Download:
pdf |
pdfFORM
D-ARCP-AS (4-11-2019)
OMB No. 0607-1006: Approval Expires 11/30/2021
This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.
1. IDENTIFICATION
HOUSING UNIT ADDRESS REGISTER
2020 Census of American Samoa
County
BCU
Book
of
2. ASSIGNMENT INFORMATION
Name – Please Print
Employee ID
Number
Telephone Number
Date
Assigned
Completed
Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.
Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator
3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Housing Units
Listed
Date
Number
4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
Housing Units
Enumerated
Date
Number
Remarks
DC
5. OFFICE USE ONLY
Name of Reviewer
American Samoa
Date
Initials
The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.
CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Housing Units.
There are no duplicate addresses listed in the Address Listing Page for Housing Units.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Housing Units.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.
SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.
FORM D-ARCP-AS (4-11-2019)
FORM
D-ARCP-GU (4-11-2019)
OMB No. 0607-1006: Approval Expires 11/30/2021
This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.
1. IDENTIFICATION
HOUSING UNIT ADDRESS REGISTER
2020 Census of Guam
County
BCU
Book
of
2. ASSIGNMENT INFORMATION
Name – Please Print
Employee ID
Number
Telephone Number
Date
Assigned
Completed
Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.
Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator
3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Housing Units
Listed
Date
Number
4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
Housing Units
Enumerated
Date
Number
Remarks
DC
5. OFFICE USE ONLY
Name of Reviewer
Guam
Date
Initials
The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.
CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Housing Units.
There are no duplicate addresses listed in the Address Listing Page for Housing Units.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Housing Units.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.
SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.
FORM D-ARCP-GU (4-11-2019)
FORM
D-ARCP-MI (4-11-2019)
OMB No. 0607-1006: Approval Expires 11/30/2021
This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.
1. IDENTIFICATION
HOUSING UNIT ADDRESS REGISTER
2020 Census of the Commonwealth of the Northern Mariana Islands
County
BCU
Book
of
2. ASSIGNMENT INFORMATION
Name – Please Print
Employee ID
Number
Telephone Number
Date
Assigned
Completed
Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.
Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator
3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Housing Units
Listed
Date
Number
4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
Housing Units
Enumerated
Date
Number
Remarks
DC
5. OFFICE USE ONLY
Name of Reviewer
Commonwealth of the
Northern Mariana Islands
Date
Initials
The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.
CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Housing Units.
There are no duplicate addresses listed in the Address Listing Page for Housing Units.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Housing Units.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.
SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.
FORM D-ARCP-MI (4-11-2019)
FORM
D-ARCP-VI (4-11-2019)
OMB No. 0607-1006: Approval Expires 11/30/2021
This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.
1. IDENTIFICATION
HOUSING UNIT ADDRESS REGISTER
2020 Census of the U.S. Virgin Islands
County
BCU
Book
of
2. ASSIGNMENT INFORMATION
Name – Please Print
Employee ID
Number
Telephone Number
Date
Assigned
Completed
Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.
Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator
3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Housing Units
Listed
Date
Number
4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
Housing Units
Enumerated
Date
Number
Remarks
DC
5. OFFICE USE ONLY
Name of Reviewer
U.S. Virgin Islands
Date
Initials
The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.
CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Housing Units.
There are no duplicate addresses listed in the Address Listing Page for Housing Units.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Housing Units.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.
SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.
FORM D-ARCP-VI (4-11-2019)
FORM
OMB No. 0607-1006: Approval Expires 11/30/2021
D-ARLP-AS (4-11-2019)
DC
ADDRESS LISTING PAGE FOR HOUSING UNITS
2020 Census of American Samoa
County
American Samoa
BCU
Line
No.
Questionnaire ID
Date
Listed
Map Spot No.
(4)
Within Map Spot ID
(1)
(1)
(2)
(3)
(2)
(3)
(5)
(4)
Address No.
