| THIS LISTING CONTAINS CONFIDENTIAL INFORMATION THE RELEASE OF WHICH IS PROHIBITED BY TITLE 13 U.S.C |
OMB NO. XXXX-XXXX-X: APPROVAL EXPIRES XX/XX/XXXX |
| FORM DH-116(GQE) |
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U.S.DEPTARTMENT OF COMMERCE |
SHEET _____ OF ___ SHEETS |
| (XX-XX-XXXX) |
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Economics and Statistics Administration |
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U.S CENSUS BUREAU |
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1. GQ NAME |
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| GROUP QUARTERS LISTING SHEET |
2. GQ ID |
| OPERATION: GROUP |
| QUARTERS ENUMERATION |
3. CFS NAME |
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| 2018 CENSUS TEST |
4. ACO NO./COUNTY/BCU NO. |
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5. ENUMERATOR NAME |
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| Room/Bed Number (a) |
Name |
Person |
Checked in Mark (x) If received |
Mark (x) one |
| Number |
(e) |
| (b) |
c |
(d) |
Incomplete |
Complete |
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| U S C E N S U S B U R E A U |
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