address provided and GEO Standardizer is stalled or disabled or otherwise inaccessible, then go to RESPONDENT If valid address provided and GEO Standardizer is functional, then go to STAN_APT_RESIDENCE.
Help Text link	APT_RESIDENCE
Special Instructions	Special Instruction #1: Setting Address Type (ADDR_TYPE) for Condominium or Residencial Addresses: IF RT_PR_APTCOMPLEX = nonblank and RT_PR_LOCWSID = nonblank and RT_PR_ZIP or RT_PR_COUNAME = nonblank THEN set ADDR_TYPE = 4 Special Instruction #2: Clearing PR Address Fields This instruction is for cases in which a respondent happens to land on any of the PR residence screens and begins to fill out an address in one of the fifty states or D.C. (this can occur when the respondent chooses a non-PR selection under the state drop-down menu). If a non-PR selection is made, the screen should take them to the RESIDENCE screen. All the PR fields that had been filled should be blanked out. If RT_PR_STATE <> “PR” then go to stateside RESIDENCE screen and blank out anything that was entered into the following fields for PR__ RESIDENCE: RT_PR_AREANM1: varchar2 (100) RT_PR_KMHM: NUM (5, excluding decimal) RT_PR_URB: varchar2 (50) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_APTCOMPLEX: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Special Instruction #3: Display Rules for <ADDRESS>* If respondents provide an address on the PR_APT_RESIDENCE screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens. Display Rules for Apartment Complex Types (ADDR_TYPE=4): For Apartment Complex Address Types, only display “<ADDRESS>” with the following: RT_PR_APTCOMPLEX and RT_PR_LOCWSID. Display Rules for Area Name Address Types (ADDR_TYPE=6): For Area Name Address Types, only display “<ADDRESS>” with the following: RT_PR_AREANM1 (and RT_PR_LOCHN, if =nonblank) and RT_PR_LOCNAME (and RT_PR_ LOCWSID; if RT_PR_ LOCWSID if =nonblank). Display Rules for General Address Types (ADDR_TYPE=7): For General Address Types, only display “<ADDRESS>” with the following: RT_PR_LOCHN and RT_PR_LOCNAME (and RT_PR_LOCWSID, if RT_PR_LOCWSID = nonblank) .

URB_RESIDENCE

Screen Name	URB_RESIDENCE
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Respondent-Provided PR URB Address Fields RT_PR_URB: varchar2 (50) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Physical Description Field ADDR_DESC_LINE1: varchar2 (250)
Data Needed
Universe	URB = “Yes”
Question Wording	Where <FILL1> on <REFDATE>? (Help) Please provide any information associated with your address. Do not include your P.O. Box or Rural Route address.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “will you be living” If the current data is on or after REFDATE, then <FILL1>= “did you live”
Response Options	Name of Urbanización: 50-character text box Ex: URB José Martí or URB Los Jardines de Caguas House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box Please provide nearby points of reference describing how to reach your home. Points of Reference: 250-character text area
Edits/Errors	Required Fields PR_LOCHN (House Number) AND PR_URB (Name of Urbanización) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (PR_LOCHN is nonblank and PR_URB is blank) OR (PR_LOCHN is blank and PR_URB is nonblank) OR [PR_LOCHN is blank and PR_URB is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide an urbanización address. If you do not live in this type of address, then please select ‘Previous’.” Second time: “In order to continue, you must provide at least an urbanizacion name, address number and Municipio or ZIP Code. If you lived on a named street, then include that as well. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto STAN_URB_RESIDENCE.
Branching	If valid address provided and GEO Standardizer is stalled or disabled or otherwise inaccessible, then go to RESPONDENT If valid address provided and GEO Standardizer is functional, then go to STAN_URB_RESIDENCE.
Help Text link	URB_RESIDENCE
Special Instructions	Special Instruction #1: Setting Address Type (ADDR_TYPE) for Urbanización Addresses: IF RT_PR_URB= nonblank and RT_PR_LOCHN = nonblank and RT_PR_ZIP or RT_PR_COUNAME = nonblank THEN set ADDR_TYPE = 5 Special Instruction #2: Clearing PR Address Fields This instruction is for cases in which a respondent happens to land on any of the PR residence screens and begins to fill out an address in one of the fifty states or D.C. (this can occur when the respondent chooses a non-PR selection under the state drop-down menu). If a non-PR selection is made, the screen should take them to the RESIDENCE screen. All the PR fields that had been filled should be blanked out. If RT_PR_STATE <> “PR” then go to stateside RESIDENCE screen and blank out anything that was entered into the following fields for PR__ RESIDENCE: RT_PR_AREANM1: varchar2 (100) RT_PR_KMHM: NUM (5, excluding decimal) RT_PR_URB: varchar2 (50) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_APTCOMPLEX: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Special Instruction #3: Display Rules for <ADDRESS>* If respondents provide an address on the PR_URB_RESIDENCE screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens. Display Rules for Urbanización Types (ADDR_TYPE=5): For Urbanización Address Types, only display “<ADDRESS>” with the following: RT_PR_URB and RT_PR_LOCHN ((and RT_PR_LOCNAME, if RT_PR_LOCNAME =nonblank) and (and RT_PR_LOCWSID, if RT_PR_LOCWSID = nonblank)).

AREANM_RESIDENCE

Screen Name	AREANM_RESIDENCE
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Physical Description Field ADDR_DESC_LINE1: varchar2 (250) Respondent-Provided PR Area Name Address Fields RT_PR_AREANM1: varchar2 (100) RT_PR_KMHM: NUM (5, excluding decimal) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5)
Data Needed
Universe	All Respondents from AREANM who answered “Yes”
Question Wording	Where <FILL1> on <REFDATE>? (Help) Please provide any information associated with your address. Do not include your P.O. Box or Rural Route address.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “will you be living” If the current data is on or after REFDATE, then <FILL1>= “did you live”
Response Options	Please provide nearby points of reference describing how to reach your home. Points of Reference: 250-character text area Name of Barrio, Barriada, Sector, Parcela, or Community: 100-character text box Ex: BDA Los Toldos, or BO Martí SECT Laguna, or COM Los Reyes, or BO Ponce PARC 10 House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: EDIF 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box
Edits/Errors	Required Fields PR_AREANM1 (Name of Barrio, barriada, sector, parcela, or comunidad) AND PR_LOCNAME (Street Name) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (PR_AREANM1 is nonblank and PR_LOCNAME is blank) OR (PR_AREANM1 is blank and PR_LOCNAME is nonblank) OR [PR_AREANM1 is blank and PR_LOCNAME is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide address with the name of a barrio, barriada, sector, communidada, or parcela. If your street has no name, then write “unnamed road”. If you do not live in this type of address, then please select ‘Previous’.” Second time: “In order to continue, you must provide at least the name of a barrio, barriada, sector, communidada, or parcela, address number, and Municipio or ZIP Code. If you lived on a named street, then include that as well. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto STAN_AREANM_RESIDENCE.
Branching	If valid address provided and GEO Standardizer is stalled or disabled or otherwise inaccessible, then go to RESPONDENT If valid address provided and GEO Standardizer is functional, then go to STAN_AREANM_RESIDENCE.
Help Text link	AREANM_RESIDENCE
Special Instructions	Special Instruction #1: Setting Address Type (ADDR_TYPE) for Area Name Addresses: IF RT_PR_AREANM1 = nonblank and RT_PR_LOCNAME = nonblank and RT_PR_ZIP or RT_PR_COUNAME = nonblank THEN set ADDR_TYPE = 6 Special Instruction #2: Clearing PR Address Fields This instruction is for cases in which a respondent happens to land on any of the PR residence screens and begins to fill out an address in one of the fifty states or D.C. (this can occur when the respondent chooses a non-PR selection under the state drop-down menu). If a non-PR selection is made, the screen should take them to the RESIDENCE screen. All the PR fields that had been filled should be blanked out. If RT_PR_STATE <> “PR” then go to stateside RESIDENCE screen and blank out anything that was entered into the following fields for PR_ _RESIDENCE: RT_PR_AREANM1: varchar2 (100) RT_PR_KMHM: NUM (5, excluding decimal) RT_PR_URB: varchar2 (50) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_APTCOMPLEX: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Special Instruction #3: Display Rules for <ADDRESS>* If respondents provide an address on the PR_AREANM_RESIDENCE screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens. Display Rules for Area Name Address Types (ADDR_TYPE=6): For Area Name Address Types, only display “<ADDRESS>” with the following: RT_PR_AREANM1 (and RT_PR_LOCHN, if =nonblank) and RT_PR_LOCNAME (and RT_PR_ LOCWSID; if RT_PR_ LOCWSID if =nonblank).