(7)
Complete Street Name OR
(9)
Apt/Unit No.
(11)
Village OR
(13)
Address Type Code
Physical Location Description
ZIP Code
Estate – U.S. Virgin Islands Only
(8)
(10)
(12)
(14)
Development/Building Name OR
Subdivision/Place Name
(6)
(6)
(7)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
Remarks
(15)
(15)
➤
APPLY LABEL HERE
(5)
➤
(16) Case Status Code – Enumeration
(17) Contact Attempts –
Enumeration (Tally)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(20)
(21) Pop. Count
Self
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(25) Contact Attempts
FFU – Tally
(27) JIC2
Proxy
(1)
(2)
(3)
➤
APPLY LABEL HERE
➤
(2)
(3)
➤
APPLY LABEL HERE
➤
(16) Case Status Code – Enumeration
(6)
(5)
(17) Contact Attempts –
Enumeration (Tally)
(16) Case Status Code – Enumeration
(1)
(4)
(4)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(6)
(18) Mailable?
(Y/N/DK)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
Proxy
(5)
(17) Contact Attempts –
Enumeration (Tally)
(7)
(20)
(19) Date Enumerated
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
(15)
(25) Contact Attempts
FFU – Tally
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(15)
(25) Contact Attempts
FFU – Tally
Proxy
Address Type Codes
S – Single Unit
GQ – Group Quarters
Case Status Codes
A – Appointment
NV – Left Notice of Visit
M – Multi-Unit
TL – Transitory Locations
T – Trailer/Mobile NLQ – Non-Living Quarters
Home
GC – Gated Community
O – Other
NC – No Contact
RA – Restricted Access
IC – Interview Conducted RE – Refusal
LB – Language Barrier
UN – Unsafe
OT – Other
Apt – Apartment
Abbreviations
Pop. – Population
BCU – Basic Collection Unit
FFU – Field Followup
No. – Number
QC – Quality Control
Y/N/DK – Yes, No,
Don’t Know
(26) JIC1
(27) JIC2
(7)
(20)
(26) JIC1
(26) JIC1
(27) JIC2
Final Interview Outcome Codes
CI – Completed Interview MOV – Moved in After April 1 UHE – Usual Home
Elsewhere
CO – Pop Count Only
NC – No Contact
UN
–
Unsafe
LB – Language Barrier
RA – Restricted Access
PI – Partial Interview
REF – Refusal
VAC – Vacant
Page Totals
Occupied
HUs
Vacant
HUs
GQs
TLs
FORM
OMB No. 0607-1006: Approval Expires 11/30/2021
D-ARLP-GU (4-11-2019)
DC
ADDRESS LISTING PAGE FOR HOUSING UNITS
2020 Census of Guam
County
Guam
BCU
Line
No.
Questionnaire ID
Date
Listed
Map Spot No.
(4)
Within Map Spot ID
(1)
(1)
(2)
(3)
(2)
(3)
(5)
(4)
Address No.
(7)
Complete Street Name OR
(9)
Apt/Unit No.
(11)
Village OR
(13)
Address Type Code
Physical Location Description
ZIP Code
Estate – U.S. Virgin Islands Only
(8)
(10)
(12)
(14)
Development/Building Name OR
Subdivision/Place Name
(6)
(6)
(7)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
Remarks
(15)
(15)
➤
APPLY LABEL HERE
(5)
➤
(16) Case Status Code – Enumeration
(17) Contact Attempts –
Enumeration (Tally)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(20)
(21) Pop. Count
Self
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(25) Contact Attempts
FFU – Tally
(27) JIC2
Proxy
(1)
(2)
(3)
➤
APPLY LABEL HERE
➤
(2)
(3)
➤
APPLY LABEL HERE
➤
(16) Case Status Code – Enumeration
(6)
(5)
(17) Contact Attempts –
Enumeration (Tally)
(16) Case Status Code – Enumeration
(1)
(4)
(4)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(6)
(18) Mailable?