GEN_RESIDENCE

Screen Name	GEN_RESIDENCE
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Respondent-Provided PR General Address Fields RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Physical Description Field ADDR_DESC_LINE1: varchar2 (250)
Data Needed
Universe	AREANM = “No”
Question Wording	Where <FILL1> on <REFDATE>? (Help) Please provide any information associated with your address. Do not include your P.O. Box or Rural Route address.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “will you be living” If the current data is on or after REFDATE, then <FILL1>= “did you live”
Response Options	House Number: 20-character text box Ex: 100 or A1 Name of Street, Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box Please provide nearby points of reference describing how to reach your home.Points of Reference: 250-character text area
Edits/Errors	Required Fields PR_LOCHN (House Number) AND PR_LOCNAME (Street Name) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (LOCHN is nonblank and PR_LOCNAME is blank) OR (LOCHN is blank and PR_LOCNAME is nonblank) OR [PR_ LOCHN is blank and PR_LOCNAME is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide your complete address. If you do not live in this type of address, then please select ‘Previous’.” Second time: “In order to continue, you must provide at least an address number, street name ,and Municipio or ZIP Code If you live in an apartment, also include your apartment number. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto STAN_GENERAL_RESIDENCE.
Branching	If valid address provided and GEO Standardizer is stalled or disabled or otherwise inaccessible, then go to RESPONDENT If valid address provided and GEO Standardizer is functional, then go to STAN_GENERAL_RESIDENCE.
Help Text link	GEN_RESIDENCE
Special Instructions	Special Instruction #1: Setting Address Type (ADDR_TYPE) for General Addresses: IF RT_PR_LOCHN = nonblank and RT_PR_LOCNAME = nonblank and RT_PR_ZIP or RT_PR_COUNAME = nonblank THEN set ADDR_TYPE = 7 Special Instruction #2: Clearing PR Address Fields This instruction is for cases in which a respondent happens to land on any of the PR residence screens and begins to fill out an address in one of the fifty states or D.C. (this can occur when the respondent chooses a non-PR selection under the state drop-down menu). If a non-PR selection is made, the screen should take them to the RESIDENCE screen. All the PR fields that had been filled should be blanked out. If RT_PR_STATE <> “PR” then go to stateside RESIDENCE screen and blank out anything that was entered into the following fields for PR__ RESIDENCE: RT_PR_AREANM1: varchar2 (100) RT_PR_KMHM: NUM (5, excluding decimal) RT_PR_URB: varchar2 (50) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_APTCOMPLEX: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5) Special Instruction #3: Display Rules for <ADDRESS>* If respondents provide an address on the PR_GEN_RESIDENCE screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens. Display Rules for General Address Types (ADDR_TYPE=7): For General Address Types, only display “<ADDRESS>” with the following: RT_PR_LOCHN and RT_PR_LOCNAME (and RT_PR_LOCWSID, if RT_PR_LOCWSID = nonblank) .

STAN_APT_RESIDENCE

Screen Name	STAN_APT_RESIDENCE
Field Names	Standardized Street Address Fields STAN_ADDR_NUMBER: varchar2 (20) STAN_STREET_NAME: varchar2 (100) STAN_UNIT_INFO: varchar2 (40) General Address Fields for Standardized Street Addresses HC_ CITY: varchar2 (16) HC_ STATE: varchar2 (2) HC_ UPZIP: varchar2 (5) HC_ COUNTY: varchar2 (16) Geocode BCU Fields for RT_MATCH_STATUS=1 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for RT_MATCH_STATUS=2 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (RT_MATCH_STATUS=3 or 5): AG_STATEFP: varchar2 (2) AG_COUNTYFP: varchar2 (3) AG_TRACTCE: varchar2 (6) AG_BCUID: varchar2 (8) match_status: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode MAFID: NUM (9) MATCH_QUALITY: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match MATCH_PREFERRED: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record MATCH_EXCLUDED: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	All Respondents who provided a valid address on the APT_RESIDENCE and GEO Standardizer is functional
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Response Options	Name of Apartment/Condominium Building or Residencial Público: 100-character text box Ex: COND Ponce de León or RES Los Jardines de Ponce Building/Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box
Edits/Errors
Branching	ranching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives RT_match_status=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; MAFID MATCH_STATUS MATCH_QUALITY MATCH_PREFERRED MATCH_EXCLUDED; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives MATCH_STATUS =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives match_status=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto APT_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives match_status=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto APT_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a RT_MATCH_STATUS of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).

Special Instructions	Fields are editable and pre-filled with the standardized version of the address. The final address on this screen should be the fill for the “<ADDRESS>” that is referenced on the remaining screens unless the match status = 0,5. There is no need to display the county field called “HCCOUNTY.” However, the internet application must populate that field when GEO returns the value for HC_ COUNTY.

STAN_URB_RESIDENCE

Screen Name	STAN_URB_RESIDENCE
Field Names	Standardized Street Address Fields STAN_ADDR_NUMBER: varchar2 (20) STAN_STREET_NAME: varchar2 (100) STAN_UNIT_INFO: varchar2 (40) General Address Fields for Standardized Street Addresses HC_ CITY: varchar2 (16) HC_ STATE: varchar2 (2) HC_ UPZIP: varchar2 (5) HC_ COUNTY: varchar2 (16) Geocode BCU Fields for RT_MATCH_STATUS=1 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for RT_MATCH_STATUS=2 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (RT_MATCH_STATUS=3 or 5): AG_STATEFP: varchar2 (2) AG_COUNTYFP: varchar2 (3) AG_TRACTCE: varchar2 (6) AG_BCUID: varchar2 (8) match_status: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode MAFID: NUM (9) MATCH_QUALITY: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match MATCH_PREFERRED: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record MATCH_EXCLUDED: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	All Respondents who provided a valid address on the URB_RESIDENCE and GEO Standardizer is functional
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Response Options	Name of Urbanización: 50-character text box Ex: URB José Martí or URB Los Jardines de Caguas House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box
Edits/Errors
Branching	ranching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives RT_match_status=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; MAFID MATCH_STATUS MATCH_QUALITY MATCH_PREFERRED MATCH_EXCLUDED; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives MATCH_STATUS =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives match_status=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto URB_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives match_status=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto URB_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a RT_MATCH_STATUS of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).

Special Instructions	Fields are editable and pre-filled with the standardized version of the address. The final address on this screen should be the fill for the “<ADDRESS>” that is referenced on the remaining screens unless the match status = 0,5. There is no need to display the county field called “HCCOUNTY.” However, the internet application must populate that field when GEO returns the value for HC_ COUNTY.

STAN_AREANM_RESIDENCE

Screen Name	STAN_AREANM_RESIDENCE
Field Names	Standardized Street Address Fields STAN_ADDR_NUMBER: varchar2 (20) STAN_STREET_NAME: varchar2 (100) STAN_UNIT_INFO: varchar2 (40) General Address Fields for Standardized Street Addresses HC_ CITY: varchar2 (16) HC_ STATE: varchar2 (2) HC_ UPZIP: varchar2 (5) HC_ COUNTY: varchar2 (16) Geocode BCU Fields for RT_MATCH_STATUS=1 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for RT_MATCH_STATUS=2 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (RT_MATCH_STATUS=3 or 5): AG_STATEFP: varchar2 (2) AG_COUNTYFP: varchar2 (3) AG_TRACTCE: varchar2 (6) AG_BCUID: varchar2 (8) match_status: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode MAFID: NUM (9) MATCH_QUALITY: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match MATCH_PREFERRED: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record MATCH_EXCLUDED: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	All Respondents who provided a valid address on the URB_RESIDENCE and GEO Standardizer is functional
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Response Options	Name of Barrio, Barriada, Sector, Parcela, or Community: 100-character text box Ex: BDA Los Toldos, or BO Martí SECT Laguna, or COM Los Reyes, or BO Ponce PARC 10 House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: EDIF 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box
Edits/Errors
Branching	ranching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives RT_match_status=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; MAFID MATCH_STATUS MATCH_QUALITY MATCH_PREFERRED MATCH_EXCLUDED; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives MATCH_STATUS =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives match_status=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto AREANM_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives match_status=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto AREANM_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a RT_MATCH_STATUS of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).

Special Instructions	Fields are editable and pre-filled with the standardized version of the address. The final address on this screen should be the fill for the “<ADDRESS>” that is referenced on the remaining screens unless the match status = 0,5. There is no need to display the county field called “HCCOUNTY.” However, the internet application must populate that field when GEO returns the value for HC_ COUNTY.

STAN_GENERAL_RESIDENCE

Screen Name	STAN_GENERAL_RESIDENCE
Field Names	Standardized Street Address Fields STAN_ADDR_NUMBER: varchar2 (20) STAN_STREET_NAME: varchar2 (100) STAN_UNIT_INFO: varchar2 (40) General Address Fields for Standardized Street Addresses HC_ CITY: varchar2 (16) HC_ STATE: varchar2 (2) HC_ UPZIP: varchar2 (5) HC_ COUNTY: varchar2 (16) Geocode BCU Fields for RT_MATCH_STATUS=1 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for RT_MATCH_STATUS=2 Cases: STATEFP: varchar2 (2) COUNTYFP: varchar2 (3) TRACTCE: varchar2 (6) BCUID: varchar2 (8) Geocode BCU Fields for Automated Geocoding by GEO (RT_MATCH_STATUS=3 or 5): AG_STATEFP: varchar2 (2) AG_COUNTYFP: varchar2 (3) AG_TRACTCE: varchar2 (6) AG_BCUID: varchar2 (8) match_status: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode MAFID: NUM (9) MATCH_QUALITY: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match MATCH_PREFERRED: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record MATCH_EXCLUDED: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	All Respondents who provided a valid address on the GEN_RESIDENCE and GEO Standardizer is functional
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Response Options	House Number: 20-character text box Ex: 100 or A1 Name of Street, Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box
Edits/Errors
Branching	ranching Instructions for Matching/Geocoding: If the respondent selects “Next”, the address is sent to RTNP. GEO will process the standardized address and one of 6 match status flags will be returned to the application: If the application receives RT_match_status=1 (Matched to a Geocoded MTdb Record), then the application will: 1) Send the matched standardized address information to eCase OCS; 2) Send the geocode information received back from GEO to eCase OCS; 3) Send the following variables to eCase OCS; MAFID MATCH_STATUS MATCH_QUALITY MATCH_PREFERRED MATCH_EXCLUDED; 5) Send the original respondent address information (before standardization) to eCase OCS; and 6) Go to the RESPONDENT so the respondent may continue the questionnaire; Else if the application receives MATCH_STATUS =1 (Matched to a geocoded MTdb) AND is not within a core county of the 2017 CT test sites, then go to the RESPONDENT screen so the respondent may continue the questionnaire. Else if the application receives match_status=2 (Matched to a MTdb record with an Unacceptable Geocode), then the geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if the application receives match_status=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the automated geocode information sent from GEO must be populated. Goto GEN_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0” or “5” then send the respondent to WEBMAP INTERFACE screen; Else if the application receives match_status=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode information will be populated. Goto GEN_RESIDENCE2 screen so the respondent can provide additional address information. If the respondent updated address receives a MATCH_STATUS of “0, then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a RT_MATCH_STATUS of “5,” then send the respondent to WEBMAP INTERFACE screen (along with the automated geocode information sent from GEO).

Special Instructions	Fields are editable and pre-filled with the standardized version of the address. The final address on this screen should be the fill for the “<ADDRESS>” that is referenced on the remaining screens unless the match status = 0,5. There is no need to display the county field called “HCCOUNTY.” However, the internet application must populate that field when GEO returns the value for HC_ COUNTY.

APT_RESIDENCE2

Screen Name	APT_RESIDENCE2
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Respondent-Provided PR Condominium/Residencial Address Fields RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_APTCOMPLEX: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5)
Data Needed	APT_RESIDENCE
Universe	Respondents who provided a valid address on the STAN_APT_RESIDENCE screens and RTNP match status = 0 or 5. All Non-ID respondents with addresses that are in the three 2017 Puerto Rico Census Test municipios or in the surrounding six fringe municipios and received a non-match status.
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Question Wording Fills	If the current date is before REFDATE then FILL1 = will be living If the current date is on or after REFDATE then FILL1 = lived
Response Options	Name of Apartment/Condominium Building or Residencial Público: 100-character text box Ex: COND Ponce de León or RES Los Jardines de Ponce Building/Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box Please provide nearby points of reference describing how to reach your home.Points of Reference: 250-character text area
Edits/Errors	Required Fields APTCOMPLEX (Name of Condominium, Apartment Building, or Residencial) AND PR_LOCWSID (Apt Unit Information; may include Building Identifier) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (PR_APTCOMPLEX is nonblank and PR_LOCWSID is blank) OR (PR_APTCOMPLEX is blank and PR_LOCWSID is nonblank) OR [PR_APTCOMPLEX is blank and PR_LOCWSID is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide a condominium or residencial address. If you do not live in this type of address, then please click ‘Previous’.” Second time: “In order to continue, you must provide at least the name of your condominium or residencial, an apartment number, and Municipio or ZIP Code. If you live on a named street, then include that as well. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto RESPONDENT
Branching	If respondent leaves responses blank, or “Next” is selected with an invalid address for third time, goto NOCOMPLETE. If respondent provides valid address and GEO Standardizer is (stalled or disabled or otherwise inaccessible goto RESPONDENT If respondent provides valid address and GEO Standardizer is functional and match status = 2.3.4.5.0, goto WEBMAP INTERFACE. If respondent provides valid address and GEO Standardizer is functional and match status = 1, goto RESPONDENT.
Help Text link	APT_RESIDENCE2
Special Instructions	If respondents provide an address on the APT_RESIDENCE2 screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens.

URB_RESIDENCE2

Screen Name	URB_RESIDENCE2
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Respondent-Provided PR URB Address Fields RT_PR_URB: varchar2 (50) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5)
Data Needed	None
Universe	Respondents who provided a valid address on the STAN_URB_RESIDENCE screens and RTNP match status = 0 or 5. All Non-ID respondents with addresses that is in the three 2017 Puerto Rico Census Test municipios.
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Question Wording Fills	If the current date is before REFDATE then FILL1 = will be living If the current date is on or after REFDATE then FILL1 = lived
Response Options	Name of Urbanización: 50-character text box Ex: URB José Martí or URB Los Jardines de Caguas House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box Please provide nearby points of reference describing how to reach your home.Points of Reference: 250-character text area
Edits/Errors	Required Fields PR_LOCHN (House Number) AND PR_URB (Name of Urbanización) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (PR_LOCHN is nonblank and PR_URB is blank) OR (PR_LOCHN is blank and PR_URB is nonblank) OR [PR_LOCHN is blank and PR_URB is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide an urbanizacion address. If you do not live in this type of address, then please select ‘Previous’.” Second time: “In order to continue, you must provide at least an urbanizacion name, address number and Municipio or ZIP Code. If you lived on a named street, then include that as well. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto RESPONDENT
Branching	If respondent leaves responses blank, or “Next” is selected with an invalid address for third time, goto NOCOMPLETE. If respondent provides valid address and GEO Standardizer is (stalled or disabled or otherwise inaccessible goto RESPONDENT If respondent provides valid address and GEO Standardizer is functional and match status = 2.3.4.5.0, goto WEBMAP INTERFACE. If respondent provides valid address and GEO Standardizer is functional and match status = 1, goto RESPONDENT.
Help Text link	URB_RESIDENCE2
Special Instructions	If respondents provide an address on the URB_RESIDENCE2 screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens.

AREANM_RESIDENCE2

Screen Name	AREANM_RESIDENCE2
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Physical Description Field ADDR_DESC_LINE1: varchar2 (250) Respondent-Provided PR Area Name Address Fields RT_PR_AREANM1: varchar2 (100) RT_PR_KMHM: NUM (5, excluding decimal) RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5)
Data Needed	None
Universe	Respondents who provided a valid address on the STAN_AREANM_RESIDENCE screens and RTNP match status = 0 or 5. All Non-ID respondents with addresses that are in the three 2017 Puerto Rico Census Test municipios or in the surrounding six fringe municipios and received a non-match status.
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Question Wording Fills	If the current date is before REFDATE then FILL1 = will be living If the current date is on or after REFDATE then FILL1 = lived
Response Options	Please provide any information associated with your address. Points of Reference: 250-character text area Name of Barrio, Barriada, Sector, Parcela, or Community: 100-character text box Ex: BDA Los Toldos, or BO Martí SECT Laguna, or COM Los Reyes, or BO Ponce PARC 10 House Number: 20-character text box Ex: 100 or A1 Name of Street or Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: EDIF 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box
Edits/Errors	PR_AREANM1 (Name of Barrio, barriada, sector, parcela, or comunidad) AND PR_LOCNAME (Street Name) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (PR_AREANM1 is nonblank and PR_LOCNAME is blank) OR (PR_AREANM1 is blank and PR_LOCNAME is nonblank) OR [PR_AREANM1 is blank and PR_LOCNAME is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide address with the name of a barrio, barriada, sector, communidada, or parcela. If your street has no name, then write “unnamed road”. If you do not live in this type of address, then please select ‘Previous’.” Second time: “In order to continue, you must provide at least the name of a barrio, barriada, sector, communidada, or parcela, address number, and Municipio or ZIP Code. If you lived on a named street, then include that as well. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto RESPONDENT
Branching	If respondent leaves responses blank, or “Next” is selected with an invalid address for third time, goto NOCOMPLETE. If respondent provides valid address and GEO Standardizer is (stalled or disabled or otherwise inaccessible goto RESPONDENT. If respondent provides valid address and GEO Standardizer is functional and match status = 2.3.4.5.0, goto WEBMAP INTERFACE. If respondent provides valid address and GEO Standardizer is functional and match status = 1, goto RESPONDENT.
Help Text link	AREANM_RESIDENCE2
Special Instructions	If respondents provide an address on the AREANM_RESIDENCE2 screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens.

GEN_RESIDENCE2

Screen Name	GEN_RESIDENCE2
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (4=Apt Complex, 5=Urb, 6=Area Name, 7=General) Respondent-Provided PR General Address Fields RT_PR_LOCHN: varchar2 (20) RT_PR_ LOCNAME: varchar2 (100) RT_PR_LOCWSID: varchar2 (40) Respondent-Provided Header-coding Address Fields RT_PR_COUNAME: varchar2 (16) RT_PR_STATE: varchar2 (2) RT_PR_ZIP: varchar2 (5)
Data Needed	None
Universe	Respondents who provided a valid address on the STAN_GENERAL_RESIDENCE screens and RTNP match status = 0 or 5. All Non-ID respondents with addresses that are in the three 2017 Puerto Rico Census Test municipios or in the surrounding six fringe municipios and received a non-match status.
Question Wording	I need to confirm that I have entered the correct address information. I have (read standardized address) Is this correct? Make corrections if necessary. If the address is correct, click next to continue.
Question Wording Fills	If the current date is before REFDATE then FILL1 = will be living If the current date is on or after REFDATE then FILL1 = lived
Response Options	House Number: 20-character text box Ex: 100 or A1 Name of Street, Avenue: 100-character text box Ex: CLL 10 or AVE FD Roosevelt Apartment Number: 40-character text box Ex: Torre 5-10, or Apt. B, or 45-9 Municipio: 16-character text box PR/State: Text box pre-filled in as “PR” and not editable ZIP Code: 5-character text box Please provide nearby points of reference describing how to reach your home.Points of Reference: 250-character text area
Edits/Errors	Required Fields PR_LOCHN (House Number) AND PR_LOCNAME (Street Name) AND RT_PR_ZIP (Zip Code) or RT_PR_COUNAME If (LOCHN is nonblank and PR_LOCNAME is blank) OR (LOCHN is blank and PR_LOCNAME is nonblank) OR [PR_ LOCHN is blank and PR_LOCNAME is blank and (RT_PR_COUNAME = nonblank OR RT_PR_ZIP=nonblank)], and the respondent selects the “Next” button: First time: “Please provide your complete address. If you do not live in this type of address, then please select ‘Previous’.” Second time: “In order to continue, you must provide at least an address number, street name ,and Municipio or ZIP Code If you live in an apartment, also include your apartment number. If you do not live in this type of address, select ‘Previous’.” 3. Third time: End the survey and display NOCOMPLETE. Address boxes and Point of Reference box should be highlighted, so the respondent is alerted to where information is invalid or missing. If “Point of Reference” is blank, provide a single error message that says: “Please provide a point of reference according to the guidelines above the text box.” However, because Point of Reference is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and goto RESPONDENT
Branching	If respondent leaves responses blank, or “Next” is selected with an invalid address for third time, goto NOCOMPLETE. If respondent provides valid address and GEO Standardizer is (stalled or disabled or otherwise inaccessible goto RESPONDENT If respondent provides valid address and GEO Standardizer is functional and match status = 2.3.4.5.0, goto WEBMAP INTERFACE. If respondent provides valid address and GEO Standardizer is functional and match status = 1, goto RESPONDENT.
Help Text link	GEN_RESIDENCE2
Special Instructions	If respondents provide an address on the GEN_RESIDENCE2 screen, the address below should be the fill for the “<ADDRESS>” variable that is referenced on the remaining screens.

Roster

RESPONDENT

Screen Name	RESPONDENT
Field Names	RESP_FIRST_NAME: CHAR 20 RESP_MIDDLE_NAME: CHAR 20 RESP_LAST_NAME: CHAR 20 RESP_PH_AREA_ID: NUM 3 RESP_PH_PREFIX_ID: NUM 3 RESP_PH_SUFFIX_ID: NUM 4 RESP_EMAIL_TEXT: CHAR 50 RESP_EMAIL_CONF_TEXT: CHAR 50
Data Needed	None
Universe	VERIFY ADDRESS=yes Valid address provided in NON_ID ADDRESS BLOCK
Question Wording	What is your name, telephone number, and email address? We will only contact you if needed for official Census Bureau business. (Help) <> Repeat back the email address to respondent to confirm it was entered correctly.<>
Question Wording Fills	N/A
Response Options	Name First Name: 20-character text box Middle Name: 20-character text box Last Name(s): 20-character text box Phone Number (separate by a hyphen with auto-tabbing) Telephone Number: two 3-digit numeric text boxes and a 4-digit numeric text box Enter email address: 50-character text box Confirm email address: 50-character text box
Response Options Fills	N/A
Edits/Errors	If there is fewer than 1 character in the name fields combined and the next button is selected: First time: “Please provide your name. If you prefer not to provide your name, please provide a nickname or description so that you will know who each question refers to.” Name boxes should be bolded and highlighted. Second time: “Your name is required to continue the survey. If you prefer not to provide your name, please provide a nickname or description.” Third time: goto NOCOMPLETE Name boxes should be bolded and highlighted.
Branching	If name field is blank and third time “next” is selected, go to NOCOMPLETE. Else, goto POPCOUNT.
Help Text link	RESPONDENT
Special Instructions	There should be a non-case sensitive confirmation check to make sure both email addresses match.

POPCOUNT

Screen Name	POPCOUNT
Field Names	H_SIZE_STATED_INT: NUM2
Data Needed	<ADDRESS> <REFDATE>
Universe	RESPONDENT
Question Wording	Including yourself, how many people <FILL1> living or staying at <ADDRESS>, on <REFDATE>? For more information on who to include, click here.
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” If current date is on or after REFDATE, then <FILL1> = “were”
Response Options	One 2-digit numerical text box.
Response Options Fills	N/A
Edits/Errors	Soft edit for no response: First time: “Please provide an answer. You must provide an answer to the question in order to continue.” Soft edit if 0 is entered: “Please include yourself when reporting the number of people.” Second time no response or 0: Display pop-up modal with "Yes" and "No" response options. On <REFDATE>, <FILL1> living or staying at <ADDRESS>? YES NO If current date is before REFDATE, then <FILL1> = “will you be” If current date is on or after REFDATE, then <FILL1> = “were you” If Yes, close pop-up modal. If No, goto OTHER_COMPLETE Third time: If the field is blank or zero and “Next” is selected for the third time, goto NOCOMPLETE
Branching	If popcount field is invalid or blank and selects “Next” for the third time, goto NOCOMPLETE If POPCOUNT=1 goto UC. Else, goto PEOPLE.
Help Text link	POPCOUNT
Special Instructions

PEOPLE

Screen Name	PEOPLE
Field Names	P_FIRST_NAME: CHAR 20 P_MIDDLE_NAME: CHAR 20 P_LAST_NAME: CHAR 20
Data Needed	<ADDRESS> <REFDATE> Name from RESPONDENT POPCOUNT response
Universe	POPCOUNT<>1
Question Wording	So far you have told me about the following people: <RESPONDENT NAME> What is the name of each person who <FILL1> living or staying at <ADDRESS> on <REFDATE>? For more information on who to include, click here.
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” If current date is on or after REFDATE, then <FILL1> = “was”
Response Options	Name First Name: 20-character text box Middle Name: 20-character text box Last Name(s): 20-character text box Click here to add more people
Response Options Fills	N/A
Branching	If all fields are blank and “next” is selected for a third time, goto UC Else if there are 99 people on the roster, including the respondent, goto HOME. Else if there is at least 1 character for any name and, goto UC.
Help Text link	PEOPLE
Special Instructions	Set PERSONCOUNT = total number of names on the roster, including respondent. Display the name from RESPONDENT above the response boxes. Display fields for the number the respondent provided in POPCOUNT. time. Add 1more field if “Click here to add more people” is selected.

Undercount

UC

Screen Name	UC
Field Names	H_UC_ADD_YES_IND: NUM1 (0=not selected and 1=selected) H_UC_ADD_NO_IND: NUM1 (0=not selected and 1=selected) P_FIRST_NAME: CHAR 20 P_MIDDLE_NAME: CHAR 20 P_LAST_NAME: CHAR 20
Data Needed	<ADDRESS> <REFDATE> ROSTER (all names from PEOPLE and RESPONDENT)
Universe	PERSONCOUNT<99 and INTERNET_UNDERCOUNT=2
Question Wording	So far you have told me about the following people: <NAMES FROM RESPONDENT AND PEOPLE> We do not want to miss any people, such as babies, children, grandchildren, foster children, nonrelatives, or any people without a permanent place to live. Were there any ADDITIONAL people that you did not mention yet who might <FILL1> at <ADDRESS> on <REFDATE>? <>After first time<> Anyone else? For more information on who to include, click here.
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “be staying” If current date is on or after REFDATE, then <FILL1> = “have stayed”
Response Options	Radio Buttons Yes No IF YES, display: Enter Name: First Name: 20-character text box Middle Name: 20-character text box Last Name(s): 20-character text box Click here to add more people
Response Options Fills	N/A
Branching	Goto HOME
Help Text link	UC
Special Instructions	The name boxes should only appear when “Yes” is selected. If the respondent clicks “No” (removing a “Yes” entry), the name boxes should disappear. When “Yes” is selected, one set of name boxes should appear. One additional set of name boxes should appear when “Click here to add more people” is selected. Increment <PERSONCOUNT> for each name added on UC. If <PERSONCOUNT>=99, remove the “Click here to add more people” link. If the name field is left blank, there is no edit message.

Tenure

HOME

Screen Name	HOME
Field Names	H_TENURE_OWNED_MORT_IND: NUM1 (0=not selected and 1=selected) H_TENURE_OWNED_FREE_IND: NUM1 (0=not selected and 1=selected) H_TENURE_RENTED_IND: NUM1 (0=not selected and 1=selected) H_TENURE_OCC_NOPAY_IND: NUM1 (0=not selected and 1=selected) H_TENURE_DK_IND: NUM1 (0=not selected and 1=selected) H_TENURE_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed
Universe	All eligible households
Question Wording	On <REFDATE>, <FILL1> the house, apartment, or mobile home at <ADDRESS> <FILL2> owned by you or someone in this household with a mortgage or loan (including home equity loans), owned by you or someone in this household free and clear, rented, or occupied without payment of rent? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will” <FILL2> = “be” If current date is on or after REFDATE, then <FILL1> = “was” <FILL2> = blank
Response Options	Radio Buttons Owned by you or someone in this household with a mortgage or loan? Include home equity loans. Owned by you or someone in this household free and clear (without a mortgage or loan)? Rented? Occupied without payment of rent? Don’t know Refused
Response Options Fills	N/A
Branching	Else if “Occupied without payment of rent” or blank, goto DASHBOARD. Else goto OWNER.
Help Text link	HOME
Special Instructions	If “Occupied without payment of rent” set <REF NAME> = Person 1.

OWNER

Screen Name	OWNER
Field Names	For each person selected: NUM1 (0=not selected and 1=selected) H_OWNER_NONE_IND: NUM1 (0=not selected and 1=selected) H_OWNER_DK_IND: NUM1 (0=not selected and 1=selected) H_OWNER_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	Roster names
Universe	Roster size >1 AND HOME = “Owned by you or someone in this household with a mortgage or loan” or “Owned by you or someone in this household free and clear” or “Rented”
Question Wording	Of the people who <FILL1> at <ADDRESS>, who <FILL2>the house, apartment, or mobile home on <REFDATE>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be living” If HOME=Rented, <FILL2> = “will rent” Else, <FILL2> = “will own” If current date is on or after REFDATE, then <FILL1> = “lived” If HOME=Rented, <FILL2> = “rented” Else, <FILL2> = “owned”
Response Options	Check boxes where each name from the roster is assigned to a check box. Also, include a box for “None of the above,” “Don’t know,” and, “Refused.”
Response Options Fills	N/A
Branching	Goto DASHBOARD
Help Text link	OWNER
Special Instructions	This question is used to select the reference person for the remainder of the survey: If one person is selected, that person is the reference person. If multiple people are selected, the first person listed - of those selected people - becomes the reference person. If "None of the above" is selected, the reference person is the first person on the list. If the respondent selects "None of the above" and any number of names, the reference person is the first (or only) person listed, that was selected. If the respondent does not provide a selection (nonresponse), the reference person is the first person on the list.

Demographics

RELATIONSHIP

Screen Name	RELATIONSHIP
Field Names	P_REL_SPOUSE_OPP_IND: NUM1 (0=not selected and 1=selected) P_REL_PARTNER_OPP_IND: NUM1 (0=not selected and 1=selected) P_REL_SPOUSE_SAME_IND: NUM1 (0=not selected and 1=selected) P_REL_PARTNER_SAME_IND: NUM1 (0=not selected and 1=selected) P_REL_SOD_IND: NUM1 (0=not selected and 1=selected) P_REL_CHILD_BIO_IND: NUM1 (0=not selected and 1=selected) P_REL_CHILD_ADOPTED_IND: NUM1 (0=not selected and 1=selected) P_REL_CHILD_STEP_IND: NUM1 (0=not selected and 1=selected) P_REL_SIBLING_IND: NUM1 (0=not selected and 1=selected) P_REL_PARENT_IND: NUM1 (0=not selected and 1=selected) P_REL_GRANDCHILD_IND: NUM1 (0=not selected and 1=selected) P_REL_INLAW_PARENT_IND: NUM1 (0=not selected and 1=selected) P_REL_OTHER_IND: NUM1 (0=not selected and 1=selected) P_REL_INLAW_CHILD_IND: NUM1 (0=not selected and 1=selected) P_REL_OTHER_REL_IND: NUM1 (0=not selected and 1=selected) P_REL_HOUSEROOMMATE_IND: NUM1 (0=not selected and 1=selected) P_REL_CHILD_FOSTER_IND: NUM1 (0=not selected and 1=selected) P_REL_OTHER_NONREL_IND: NUM1 (0=not selected and 1=selected) P_REL_DK_IND: NUM1 (0=not selected and 1=selected) P_REL_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	REFERENCE PERSON NAME#
Universe	PERSONCOUNT=(1-99) who aren’t the reference person
Question Wording	How is <NAME#> related to <REF NAME>? <NAME#> is <REF NAME>’s ... (Help)
Response Options	Radio Buttons Opposite-sex husband/wife/spouse Opposite-sex unmarried partner Same-sex husband/wife/spouse Same-sex unmarried partner Son or daughter Biological son or daughter Adopted son or daughter Stepson or stepdaughter Brother or sister Father or mother Grandchild Other Parent-in-law Son-in-law or daughter-in-law Other relative Roommate or housemate Foster child Other nonrelative Don’t know Refused
Branching	Goto SEX
Help Text link	RELATIONSHIP
Special Instructions	This screen is not displayed for single-person households. This screen is not displayed for the reference person.

SEX

Screen Name	SEX
Field Names	P_SEX_MALE_IND: NUM1 (0=not selected and 1=selected) P_SEX_FEMALE_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-99)
Question Wording	Is <NAME#> male or female? (Help)
Response Options	Radio Buttons Male Female Don’t know Refused
Branching	Goto DOB
Help Text link	SEX
Special Instructions

SEXRELEDIT

Screen Name	SEXRELEDIT
Field Names	P_SEX_CONF_YES_IND: numeric (0 = not selected, 1 = if selected) P_SEX_CONF_NO_IND: numeric (0 = not selected, 1 = if selected) P_SEX_MALE_CH_IND: numeric (0 = not selected, 1 = if selected) P_SEX_FEMALE_CH_IND: numeric (0 = not selected, 1 = if selected) P_REL_SPOUSE_OPP_CH_IND: numeric (0 = not selected, 1 = if selected) P_REL_SPOUSE_SAME_CH_IND: numeric (0 = not selected, 1 = if selected) P_REL_PARTNER_OPP_CH_IND: numeric (0 = not selected, 1 = if selected) P_REL_PARTNER_SAME_CH_IND: numeric (0 = not selected, 1 = if selected) P_REL_OTHER_REL_CH_IND: numeric (0 = not selected, 1 = if selected)
Data Needed	<NAME#> <REF NAME>
Universe	Inconsistent sex and relationship is found
Question and Response Wording	Let me confirm that I have your answers correct: I recorded <Name#> as <Name# Sex>. Is that correct? Yes or No. If no: 1) the P_SEX_MALE_CH_IND and P_SEX_FEMALE_CH_IND variables will have the opposite values of the P_SEX_MALE and P_SEX_FEMALE variables. 2) then path to the DOB screen for current person. If yes, then unfold the second question: If next button, then unfold the second question: I recorded <REF NAME> as <REFNAME SEX>. Is that correct? Yes or No. If no 1) the P_SEX_MALE_CH_IND and P_SEX_FEMALE_CH_FEMAL variables will have the opposite values of the P_SEX_MALE and P_SEX_FEMALE variables. 2) then path to the DOB screen for current person. If yes, then unfold the third question: If next button, then unfold third question: <NAME> is <REF NAME>'s opposite sex husband/wife/spouse opposite sex unmarried partner same sex husband/wife/spouse same sex unmarried partner other
Branching	if no for edit question 1 then go to DOB screen If yes for edit question 1 then go to edit question 2. if no for edit question 2 then go to DOB screen. If yes for edit question 2 then go to edit question 3. if next then go to DOB screen.
Help Text link	N/A
Special Instructions	Inconsistent sex and relationship is defined as: Sex of reference person and sex of partner are the same, and relationship is opposite sex partner or opposite sex spouse. Sex of reference person and sex of partner are not the same, and relationship is same sex partner or same sex spouse. If there is an inconsistency in the sex and relationship questions between the reference person and the reference person's partner, thus triggering this sex/rel edit, then P_SEX_CONF_YES_IND = 1, and P_SEX_CONF_NO_IND = 0.

DOB

Screen Name	DOB
Field Names	P_BIRTH_MONTH_INT: numeric (1 through 12) P_BIRTH_DAY_INT: NUM 2 P_BIRTH_YEAR_INT: NUM 4 P_BIRTH_YEAR_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_YEAR_REF_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_DAY_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_DAY_REF_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_MONTH_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_MONTH_REF_IND: numeric (0 = not selected, 1 = if selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-99)
Question Wording	What is <NAME#>’s date of birth? (Help)
Response Options	The responses for the first question need to be drop down boxes for Month (Jan – Dec), Day (01-31), and Year (1891 – 2017). . These drop down input fields should also have the functionality of a text box, in that a respondent can type data into the fields, and have the appropriate data selected (example – typing “JA”or “ja” in the month field would bring up “Jan”, typing “2” into day field would bring up “20”.Same functionality one would find in a state dropdown menu, where typing an “M” would quick scroll to the first state that starts with an “M”. "Don't know" and "Refused" (checkboxes) should be possible response options for the CQA agent, for the Month, Day, and Year variables.
Branching	Goto RACE.
Help Text link	DOB
Special Instructions	In the Day of Birth drop down for February, the range for February days depends upon whether the year is a leap year. 1-28 when February and year is 1900 or not divisible by 4. 1-29 when February and year is divisible by 4 and not 1900. Currently, the instrument will remove "29" if a respondent selects "February" and a non-leap year. For example, if I chose Feb 29 for the month and day on the instrument. If I then choose a non-leap year for the year, the 29 becomes "DAY" (i.e., blank). After a date of birth has been entered, determine whether age can be calculated. If so, calculate the age and pre-fill it in the age answer space. Allow the respondent to change the number. Calculate the Age if: 1. there is a Month and Year of birth, and the Year is between {current year – 126} and current year, and the Month is not reference day month (<REFMONTH >); or 2. there is a Month and Year of birth, and the Year is between {current year – 126} and current year, and the Month is reference day month (<REFMONTH >), and there is a valid entry for Day. Note that the final output on the URdbS is numeric only. While we do want the Internet instrument to allow alphanumeric entries, any entries with alpha or symbol characters will be deleted from the final response data.

BABYFLAG

Screen Name	BABY
Field Names	P_BIRTH_ACD_YES_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_ACD_NO_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_ACD_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_ACD_REF_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_MONTH_INT: numeric (1 through 12) P_BIRTH_DAY_INT: NUM 2 P_BIRTH_YEAR_INT: NUM 4 P_BIRTH_YEAR_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_YEAR_REF_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_DAY_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_DAY_REF_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_MONTH_DK_IND: numeric (0 = not selected, 1 = if selected) P_BIRTH_MONTH_REF_IND: numeric (0 = not selected, 1 = if selected)
Data Needed
Universe	DOB enetered is after <REFDATE> byt before or on December 31, <REF YEAR> on the DOB screen.
Question Wording	For the Census, we need to record age as of <REFDATE>. So, just to confirm, <NAME#> was born after <REFDATE>? If a respondent selects "No" then the following question will unfold: What was <NAME#>'s date of birth?
Response Options	Yes No Don’t know Refused The response option will be Three dropdown boxes, for Month, Day, and Year.
Branching	If the respondent selects "Don't know" or "Refused", then selects "next" - go to the Race screen. If the respondent selects “No”, is presented with the unfolding question, and then selects "next" - go to the Race screen If the respondent selects “Yes”, go to RACE
Help Text link	BABYFLAG
Special Instructions

Screen Name	AGECONFIRM
Field Names	P_AGE_CONF_YES_IND: numeric (0 = not selected, 1 = if selected) P_AGE_CONF_NO_IND: numeric (0 = not selected, 1 = if selected) P_AGE_CONF_DK_IND: numeric (0 = not selected, 1 = if selected) P_AGE_CONF_REF_IND: numeric (0 = not selected, 1 = if selected) P_AGE_INT: numberic (1 through 125) P_AGE_DK_IND: numeric (0 = not selected, 1 = if selected) P_AGE_REF_IND: numeric (0 = not selected, 1 = if selected)
Data Needed
Universe
Question Wording	So, just to confirm, <NAME#> was <Fill1> on <REFDATE>? If calculated age > 0, then <Fill1> = <Calculated Age>* If calculated age = 0, then <Fill1> = "less than one year old" calculated age should be presented to the respondent in the question stem, and not editable (in a text box). Calculated age should be saved/written out as the "P_AGE_CALC_INT" variable (see the output variable layout below). If "no" is selected, the following question will unfold: What was <Name#>'s age on <REFDATE>?*
Response Options	Yes No Don’t know Refused If a respondent selects "No" then the following response option will unfold: The response option will be a three digit text box. Acceptable responses are 0 through 125. The text box should not be prefilled, but rather should be blank. The text box should allow only numeric entry. this respondent provided age should be saved/written out as the "P_AGE_RESP_INT" variable (see the output variable layout below). If no response is provided and "next" is clicked, the respondent will proceed to the next screen without any other edits.
Branching	If the respondent selects “Yes”, go to CQARACE screen if the respondent selects "No", is presented the unfolding question, and selects next, then go to CQARACE screen If respondent selects "Don't Know/Refuse", then go to CQARACE screen.
Help Text link	AGE
Special Instructions

AGE

Screen Name	AGE
Field Names	P_AGE_INT: numberic (1 through 125) P_AGE_DK_IND: numeric (0 = not selected, 1 = if selected) P_AGE_REF_IND: numeric (0 = not selected, 1 = if selected
Data Needed
Universe
Question Wording	What was <NAME#>’s age on <REFDATE>? If you don’t know the exact age, please estimate. Interviewer instruction: Make sure the respondent gives the age in completed years as of <REFDATE>. Do not round up. Do not enter age in months. For babies less than 1 year old enter 0 as the age.
Response Options	3-digit numeric only text box - only values between 0 and 125, or blank, should be allowed A don't know checkbox A Refused checkbox.
Branching	Goto RACE
Help Text link	AGE
Special Instructions

RACE

Screen Name	RACE
Field Names	P_RACE_WHITE_IND: NUM1 (0=not selected and 1=selected) P_RACE_HISP_IND: NUM1 (0=not selected and 1=selected) P_RACE_BLACK_IND: NUM1 (0=not selected and 1=selected) P_RACE_ASIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE_AIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE_MENA_IND: NUM1 (0=not selected and 1=selected) P_RACE_NHPI_IND: NUM1 (0=not selected and 1=selected) P_RACE_SOR_IND: NUM1 (0=not selected and 1=selected) P_RACE_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-99)
Question Wording	What is <NAME#>’s race or ethnicity? Is <NAME> White, Hispanic, Latino, or Spanish origin, Black or African American, Asian, American Indian or Alaska Native, Middle Eastern or North African, Native Hawaiian or Other Pacific Islander, or Some other race or ethnicity? (Help) Select all boxes that apply. Note, you may report more than one group.
Response Options	Checkboxes White For example, German, Irish, English, Italian, Polish, French, etc. Hispanic, Latino, or Spanish For example, Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc. Black or African American For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. Asian For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. American Indian or Alaska Native For example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Tlingit, etc. Middle Eastern or North African For example, Lebanese, Iranian, Egyptian, Syrian, Moroccan,Israeil , etc. Native Hawaiian or Other Pacific Islander For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc. Some other race or ethnicity Don’t know Refused
Response Options Fills
Branching	If RACE = “White” goto WHITE Else if RACE = “Hispanic” goto HISPANIC Else if RACE = “Black” goto BLACK Else if RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHPI Else if RACE = “Some other race or ethnicity” goto SOR Else if RACE = blank goto TRBENR_1
Help Text link	RACE
Special Instructions

WHITE

Screen Name	WHITE
Field Names	P_RACE2_GERMAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_IRISH_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ENGLISH_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ITALIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_POLISH_IND: NUM1 (0=not selected and 1=selected) P_RACE2_FRENCH_IND: NUM1 (0=not selected and 1=selected) P_RACE2_WHITE_TEXT: CHAR 200 P_RACE2_WHITE_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_WHITE_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	RACE = “White” RACE
Question Wording	For person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> WHITE ethnicities? For example, German, Irish, English, Italian, Polish, French, etc. Note, you may report more than one group. (Help)
Response Options	Checkboxes German Irish English Italian Polish French Enter, for example, Scottish, Norwegian, Dutch, etc. {display 200-character textbox} Don’t know Refused
Branching	If RACE = “White” goto WHITE Else if RACE = “Hispanic” goto HISPANIC Else if RACE = “Black” goto BLACK Else if RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE = blank, goto TRBENR_1
Help Text link	RACE
Special Instructions

HISPANIC

Screen Name	HISPANIC
Field Names	P_RACE2_MEXICAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_PUERTORICAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_CUBAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_SALVADORAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_DOMINICAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_COLOMBIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_HISP_TEXT: CHAR 200 P_RACE2_HISP_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_HISP_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “Hispanic, Latino, or Spanish”
Question Wording	If Person 1 RACE <> White, for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> HISPANIC, LATINO, OR SPANISH ethnicities? For example, Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc. Note, you may report more than one group. (Help)
Response Options	Checkboxes Mexican or Mexican American Puerto Rican Cuban Salvadoran Dominican Colombian Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. {display 200-character textbox} Don’t know Refused
Branching	If RACE = “Black” goto BLACK Else if RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHPI Else if RACE = “Some other race” goto SOR Else if RACE = blank, goto TRBENR_1
Help Text link	RACE
Special Instructions

BLACK

Screen Name	BLACK
Field Names	P_RACE2_AFAM_IND: NUM1 (0=not selected and 1=selected) P_RACE2_JAMAICAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_HAITIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_NIGERIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ETHIOPIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_SOMALI_IND: NUM1 (0=not selected and 1=selected) P_RACE2_BLACK_TEXT: CHAR 200 P_RACE2_BLACK_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_BLACK_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “Black or African American”
Question Wording	If Person 1 RACE <> (White, Hispanic), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> BLACK OR AFRICAN AMERICAN ethnicities? For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Checkboxes African American Jamaican Haitian Nigerian Ethiopian Somali Enter, for example, Ghanaian, South African, Barbadian, etc. {display 200-character textbox} Don’t know Refused
Branching	If RACE = “Asian” goto CQAASIAN Else if RACE = “American Indian or Alaska Native” goto CQAAIAN Else if RACE = “Middle Eastern or North African” goto CQAMENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto CQANHPI Else if RACE = “Some other race, ethnicity, or origin” goto CQASOR Else if RACE = blank, goto CQATRBENR_1
Help Text link	RACE
Special Instructions

ASIAN

Screen Name	ASIAN
Field Names	P_RACE2_ASIAN_TEXT: CHAR 200 P_RACE2_CHINESE_IND: NUM1 (0=not selected and 1=selected) P_RACE2_FILIPINO_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ASIANINDIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_VIETNAMESE_IND: NUM1 (0=not selected and 1=selected) P_RACE2_KOREAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_JAPANESE_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ASIAN_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ASIAN_REF_IND:NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “Asian”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese etc. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Checkboxes Chinese Filipino Asian Indian Vietnamese Korean Japanese Enter, for example, Pakistani, Cambodian, Hmong, etc. {display 200-character textbox} Don’t know Refused
Branching	If RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE = blank, goto TRBENR_1
Help Text link	RACE
Special Instructions

AIAN

Screen Name	AIAN
Field Names	P_RACE2_AIAN_TEXT: CHAR 200 P_RACE2_AIAN_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_AIAN_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “American Indian or Alaska Native”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> AMERICAN INDIAN OR ALASKA NATIVE ethnicities? For example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Tlingit, etc. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	AMERICAN INDIAN OR ALASKA NATIVE Enter, for example, Navajo Nation, Blackfeet Tribe, Blackfeet Tribe, Mayan, Aztec, Native village of Barrow Inpuiat Traditional Government, Tlingit, etc. Text box display 200-character textbox}
Branching	If RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE = blank, goto TRBENR_1
Help Text link	RACE
Special Instructions

MENA

Screen Name	MENA
Field Names	P_RACE2_MENA_TEXT: CHAR 200 P_RACE2_LEBANESE_IND: NUM1 (0=not selected and 1=selected) P_RACE2_IRANIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_EGYPTIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_SYRIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_MOROCCAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_ISRAELI_IND: NUM1 (0=not selected and 1=selected) P_RACE2_MENA_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_MENA_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “Middle Eastern or North African”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian, American Indian), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> MIDDLE EASTERN OR NORTH AFRICAN ethnicities? For example, Lebanese, Iranian, Egyptian, Syrian, Moroccan, Israeli, etc. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Checkboxes Lebanese Iranian Egyptian Syrian Moroccan Isreali Enter, for example, Algerian, Iraqi, Kurdish, etc. {display 200-character textbox} Don’t know Refused
Branching	If RACE = “Native Hawaiian or Other Pacific Islander” goto NHPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE, goto TRBENR_1
Help Text link	RACE
Special Instructions

NHPI

Screen Name	NHPI
Field Names	P_RACE2_NHPI_TEXT: CHAR 200 P_RACE2_NATHAWAIIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_SAMOAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_CHAMORRO_IND: NUM1 (0=not selected and 1=selected) P_RACE2_TONGAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_FIJIAN_IND: NUM1 (0=not selected and 1=selected) P_RACE2_MARSHALLESE_IND: NUM1 (0=not selected and 1=selected) P_RACE2_NHPI_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_NHPI_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “Middle Eastern or North African”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian, American Indian, Middle Eastern), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER ethnicities? For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese etc. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Checkboxes Native Hawaiian Samoan Chamorro Tongan Fijian Marshallese Enter, for example, Palauan, Tahitian, Chuukese, etc. {display 200-character textbox} Don’t know Refused
Branching	If RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE = blank, goto TRBENR_1
Help Text link	RACE
Special Instructions

SOR

Screen Name	SOR
Field Names	P_RACE2_SOR_TEXT: CHAR 200 P_RACE2_SOR_DK_IND: NUM1 (0=not selected and 1=selected) P_RACE2_SOR_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# RACE
Universe	RACE = “Some other race, ethnicity, or origin”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian, American Indian, Middle Eastern), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#>’s other race or ethnicity details? Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	{display 200-character textbox} Don’t know Refused
Branching	Goto TRBENR_1
Help Text link	RACE
Special Instructions

TRBENR_1

Screen Name	TRBENR_1
Field Names	P_TRBENR_YES_IND: NUM1 (0=not selected and 1=selected) P_TRBENR_NO_IND: NUM1 (0=not selected and 1=selected) P_TRBENR_DK_IND: NUM1 (0=not selected and 1=selected) P_TRBENR_REF_IND: NUM1 (0=not selected and 1=selected) P_TRBENR_TRIBE_NAME: CHAR 200 P_TRBENR_TRIBE_DK_IND: NUM1 (0=not selected and 1=selected) P_TRBENR_TRIBE_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-99) and TE_FLAG=1
Question Wording	On <REFDATE>, <FILL1> <NAME#> <FILL2> enrolled in any American Indian tribe or Alaska Native tribe or village?
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will” <FILL2> = “be” If current date is on or after REFDATE, then <FILL1> = “was”
Response Options	No, not enrolled Yes, enrolled Don’t know Refused IF YES, display: What is the name of the American Indian tribe or Alaska Native tribe or village that you were enrolled in? <>Enter enrolled tribe(s) or village(s) (Interviewer instruction). <> {display 200-character textbox}
Branching	If PERSONCOUNT = 1, goto OC If PERSONCOUNTER > 1, goto OC_HH
Help Text link	TRBENR_1
Special Instructions

TRBENR_2

Screen Name	TRBENR_2
Field Names	P_TRBSHR_YES_IND: NUM1 (0=not selected and 1=selected) P_TRBSHR_NO_IND: NUM1 (0=not selected and 1=selected) P_TRBSHR_DK_IND: NUM1 (0=not selected and 1=selected) P_TRBSHR_REF_IND: NUM1 (0=not selected and 1=selected) P_TRBSHR_CORP_NAME: CHAR 200 P_TRBSHR_CORP_DK_IND: NUM1 (0=not selected and 1=selected) P_TRBSHR_CORP_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-99) and TE_FLAG=2
Question Wording	On <REFDATE>, <FILL1> <NAME#> <FILL2> a shareholder of any Alaska Native regional or village corporation?
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will” <FILL2> = “be” If current date is on or after REFDATE, then <FILL1> = “was”
Response Options	No, not a shareholder Yes, a shareholder Don’t know Refused IF YES, display: What is the name of the Alaska Native regional or village corporation that you were a shareholder of? <>Enter Alaska Native regional or village corporation(s). (Interviewer instruction).<> {display 200-character textbox}
Branching	If PERSONCOUNT = 1, goto OC If PERSONCOUNTER > 1, goto OC_HH
Help Text link	TRBENR_2
Special Instructions

Overcount

OC

Screen Name	OC
Field Names	P_LOC_ELSE_NO_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_RELATIVES_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_COLLEGE_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_MILITARY_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_JOB_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_NURSINGHOME_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_JAIL_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_SEASONAL_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_OTHER_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_OTHER_TEXT: CHAR 250 P_LOC_ELSE_DK_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME# <ADDRESS>
Universe	PERSONCOUNT=(1)
Question Wording	Does <NAME> usually live or stay somewhere else, other than <ADDRESS>? For example: With a parent, grandparent, or other person While attending college For a military assignment To be closer to a job or business In a nursing home or group home In a jail or prison At a seasonal or second residence Select all that apply. If “Yes, for another reason” is selected, display: For what reason?
Question Wording Fills
Response Options	Checkboxes No Yes, with a parent, grandparent, or other person Yes, while attending college Yes, for a military assignments Yes, to be closer to a job Yes, in a nursing home or a group home Yes, in a jail or prison Yes, at a seasonal or second residence Yes, for another reason Don't know Refused If “Yes, for another reason” is selected: {display 250-character textbox}
Branching	Goto DASHBOARD
Help Text link	OC
Special Instructions	Display “For what reason?” and a 250 character text box write in field only if “Yes, for another reason” is selected.

OC_HH

Screen Name	OC_HH
Field Names	P_LIVEDELSE_OC_HH NUM1 (0=not selected and 1=selected)
Data Needed	NAME# <ADDRESS>
Universe	PERSONCOUNT=(2-99)
Question Wording	Some people live or stay in more than one place, and we would like to make sure everyone is only counted once. For example: With a parent, grandparent, or other person While attending college For a military assignment To be closer to a job or business In a nursing home or group home In a jail or prison At a seasonal or second residence Do any of the following people usually live or stay somewhere else, other than <ADDRESS>?
Question Wording Fills
Response Options	Check boxes <> Interview reads each name below. Select all that apply <> <NAME 1> <NAME 2> <NAME 3> None of the above Don't know Refused
Branching	If respondent leaves blank, or selects only “None of the above,” or selects only "Don't know/Refused," goto DASHBOARD If respondent selects one or more <Name #>, goto OC_P screen.
Help Text link	OC_HH
Special Instructions

OC_P

Screen Name	OC_P
Field Names	P_LOC_ELSE_NO_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_RELATIVES_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_COLLEGE_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_MILITARY_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_JOB_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_NURSINGHOME_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_JAIL_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_SEASONAL_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_OTHER_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_OTHER_TEXT: CHAR 250 P_LOC_ELSE_DK_IND: NUM1 (0=not selected and 1=selected) P_LOC_ELSE_REF_IND: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	If the number of persons selected on OC_HH screen = 1 and respondent selects “Next” from OC_HH screen. If the number of persons selected on the OC_HH screen >1 and respondent selects “Next” from previous OC_P screen.
Question Wording	Why does <NAME> usually live or stay somewhere else? Select all that apply. If “For another reason” is selected, display: For what reason?
Question Wording Fills
Response Options	Checkboxes To be with a parent, grandparent, or other person For college For a military assignments To be closer to a job In a nursing home or a group home In a jail or prison At a seasonal or second residence For another reason Don't know Refused If “For another reason” is selected: {display 250-character textbox}
Branching	If persons selected on OC_HH screen = 1, goto Dashboard – Complete. If persons selected on list > 1, go to OC_P.
Help Text link	OC_P
Special Instructions	The number of times this screen is displayed will depend on the number of persons selected on the OC_HH screen. One a respondent has proceeded through all of the coverage (OC) screens, they will be taken to DASHBOARD – Complete.

SUBMIT DASHBOARD

Screen Name	SUBMIT DASHBOARD
Field Names
Data Needed
Universe	Cases where respondents are sufficient
Question Wording
Question Wording Fills
Response Options	Submit Census Form (button)
Response Options Fills	N/A
Edits/Errors
Branching	goto SUBMIT
Help Text link
Special Instructions

SUBMIT

Screen Name	SUBMIT
Field Names
Data Needed
Universe	Cases where respondent clicks “Submit Census Form”.
Question Wording	Submitting your Survey Once your survey is submitted, you will not be able to access your information or change any of your responses. After you submit your survey and are shown the confirmation page, you may close the web browser. Would you like to submit your survey now?
Question Wording Fills
Response Options	Yes No (buttons)
Response Options Fills	N/A
Edits/Errors
Branching	Yes goto CONFIRMATION No goto DASHBOARD
Help Text link
Special Instructions	SUBMIT SURVEY will be a popup on the Dashboard. Once a respondent submits a survey, they will not be permitted to return to the survey.

CONFIRMATION

Screen Name	CONFIRMATION
Field Names
Data Needed	All submitted cases.
Universe	Cases where the user has submitted the survey from the Dashboard.
Question Wording	Thank you for completing the 2017 Census Test. Insert <time and date stamp>
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching
Help Text link
Special Instructions	Center all text.

COMPLETE

Screen Name	COMPLETE
Field Names
Data Needed	USER IDs and email addresses from completed cases.
Universe	Completed cases who log in again.
Question Wording	The 2017 Census Test has already been completed for this address.
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching
Help Text link
Special Instructions	Center all text.

NO_COMPLETE

Screen Name	NO_COMPLETE
Field Names
Data Needed
Universe	Cases where no valid address is provided. Cases where no name is provided on the RESPONDENT screen. Cases where POPCOUNT = 0 or blank no is provided on the POPCOUNT screen.
Question Wording	You do not need to complete this survey. Thank You.
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching
Help Text link
Special Instructions	Center all text.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Gianna S Dusch
File Modified	0000-00-00
File Created	2021-01-23

2017 Census Test - Self Response

2017 Census Test

2017 CT ISR CQA Specification 10242016