(Y/N/DK)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
Proxy
(5)
(17) Contact Attempts –
Enumeration (Tally)
(7)
(20)
(19) Date Enumerated
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
(15)
(25) Contact Attempts
FFU – Tally
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(15)
(25) Contact Attempts
FFU – Tally
Proxy
Address Type Codes
S – Single Unit
GQ – Group Quarters
Case Status Codes
A – Appointment
NV – Left Notice of Visit
M – Multi-Unit
TL – Transitory Locations
T – Trailer/Mobile NLQ – Non-Living Quarters
Home
GC – Gated Community
O – Other
NC – No Contact
RA – Restricted Access
IC – Interview Conducted RE – Refusal
LB – Language Barrier
UN – Unsafe
OT – Other
Apt – Apartment
Abbreviations
Pop. – Population
BCU – Basic Collection Unit
FFU – Field Followup
No. – Number
QC – Quality Control
Y/N/DK – Yes, No,
Don’t Know
(26) JIC1
(27) JIC2
(7)
(20)
(26) JIC1
(26) JIC1
(27) JIC2
Final Interview Outcome Codes
CI – Completed Interview MOV – Moved in After April 1 UHE – Usual Home
Elsewhere
CO – Pop Count Only
NC – No Contact
UN
–
Unsafe
LB – Language Barrier
RA – Restricted Access
PI – Partial Interview
REF – Refusal
VAC – Vacant
Page Totals
Occupied
HUs
Vacant
HUs
GQs
TLs
FORM
OMB No. 0607-1006: Approval Expires 11/30/2021
D-ARLP-MI (4-11-2019)
DC
Line
No.
ADDRESS LISTING PAGE FOR HOUSING UNITS
2020 Census of the Commonwealth of the Northern Mariana Islands
Commonwealth of the
Northern Mariana Islands
BCU
Questionnaire ID
Date
Listed
Map Spot No.
(4)
(1)
(2)
(3)
(2)
(3)
(5)
(4)
Address No.
(7)
Complete Street Name OR
(9)
Apt/Unit No.
(11)
Village OR
(13)
Address Type Code
Physical Location Description
ZIP Code
Estate – U.S. Virgin Islands Only
(8)
(10)
(12)
(14)
Development/Building Name OR
Subdivision/Place Name
Within Map Spot ID
(1)
County
(6)
(6)
(7)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
Remarks
(15)
(15)
➤
APPLY LABEL HERE
(5)
➤
(16) Case Status Code – Enumeration
(17) Contact Attempts –
Enumeration (Tally)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(20)
(21) Pop. Count
Self
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(25) Contact Attempts
FFU – Tally
(27) JIC2
Proxy
(1)
(2)
(3)
➤
APPLY LABEL HERE
➤
(2)
(3)
➤
APPLY LABEL HERE
➤
(16) Case Status Code – Enumeration
(6)
(5)
(17) Contact Attempts –
Enumeration (Tally)
(16) Case Status Code – Enumeration
(1)
(4)
(4)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(6)
(18) Mailable?
(Y/N/DK)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
Proxy
(5)
(17) Contact Attempts –
Enumeration (Tally)
(7)
(20)
(19) Date Enumerated
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
(15)
(25) Contact Attempts
FFU – Tally
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(15)
(25) Contact Attempts
FFU – Tally
Proxy
Case Status Codes
A – Appointment
NV – Left Notice of Visit
Address Type Codes
S – Single Unit
GQ – Group Quarters
M – Multi-Unit
TL – Transitory Locations
T – Trailer/Mobile NLQ – Non-Living Quarters
Home
GC – Gated Community
O – Other
NC – No Contact
RA – Restricted Access
IC – Interview Conducted RE – Refusal
LB – Language Barrier
UN – Unsafe
OT – Other
Apt – Apartment
Abbreviations
Pop. – Population
BCU – Basic Collection Unit
FFU – Field Followup
No. – Number
QC – Quality Control
Y/N/DK – Yes, No,
Don’t Know
(26) JIC1
(27) JIC2
(7)
(20)
(26) JIC1
(26) JIC1
(27) JIC2
Final Interview Outcome Codes
CI – Completed Interview MOV – Moved in After April 1 UHE – Usual Home
Elsewhere
CO – Pop Count Only
NC – No Contact
UN
–
Unsafe
LB – Language Barrier
RA – Restricted Access
PI – Partial Interview
REF – Refusal
VAC – Vacant
Page Totals
Occupied
HUs
Vacant
HUs
GQs
TLs
FORM
OMB No. 0607-1006: Approval Expires 11/30/2021
D-ARLP-VI (4-11-2019)
DC
ADDRESS LISTING PAGE FOR HOUSING UNITS
2020 Census of the U.S. Virgin Islands
County
U.S. Virgin Islands
BCU
Line
No.
Questionnaire ID
Date
Listed
Map Spot No.
(4)
Within Map Spot ID
(1)
(1)
(2)
(3)
(2)
(3)
(5)
(4)
Address No.
(7)
Complete Street Name OR
(9)
Apt/Unit No.
(11)
Village OR
(13)
Address Type Code
Physical Location Description
ZIP Code
Estate – U.S. Virgin Islands Only
(8)
(10)
(12)
(14)
Development/Building Name OR
Subdivision/Place Name
(6)
(6)
(7)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
Remarks
(15)
(15)
➤
APPLY LABEL HERE
(5)
➤
(16) Case Status Code – Enumeration
(17) Contact Attempts –
Enumeration (Tally)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(20)
(21) Pop. Count
Self
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(25) Contact Attempts
FFU – Tally
(27) JIC2
Proxy
(1)
(2)
(3)
➤
APPLY LABEL HERE
➤
(2)
(3)
➤
APPLY LABEL HERE
➤
(16) Case Status Code – Enumeration
(6)
(5)
(17) Contact Attempts –
Enumeration (Tally)
(16) Case Status Code – Enumeration
(1)
(4)
(4)
(18) Mailable?
(Y/N/DK)
(19) Date Enumerated
(6)
(18) Mailable?
(Y/N/DK)
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
Proxy
(5)
(17) Contact Attempts –
Enumeration (Tally)
(7)
(20)
(19) Date Enumerated
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(9)
(11)
(13)
(8)
(10)
(12)
(14)
(21) Pop. Count
Self
(15)
(25) Contact Attempts
FFU – Tally
(22) Final Interview
Outcome Code
(23) QC Action (24) Case Status
Code – FFU
(15)
(25) Contact Attempts
FFU – Tally
Proxy
Address Type Codes
S – Single Unit
GQ – Group Quarters
Case Status Codes
A – Appointment
NV – Left Notice of Visit
M – Multi-Unit
TL – Transitory Locations
T – Trailer/Mobile NLQ – Non-Living Quarters
Home
GC – Gated Community
O – Other
NC – No Contact
RA – Restricted Access
IC – Interview Conducted RE – Refusal
LB – Language Barrier
UN – Unsafe
OT – Other
Apt – Apartment
Abbreviations
Pop. – Population
BCU – Basic Collection Unit
FFU – Field Followup
No. – Number
QC – Quality Control
Y/N/DK – Yes, No,
Don’t Know
(26) JIC1
(27) JIC2
(7)
(20)
(26) JIC1
(26) JIC1
(27) JIC2
Final Interview Outcome Codes
CI – Completed Interview MOV – Moved in After April 1 UHE – Usual Home
Elsewhere
CO – Pop Count Only
NC – No Contact
UN
–
Unsafe
LB – Language Barrier
RA – Restricted Access
PI – Partial Interview
REF – Refusal
VAC – Vacant
Page Totals
Occupied
HUs
Vacant
HUs
GQs
TLs
File Type | application/pdf |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |