2019 Census Test NSC

2019 Census Test_NSC 021319.pdf

American Community Survey Methods Panel Tests

2019 Census Test NSC

OMB: 0607-0936

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0607-0936 can be found here:

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OMB Nonsubstantive Change Request
Department: Commerce
Agency: U.S. Census Bureau
Title: American Community Survey Methods Panel Tests, 2019 Census Test
OMB Control Number: 0607-0936
Expiration Date: 08/31/2021
Request: The U.S. Census Bureau plans to conduct additional research under the American
Community Survey (ACS) Methods Panel Tests clearance to test the potential impact of the
inclusion of the citizenship question on the 2020 Census to better plan for the Nonresponse
Followup (NRFU) operation. The Census Bureau proposes to conduct a national self-response
test with a separate sample from the ACS production panel mid-June to mid-August 2019. No
additional burden is expected.
Background: The Census Bureau has limited empirical evidence about the potential impact of
including the citizenship question on self-response rates for the 2020 Census. The results of this
test will inform the Integrated Partnership and Communications Campaign and the planning for
the Nonresponse Followup (NRFU) operation, the operation designed to collect a response inperson from addresses that do not self-respond.
Time line: The test will have a Census Day of July 1, 2019. The first mailing will go out midJune 2019. The data collection period will be nine weeks. Data collection will end mid-August.
The test will utilize the 2020 Census mail strategy, including Internet First and Internet Choice
strategies, and the use of English-only and English/Spanish bilingual materials.
Method: For the 2019 Census Test, the Census Bureau will compare two treatments using a
randomized controlled experiment. The control treatment questionnaire will ask the planned
2020 Census questions (i.e., number of people, tenure, sex, age, date of birth, Hispanic origin,
race, citizenship, relationship to householder, and coverage questions). The experimental
treatment questionnaire will ask these same questions minus the citizenship question.
Analysis Metrics: The Census Bureau will assess the effect of the inclusion of the citizenship
question in the 2020 Census by comparing the control and experimental treatments through
various measures, including self-response rates, form completeness rates, item nonresponse rates,
and comparison of response distributions. These measures will be compared overall and on
subgroup levels, where possible.
Sample: The test will employ a sample size of 480,000 addresses that will be divided evenly
between the control and the experimental treatments. This sample size is designed to detect a
difference of 0.5 percentage points between the self-response rates of the control and
experimental treatments at the national level. The sample, which will be separate from the ACS
production sample, will oversample areas with high proportions of noncitizens and low selfresponse. The sample construction will also allow for limited analysis for race and Hispanic
origin subpopulations.
Use of Incentives: None.

Burden: There is no change in burden to the public associated with this test. The test is being
conducted using a separate sample from the ACS production sample. The burden to the public
will fall within the burden hours estimated in the request submitted by the Census Bureau to the
Office of Management and Budget for authorization to conduct the ACS Methods Panel tests.
Attachments:
Attachment A: 2019 Census Test Mail Materials List
Attachment B: 2019 Census Test Mail Materials
Attachment C: ACS Methods Panel Hour Tracker
Attachment D: 30 Day Federal Register Notice
Attachment E: 2019 Census Test ACS Research and Evaluation Analysis Plan
Contact Information:
Please contact the following individuals for further information about this test:
Data Collection:
Donna Daily
American Community Survey Office
U.S. Census Bureau
Washington, D.C. 20233
(301) 763-5258
Donna.M.Daily@census.gov

Statistical Aspects:
Elizabeth Poehler
Decennial Statistical Studies Division
U.S. Census Bureau
Washington, D.C. 20233
(301) 763-9305
Elizabeth.A.Poehler@census.gov

Attachment A: 2019 Census Test Mail Materials List1
INTERNET FIRST
(English only)
CONTROL

Outgoing
Package
Envelope
DM-EO-F1(E/S)

TEST 2

DM-EO-F1(E/S)

INTERNET FIRST
(English/Spanish)

1st Mailing
Invitation
Letter
DM-LF1

Language
Assistance
Sheet
DM-LI

2nd Mailing
Outgoing
Letter
Reminder
Envelope
Letter
DM-EO2(E/S)
DM-LF2

DM-LF1

DM-LI

DM-EO2(E/S)

4th Mailing

Reminder
Postcard
DM-PF3

Outgoing
Package
Envelope
DM-EO4(E/S)

Reminder
Letter
DM-L4

DM-PF3

DM-EO4(E/S)

DM-L4

5th mailing
Final
Reminder
Postcard
DM-P5

DM-QB

DM-LI

DM-ER-IN(E/S)

DM-P5

CONTROL

Invitation
Letter
DM-LF1(E/S)

FAQ
Insert 3
DM-FL(E/S)

Language
Assistance
Sheet
DM-LI

Outgoing
Letter
Envelope
DM-EO2(E/S)

Reminder
Letter
DM-LF2(E/S)

Reminder
Postcard
DM-PF3(E/S)

Outgoing
Package
Envelope
DM-EO4(E/S)

Reminder
Letter
DM-L4(E/S)

TEST

DM-EO-F1(E/S)

DM-LF1(E/S)

DM-FL(E/S)

DM-LI

DM-EO2(E/S)

DM-LF2(E/S)

DM-PF3(E/S)

DM-EO4(E/S)

DM-L4(E/S)

DM-QB(E/S)

CONTROL

Outgoing
Package
Envelope
DM-EO-C1(E/S)

Invitation
Letter
DM-LC1

TEST

DM-EO-C1(E/S)

DM-LC1

INTERNET CHOICE
(English/Spanish)

3rd Mailing

Business
Reply Return
Envelope
DM-ER-IN(E/S)

Outgoing
Package
Envelope
DM-EO-F1(E/S)

1st Mailing

2nd Mailing

Questionnaire
DM-QA

Language
Assistance
Sheet
DM-LI

4th Mailing
Language
Assistance
Questionnaire
Sheet
DM-QA(E/S)
DM-LI

INTERNET CHOICE
(English only)

1st Mailing

DM-LF2

3rd Mailing

Questionnaire
DM-QA

Language
Assistance
Sheet
DM-LI

Business
Reply Return
Envelope
DM-ER-IN(E/S)

2nd Mailing
Outgoing
Letter
Reminder
Envelope
Letter
DM-EO2(E/S)
DM-LC2

DM-QB

DM-LI

DM-ER-IN(E/S)

DM-EO2(E/S)

1st Mailing

CONTROL

Outgoing
Package
Envelope
DM-EO-C1(E/S)

Invitation
Letter
DM-LC1(E/S)

Questionnaire
DM-QA(E/S)

TEST

DM-EO-C1(E/S)

DM-LC1(E/S)

DM-QB(E/S)

DM-LC2

FAQ
Insert
DM-FA(E/S)

Language
Assistance
Sheet
DM-LI

Business
Reply Return
Envelope
DM-ER-IN(E/S)

2nd Mailing
Outgoing
Letter
Reminder
Envelope
Letter
DM-EO2(E/S)
DM-LC2(E/S)

DM-FA(E/S)

DM-LI

DM-ER-IN(E/S)

DM-EO2(E/S)

DM-LC2(E/S)

3rd Mailing

Business
Reply Return
Envelope
DM-ER-IN(E/S)

DM-FA(E/S)

DM-ER-IN(E/S)

DM-P5(E/S)

4th Mailing

Reminder
Postcard
DM-PC3

Outgoing
Package
Envelope
DM-EO4(E/S)

Reminder
Letter
DM-L4

DM-PC3

DM-EO4(E/S)

DM-L4

3rd Mailing

DM-LI

FAQ
Insert
DM-FA(E/S)

5th mailing
Final
Reminder
Postcard
DM-P5(E/S)

Reminder
Postcard
DM-PC3(E/S)

Outgoing
Package
Envelope
DM-EO4(E/S)

Reminder
Letter
DM-L4(E/S)

DM-PC3(E/S)

DM-EO4(E/S)

DM-L4(E/S)

Questionnaire
DM-QA

Language
Assistance
Sheet
DM-LI

Business
Reply Return
Postcard
DM-ER-IN(E/S)

5th mailing
Final
Reminder
Postcard
DM-P5

DM-QB

DM-LI

DM-ER-IN(E/S)

DM-P5

4th Mailing
Language
Assistance
Questionnaire Sheet
DM-QA(E/S)
DM-LI
DM-QB(E/S)

DM-LI

FAQ
Insert
DM-FA(E/S)

Business
Reply Return
Envelope
DM-ER-IN(E/S)

5th mailing
Final
Reminder
Postcard
DM-P5(E/S)

DM-FA(E/S)

DM-ER-IN(E/S)

DM-P5(E/S)

All sampled addresses will receive the first two mailings. After the second mailing, the nonresponding addresses will receive the third mailing. After the third mailing, the nonresponding addresses will receive the fourth mailing. After the
fourth mailing, the remaining nonresponding addresses will receive the fifth mailing.
2
The TEST data collection instruments (internet and paper questionnaire) will not contain the citizenship question.
3
FAQ Insert: Same frequently asked questions that appear on the reverse side of the English-only letter.
1

Attachment B
2019 Census Test Mail Materials
Document
DM-QA (control)

Description
Questionnaire

DM-QB (test)

Questionnaire

DM-QA(E/S) (control)

Questionnaire

DM-QB(E/S) (test)

Questionnaire

DM-LF1

Invitation Letter

DM-LF1(E/S)

Invitation Letter

DM-LC1

Invitation Letter

DM-LC1(E/S)

Invitation Letter

DM-LF2

Reminder Letter

DM-LF2(E/S)

Reminder Letter

DM-LC2

Reminder Letter

DM-LC2(E/S)

Reminder Letter

DM-PF3

Reminder Postcard

DM-PF3(E/S)

Reminder Postcard

DM-PC3

Reminder Postcard

DM-PC3(E/S)

Reminder Postcard

DM-L4

Reminder Letter

DM-L4(E/S)

Reminder Letter

DM-P5

Reminder Postcard

DM-P5(E/S)

Reminder Postcard

DM-LI

Language Assistance Sheet

DM-FL(E/S)

FAQ Insert

DM-FA(E/S)

FAQ Insert

DM-ER-IN(E/S)

Business Reply Return Envelope

DM-EO-F1(E/S)

Outgoing Package Envelope

DM-EO-C1(E/S)

Outgoing Package Envelope

DM-EO2(E/S)

Outgoing Window Envelope

DM-EO4(E/S)

Outgoing Package Envelope

Filename
Item 01 - DM-QA_121218
Item 02 - DM-QB_121218
Item 03 - DM-QA(ES)_121218
Item 04 - DM-QB(ES)_121218
Invitation Letter_First_English_DM_LF1_20181212
Invitation Letter_First_English and Spanish_DM_LF1_ES_20181212
Item 05 - dm_lc1_20181217
Item 06 - dm_lc1_es_20181212
Reminder Letter_First_English_DM-LF2_20181218
Reminder Letter_First_English and Spanish_DM-LF2(ES)_20181218
Reminder Letter_Choice_English_DM-LC2_20181218
Reminder Letter_Choice_English and Spanish_DM-LC2(ES)_20181218
Reminder Postcard_First_English_DM-PF3_20181212
Reminder Postcard_First_English and Spanish_DM_PF3_ES_20181212
Reminder Postcard_Choice_English_DM-PC3_20181212
Reminder Postcard_Choice_English and Spanish_DM-PC3(ES)_20181214
Item 07 - dm_l4_20181217
Item 08 - dm_l4_es_20181217
Final Reminder Postcard_English_DM-P5_20181212
Final Reminder Postcard_English and Spanish_DM_P5_ES_20181213
Item 09 - dm_li_12072018
Item 10 - dm_fl_es_20181217
Item 11 - dm_fa_es_20181217
Item 12 - dm_er_in_es_010719
Item 13 - dm_eo_f1_es_20181218
Item 14 - dm_eo_c1_es_20181218
Item 15 - dm_eo2_es_20181217
Item 16 - dm_eo4_es_121818

§.g{4¤

OMB No. 0607-0936: Approval Expires 08/31/2021
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

2019 Census Test

FOR
OFFICIAL
USE ONLY

Start here

OR go online at respond.census.gov/2019CensusTest to complete your 2019 Census Test questionnaire.

Use a blue or black pen.

Before you answer Question 1, count the people living in
this house, apartment, or mobile home using our
guidelines.

Were there any additional people staying here on
July 1, 2019 that you did not include in Question 1?
Mark I
K all that apply.
J
Children, related or unrelated, such as newborn babies,
grandchildren, or foster children

• Count all people, including babies, who live and sleep
here most of the time.
• If no one lives and sleeps at this address most of the time,
go online at respond.census.gov/2019CensusTest or call
the number on page 8.
The census must also include people without a permanent
place to live, so:
• If someone who does not have a permanent place to live
is staying here on July 1, 2019, count that person.
The Census Bureau also conducts counts in institutions
and other places, so:
• Do not count anyone living away from here, either at
college or in the Armed Forces.
• Do not count anyone in a nursing home, jail, prison,
detention facility, etc., on July 1, 2019.
• Leave these people off your questionnaire, even if they
will return to live here after they leave college, the nursing
home, the military, jail, etc. Otherwise, they may be
counted twice.

How many people were living or staying in this house,
apartment, or mobile home on July 1, 2019?

Relatives, such as adult children, cousins, or in-laws
Nonrelatives, such as roommates or live-in babysitters
People staying here temporarily
No additional people

Is this house, apartment, or mobile home —
Mark K
J ONE box.
I
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?

What is your telephone number?
We will only contact you if needed for official Census Bureau
business.
Telephone Number
–

Number of people =
FORM

DM-QA (12-12-2018)

13709019

–

§.g{<¤
Person 1

Please provide information for each person living here.
If there is someone living here who pays the rent or
owns this residence, start by listing him or her as
Person 1. If the owner or the person who pays the rent
does not live here, start by listing any adult living here
as Person 1.

What is Person 1’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

What is Person 1’s name? Print name below.
First Name

MI
Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Last Name(s)

What is Person 1’s sex? Mark K
J ONE box.
I
Male

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Female

What is Person 1’s age and what is Person 1’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Year of birth

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

years

Some other race – Print race or origin. C

➜ NOTE: Please answer BOTH Question 8 about Hispanic
origin and Question 9 about race. For this census,
Hispanic origins are not races.

Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin

10.

Is Person 1 a citizen of the United States?

Yes, Mexican, Mexican Am., Chicano

Yes, born in the United States

Yes, Puerto Rican

Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

Yes, Cuban

Yes, born abroad of U.S. citizen parent or parents

Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

Yes, U.S. citizen by naturalization – Print year
of naturalization. C

No, not a U.S. citizen

➜ If more people were counted in Question 1 on
the front page, continue with Person 2 on the
next page.

13709027

§.g{D¤
1.

Person 2

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

➜ If more people were counted in Question 1 on
the front page, continue with Person 3 on the
next page.

13709035

§.g{L¤
1.

Person 3

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 4 on the
next page.

13709043

§.g{S¤
1.

Person 4

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 5 on the
next page.

13709050

§.g{e¤
1.

Person 5

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 6 on the
next page.

13709068

§.g{m¤
1.

Person 6

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 7 on the
next page.

13709076

§.g{u¤
Use this section to complete information for the rest of the people you counted in Question 1 on the front page.
We may call for additional information about them.

Person 7
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?
Yes

years

Person 8
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 9
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 10
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

FOR OFFICIAL USE ONLY

Thank you for completing your questionnaire.
If your enclosed postage-paid envelope is missing,
please mail your completed questionnaire to:

JIC1

JIC2

U.S. Census Bureau
National Processing Center
P.O. Box 5220
Jeffersonville, IN 47199-5220

If you need help completing this questionnaire, call toll-free 1-866-208-8248, Monday through Friday from 9:00 a.m. to midnight ET,
Saturday from 9:00 a.m. to 10:00 p.m. ET, and Sunday from 11:00 a.m. to midnight ET.
TDD — Telephone display device for the hearing impaired. Call toll-free 1-800-582-8330, Monday through Friday from 9:00 a.m. to midnight ET,
Saturday from 9:00 a.m. to 10:00 p.m. ET, and Sunday from 11:00 a.m. to midnight ET.
The U.S. Census Bureau estimates that completing the questionnaire will take 10 minutes on average. Send comments regarding this burden estimate or any
other aspect of this burden to: Paperwork Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277, 4600 Silver Hill Road, Washington, DC 20233.
You may email comments to . Use “Paperwork Reduction Project 0607-0936” as the subject.
This collection of information has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number 0607-0936 confirms
this approval. If this number were not displayed, we could not conduct this survey.

13709084

§.i{2¤

OMB No. 0607-0936: Approval Expires 08/31/2021
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

2019 Census Test

FOR
OFFICIAL
USE ONLY

Start here

OR go online at respond.census.gov/2019CensusTest to complete your 2019 Census Test questionnaire.

Use a blue or black pen.

Before you answer Question 1, count the people living in
this house, apartment, or mobile home using our
guidelines.

How many people were living or staying in this house,
apartment, or mobile home on July 1, 2019?

Relatives, such as adult children, cousins, or in-laws
Nonrelatives, such as roommates or live-in babysitters
People staying here temporarily
No additional people

What is your telephone number?
We will only contact you if needed for official Census Bureau
business.
Telephone Number
–

Number of people =
FORM

DM-QB (12-11-2018)

13729017

–

§.i{:¤
Person 1

What is Person 1’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

What is Person 1’s name? Print name below.
First Name

MI
Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Last Name(s)

What is Person 1’s sex? Mark K
J ONE box.
I
Male

Female

What is Person 1’s age and what is Person 1’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Year of birth

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

years

Some other race – Print race or origin. C

➜ NOTE: Please answer BOTH Question 8 about Hispanic
origin and Question 9 about race. For this census,
Hispanic origins are not races.

Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

➜ If more people were counted in Question 1 on
the front page, continue with Person 2 on the
next page.

13729025

§.i{B¤
1.

Person 2

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 3 on the
next page.

13729033

§.i{J¤
1.

Person 3

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 4 on the
next page.

13729041

§.i{[¤
1.

Person 4

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 5 on the
next page.

13729058

§.i{c¤
1.

Person 5

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 6 on the
next page.

13729066

§.i{k¤
1.

Person 6

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 7 on the
next page.

13729074

§.i{s¤
Use this section to complete information for the rest of the people you counted in Question 1 on the front page.
We may call for additional information about them.

Person 7
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Month

Day

Year of birth

Related to Person 1?

years

Female

Yes

Person 8
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 9
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 10
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

FOR OFFICIAL USE ONLY

Thank you for completing your questionnaire.
If your enclosed postage-paid envelope is missing,
please mail your completed questionnaire to:

JIC1

JIC2

U.S. Census Bureau
National Processing Center
P.O. Box 5220
Jeffersonville, IN 47199-5220

13729082

§.h{3¤

OMB No. 0607-0936: Approval Expires 08/31/2021
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

2019 Census Test

Para completar el cuestionario en español, dele la vuelta y complete el lado verde.
FOR
OFFICIAL
USE ONLY

Start here

OR go online at respond.census.gov/2019CensusTest to complete your 2019 Census Test questionnaire.

Use a blue or black pen.

Before you answer Question 1, count the people living in
this house, apartment, or mobile home using our
guidelines.

How many people were living or staying in this house,
apartment, or mobile home on July 1, 2019?

Relatives, such as adult children, cousins, or in-laws
Nonrelatives, such as roommates or live-in babysitters
People staying here temporarily
No additional people

What is your telephone number?
We will only contact you if needed for official Census Bureau
business.
Telephone Number
–

Number of people =
FORM

DM-QA(E/S) (12-12-2018)

13719018

–

§.h{;¤
Person 1

What is Person 1’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

What is Person 1’s name? Print name below.
First Name

MI
Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Last Name(s)

What is Person 1’s sex? Mark K
J ONE box.
I
Male

Female

What is Person 1’s age and what is Person 1’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Year of birth

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

years

Some other race – Print race or origin. C

➜ NOTE: Please answer BOTH Question 8 about Hispanic
origin and Question 9 about race. For this census,
Hispanic origins are not races.

Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin

10.

Is Person 1 a citizen of the United States?

Yes, Mexican, Mexican Am., Chicano

Yes, born in the United States

Yes, Puerto Rican

Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

Yes, Cuban

Yes, born abroad of U.S. citizen parent or parents

Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

Yes, U.S. citizen by naturalization – Print year
of naturalization. C

No, not a U.S. citizen

➜ If more people were counted in Question 1 on
the front page, continue with Person 2 on the
next page.

13719026

§.h{C¤
1.

Person 2

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 3 on the
next page.

13719034

§.h{K¤
1.

Person 3

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No
Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

Chinese

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Korean

Samoan

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Filipino

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Native Hawaiian

Asian Indian

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Vietnamese

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 4 on the
next page.

13719042

§.h{\¤
1.

Person 4

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 5 on the
next page.

13719059

§.h{d¤
1.

Person 5

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 6 on the
next page.

13719067

§.h{l¤
1.

Person 6

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Is this person a citizen of the United States?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or
Northern Marianas

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Print numbers in boxes.
Month
Day

Vietnamese

Some other race – Print race or origin. C

Female

Age on July 1, 2019

Chinese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization – Print year
of naturalization. C

Year of birth
No, not a U.S. citizen

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 7 on the
next page.

13719075

§.h{t¤
Use this section to complete information for the rest of the people you counted in Question 1 on the front page.
We may call for additional information about them.

Person 7
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Month

Day

Year of birth

Related to Person 1?

years

Female

Yes

Person 8
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 9
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 10
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

FOR OFFICIAL USE ONLY

Thank you for completing your questionnaire.
If your enclosed postage-paid envelope is missing,
please mail your completed questionnaire to:

JIC1

JIC2

U.S. Census Bureau
National Processing Center
P.O. Box 5220
Jeffersonville, IN 47199-5220

13719083

§.h{|¤
Use esta sección para completar la información sobre el resto de las personas que usted contó en la Pregunta 1
de la primera página. Puede que lo llamemos para obtener información adicional sobre ellas.

Persona 7
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Femenino

Sí

Persona 8
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Femenino

Sí

Persona 9
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Femenino

Sí

Persona 10
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Femenino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Sí

PARA USO OFICIAL SOLAMENTE

Gracias por completar su cuestionario.
Si no tiene el sobre con sello que se incluye para la
devolución del cuestionario, por favor, envíe por
correo su cuestionario completado a:

JIC1

JIC2

U.S. Census Bureau
National Processing Center
P.O. Box 5220
Jeffersonville, IN 47199-5220

Si necesita ayuda para completar este cuestionario, llame gratis al 1-888-369-3597, lunes a viernes de 9:00 a. m. a la medianoche ET, sábados
de 9:00 a. m. a 10:00 p. m. ET y domingos de 11:00 a. m. a la medianoche ET.

La Oficina del Censo de los EE. UU. calcula que completar el cuestionario tomará 10 minutos como promedio. Los comentarios sobre el cálculo del tiempo o cualquier otro
aspecto relacionado deben dirigirse a: Paperwork Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277, 4600 Silver Hill Road, Washington, DC 20233. Puede
enviar comentarios por correo electrónico a . Use “Paperwork Reduction Project 0607-0936” como tema.
Esta recopilación de información ha sido aprobada por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). El número de aprobación de ocho
dígitos de la OMB 0607-0936 confirma la aprobación. De no mostrarse este número, no podríamos realizar esta encuesta.

13719091

§.h|*¤
1.

Escriba el nombre de la

Persona 6

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

Nativa de Hawái

Coreana

Samoana

India asiática

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

¿Es esta persona ciudadana de los Estados Unidos?
Sí, nacido(a) en los Estados Unidos
Sí, nacido(a) en Puerto Rico, Guam, las Islas Vírgenes de los
EE. UU., o las Islas Marianas del Norte

Femenino

Sí, nacido(a) en el extranjero de padre o madre que es
ciudadano(a) de los EE. UU.
Sí, ciudadano(a) de los EE. UU. por naturalización – Escriba
el año de naturalización. C

Escriba los números en las casillas.
Mes

Vietnamita

Filipina

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

China

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Indígena de las Américas o nativa de Alaska – Escriba el
nombre de la(s) tribu(s) en la(s) que está inscrita o la(s)
tribu(s) principal(es), por ejemplo, Navajo Nation, Blackfeet
Tribe, maya, azteca, Native Village of Barrow Inupiat
Traditional Government, Nome Eskimo Community, etc. C

Día

Año de nacimiento

años
No, no es ciudadano(a) de los EE. UU.

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

¿Es esta persona de origen hispano, latino o español?
No, no es de origen hispano, latino o español
Sí, mexicano, mexicanoamericano, chicano
Sí, puertorriqueño
Sí, cubano
Sí, de otro origen hispano, latino o español – Escriba, por
ejemplo, salvadoreño, dominicano, colombiano, guatemalteco,
español, ecuatoriano, etc. C

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 7 de la
próxima página.

13719109

§.h|2¤
1.

Escriba el nombre de la

Persona 5

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

Nativa de Hawái

Coreana

Samoana

India asiática

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

¿Es esta persona ciudadana de los Estados Unidos?
Sí, nacido(a) en los Estados Unidos
Sí, nacido(a) en Puerto Rico, Guam, las Islas Vírgenes de los
EE. UU., o las Islas Marianas del Norte

Femenino

Sí, nacido(a) en el extranjero de padre o madre que es
ciudadano(a) de los EE. UU.
Sí, ciudadano(a) de los EE. UU. por naturalización – Escriba
el año de naturalización. C

Escriba los números en las casillas.
Mes

Vietnamita

Filipina

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

China

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Día

Año de nacimiento

años
No, no es ciudadano(a) de los EE. UU.

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 6 de la
próxima página.

13719117

§.h|:¤
1.

Escriba el nombre de la

Persona 4

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

Nativa de Hawái

Coreana

Samoana

India asiática

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

¿Es esta persona ciudadana de los Estados Unidos?
Sí, nacido(a) en los Estados Unidos
Sí, nacido(a) en Puerto Rico, Guam, las Islas Vírgenes de los
EE. UU., o las Islas Marianas del Norte

Femenino

Sí, nacido(a) en el extranjero de padre o madre que es
ciudadano(a) de los EE. UU.
Sí, ciudadano(a) de los EE. UU. por naturalización – Escriba
el año de naturalización. C

Escriba los números en las casillas.
Mes

Vietnamita

Filipina

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

China

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Día

Año de nacimiento

años
No, no es ciudadano(a) de los EE. UU.

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 5 de la
próxima página.

13719125

§.h|B¤
1.

Escriba el nombre de la

Persona 3

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

Nativa de Hawái

Coreana

Samoana

India asiática

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

¿Es esta persona ciudadana de los Estados Unidos?
Sí, nacido(a) en los Estados Unidos
Sí, nacido(a) en Puerto Rico, Guam, las Islas Vírgenes de los
EE. UU., o las Islas Marianas del Norte

Femenino

Sí, nacido(a) en el extranjero de padre o madre que es
ciudadano(a) de los EE. UU.
Sí, ciudadano(a) de los EE. UU. por naturalización – Escriba
el año de naturalización. C

Escriba los números en las casillas.
Mes

Vietnamita

Filipina

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

China

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Día

Año de nacimiento

años
No, no es ciudadano(a) de los EE. UU.

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 4 de la
próxima página.

13719133

§.h|J¤
1.

Escriba el nombre de la

Persona 2

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

Nativa de Hawái

Coreana

Samoana

India asiática

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

¿Es esta persona ciudadana de los Estados Unidos?
Sí, nacido(a) en los Estados Unidos
Sí, nacido(a) en Puerto Rico, Guam, las Islas Vírgenes de los
EE. UU., o las Islas Marianas del Norte

Femenino

Sí, nacido(a) en el extranjero de padre o madre que es
ciudadano(a) de los EE. UU.
Sí, ciudadano(a) de los EE. UU. por naturalización – Escriba
el año de naturalización. C

Escriba los números en las casillas.
Mes

Vietnamita

Filipina

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

China

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Día

Año de nacimiento

años
No, no es ciudadano(a) de los EE. UU.

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 3 de la
próxima página.

13719141

§.h|[¤
Persona 1

Por favor, provea información para cada persona que vive
aquí. Si hay alguien que vive aquí que paga el alquiler (renta)
o es propietario de esta vivienda, comience la lista con él o
ella como la Persona 1. Si el propietario o la persona que
paga el alquiler (renta) no vive aquí, comience la lista con
cualquier adulto que viva aquí como la Persona 1.

¿Cuál es la raza de la Persona 1?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

¿Cuál es el nombre de la Persona 1? Escriba el nombre a
continuación.
Nombre

Inicial

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

Apellido(s)

¿Cuál es el sexo de la Persona 1? Marque K
J UNA casilla.
I
Masculino

Femenino
China

¿Cuál es la edad de la Persona 1 y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 8 sobre

Filipina

Coreana

Samoana

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

origen hispano y la Pregunta 9 sobre raza. Para este censo,
origen hispano no es una raza.

Nativa de Hawái

India asiática
Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Escriba los números en las casillas.
Mes

Vietnamita

¿Es la Persona 1 de origen hispano, latino o español?
No, no es de origen hispano, latino o español
Sí, mexicano, mexicanoamericano, chicano

10.

¿Es la Persona 1 ciudadana de los Estados Unidos?

Sí, puertorriqueño

Sí, nacido(a) en los Estados Unidos

Sí, cubano

Sí, nacido(a) en Puerto Rico, Guam, las Islas Vírgenes de los
EE. UU., o las Islas Marianas del Norte

Sí, de otro origen hispano, latino o español – Escriba, por
ejemplo, salvadoreño, dominicano, colombiano, guatemalteco,
español, ecuatoriano, etc. C

Sí, nacido(a) en el extranjero de padre o madre que es
ciudadano(a) de los EE. UU.
Sí, ciudadano(a) de los EE. UU. por naturalización – Escriba
el año de naturalización. C

No, no es ciudadano(a) de los EE. UU.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 2 de la
próxima página.

13719158

§.h|c¤

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

Prueba del Censo del 2019

To complete the English questionnaire, flip this over and complete the blue side.
PARA USO
OFICIAL
SOLAMENTE

Comience aquí

O visite por internet respond.census.gov/2019CensusTest para completar su cuestionario de la Prueba del Censo del 2019.

Use un bolígrafo de tinta
azul o negra.

¿Había personas adicionales quedándose aquí el 1 de julio
de 2019 que usted no incluyó en la Pregunta 1?
Marque I
K todas las que correspondan.
J

Antes de contestar la Pregunta 1, cuente a las personas que viven
en esta casa, apartamento o casa móvil usando nuestras
instrucciones.

Niños, emparentados o no, tales como bebés recién nacidos,
nietos o hijos de crianza (foster)

• Cuente a todas las personas, incluyendo a bebés, que viven y
duermen aquí la mayor parte del tiempo.
• Si nadie vive y duerme en esta dirección la mayor parte del
tiempo, visite por internet respond.census.gov/2019CensusTest
o llame al número que aparece en la página 8.
El censo también tiene que incluir a las personas sin un lugar
permanente donde vivir, por lo tanto:
• Si alguien que no tenga un lugar permanente donde vivir se está
quedando aquí el 1 de julio de 2019, cuente a esa persona.

Parientes, tales como hijos adultos, primos o parientes políticos
Personas que no son parientes, tales como compañeros de
casa o cuarto, o niñeras que viven en el hogar
Personas que se quedan aquí temporalmente
No hay personas adicionales

¿Es esta casa, apartamento o casa móvil —
Marque K
J UNA casilla.
I
Propiedad suya o de alguien en este hogar con una hipoteca
o crédito hipotecario? Esto incluye los préstamos con la
propiedad como garantía.

La Oficina del Censo también lleva a cabo recuentos en
instituciones y otros lugares, por lo tanto:
• No cuente a alguien que vive lejos de aquí por estar en la
universidad o en las Fuerzas Armadas.
• No cuente a alguien que está en un hogar de ancianos o nursing
home, cárcel, prisión, centro de detención, etc., el 1 de julio de
2019.
• No incluya a estas personas en su cuestionario, aunque vuelvan
a vivir aquí después de salir de la universidad, hogar de
ancianos o nursing home, las Fuerzas Armadas, cárcel, etc. De
otra manera, tal vez sean contadas dos veces.

Propiedad suya o de alguien en este hogar libre y sin deuda
(sin una hipoteca o crédito hipotecario)?
Alquilado(a) o rentado(a)?
Ocupado(a) sin pago de alquiler o renta?

¿Cuál es su número de teléfono?
Nos comunicaremos con usted solo si es necesario para asuntos
oficiales de la Oficina del Censo.
Número de teléfono

¿Cuántas personas estaban viviendo o quedándose en esta
casa, apartamento o casa móvil el 1 de julio de 2019?

–

Número de personas =
FORM

DM-QA(E/S) (12-12-2018)

13719166

–

§.j{1¤

OMB No. 0607-0936: Approval Expires 08/31/2021
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

2019 Census Test

Para completar el cuestionario en español, dele la vuelta y complete el lado verde.
FOR
OFFICIAL
USE ONLY

Start here

OR go online at respond.census.gov/2019CensusTest to complete your 2019 Census Test questionnaire.

Use a blue or black pen.

Before you answer Question 1, count the people living in
this house, apartment, or mobile home using our
guidelines.

How many people were living or staying in this house,
apartment, or mobile home on July 1, 2019?

Relatives, such as adult children, cousins, or in-laws
Nonrelatives, such as roommates or live-in babysitters
People staying here temporarily
No additional people

What is your telephone number?
We will only contact you if needed for official Census Bureau
business.
Telephone Number
–

Number of people =
FORM

DM-QB(E/S) (12-12-2018)

13739016

–

§.j{9¤
Person 1

What is Person 1’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

What is Person 1’s name? Print name below.
First Name

MI
Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Last Name(s)

What is Person 1’s sex? Mark K
J ONE box.
I
Male

Female

What is Person 1’s age and what is Person 1’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Year of birth

Chamorro
Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

years

Some other race – Print race or origin. C

➜ NOTE: Please answer BOTH Question 8 about Hispanic
origin and Question 9 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 2 on the
next page.

13739024

§.j{A¤
1.

Person 2

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 3 on the
next page.

13739032

§.j{I¤
1.

Person 3

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No
Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

Chinese

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Vietnamese

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 4 on the
next page.

13739040

§.j{Z¤
1.

Person 4

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 5 on the
next page.

13739057

§.j{b¤
1.

Person 5

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No
Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

Chinese

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Vietnamese

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 6 on the
next page.

13739065

§.j{j¤
1.

Person 6

Print name of

First Name

What is this person’s race?
Mark K
J one or more boxes AND print origins.
I
White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

Last Name(s)

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

Does this person usually live or stay somewhere else?
Mark K
J all that apply.
I
No

Yes, for college

Yes, with a parent or
other relative

Yes, for a military assignment

Yes, at a seasonal or
second residence

Yes, for a job or business

Yes, in a jail or prison

Yes, in a nursing home

Yes, for another reason

How is this person related to Person 1? Mark K
J ONE box.
I
Opposite-sex husband/wife/spouse

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or
daughter-in-law

Biological son or daughter

Other relative

Adopted son or daughter

Roommate or housemate

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

What is this person’s sex? Mark K
J ONE box.
I
Male

Female

What is this person’s age and what is this person’s date of
birth? For babies less than 1 year old, do not write the age in
months. Write 0 as the age.
Age on July 1, 2019

Print numbers in boxes.
Month
Day

Year of birth

years

➜ NOTE: Please answer BOTH Question 6 about Hispanic
origin and Question 7 about race. For this census,
Hispanic origins are not races.

➜ If more people were counted in Question 1 on
the front page, continue with Person 7 on the
next page.

13739073

§.j{r¤
Use this section to complete information for the rest of the people you counted in Question 1 on the front page.
We may call for additional information about them.

Person 7
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Month

Day

Year of birth

Related to Person 1?

years

Female

Yes

Person 8
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 9
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

Person 10
First Name

Last Name(s)

Date of Birth
Sex

Age on July 1, 2019
Male

Female

Month

Day

Year of birth

Related to Person 1?

years

Yes

FOR OFFICIAL USE ONLY

Thank you for completing your questionnaire.
If your enclosed postage-paid envelope is missing,
please mail your completed questionnaire to:

JIC1

JIC2

U.S. Census Bureau
National Processing Center
P.O. Box 5220
Jeffersonville, IN 47199-5220

13739081

§.j{ƒ¤
Use esta sección para completar la información sobre el resto de las personas que usted contó en la Pregunta 1
de la primera página. Puede que lo llamemos para obtener información adicional sobre ellas.

Persona 7
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Femenino

Sí

Persona 8
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Femenino

Sí

Persona 9
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Femenino

Sí

Persona 10
Nombre

Inicial

Edad el 1 de
julio de 2019

Sexo
Masculino

Femenino

Apellido(s)

Fecha de nacimiento
Mes

Día

Año de nacimiento

¿Es pariente
de la Persona 1?

años

Sí

PARA USO OFICIAL SOLAMENTE

Gracias por completar su cuestionario.
Si no tiene el sobre con sello que se incluye para la
devolución del cuestionario, por favor, envíe por
correo su cuestionario completado a:

JIC1

JIC2

U.S. Census Bureau
National Processing Center
P.O. Box 5220
Jeffersonville, IN 47199-5220

13739099

§.j|(¤
1.

Escriba el nombre de la

Persona 6

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

China

Vietnamita

Nativa de Hawái

Filipina

Coreana

Samoana

India asiática

Japonesa

Chamorra

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Femenino

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Escriba los números en las casillas.
Mes

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 7 de la
próxima página.

13739107

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1.

Escriba el nombre de la

Persona 5

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

China

Vietnamita

Nativa de Hawái

Filipina

Coreana

Samoana

India asiática

Japonesa

Chamorra

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Femenino

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Escriba los números en las casillas.
Mes

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 6 de la
próxima página.

13739115

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1.

Escriba el nombre de la

Persona 4

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

China

Vietnamita

Nativa de Hawái

Filipina

Coreana

Samoana

India asiática

Japonesa

Chamorra

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Femenino

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Escriba los números en las casillas.
Mes

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 5 de la
próxima página.

13739123

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1.

Escriba el nombre de la

Persona 3

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

China

Vietnamita

Nativa de Hawái

Filipina

Coreana

Samoana

India asiática

Japonesa

Chamorra

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Femenino

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Escriba los números en las casillas.
Mes

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 4 de la
próxima página.

13739131

§.j|R¤
1.

Escriba el nombre de la

Persona 2

Nombre

Inicial

¿Cuál es la raza de esta persona?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

Apellido(s)

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

¿Vive o se queda esta persona habitualmente en algún otro
lugar? Marque K
J todas las que correspondan.
I
No

Sí, para ir a la universidad

Sí, con el padre, la madre
u otro pariente

Sí, por un destino militar

Sí, en una vivienda de
temporada o segunda
residencia

Sí, por un empleo o negocio

Sí, en una cárcel o prisión

Sí, en un hogar de
ancianos o nursing home

Sí, por alguna otra razón

¿Cómo está esta persona relacionada con la Persona 1?
Marque K
J UNA casilla.
I
Esposo(a) del sexo opuesto

Padre o madre

Pareja no casada del sexo opuesto

Nieto(a)

Esposo(a) del mismo sexo

Suegro(a)

Pareja no casada del mismo sexo

Yerno o nuera

Hijo(a) biológico(a) o de sangre

Otro pariente

Hijo(a) adoptivo(a)

Roommate o compañero(a)
de casa

Hijastro(a)

Hijo(a) foster

Hermano(a)

Otra persona que no es
pariente

China

Vietnamita

Nativa de Hawái

Filipina

Coreana

Samoana

India asiática

Japonesa

Chamorra

Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

¿Cuál es el sexo de esta persona? Marque K
J UNA casilla.
I
Masculino

Femenino

¿Cuál es la edad de esta persona y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Escriba los números en las casillas.
Mes

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 6 sobre
origen hispano y la Pregunta 7 sobre raza. Para este censo,
origen hispano no es una raza.

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 3 de la
próxima página.

13739149

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Persona 1

¿Cuál es la raza de la Persona 1?
Marque K
J una o más casillas Y escriba los orígenes.
I
Blanca – Escriba, por ejemplo, alemán, irlandés, inglés,
italiano, libanés, egipcio, etc. C

¿Cuál es el nombre de la Persona 1? Escriba el nombre a
continuación.
Nombre

Inicial

Negra o afroamericana – Escriba, por ejemplo, afroamericano,
jamaiquino, haitiano, nigeriano, etíope, somalí, etc. C

Apellido(s)

¿Cuál es el sexo de la Persona 1? Marque K
J UNA casilla.
I
Masculino

Femenino
China

¿Cuál es la edad de la Persona 1 y cuál es su fecha de
nacimiento? Para bebés menores de un año, no escriba los
meses de edad. Solo escriba 0.
Edad el 1 de julio
de 2019

Mes

Día

Año de nacimiento

años

➜ NOTA: Conteste AMBAS preguntas, la Pregunta 8 sobre

Filipina

Coreana

Samoana

Japonesa

Chamorra
Otra de las islas del
Pacífico – Escriba,
por ejemplo, tongano,
fiyiano, de las Islas
Marshall, etc. C

Alguna otra raza – Escriba la raza o el origen. C

origen hispano y la Pregunta 9 sobre raza. Para este censo,
origen hispano no es una raza.

Nativa de Hawái

India asiática
Otra asiática –
Escriba, por
ejemplo, pakistaní,
camboyano,
hmong, etc. C

Escriba los números en las casillas.

Vietnamita

¿Es la Persona 1 de origen hispano, latino o español?
No, no es de origen hispano, latino o español
Sí, mexicano, mexicanoamericano, chicano
Sí, puertorriqueño
Sí, cubano
Sí, de otro origen hispano, latino o español – Escriba, por
ejemplo, salvadoreño, dominicano, colombiano, guatemalteco,
español, ecuatoriano, etc. C

➜ Si se contaron más personas en la Pregunta 1 de la
primera página, continúe con la Persona 2 de la
próxima página.

13739156

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Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

Prueba del Censo del 2019

To complete the English questionnaire, flip this over and complete the blue side.
PARA USO
OFICIAL
SOLAMENTE

Comience aquí

O visite por internet respond.census.gov/2019CensusTest para completar su cuestionario de la Prueba del Censo del 2019.

Use un bolígrafo de tinta
azul o negra.

¿Había personas adicionales quedándose aquí el 1 de julio
de 2019 que usted no incluyó en la Pregunta 1?
Marque I
K todas las que correspondan.
J

Antes de contestar la Pregunta 1, cuente a las personas que viven
en esta casa, apartamento o casa móvil usando nuestras
instrucciones.

Niños, emparentados o no, tales como bebés recién nacidos,
nietos o hijos de crianza (foster)

Propiedad suya o de alguien en este hogar libre y sin deuda
(sin una hipoteca o crédito hipotecario)?
Alquilado(a) o rentado(a)?
Ocupado(a) sin pago de alquiler o renta?

¿Cuál es su número de teléfono?
Nos comunicaremos con usted solo si es necesario para asuntos
oficiales de la Oficina del Censo.
Número de teléfono

¿Cuántas personas estaban viviendo o quedándose en esta
casa, apartamento o casa móvil el 1 de julio de 2019?

–

Número de personas =
FORM

DM-QB(E/S) (12-12-2018)

13739164

–

Draft 6 (12-12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

June 13, 2019

Dear Resident:

AF
T

A Message from the Director, U.S. Census Bureau

To prepare for the 2020 Census, the Census Bureau is conducting the 2019 Census Test. The
Census Bureau conducts this important 10-minute survey to help make the 2020 Census easier,
more convenient, and less costly.
Results from the 2020 Census will be used to:

● Direct billions of dollars in federal funds to local communities for schools, roads, and other
public services.
● Help your community prepare to meet transportation and emergency readiness needs.

D
R

● Determine the number of seats each state has in the U.S. House of Representatives and
your political representation at all levels of government.

Respond by July 1 at
respond.census.gov/
2019CensusTest

Your Census ID is:

The Census Bureau is using the internet to securely collect your information. Responding online
helps us conserve natural resources, save taxpayer money, and process data more efficiently. If
you are unable to complete your questionnaire online, we will send you a paper questionnaire in a
few weeks for you to complete and mail back.
The census is so important that your response is required by law, and your answers are kept
completely confidential. If you do not respond, we will need to send a Census Bureau interviewer
to your home to collect your answers in person. If you need help completing your questionnaire,
please call toll-free 1-866-208-8248.
Thank you in advance for your prompt response.
Enclosures
Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.
census.gov

DM-LF1 (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

AF
T

Am I required to respond?
Yes, you are required by law to respond to this survey (Title 13, U.S. Code, Sections 141 and
193). We are conducting this survey under the authority of Title 13, U.S. Code, Sections 141,
193 and 221. This collection of information has been approved by the Office of Management
and Budget (OMB). The eight-digit OMB approval number is 0607-0936. If this number were
not displayed, we could not conduct this survey.
How long will my questionnaire take?
The Census Bureau estimates that completing the questionnaire will take 10 minutes on
average.
Send comments regarding this burden estimate or any other aspect of this burden to:
Paperwork Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277,
4600 Silver Hill Road, Washington, DC 20233. You may email comments to
. Use "Paperwork Reduction Project 0607-0936"
as the subject.

D
R

How do I respond?
Go to respond.census.gov/2019CensusTest to complete your questionnaire online. You
will need the 10-digit Census ID found on the other side.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics.
Are my answers conﬁdential and private?
Yes. The Census Bureau is required by law to protect your information (Title 13, U.S. Code,
Section 9). The Census Bureau is not permitted to publicly release your responses in a way
that could identify you or your household. Per the Federal Cybersecurity Enhancement Act of
2015, your data are protected from cybersecurity risks through screening of the systems that
transmit your data. All web data submissions are encrypted in order to protect your privacy.
Title 13 of the U.S. Code protects the confidentiality of all your information. Violating the
confidentiality of a respondent is a federal crime with serious penalties, including a federal
prison sentence of up to five years, a fine of up to $250,000, or both. Only authorized
individuals have access to the stored data, and the information you provide to the Census
Bureau may only be used by a restricted number of authorized individuals who are sworn for
life to protect the confidentiality of your individual responses. Your answers cannot be used
against you by any government agency or court.
For more information about how we protect your information, please visit our Web site at
census.gov and click on "Data Protection and Privacy Policy" at the bottom of the home page.
This page also includes information about the collection, storage, and use of these records.
Click on "System of Records Notices (SORN)" and look for Privacy Act System of Records
Notice COMMERCE/CENSUS-5, Decennial Census Program.
DM-LF1 (12-2018)

Draft 4 (12-12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

June 13, 2019

Dear Resident:

AF
T

A Message from the Director, U.S. Census Bureau

To prepare for the 2020 Census, the Census Bureau is conducting the 2019 Census Test.
The Census Bureau conducts this important 10-minute survey to help make the 2020 Census
easier, more convenient, and less costly.
Results from the 2020 Census will be used to:

● Direct billions of dollars in federal funds to local communities for schools,
roads, and other public services.

D
R

● Help your community prepare to meet transportation and emergency
readiness needs.

● Determine the number of seats each state has in the U.S. House of
Representatives and your political representation at all levels of government.

Respond by July 1 at
respond.census.gov/
2019CensusTest

Your Census ID is:

The Census Bureau is using the internet to securely collect your information. Responding
online helps us conserve natural resources, save taxpayer money, and process data more
efficiently. If you are unable to complete your questionnaire online, we will send you a paper
questionnaire in a few weeks for you to complete and mail back.
The census is so important that your response is required by law, and your answers are kept
completely confidential. If you do not respond, we will need to send a Census Bureau
interviewer to your home to collect your answers in person. If you need help completing your
questionnaire, please call toll-free 1-866-208-8248.
Thank you in advance for your prompt response.
Enclosures
census.gov

DM-LF1(E/S) (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

13 de junio de 2019
Mensaje del Director de la Oficina del Censo de los EE. UU.

AF
T

Estimado residente de esta vivienda:

Como preparación para el Censo del 2020, la Oficina del Censo está llevando a cabo la Prueba
del Censo del 2019. La Oficina del Censo está llevando a cabo esta importante encuesta de 10
minutos para ayudar a que el Censo del 2020 sea más fácil, más conveniente y menos costoso.
Los resultados del Censo del 2020 se usarán para:

D
R

● Determinar el número de escaños que tiene cada estado en la Cámara de
Representantes de los EE. UU., así como su representación política a todos los
niveles del gobierno.

Responda antes del 1 de julio en
respond.census.gov/
2019CensusTest

Su Identificación del Censo es:

La Oficina del Censo está usando internet para recopilar su información de manera segura.
Responder por internet nos ayuda a conservar recursos naturales, a ahorrar dinero de los
contribuyentes y a procesar los datos de manera más eficiente. Si usted no puede completar el
cuestionario por internet, dentro de unas semanas le enviaremos un cuestionario impreso para que
lo complete y lo envíe de vuelta por correo.
El censo es tan importante que la ley requiere que usted responda, y sus respuestas se mantienen
completamente confidenciales. Si usted no responde, tendremos que enviar a un entrevistador de
la Oficina del Censo para que recopile sus respuestas en persona. Si necesita ayuda para
completar el cuestionario, llame gratis al 1-888-369-3597.
Gracias de antemano por su rápida respuesta.
Documentos adjuntos

census.gov
DM-LF1(E/S) (12-2018)

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Overlay prints green #368 (10%)

Draft 8 (12-12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

June 13, 2019
A Message from the Director, U.S. Census Bureau
Dear Resident:
To prepare for the 2020 Census, the Census Bureau is conducting the 2019 Census Test.
The Census Bureau conducts this important 10-minute survey to help make the 2020 Census
easier, more convenient, and less costly.
Results from the 2020 Census will be used to:
● Direct billions of dollars in federal funds to local communities for schools, roads, and other

public services.
● Help your community prepare to meet transportation and emergency readiness needs.
● Determine the number of seats each state has in the U.S. House of Representatives and

your political representation at all levels of government.
Please respond by July 1 using ONE of the following options:
Option 1:
Go to respond.census.gov/2019CensusTest to complete your
questionnaire online. You will need your 10-digit Census ID, which is
printed below the barcode on the front of the enclosed questionnaire.
Option 2:
Complete and mail back the enclosed questionnaire in the postage-paid
envelope provided.
Respond online to help us conserve natural resources, save taxpayer money, and process
data more efficiently.
The census is so important that your response is required by law, and your answers are kept
completely confidential. If you do not respond, we will need to send a Census Bureau
interviewer to your home to collect your answers in person. If you need help completing your
questionnaire, please call toll-free 1-866-208-8248.
Thank you in advance for your prompt response.
Enclosures

Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.
census.gov
DM-LC1 (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

FREQUENTLY ASKED QUESTIONS
respond.census.gov/2019CensusTest
What is the 2019 Census Test?
The 2019 Census Test is a survey that the U.S. Census Bureau is conducting in preparation
for the 2020 Census. By completing this survey, you help prepare for a more accurate count of
all populations in the 2020 Census.
Am I required to respond?
Yes, you are required by law to respond to this survey (Title 13, U.S. Code, Sections 141 and
193). We are conducting this survey under the authority of Title 13, U.S. Code, Sections 141,
193 and 221. This collection of information has been approved by the Office of Management
and Budget (OMB). The eight-digit OMB approval number is 0607-0936. If this number were
not displayed, we could not conduct this survey.
How long will my questionnaire take?
The Census Bureau estimates that completing the questionnaire will take 10 minutes on
average.
Send comments regarding this burden estimate or any other aspect of this burden to:
Paperwork Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277,
4600 Silver Hill Road, Washington, DC 20233. You may email comments to
. Use "Paperwork Reduction Project 0607-0936"
as the subject.
How do I respond?
Go to respond.census.gov/2019CensusTest to complete your questionnaire online. You
will need the 10-digit Census ID found below the barcode on the questionnaire.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics.
Are my answers conﬁdential and private?
Yes. The Census Bureau is required by law to protect your information (Title 13, U.S. Code,
Section 9). The Census Bureau is not permitted to publicly release your responses in a way
that could identify you or your household. Per the Federal Cybersecurity Enhancement Act of
2015, your data are protected from cybersecurity risks through screening of the systems that
transmit your data. All web data submissions are encrypted in order to protect your privacy.
Title 13 of the U.S. Code protects the confidentiality of all your information. Violating the
confidentiality of a respondent is a federal crime with serious penalties, including a federal
prison sentence of up to five years, a fine of up to $250,000, or both. Only authorized
individuals have access to the stored data, and the information you provide to the Census
Bureau may only be used by a restricted number of authorized individuals who are sworn for
life to protect the confidentiality of your individual responses. Your answers cannot be used
against you by any government agency or court.
For more information about how we protect your information, please visit our Web site at
census.gov and click on "Data Protection and Privacy Policy" at the bottom of the home page.
This page also includes information about the collection, storage, and use of these records.
Click on "System of Records Notices (SORN)" and look for Privacy Act System of Records
Notice COMMERCE/CENSUS-5, Decennial Census Program.

DM-LC1 (12-2018)

Draft 4 (12-12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

public services.
● Help your community prepare to meet transportation and emergency readiness needs.
● Determine the number of seats each state has in the U.S. House of Representatives and

Base prints black 100%

overlay prints cyan #6 (10 percent)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

13 de junio de 2019
Mensaje del Director de la Oficina del Censo de los EE. UU.
Estimado residente de esta vivienda:
Como preparación para el Censo del 2020, la Oficina del Censo está llevando a cabo la Prueba del
Censo del 2019. La Oficina del Censo está llevando a cabo esta importante encuesta de 10 minutos
para ayudar a que el Censo del 2020 sea más fácil, más conveniente y menos costoso.
Los resultados del Censo del 2020 se usarán para:

● Destinar miles de millones de dólares de fondos federales a las comunidades locales
para escuelas, carreteras y otros servicios públicos.
● Ayudar a su comunidad a prepararse para satisfacer necesidades relacionadas con
el transporte y la preparación para emergencias.
● Determinar el número de escaños que tiene cada estado en la Cámara de Representantes
de los EE. UU., así como su representación política a todos los niveles del gobierno.
Responda antes del 1 de julio usando UNA de las siguientes opciones:
Opción 1:
Visite respond.census.gov/2019CensusTest para completar el cuestionario por
internet. Usted va a necesitar su número de Identificación del Censo de 10 dígitos, que
se encuentra debajo del código de barras en la primera página del cuestionario adjunto.
Opción 2:
Complete y envíe por correo postal el cuestionario impreso adjunto en el sobre con
franqueo pagado que se provee.
Responda por internet para conservar recursos naturales, ahorrar dinero de los contribuyentes y
procesar datos con más eficiencia.
El censo es tan importante que la ley requiere que usted responda, y sus respuestas se mantienen
completamente confidenciales. Si usted no responde, tendremos que enviar a un entrevistador de la
Oficina del Censo para que recopile sus respuestas en persona. Si necesita ayuda para completar el
cuestionario, llame gratis al 1-888-369-3597.
Gracias de antemano por su rápida respuesta.
Documentos adjuntos

census.gov
DM-LC1(E/S) (12-2018)

Base prints black 100%

overlay prints green #368 (10 percent)

Draft 6 (12-18-2018)
OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001

June 17, 2019

AF
T

Office of the Director

A Message from the Director, U.S. Census Bureau
Dear Resident:

D
R

Recently, you should have received instructions for completing your questionnaire online. Local
communities depend on information from the Census Bureau to fund programs that promote
the well-being of families and children as well as equal employment opportunities for you and
your neighbors. If you have not already responded, please complete your short 10-minute
questionnaire now.
Respond now at
respond.census.gov/
2019CensusTest

Your Census ID is:

If we do not receive your response online, we will mail a paper questionnaire to your address
in a few weeks.
Your response is important to your local community and your country. By law, your response
is required, and your answers are confidential. If you do not respond, we will need to send a
Census Bureau interviewer to your home to collect your answers in person.
If you need help completing your questionnaire, please call toll-free 1-866-208-8248.
If you have already completed your questionnaire, we thank you.

Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.

census.gov

DM-LF2 (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

Draft 6 (12-18-2018)
OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001

June 17, 2019

AF
T

Office of the Director

A Message from the Director, U.S. Census Bureau
Dear Resident:

D
R

Your Census ID is:

census.gov

DM-LF2(E/S) (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001

17 de junio de 2019

AF
T

Office of the Director

Mensaje del Director de la Oficina del Censo de los EE. UU.
Estimado residente de esta vivienda:

D
R

Recientemente, usted debe haber recibido instrucciones para completar el cuestionario por
internet. Las comunidades locales dependen de la información de la Oficina del Censo para
asignar fondos a los programas que promueven el bienestar de las familias y los niños, así
como la igualdad de oportunidades de empleo para usted y para sus vecinos. Si usted no ha
respondido aún, complete ahora mismo este breve cuestionario de 10 minutos o complete y
envíe de vuelta el cuestionario impreso que le enviamos anteriormente.
Responda ahora en
respond.census.gov/
2019CensusTest

Su Identificación del Censo es:

Si no recibimos su respuesta por internet, dentro de unas semanas le enviaremos otro
cuestionario impreso por correo postal a su dirección.
Su respuesta es importante para su comunidad local y para su país. La ley requiere que usted
responda, y sus respuestas se mantienen confidenciales. Si usted no responde rápido,
tendremos que enviar a un entrevistador de la Oficina del Censo para que recopile sus
respuestas en persona.
Si necesita ayuda para completar el cuestionario, llame gratis al 1-888-369-3597.
Si usted ya ha completado el cuestionario, se lo agradecemos.

census.gov

DM-LF2(E/S) (12-2018)

Base prints black 100%

Overlay prints green #368 (10%)

Draft 6 (12-18-2018)
OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001

June 17, 2019

AF
T

Office of the Director

A Message from the Director, U.S. Census Bureau
Dear Resident:

D
R

Recently, you should have received instructions for completing your questionnaire online. Local
communities depend on information from the Census Bureau to fund programs that promote
the well-being of families and children as well as equal employment opportunities for you and
your neighbors. If you have not already responded, please complete your short 10-minute
questionnaire online now, or complete and return the paper questionnaire that we sent you
earlier.

Respond now at
respond.census.gov/
2019CensusTest

Your Census ID is:

If we do not receive your response online or by mail, we will mail another paper questionnaire
to your address in a few weeks.
Your response is important to your local community and your country. By law, your response is
required, and your answers are confidential. If you do not respond, we will need to send a Census
Bureau interviewer to your home to collect your answers in person.
If you need help completing your questionnaire, please call toll-free 1-866-208-8248.
If you have already completed your questionnaire, we thank you.
Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.
census.gov

DM-LC2 (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

Draft 6 (12-18-2018)
OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001

June 17, 2019

AF
T

Office of the Director

A Message from the Director, U.S. Census Bureau
Dear Resident:

D
R

Recently, you should have received instructions for completing your questionnaire online. Local
communities depend on information from the Census Bureau to fund programs that promote
the well-being of families and children as well as equal employment opportunities for you and
your neighbors. If you have not already responded, please complete your short 10-minute
questionnaire online now, or complete and return the paper questionnaire that we sent you
earlier.

Respond now at
respond.census.gov/
2019CensusTest

Your Census ID is:

If we do not receive your response online or by mail, we will mail another paper questionnaire
to your address in a few weeks.
Your response is important to your local community and your country. By law, your response
is required, and your answers are confidential. If you do not respond, we will need to send a
Census Bureau interviewer to your home to collect your anwers in person.
If you need help completing your questionnaire, please call toll-free 1-866-208-8248.
If you have already completed your questionnaire, we thank you.

census.gov

DM-LC2(E/S) (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10%)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001

17 de junio de 2019

AF
T

Office of the Director

Mensaje del Director de la Oficina del Censo de los EE. UU.
Estimado residente de esta vivienda:

D
R

Responda ahora en
respond.census.gov/
2019CensusTest

Su Identificación del Censo es:

Si no recibimos su respuesta por internet o por correo postal, dentro de unas semanas le
enviaremos otro cuestionario impreso por correo postal a su dirección.
Su respuesta es importante para su comunidad local y para su país. La ley requiere que usted
responda, y sus respuestas se mantienen confidenciales. Si usted no responde rápido,
tendremos que enviar a un entrevistador de la Oficina del Censo para que recopile sus
respuestas en persona.
Si necesita ayuda para completar el cuestionario, llame gratis al 1-888-369-3597.
Si usted ya ha completado el cuestionario, se lo agradecemos.

census.gov
DM-LC2(E/S) (12-2018)

Base prints black 100%

Overlay prints green #368 (10%)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

AF
T

Your response is required by law.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

June 27, 2019

A Message from the Director, U.S. Census Bureau

Dear Resident:

Now is the time to respond.

The Census Bureau sent you several requests to complete your questionnaire. If you have not already responded,
it is important that you complete your 10-minute questionnaire now.

Respond now at respond.census.gov/2019CensusTest

Respond now at respond.census.gov/2019CensusTest
You are required by law to respond to this survey. Help us conserve natural resources, process data more
efficiently, and save taxpayer money by responding online. Otherwise, a Census Bureau interviewer will need to
visit you to complete your questionnaire.

The Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly
release your information in a way that could identify you or your household.

If you are unable to respond online, we will mail you a paper questionnaire. If you need help completing your
questionnaire, please call toll-free 1-866-208-8248.

AF
T

You are required by law to respond to this survey. Help us conserve natural resources, process data more
efficiently, and save taxpayer money by responding online. Otherwise, a Census Bureau interviewer will need to
visit you to complete your questionnaire.

Mensaje importante: Para completar su cuestionario, visite respond.census.gov/2019CensusTest
o llame gratis al 1-888-369-3597.

DM-PF3 (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

June 27, 2019

A Message from the Director, U.S. Census Bureau
Dear Resident:

Now is the time to respond.

June 27, 2019

OMB No. 0607-0936: Approval Expires 08/31/2021

The Census Bureau sent you several requests to complete your questionnaire. If you have not already responded,
it is important that you complete your 10-minute questionnaire now.

A Message from the Director, U.S. Census Bureau
Dear Resident:
Now is the time to respond.
The Census Bureau sent you several requests to complete your questionnaire. If you have not already responded,
it is important that you complete your 10-minute questionnaire now.

Respond now at respond.census.gov/2019CensusTest

The Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly
release your information in a way that could identify you or your household.

If you are unable to respond online, we will mail you a paper questionnaire. If you need help completing your
questionnaire, please call toll-free 1-866-208-8248.

Mensaje importante: Para completar su cuestionario, visite respond.census.gov/2019CensusTest
o llame gratis al 1-888-369-3597.

DM-PF3 (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.
Su respuesta es requerida por ley.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.
Su respuesta es requerida por ley.

June 27, 2019

27 de junio de 2019

A Message from the Director, U.S. Census Bureau

Mensaje del Director de la Oficina del Censo de los EE. UU.

Dear Resident:

Estimado residente de esta vivienda:

Now is the time to respond.

Ahora es el momento de responder.

The Census Bureau sent you several requests to complete your questionnaire.
If you have not already responded, it is important that you complete your
10-minute questionnaire now.

La Oficina del Censo le ha enviado varias solicitudes para que complete el
cuestionario. Si todavía no ha respondido, es importante que complete ahora
este cuestionario de 10 minutos.

Respond now at respond.census.gov/2019CensusTest

Responda ahora en respond.census.gov/2019CensusTest

You are required by law to respond to this survey. Help us conserve natural
resources, process data more efficiently, and save taxpayer money by
responding online. Otherwise, a Census Bureau interviewer will need to visit you
to complete your questionnaire.

A usted se le requiere por ley que responda a esta encuesta. Ayúdenos a
conservar recursos naturales, a procesar los datos de manera más eficiente y a
ahorrar dinero de los contribuyentes respondiendo por internet. De lo contrario,
un entrevistador de la Oficina del Censo tendrá que visitarlo para completar el
cuestionario.

The Census Bureau is required by law to protect your information. The Census
Bureau is not permitted to publicly release your information in a way that could
identify you or your household.
If you are unable to respond online, we will mail you a paper questionnaire. If you
need help completing your questionnaire, please call toll-free 1-866-208-8248.

DM-PF3(E/S) (12-2018)

La Oficina del Censo está obligada por ley a proteger su información. A la
Oficina del Censo no se le permite divulgar sus respuestas de manera que
usted o su hogar pudieran ser identificados.
Si usted no puede responder por internet, le enviaremos un cuestionario
impreso. Si necesita ayuda para completar el cuestionario, llame gratis al
1-888-369-3597.

OMB No. 0607-0936: Approval Expires 08/31/2021

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

June 27, 2019

27 de junio de 2019

A Message from the Director, U.S. Census Bureau

Mensaje del Director de la Oficina del Censo de los EE. UU.

Dear Resident:

Estimado residente de esta vivienda:

Now is the time to respond.

Ahora es el momento de responder.

The Census Bureau sent you several requests to complete your questionnaire.
If you have not already responded, it is important that you complete your
10-minute questionnaire now.

La Oficina del Censo le ha enviado varias solicitudes para que complete el
cuestionario. Si todavía no ha respondido, es importante que complete ahora
este cuestionario de 10 minutos.

Respond now at respond.census.gov/2019CensusTest

Responda ahora en respond.census.gov/2019CensusTest

You are required by law to respond to this survey. Help us conserve natural
resources, process data more efficiently, and save taxpayer money by
responding online. Otherwise, a Census Bureau interviewer will need to visit you
to complete your questionnaire.

DM-PF3(E/S) (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

OFFICIAL BUSINESS
Penalty for Private Use $300

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

AF
T

Your response is required by law.

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

June 27, 2019

A Message from the Director, U.S. Census Bureau

Dear Resident:

Now is the time to respond.

The Census Bureau sent you several requests to complete your questionnaire. If you have not already responded,
it is important that you complete your 10-minute questionnaire now.

Respond now at respond.census.gov/2019CensusTest
OR complete and return the paper questionnaire that we sent you earlier.

The Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly
release your information in a way that could identify you or your household.

If you are unable to respond online, we will send you another paper questionnaire. If you need help completing
your questionnaire, please call toll-free 1-866-208-8248.

Mensaje importante: Para completar su cuestionario, visite respond.census.gov/2019CensusTest
o llame gratis al 1-888-369-3597.

DM-PC3 (12-2018)

AF
T

OMB No. 0607-0936: Approval Expires 08/31/2021

A Message from the Director, U.S. Census Bureau
Dear Resident:

Now is the time to respond.

June 27, 2019

The Census Bureau sent you several requests to complete your questionnaire. If you have not already responded,
it is important that you complete your 10-minute questionnaire now.

Respond now at respond.census.gov/2019CensusTest
OR complete and return the paper questionnaire that we sent you earlier.

The Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly
release your information in a way that could identify you or your household.

If you are unable to respond online, we will send you another paper questionnaire. If you need help completing
your questionnaire, please call toll-free 1-866-208-8248.

Mensaje importante: Para completar su cuestionario, visite respond.census.gov/2019CensusTest
o llame gratis al 1-888-369-3597.

DM-PC3 (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.
Su respuesta es requerida por ley.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.
Su respuesta es requerida por ley.

June 27, 2019

27 de junio de 2019

A Message from the Director, U.S. Census Bureau

Mensaje del Director de la Oficina del Censo de los EE. UU.

Dear Resident:

Estimado residente de esta vivienda:

Now is the time to respond.

Ahora es el momento de responder.

The Census Bureau sent you several requests to complete your
questionnaire. If you have not already responded, it is important that you
complete your 10-minute questionnaire now.

La Oficina del Censo le ha enviado varias solicitudes para que complete el
cuestionario. Si todavía no ha respondido, es importante que complete
ahora este cuestionario de 10 minutos.

Respond now at respond.census.gov/2019CensusTest
OR complete and return the paper questionnaire
that we sent you earlier.
You are required by law to respond to this survey. Help us conserve natural
resources, process data more efficiently, and save taxpayer money by
responding online. Otherwise, a Census Bureau interviewer will need to visit
you to complete your questionnaire.
The Census Bureau is required by law to protect your information. The
Census Bureau is not permitted to publicly release your information in a
way that could identify you or your household.
If you are unable to respond online, we will send you another paper
questionnaire. If you need help completing your questionnaire, please call
toll-free 1-866-208-8248.

DM-PC3(E/S) (12-2018)

Responda ahora en respond.census.gov/2019CensusTest
O complete y envíe el cuestionario impreso
que le enviamos anteriormente.
A usted se le requiere por ley que responda a esta encuesta. Ayúdenos a
conservar recursos naturales, a procesar los datos de manera más eficiente
y a ahorrar dinero de los contribuyentes respondiendo por internet. De lo
contrario, un entrevistador de la Oficina del Censo tendrá que visitarlo para
completar el cuestionario.
La Oficina del Censo está obligada por ley a proteger su información. A la
Oficina del Censo no se le permite divulgar sus respuestas de manera que
usted o su hogar pudieran ser identificados.
Si usted no puede responder por internet, le enviaremos otro cuestionario
impreso. Si necesita ayuda para completar el cuestionario, llame gratis al
1-888-369-3597.

OMB No. 0607-0936: Approval Expires 08/31/2021

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

June 27, 2019

27 de junio de 2019

A Message from the Director, U.S. Census Bureau

Mensaje del Director de la Oficina del Censo de los EE. UU.

Dear Resident:

Estimado residente de esta vivienda:

Now is the time to respond.

Ahora es el momento de responder.

The Census Bureau sent you several requests to complete your
questionnaire. If you have not already responded, it is important that you
complete your 10-minute questionnaire now.

La Oficina del Censo le ha enviado varias solicitudes para que complete el
cuestionario. Si todavía no ha respondido, es importante que complete
ahora este cuestionario de 10 minutos.

DM-PC3(E/S) (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

Draft 7 (12-12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

Important Note:
You are receiving this notice
because we did not receive
your response before this
letter was mailed.

July 10, 2019
A Message from the Director, U.S. Census Bureau
Dear Resident:
A few weeks ago, the Census Bureau sent instructions for completing your questionnaire
online. If you have already completed your questionnaire, you do not need to take any further
action. If you have not already responded to this important 10-minute questionnaire, please do
so now.
Complete your questionnaire using ONLY ONE of the following options:
● Respond online at respond.census.gov/2019CensusTest

You will need to provide your 10-digit Census ID, which is printed below the barcode
on the front of the enclosed questionnaire.
● If you are unable to respond online, complete and mail back the enclosed questionnaire in

the postage-paid envelope provided.
Your response is important to your community.
You are required by law to respond to this survey. It is vital that you complete your
questionnaire to help meet critical needs in your area – such as helping to put roads, parks,
and hospitals where they are needed most.
If you do not respond promptly, we will need to send a Census Bureau interviewer to your
home to collect your answers in person.
Your answers are completely conﬁdential.
By law, the Census Bureau is required to protect your information.
If you need help completing your questionnaire, please call toll-free 1-866-208-8248.
Thank you for your prompt response.
Enclosures

Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.

census.gov
DM-L4 (12-2018)

Base prints black 100% overlay prints cyan #6 10%

DM-L4 (12-2018)

Draft 5 (12-12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

Important Note:
You are receiving this notice
because we did not receive
your response before this
letter was mailed.

census.gov
DM-L4(E/S) (12-2018)

Base prints black 100%

Overlay prints cyan #6 (10 percent)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

DC
U.S. Census Bureau
Washington, DC 20233-0001
Office of the Director

Aviso importante:
Usted está recibiendo este aviso
porque no recibimos su respuesta
antes de que se enviara esta carta.

10 de julio de 2019
Mensaje del Director de la Oficina del Censo de los EE. UU.
Estimado residente de esta vivienda:
Hace unas semanas la Oficina del Censo le envió instrucciones para que completara por
internet el cuestionario. Si ya usted ha completado el cuestionario, no tiene que hacer nada
más. Si todavía no ha respondido a este importante cuestionario de 10 minutos, tenga la
bondad de hacerlo ahora.
Complete el cuestionario usando solo UNA de las siguientes opciones:
• Responda por internet en respond.census.gov/2019CensusTest

Usted deberá proporcionar su número de Identificación del Censo de 10 dígitos, que
aparece debajo del código de barras en la primera página del cuestionario adjunto.
• Si usted no puede responder por internet, complete el cuestionario adjunto y envíelo por

correo postal en el sobre con franqueo pagado que se incluye.
Su respuesta es importante para su comunidad.
A usted se le requiere por ley que responda a esta encuesta. Es de vital importancia que
complete el cuestionario para ayudar a satisfacer importantes necesidades en su área: entre
ellas, ayudar a construir carreteras, parques y hospitales donde más se necesiten.
Si usted no responde rápido, tendremos que enviar a un entrevistador de la Oficina del Censo
para que recopile sus respuestas en persona.
Sus respuestas son absolutamente conﬁdenciales.
Por ley, a la Oficina del Censo se le requiere que proteja su información.
Si necesita ayuda para completar el cuestionario, llame gratis al 1-888-369-3597.
Gracias por su rápida respuesta.
Documentos adjuntos

census.gov
DM-L4(E/S) (12-2018)

Base prints black 100%

Overlay prints green #368 (10 percent)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

AF
T

Your response is required by law.

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

Your response is required by law.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

July 22, 2019

A Message from the Director, U.S. Census Bureau

Dear Resident:

It is not too late to respond! Make sure you are counted!

Please respond now at respond.census.gov/2019CensusTest or complete and
return the paper questionnaire we sent you earlier. If you are unable to respond online
or need assistance, please call toll-free 1-866-208-8248.

Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.

DM-P5 (12-2018)

AF
T

July 22, 2019

OMB No. 0607-0936: Approval Expires 08/31/2021

July 22, 2019

OMB No. 0607-0936: Approval Expires 08/31/2021

July 22, 2019

A Message from the Director, U.S. Census Bureau

Dear Resident:

It is not too late to respond! Make sure you are counted!

Mensaje importante: Para completar su cuestionario, visite
respond.census.gov/2019CensusTest o llame gratis al 1-888-369-3597.

DM-P5 (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

Your response is required by law.

National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

U.S. Census Bureau

AF
T

Su respuesta es requerida por ley.

Your response is required by law.

Su respuesta es requerida por ley.

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

22 de julio de 2019

A Message from the Director,
U.S. Census Bureau

Mensaje del Director
de la Oficina del Censo de los EE. UU.

Dear Resident:

Estimado residente de esta vivienda:

It is not too late to respond!
Make sure you are counted!

¡Todavía está a tiempo de responder!
¡Asegúrese de que lo cuenten!

Please respond now at
respond.census.gov/2019CensusTest or complete
and return the paper questionnaire we sent you earlier. If
you are unable to respond online or need assistance, please
call toll-free 1-866-208-8248.

Responda ahora en
respond.census.gov/2019CensusTest o complete y
envíe el cuestionario impreso que le enviamos
anteriormente. Si no puede responder por internet o si
necesita ayuda, llame gratis al 1-888-369-3597.

OMB No. 0607-0936: Approval Expires 08/31/2021

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

July 22, 2019

DM-P5(E/S) (12-2018)

AF
T

July 22, 2019

22 de julio de 2019

A Message from the Director,
U.S. Census Bureau

Mensaje del Director
de la Oficina del Censo de los EE. UU.

Dear Resident:

Estimado residente de esta vivienda:

It is not too late to respond!
Make sure you are counted!

¡Todavía está a tiempo de responder!
¡Asegúrese de que lo cuenten!

Please respond now at
respond.census.gov/2019CensusTest or complete
and return the paper questionnaire we sent you earlier. If
you are unable to respond online or need assistance, please
call toll-free 1-866-208-8248.

DM-P5(E/S) (12-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

OMB No. 0607-0936: Approval Expires 08/31/2021

English
For help completing your 2019 Census Test questionnaire, call toll-free 1-866-208-8248.
Español (Spanish)
Si necesita ayuda para completar el cuestionario de la Prueba del Censo del 2019, llame gratis al
1-888-369-3597.
中文 (Chinese)
如果您填写2019年人口普查测试问卷表时需要帮助，请拨打免费电话 1-866-208-8248。
Tiếng Việt (Vietnamese)
Để được trợ giúp hoàn thành bản câu hỏi Thử Nghiệm Thống Kê Dân Số 2019 của quý vị, hãy gọi số
miễn phí 1-866-208-8248.
한국어 (Korean)
2019 년 인구 센서스 시범 조사 설문지 작성에 도움이 필요하시면, 무료 번호
1-866-208-8248 으로 전화해 주십시오.
Русский (Russian)
Для помощи в заполнении анкеты Пробная перепись населения 2019 года , позвоните по номеру
1-866-208-8248 (бесплатно).
‫( العربية‬Arabic)
. 1-866-208-8248: ‫ اتصل برقم الهاتف المجاني‬2019 ‫للحصول على مساعدة في إكمال التعداد السكاني التجريبي لعام‬
Tagalog (Tagalog)
Para sa tulong sa pagkumpleto ng iyong palatanungan Pagsubok ng 2019 Senso, tumawag nang toll free
sa 1-866-208-8248.
Français (French)
Pour obtenir une aide afin de remplir votre questionnaire de test du Recensement 2019, appelez
gratuitement le 1-866-208-8248.
Kreyòl (Haitian Creole)
Pou jwenn èd pou ranpli Kesyonè Tès Resansman 2019 nou an, rele nimewo gratis nou an ki se
1-866-208-8248.
Português (Portuguese)
Para obter ajuda para responder ao questionário do teste do Censo de 2019, ligue gratuitamente
para o telefone 1-866-208-8248.

FORM DM-LI (12-07-2018)

English
Go to and select “English,” located in the upper-right corner of
the window, to access your questionnaire in English.
Español (Spanish)
Vaya a y seleccione “Español,” en la esquina superior
derecha de la ventana, para acceder al cuestionario en español.

FREQUENTLY ASKED
QUESTIONS
respond.census.gov/2019CensusTest

What is the 2019 Census Test?
The 2019 Census Test is a survey that the U.S. Census Bureau is conducting in preparation for
the 2020 Census. By completing this survey, you help prepare for a more accurate count of all
populations in the 2020 Census.
Am I required to respond?
Yes, you are required by law to respond to this survey (Title 13, U.S. Code, Sections 141 and
193). We are conducting this survey under the authority of Title 13, U.S. Code, Sections 141,
193 and 221. This collection of information has been approved by the Office of Management
and Budget (OMB). The eight-digit OMB approval number is 0607-0936. If this number were
not displayed, we could not conduct this survey.
How long will my questionnaire take?
The Census Bureau estimates that completing the questionnaire will take 10 minutes on average.
Send comments regarding this burden estimate or any other aspect of this burden to: Paperwork
Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277, 4600 Silver Hill Road,
Washington, DC 20233. You may email comments to . Use
"Paperwork Reduction Project 0607-0936" as the subject.
How do I respond?
Go to respond.census.gov/2019CensusTest to complete your questionnaire online. You
will need the 10-digit Census ID found on the enclosed letter.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics.
Are my answers conﬁdential and private?
Yes. The Census Bureau is required by law to protect your information (Title 13, U.S. Code,
Section 9). The Census Bureau is not permitted to publicly release your responses in a way that
could identify you or your household. Per the Federal Cybersecurity Enhancement Act of 2015,
your data are protected from cybersecurity risks through screening of the systems that transmit
your data. All web data submissions are encrypted in order to protect your privacy.
Title 13 of the U.S. Code protects the confidentiality of all your information. Violating the
confidentiality of a respondent is a federal crime with serious penalties, including a federal prison
sentence of up to five years, a fine of up to $250,000, or both. Only authorized individuals have
access to the stored data, and the information you provide to the Census Bureau may only be
used by a restricted number of authorized individuals who are sworn for life to protect the
confidentiality of your individual responses. Your answers cannot be used against you by any
government agency or court.
For more information about how we protect your information, please visit our Web site at
census.gov and click on "Data Protection and Privacy Policy" at the bottom of the home page.
This page also includes information about the collection, storage, and use of these records. Click
on "System of Records Notices (SORN)" and look for Privacy Act System of Records Notice
COMMERCE/CENSUS-5, Decennial Census Program.

FORM DM-FL(E/S) (11-21-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

PREGUNTAS
FRECUENTES
respond.census.gov/2019CensusTest

¿Qué es la Prueba del Censo del 2019?
La Prueba del Censo del 2019 es una encuesta que la Oficina del Censo de los EE. UU. está
llevando a cabo en preparación para el Censo del 2020. Al completar esta encuesta, usted nos
ayuda a preparar un conteo más preciso de todas las poblaciones en el Censo del 2020.
¿Debo responder?
Sí, a usted se le requiere por ley que responda a esta encuesta (Secciones 141 y 193 del
Título 13 del Código de los EE. UU.). Estamos llevando a cabo esta encuesta en conformidad
con las Secciones 141, 193 y 221 del Título 13 del Código de los EE. UU. Esta recopilación de
información ha sido aprobada por la Oficina de Administración y Presupuesto (OMB, por sus
siglas en inglés). El número de aprobación de ocho dígitos de la OMB es 0607-0936. De no
mostrarse este número, no podríamos realizar esta encuesta.
¿Cuánto tiempo va a tomar el cuestionario?
La Oficina del Censo calcula que completar el cuestionario tomará 10 minutos como promedio.
Los comentarios sobre el cálculo de tiempo y esfuerzo o cualquier otro aspecto relacionado
deben dirigirse a: Paperwork Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277,
4600 Silver Hill Road, Washington, DC 20233. Puede enviar comentarios por correo electrónico
a . Use "Paperwork Reduction Project 0607-0936" como tema.
¿Cómo respondo?
Visite respond.census.gov/2019CensusTest para completar el cuestionario por internet.
Usted va a necesitar el número de Identificación del Censo de 10 dígitos que se encuentra en la
carta adjunta.
¿Cómo usará la Oﬁcina del Censo la información que yo proporcione?
Por ley, la Oficina del Censo solo puede usar sus respuestas para producir estadísticas.
¿Mis respuestas son conﬁdenciales y privadas?
Sí. La Oficina del Censo está obligada por ley a proteger su información (Sección 9 del Título 13
del Código de los EE. UU.). A la Oficina del Censo no se le permite divulgar sus respuestas de
manera que usted o su hogar pudieran ser identificados. Según la Ley Federal para el
Fortalecimiento de la Seguridad Informática de 2015, sus datos están protegidos de los riesgos
de la seguridad en la internet mediante controles en los sistemas que transmiten sus datos. Todas
las transmisiones de datos por internet están cifradas para proteger su privacidad.
El Título 13 del Código de los EE. UU. protege la confidencialidad de toda su información. Violar la
confidencialidad de una persona encuestada es un delito federal con serias sanciones, incluyendo
una condena de hasta cinco años en una prisión federal, una multa de hasta $250,000 o ambas.
Solo personas autorizadas tienen acceso a los datos recopilados, y la información que usted
proporcione a la Oficina del Censo puede ser usada solamente por un número limitado de personas
autorizadas que han jurado de por vida proteger la confidencialidad de sus respuestas individuales.
Sus respuestas no pueden ser usadas en su contra por ninguna agencia o tribunal del gobierno.
Para obtener más información sobre cómo protegemos su información, visite nuestro sitio web
census.gov y haga clic en “Data Protection and Privacy Policy” (Normas de protección de datos y
privacidad) en la parte inferior de la página principal. La página sobre protección de datos y normas
de privacidad también incluye información sobre la recopilación, almacenamiento y uso de esos
registros. Haga clic en "System of Records Notices (SORN)" (Avisos sobre el Sistema de Registros
Escritos) y busque Privacy Act System of Records Notice COMMERCE/CENSUS-5, Decennial
Census Program (Aviso sobre el Sistema de Registros de la Ley sobre la Privacidad
COMMERCE/CENSUS-5, Programa del Censo Decenal).

FORM DM-FL(E/S) (11-21-2018)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

FREQUENTLY ASKED
QUESTIONS
respond.census.gov/2019CensusTest

What is the 2019 Census Test?
The 2019 Census Test is a survey that the U.S. Census Bureau is conducting in preparation for
the 2020 Census. By completing this survey, you help prepare for a more accurate count of all
populations in the 2020 Census.
Am I required to respond?
Yes, you are required by law to respond to this survey (Title 13, U.S. Code, Sections 141
and 193). We are conducting this survey under the authority of Title 13, U.S. Code, Sections 141,
193 and 221. This collection of information has been approved by the Office of Management and
Budget (OMB). The eight-digit OMB approval number is 0607-0936. If this number were not
displayed, we could not conduct this survey.
How long will my questionnaire take?
The Census Bureau estimates that completing the questionnaire will take 10 minutes on average.
Send comments regarding this burden estimate or any other aspect of this burden to: Paperwork
Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277, 4600 Silver Hill Road,
Washington, DC 20233. You may email comments to .
Use "Paperwork Reduction Project 0607-0936" as the subject.
How do I respond?
Go to respond.census.gov/2019CensusTest to complete your questionnaire online. You
will need the 10-digit Census ID found below the barcode on the questionnaire.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics.
Are my answers conﬁdential and private?
Yes. The Census Bureau is required by law to protect your information (Title 13, U.S. Code,
Section 9). The Census Bureau is not permitted to publicly release your responses in a way that
could identify you or your household. Per the Federal Cybersecurity Enhancement Act of 2015,
your data are protected from cybersecurity risks through screening of the systems that transmit
your data. All web data submissions are encrypted in order to protect your privacy.
Title 13 of the U.S. Code protects the confidentiality of all your information. Violating the
confidentiality of a respondent is a federal crime with serious penalties, including a federal prison
sentence of up to five years, a fine of up to $250,000, or both. Only authorized individuals have
access to the stored data, and the information you provide to the Census Bureau may only be
used by a restricted number of authorized individuals who are sworn for life to protect the
confidentiality of your individual responses. Your answers cannot be used against you by any
government agency or court.
For more information about how we protect your information, please visit our Web site at
census.gov and click on "Data Protection and Privacy Policy" at the bottom of the home page.
This page also includes information about the collection, storage, and use of these records.
Click on "System of Records Notices (SORN)" and look for Privacy Act System of Records Notice
COMMERCE/CENSUS-5, Decennial Census Program.

FORM DM-FA(E/S) (11-21-2018)

OMB No. 0607-0936: Approval Expires 08/31/2021

PREGUNTAS
FRECUENTES
respond.census.gov/2019CensusTest

¿Qué es la Prueba del Censo del 2019?
La Prueba del Censo del 2019 es una encuesta que la Oficina del Censo de los EE. UU. está
llevando a cabo en preparación para el Censo del 2020. Al completar esta encuesta, usted nos
ayuda a preparar un conteo más preciso de todas las poblaciones en el Censo del 2020.
¿Debo responder?
Sí, a usted se le requiere por ley que responda a esta encuesta (Secciones 141 y 193 del
Título 13 del Código de los EE. UU.). Estamos llevando a cabo esta encuesta en conformidad
con las Secciones 141, 193 y 221 del Título 13 del Código de los EE. UU. Esta recopilación de
información ha sido aprobada por la Oficina de Administración y Presupuesto (OMB, por sus
siglas en inglés). El número de aprobación de ocho dígitos de la OMB es 0607-0936. De no
mostrarse este número, no podríamos realizar esta encuesta.
¿Cuánto tiempo va a tomar el cuestionario?
La Oficina del Censo calcula que completar el cuestionario tomará 10 minutos como promedio.
Los comentarios sobre el cálculo de tiempo y esfuerzo o cualquier otro aspecto relacionado
deben dirigirse a: Paperwork Reduction Project 0607-0936, U.S. Census Bureau, ADDC-4H277,
4600 Silver Hill Road, Washington, DC 20233. Puede enviar comentarios por correo electrónico
a . Use "Paperwork Reduction Project 0607-0936" como tema.
¿Cómo respondo?
Visite respond.census.gov/2019CensusTest para completar el cuestionario por internet.
Usted va a necesitar el número de Identificación del Censo de 10 dígitos que se encuentra debajo
del código de barras en el cuestionario.
¿Cómo usará la Oﬁcina del Censo la información que yo proporcione?
Por ley, la Oficina del Censo solo puede usar sus respuestas para producir estadísticas.
¿Mis respuestas son conﬁdenciales y privadas?
Sí. La Oficina del Censo está obligada por ley a proteger su información (Sección 9 del Título 13
del Código de los EE. UU.). A la Oficina del Censo no se le permite divulgar sus respuestas de
manera que usted o su hogar pudieran ser identificados. Según la Ley Federal para el
Fortalecimiento de la Seguridad Informática de 2015, sus datos están protegidos de los riesgos de
la seguridad en la internet mediante controles en los sistemas que transmiten sus datos. Todas las
transmisiones de datos por internet están cifradas para proteger su privacidad.
El Título 13 del Código de los EE. UU. protege la confidencialidad de toda su información. Violar la
confidencialidad de una persona encuestada es un delito federal con serias sanciones, incluyendo
una condena de hasta cinco años en una prisión federal, una multa de hasta $250,000 o ambas.
Solo personas autorizadas tienen acceso a los datos recopilados, y la información que usted
proporcione a la Oficina del Censo puede ser usada solamente por un número limitado de personas
autorizadas que han jurado de por vida proteger la confidencialidad de sus respuestas individuales.
Sus respuestas no pueden ser usadas en su contra por ninguna agencia o tribunal del gobierno.
Para obtener más información sobre cómo protegemos su información, visite nuestro sitio web
census.gov y haga clic en “Data Protection and Privacy Policy” (Normas de protección de datos y
privacidad) en la parte inferior de la página principal. La página sobre protección de datos y normas
de privacidad también incluye información sobre la recopilación, almacenamiento y uso de esos
registros. Haga clic en "System of Records Notices (SORN)" (Avisos sobre el Sistema de Registros
Escritos) y busque Privacy Act System of Records Notice COMMERCE/CENSUS-5, Decennial
Census Program (Aviso sobre el Sistema de Registros de la Ley sobre la Privacidad
COMMERCE/CENSUS-5, Programa del Censo Decenal).

FORM DM-FA(E/S) (11-21-2018)

Núm. de OMB 0607-0936: Aprobado hasta 08/31/2021

DC
U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

To return your census questionnaire, please make sure the
BARCODE ABOVE YOUR ADDRESS appears in this window.
Para enviar de vuelta su cuestionario del censo,
asegúrese de que el CÓDIGO DE BARRAS ENCIMA
DE SU DIRECCIÓN aparezca en esta ventana.

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 17162

WASHINGTON DC

POSTAGE WILL BE PAID BY U.S. CENSUS BUREAU

US CENSUS BUREAU
NATIONAL PROCESSING CENTER
PO BOX 5220
JEFFERSONVILLE IN 47199-5220

AATADFDTFFFDADTFDAAFFTDTATAAAFFTDDTTDFATADDADFFTDFDDFAATFATTDTDAD

Size: 8-3/4 x 5-3/4"

window: 4-5/8 x 7/8"

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

Thank you for participating.
Gracias por participar.

Your return envelope should look like this.
Make sure the BARCODE ABOVE YOUR ADDRESS
appears in the window.

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

OFFICIAL BUSINESS
Penalty for Private Use $300

▼

Su sobre para enviar el cuestionario debe ser como
este. Asegúrese de que el CÓDIGO DE BARRAS
ENCIMA DE SU DIRECCIÓN aparezca
en la ventana.

a199999999b
BUSINESS REPLY MAIL
FIRST-CLASS MAIL PERMIT NO. 17162 WASHINGTON DC

POSTAGE WILL BE PAID BY U.S. CENSUS BUREAU

US CENSUS BUREAU
NATIONAL PROCESSING CENTER
PO BOX 5220
JEFFERSONVILLE IN 47199-5220

DM-ER-IN(E/S) (1-2019)

"Thank you for participating", prints on the interior of the flap.

DM-ER-IN(E/S) (BACK)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

YOUR RESPONSE IS
REQUIRED BY LAW
SU RESPUESTA ES
REQUERIDA POR LEY

Size 9-1/4" x 5-7/8"

covered window 5" x 1-5/8"

Available online
Disponible en internet

respond.census.gov/2019CensusTest
DM-EO-F1(E/S) (12-2018)

Size 9-1/4" x 5-7/8"

DC
U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

YOUR RESPONSE IS
REQUIRED BY LAW
SU RESPUESTA ES
REQUERIDA POR LEY

Size 9-1/2 x 6-1/16" Open window 4-1/2" x 2-3/4"

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

Available online
Disponible en internet

respond.census.gov/2019CensusTest

DM-EO-C1(E/S) (12-2018)

DC
U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

Size 9 -1/2 x 4-1/8 with covered window 1-1/2 x 5

YOUR RESPONSE IS
REQUIRED BY LAW
SU RESPUESTA ES
REQUERIDA POR LEY

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

Available online
Disponible en internet

respond.census.gov/2019CensusTest
DM-EO2(E/S) (12-2018)

DC
U.S. Census Bureau
National Processing Center
1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300

YOUR RESPONSE IS
REQUIRED BY LAW

We have not yet received your response

SU RESPUESTA ES
REQUERIDA POR LEY

Todavía no hemos recibido su respuesta

Size 9-1/2 x 6-1/16" Open window 4-1/2" x 2-3/4"

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58

Available online
Disponible en internet

respond.census.gov/2019CensusTest
DM-EO4(E/S) (12-2018)

Attachment C

Methods Panel Burden Tracker

3-year American Community Survey Methods Panel Tests (0607-0936) (August 2018 - August 2021)
Total Burden Hours Requested over 3 years: 348,167

Methods Panel Submissions for Tests in
August 2018-August 2021
Mail Materials Test
2019 Census Test

Total

Field Date
September 2018
June 2019

Sample
Size (HUs)
480,000

Estimated
Number of
Respondents

Cost to
Respondent
$0
241,440
$0

Burden
Hours
Requested

Estimated
Burden Hours
Used
0
0
40,000
40,240

40,000

Notes
part of production sample

40,240

2/13/2019

Attachment D

amozie on DSK3GDR082PROD with NOTICES1

5986

Federal Register / Vol. 84, No. 37 / Monday, February 25, 2019 / Notices

Public Call Information: Dial: 877–
260–1479. Conference ID: 8906085.
FOR FURTHER INFORMATION CONTACT: Ana
Victoria Fortes (DFO) at afortes@
usccr.gov or (213) 894–3437.
SUPPLEMENTARY INFORMATION: This
meeting is available to the public
through the following toll-free call-in
number: 877–260–1479, conference ID
number: 8906085. Any interested
member of the public may call this
number and listen to the meeting.
Callers can expect to incur charges for
calls they initiate over wireless lines,
and the Commission will not refund any
incurred charges. Callers will incur no
charge for calls they initiate over landline connections to the toll-free
telephone number. Persons with hearing
impairments may also follow the
proceedings by first calling the Federal
Relay Service at 1–800–877–8339 and
providing the Service with the
conference call number and conference
ID number.
Members of the public are entitled to
make comments during the open period
at the end of the meeting. Members of
the public may also submit written
comments; the comments must be
received in the Regional Programs Unit
within 30 days following the meeting.
Written comments may be mailed to the
Western Regional Office, U.S.
Commission on Civil Rights, 300 North
Los Angeles Street, Suite 2010, Los
Angeles, CA 90012. They may be faxed
to the Commission at (213) 894–0508, or
emailed Ana Victoria Fortes at afortes@
usccr.gov. Persons who desire
additional information may contact the
Regional Programs Unit at (213) 894–
3437.
Records and documents discussed
during the meeting will be available for
public viewing prior to and after the
meeting at. https://
www.facadatabase.gov/FACA/
FACAPublicViewCommitteeDetails?id=
a10t0000001gzljAAA. Please click on
the ‘‘Meeting Details’’ and ‘‘Documents’’
links. Records generated from this
meeting may also be inspected and
reproduced at the Regional Programs
Unit, as they become available, both
before and after the meeting. Persons
interested in the work of this Committee
are directed to the Commission’s
website, https://www.usccr.gov, or may
contact the Regional Programs Unit at
the above email or street address.
Agenda
I. Welcome
II. Review Report Draft
III. Public Comment
IV. Next Steps
V. Adjournment

VerDate Sep<11>2014

16:22 Feb 22, 2019

Jkt 247001

Dated: February 20, 2019.
David Mussatt,
Supervisory Chief, Regional Programs Unit.
[FR Doc. 2019–03202 Filed 2–22–19; 8:45 am]
BILLING CODE P

DEPARTMENT OF COMMERCE
U.S. Census Bureau
Submission for OMB Review;
Comment Request
The Department of Commerce will
submit to the Office of Management and
Budget (OMB) for clearance the
following proposal for collection of
information under the provisions of the
Paperwork Reduction Act.
Agency: U.S. Census Bureau.
Title: American Community Survey
Methods Panel Tests, 2019 Census Test.
OMB Control Number: 0607–0936.
Form Number(s): DM–QA, DM–QA(E/
S), DM–QB, DM–QB(E/S).
Type of Request: Non-Substantive
Change Request.
Number of Respondents: 480,000.
Average Hours per Response: 10
minutes for the average household
questionnaire.
Burden Hours: No additional burden
hours are requested under this nonsubstantive change request.
Needs and Uses: The U.S. Census
Bureau requests authorization from the
Office of Management and Budget
(OMB) for the American Community
Survey (ACS) Methods Panel 2019
Census Test. The purpose of this
proposed test is to gather direct,
quantitative information on the
potential impact of the inclusion of the
citizenship question on self-response in
the 2020 Census to fine-tune the
planning for the 2020 Census
Nonresponse Follow-up (NRFU)
operation, which is designed to collect
responses from addresses that did not
self-respond. The potential impact on
self-response is of particular interest
since it is the primary and most costeffective mode of data collection in the
decennial census. The Census Bureau
lacks definitive, empirical evidence on
the impact of the inclusion of the
citizenship question on self-response in
the 2020 Census. The information
obtained from this test may also inform
the Integrated Partnership and
Communications Campaign, which is
the outreach campaign to maximize selfresponse to the 2020 Census.
The 2019 Census Test will use the
ACS Methods Panel to conduct the test.
This will allow the Census Bureau to
continue devoting its full complement
of staff resources to 2020 Census
operations.

PO 00000

Frm 00008

Fmt 4703

Sfmt 4703

The ACS Methods Panel is a research
program designed to address and
respond to emerging issues and needs of
the Census Bureau’s Decennial Census
Programs, including the 2020 Census
and ACS. Every year, the Census Bureau
contacts over 3.5 million sampled
addresses across the country to
participate in the ACS and hundreds of
millions each decade for the decennial
census. The complexity of both of these
programs requires that the Census
Bureau continue research, testing, and
evaluations aimed at reducing
respondent burden, improving data
quality, achieving survey cost
efficiencies, and improving
questionnaire content and related data
collection materials.
For the 2019 Census Test, the Census
Bureau will compare two treatments
using a randomized controlled
experiment. The control treatment
questionnaire will ask 2020 Census
questions (i.e., number of people,
tenure, sex, age, date of birth, Hispanic
origin, race, citizenship, relationship to
householder, and coverage questions).
The experimental treatment
questionnaire will ask these same
questions minus the citizenship
question.
The test will employ a sample size of
480,000 addresses that will be divided
evenly between the control and the
experimental treatments. This sample
size is designed to detect a difference of
0.5 percentage points between the selfresponse rates of the control and
experimental treatments at the national
level. The sample, which will be
separate from the ACS production
sample, will oversample areas with high
proportions of non-citizens and
historically low self-response rates. The
sample construction will allow for
limited analysis by race and Hispanic
origin.
The test will have a Census Day
(reference date) of July 1, 2019. The first
mailing will go out mid-June 2019. The
data collection period will be nine
weeks. Data collection will end midAugust 2019. The test will utilize the
2020 Census mail strategy, including
internet First and internet Choice
contact strategies, and the use of
English-only and English/Spanish
bilingual materials. With the internet
First contact strategy, the initial mailing
only provides instructions for
responding online. The initial mailing
for the internet Choice contact strategy
also includes a paper questionnaire. For
each contact strategy, a subset of the
areas will receive bilingual materials
(English/Spanish).
The 2019 Census Test will be of the
household population and will include

E:\FR\FM\25FEN1.SGM

25FEN1

5987

Federal Register / Vol. 84, No. 37 / Monday, February 25, 2019 / Notices
areas designated to be self-response
areas in the 2020 Census, specifically
excluding Puerto Rico and the
population living in group quarters. The
test will be conducted using selfresponse only. The Census Bureau will
also provide telephone questionnaire
assistance (TQA). Respondents will be
able to call TQA with questions about
the survey and may also complete their
survey over the phone. TQA can
support 10 of the 12 non-English
languages supported in the 2020
Census: Spanish, Chinese (Mandarin
and Cantonese), Vietnamese, Korean,
Russian, Arabic, Tagalog, French,
Haitian Creole, and Portuguese. The
exceptions are Japanese and Polish.
Preliminary results that can be used to
adjust NRFU hiring and refine
messaging for the Integrated Partnership
and Communications Campaign will be
available on a rolling basis. Selfresponse rates will be available by the
end of August 2019, and preliminary
results will be available in early October
2019. Final results are expected by
spring 2020.

Affected Public: Individuals or
households.
Frequency: One-time test.
Respondent’s Obligation: Mandatory.
Legal Authority: Title 13, United
States Code, Sections 141, 193, and 221.
This information collection request
may be viewed at www.reginfo.gov.
Follow the instructions to view
Department of Commerce collections
currently under review by OMB.
Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to OIRA_Submission@
omb.eop.gov or fax to (202) 395–5806.
Sheleen Dumas,
Departmental Lead PRA Officer, Office of the
Chief Information Officer, Commerce
Department.
[FR Doc. 2019–03200 Filed 2–22–19; 8:45 am]
BILLING CODE 3510–07–P

DEPARTMENT OF COMMERCE
Economic Development Administration
Notice of Petitions by Firms for
Determination of Eligibility To Apply
for Trade Adjustment Assistance
Economic Development
Administration, U.S. Department of
Commerce.
ACTION: Notice and opportunity for
public comment.
AGENCY:

The Economic Development
Administration (EDA) has received
petitions for certification of eligibility to
apply for Trade Adjustment Assistance
from the firms listed below.
Accordingly, EDA has initiated
investigations to determine whether
increased imports into the United States
of articles like or directly competitive
with those produced by each of the
firms contributed importantly to the
total or partial separation of the firms’
workers, or threat thereof, and to a
decrease in sales or production of each
petitioning firm.
SUPPLEMENTARY INFORMATION:
SUMMARY:

LIST OF PETITIONS RECEIVED BY EDA FOR CERTIFICATION OF ELIGIBILITY TO APPLY FOR TRADE ADJUSTMENT
ASSISTANCE

amozie on DSK3GDR082PROD with NOTICES1

[01/29/2019 through 02/18/2019]
Date
accepted for
investigation

Firm name

Firm address

MTI Precision Products, LLC d/b/a MTI
Dental Products.

131 Birch Street, Coatesville, PA 19320

2/8/2019

Snow Country Hardwoods, Inc .................

1300 Odanah Road, Hurley, WI 54534 ..

2/8/2019

Buckeye Fabric Finishers, Inc. d/b/a
Buckeye Fabric Finishing Company.

1260 East Main Street, Coshocton, OH
43812.

2/11/2019

Banneker Industries, Inc ...........................

582 Great Road, Suite 101, North
Smithfield, RI 02896.

2/12/2019

FormPak, Inc ............................................

355 Paul Avenue, Ferguson, MO 63135

2/13/2019

Custom Storefronts, Inc ............................

1490 West Ironwood Street, Olathe, KS
66061.

2/14/2019

Miller EPS, LLC ........................................

613 West 3rd Street, Mountain Grove,
MO 65711.

2/14/2019

Any party having a substantial
interest in these proceedings may
request a public hearing on the matter.
A written request for a hearing must be
submitted to the Trade Adjustment
Assistance Division, Room 71030,

VerDate Sep<11>2014

16:22 Feb 22, 2019

Jkt 247001

Economic Development Administration,
U.S. Department of Commerce,
Washington, DC 20230, no later than ten
(10) calendar days following publication
of this notice. These petitions are

PO 00000

Frm 00009

Fmt 4703

Sfmt 4703

Product(s)
The firm manufactures dental handpieces and related attachments for
drilling and polishing teeth.
The firm manufactures wood flooring,
paneling, moldings, and other wood
products from a wide range of tree
species.
The firm applies coatings to a wide
range of textiles, including wax, resin,
vinyl, acrylic, and other custom coatings.
The firm provides supply chain management and integrated logistics services
for large manufacturers and service
firms.
The firm manufactures dry material handling and packaging systems, including equipment for filling and unloading
sacks of dry materials.
The firm designs and manufactures custom windows and doors of metal and
wood.
The firm manufactures plastic plumbing
fixtures.

received pursuant to section 251 of the
Trade Act of 1974, as amended.
Please follow the requirements set
forth in EDA’s regulations at 13 CFR
315.9 for procedures to request a public
hearing. The Catalog of Federal

E:\FR\FM\25FEN1.SGM

25FEN1

Attachment E

American Community Survey Research and Evaluation Program
February 22, 2019

ACS Research & Evaluation Analysis Plan (REAP)

2019 Census Test
Work Request ID: RS19-1-1271

Elizabeth Poehler,
Dorothy Barth, and Broderick Oliver
DSSD
Author
David Raglin
ACSO
Project Manager
Victoria Velkoff
Division Authority

REAP Revision Log
Version
0.1
0.2

Date
10/29/2018
1/7/2019

0.3

1/28/2019

0.4

2/22/2019

Description
Initial Draft
Draft sent to Critical Reviewers
Comments from Critical Review
incorporated
Comments from Approval incorporated

Author
Elizabeth Poehler
Elizabeth Poehler
Elizabeth Poehler,
Dorothy Barth
Elizabeth Poehler,
Dorothy Barth

TABLE OF CONTENTS
1

Introduction ................................................................................................................... 1

Background .................................................................................................................... 1
2.1
2.2

Citizenship Question ..................................................................................................... 1
Self-Response Strategy ................................................................................................. 2

2.2.1 Internet First Contact Strategy ..................................................................................... 3
2.2.2 Internet Choice Contact Strategy ................................................................................. 5
3

Research Questions and Methodology ............................................................................ 6
3.1
3.2
3.3
3.4

Sample Design ............................................................................................................... 6
2019 Census Test Operational Plan .............................................................................. 7
Research Questions ...................................................................................................... 9
Unit Response Analysis ............................................................................................... 10

3.4.1
3.4.2
3.4.3
3.4.4
3.4.5
3.4.6
3.4.7

Overall Self-Response Rates (RQ1) ............................................................................. 10
Self-Response Rates Over Time (RQ2a) ...................................................................... 11
Self-Response Rates by Mode (RQ2b) ........................................................................ 12
Self-Response Rates by Contact and Language Strategy Areas (RQ2c) ...................... 12
Self-Response Rates in Areas with Different Non-Citizen Rates (RQ2d) .................... 13
Self-Response Rates by Low Response Score (RQ2e) ................................................. 13
Self-Response Rates in Areas with Different Rates of Foreign-Born Residents in
the Tract (RQ2f) ......................................................................................................... 14
3.4.8 Self-Response Rates in Areas with Different Rates of Hispanic Residents in the
Tract (RQ2g)............................................................................................................... 14
3.4.9 Self-Response Rates by Regional Census Center (RQ2h)............................................ 15
3.4.10 Self-Response Rates by Urban/Rural Areas (RQ2i) ..................................................... 15

3.5

Item-Level Analysis ..................................................................................................... 16

3.5.1
3.5.2
3.5.3
3.5.4

Demographic Analyses................................................................................................ 16
Item Nonresponse and Form Completeness (RQ4 and RQ5) ..................................... 19
Internet Breakoff Rate (RQ6) ...................................................................................... 22
Citizenship Question Item Nonresponse Rate (RQ7).................................................. 23

3.6

Standard Errors ........................................................................................................... 23

Assumptions and Limitations ........................................................................................ 24
4.1
4.2

Assumptions................................................................................................................ 24
Limitations................................................................................................................... 24

Table Shells .................................................................................................................. 25

Potential Impacts.......................................................................................................... 27

References.................................................................................................................... 27
ii

Appendix A. Images of the Paper Questionnaires ................................................................. 29
Appendix B. Internet First Mail Materials............................................................................. 33
Appendix C. Internet Choice Mail Materials ......................................................................... 34
Appendix D. Census Bureau 2020 Regional Census Center Boundaries ................................. 35

iii

INTRODUCTION

In December 2017, the Department of Justice (DOJ) made a request to reinstate the citizenship
question on the 2020 Census. As a result of the request, the 2020 Census may ask respondents to
answer a question regarding their citizenship status.
During the Department of Commerce’s review of the DOJ request, the Census Bureau studied the
quality of citizenship data by comparing self-reported responses from several surveys with
administrative records on citizenship from the Social Security Administration. The results of the
study suggested that “adding a citizenship question to the 2020 Census would lead to lower selfresponse rates in households potentially containing non-citizens…” compared to households with all
citizens (Brown, Heggeness, Dorinski, Lawrence, & Yi, 2018). However, the authors noted that the
analysis conducted was not the ideal method for studying the self-response effect of including a
citizenship question on the 2020 Census. They recommended a randomized control trial to compare
response rates on a questionnaire without a citizenship question to one with the citizenship
question. In response to the recommendation, the U.S. Census Bureau will conduct the 2019 Census
Test, a nationwide, randomized field experiment designed to study the potential impact on selfresponse of including a citizenship question on the census questionnaire.
Understanding the effect of the citizenship question on self-response rates is important for 2020
Census cost purposes and planning. A lower self-response rate prior to the start of Nonresponse
Followup (NRFU) results in a larger workload. These in-person and telephone contacts during NRFU
with respondents are much more expensive than self-response.
The 2019 Census Test will measure the operational effect of including a citizenship question on a
census questionnaire. The results of this test will help plan for the NRFU operation in 2020 and
inform the Integrated Partnership and Communications Campaign, should the citizenship question
appear on the 2020 Census form.

2
2.1

BACKGROUND
Citizenship Question

A question on citizenship has been asked in previous censuses including in 1820, 1830, 1870, and
1890 to 1950 (U.S. Census Bureau, 2018b). However, from 1960 to 2000, only the sample of
households (one-in-six for the 2000 Census) that were selected to complete the decennial long-form
were asked this question. Households receiving the decennial short-form were not asked this
question. The American Community Survey, which replaced the decennial long-form questionnaire,
has included the citizenship question since its inception in 2005. 1 As such, the citizenship question
was not asked as part of the 2010 Census.

The American Community Survey selects a sample of about 3.5 million housing unit addresses each year (about
288,000 each month).

Figure 1 shows the citizenship question that will be used for the 2019 Census Test and is being
proposed for the 2020 Census. If it appears on the 2020 Census, it will be the first time that the
citizenship question will be asked of everyone in a decennial census since the 1950 Census. If
implemented, the proposed 2020 Census citizenship question would be asked of each person
rostered on the form. 2 It would be the last question asked after collecting a person’s name,
relationship to first person rostered, sex, age, date of birth, Hispanic origin, and race. See Appendix
A for images of the questionnaires.
Figure 1. Citizenship Question

For the 2019 Census Test, about half of the respondents will receive a questionnaire containing the
citizenship question and the other half of the respondents will receive a questionnaire without the
citizenship question. See Section 3 for more details.
2.2

Self-Response Strategy

To encourage self-response during the 2020 Census, the Census Bureau will use one of two mail
contact strategies: Internet First or Internet Choice. These same contact strategies will be used for
the 2019 Census Test.
Because response by internet is more cost effective than response by paper questionnaire, a
majority of the housing units in self-response mailout areas will receive up to five mailings using the
Internet First contact strategy. 3 With the Internet First strategy, the initial mailings provide the
options to respond online or to call to respond over the phone. For some areas of the country, such
2

The internet and Telephone Questionnaire Assistance (TQA) instruments roster up to 99 people for each household
and asks the question for all people rostered. The paper questionnaire rosters up to ten people, but only asks the
citizenship question for the first six people rostered.
3
For the purpose of the decennial census, geographic areas in the United States are assigned to one specific Type of
Enumeration Area (TEA). The TEA assignment is based on address types and other characteristics of the area, including
an assessment of the likelihood of residents to self-respond and the accessibility of the area. The TEA assignment
determines the methodology used for frame creation and enumeration of people in the area. A majority of the country
is enumerated using self-response mailout methods.

as areas with low internet access or areas that are historically less likely to self-respond, this
strategy is not ideal. Instead, an Internet Choice contact strategy will be used for those areas. With
the Internet Choice contact strategy, the initial mailings include online, telephone, and paper
questionnaire response options. About 20 percent of housing units in self-response mailout areas
will receive up to five mailings using the Internet Choice contact strategy. All nonresponding housing
units will receive a paper questionnaire in the fourth mailing regardless of the initial contact
strategy. Sections 2.2.1 and 2.2.2 provide more details about these two contact strategies.
For each contact strategy, a subset of areas will receive bilingual (English and Spanish) materials.4 As
was done for the 2010 Census, tracts in which at least 20 percent of the occupied housing units have
at least one adult in the household who speaks Spanish and does not speak English “very well” will
be identified as bilingual (Bentley, 2008). All housing units in these tracts will receive bilingual
materials. Overall, about 10 percent of housing units in the country will receive bilingual materials in
the 2020 Census.
2.2.1 Internet First Contact Strategy
The Internet First contact strategy emphasizes online response as the primary self-response option.
This strategy includes up to five mailings. The first mailing invites respondents to complete the
census online. The subsequent mailings include a reminder letter, a reminder postcard, a paper
questionnaire package, and a final reminder postcard. All households in this contact strategy will
receive the first two mailings.
Subsequent contact with a household is dependent upon if and when the Census Bureau receives a
response from the household. New mailing universes, where addresses of respondents from the
previous mailing are removed, will be created after the second, third, and fourth mailings.
The Census Bureau will provide a telephone number in all mailings that respondents may use to
complete the questionnaire over the telephone or to ask questions. During the 2020 Census, the
mailings in this contact strategy will be delivered in four cohorts to more evenly distribute expected
workloads for the Census Questionnaire Assistance operation and the processing systems. This
staggered mail delivery approach will not be employed in the 2019 Census Test, since the lower
volume of responses are not expected to overload the telephone workload and processing systems.
2.2.1.1 First and Second Mailings (Initial Mailing Universe)
The first mailing, or the initial mailing, will be sent to all mailable housing unit addresses in the selfresponse mailout areas identified for the Internet First contact strategy.5 This mailing includes an
4
5

Throughout this report the term “bilingual” will refer to materials that contain both English and Spanish wording.
A mailable address is a complete city-style address including a house number, street name, and a ZIP Code or a
complete rural-route address including a rural-route number, box number, and a ZIP Code (U.S. Census Bureau, 2014).

invitation to respond online and states that a paper questionnaire will be sent in a few weeks to
those who are not able to respond online. The initial mailing will also include a language assistance
sheet, which gives telephone numbers for help completing the questionnaire in non-English
languages. A Frequently Asked Questions (FAQ) insert is also included in areas that receive the
bilingual materials. These same FAQs are provided on the back of the English letters in non-bilingual
areas.
About four days after receiving the first mailing, these same addresses receive the second mailing,
which is a reminder letter to respond online, via phone, or wait for a paper questionnaire.
2.2.1.2 Third Mailing (Second Mailing Universe)
About 10 days after receiving the second mailing, the nonresponding addresses will receive the third
mailing, which is a reminder postcard that reiterates the instructions for responding online.6 The
recipients are also reminded that they have the option of responding by a paper questionnaire,
which will be mailed to them in the next mailing.
2.2.1.3 Fourth Mailing (Third Mailing Universe)
About two weeks after receiving the third mailing, the nonresponding addresses will receive the
fourth mailing, a paper questionnaire package. This mailing includes a paper questionnaire, a letter,
a language assistance sheet, and a business reply envelope. The enclosed letter informs respondents
that they can respond by paper questionnaire or online. The paper questionnaire package for
bilingual areas will also include an FAQ insert. These same FAQs are provided on the back of the
English letters in non-bilingual areas.
2.2.1.4 Fifth Mailing (Fourth Mailing Universe)
About two weeks after receiving the fourth mailing, the nonresponding addresses will receive the
fifth mailing, a final reminder postcard. Between one to two weeks later, depending on the mailout
group, responding addresses are removed to create the initial universe of addresses eligible for the
NRFU operation. 7
See Appendix B for the Internet First mail materials.
For more information about the 2020 Internet Self-Response operation, see the 2020 Census
Detailed Operational Plan (U.S. Census Bureau, 2018a).

6
7

“Nonresponding addresses” refers to mailable housing unit addresses from which a response has not been received.
Note that the 2019 Census Test will not include the NRFU operation.

2.2.2 Internet Choice Contact Strategy
The Internet Choice contact strategy will be used in areas with low internet connectivity or areas
with characteristics that make it less likely the recipients will complete the census questionnaire
online. 8 In Internet Choice areas, a paper questionnaire is provided in the first mailing in addition to
instructions for responding online. This mailing and subsequent mailings will also provide a
telephone number that the respondent may call to ask questions or complete the questionnaire
over the phone.
Like the Internet First contact strategy, after the second mailing, subsequent contact with a
household is dependent upon if and when the Census Bureau receives a response from the
household. New mailing universes, where respondents from the previous mailing are removed, will
be created after the second, third, and fourth mailings.
2.2.2.1 First and Second Mailings (Initial Mailing Universe)
The first mailing, the initial paper questionnaire package, is sent to all mailable housing unit
addresses in the self-response mailout areas identified for the Internet Choice contact strategy. The
mailing includes an invitation letter, a paper questionnaire, a business reply envelope, and a
language assistance sheet. The invitation letter instructs respondents to respond online or mail back
the paper questionnaire. The language assistance sheet provides telephone numbers for help
completing the questionnaire in non-English languages. Bilingual areas also receive a FAQ insert.
These same FAQs are provided on the back of the English letters in non-bilingual areas.
About four days after receiving the first mailing, these same addresses receive the second mailing, a
reminder letter, which repeats the instructions to either respond online, send back the paper
questionnaire, or call the telephone questionnaire assistance line to obtain answers to any
questions.
2.2.2.2 Third Mailing (Second Mailing Universe)
About 10 days after receiving the second mailing, the nonresponding addresses will receive the third
mailing, a reminder postcard, which repeats the instruction to respond online or mail back the paper
questionnaire.
2.2.2.3 Fourth Mailing (Third Mailing Universe)
About two weeks after receiving the third mailing, the nonresponding addresses will receive the
fourth mailing, a replacement paper questionnaire package that includes a letter, a paper
questionnaire, a business reply envelope, and a language assistance sheet. Bilingual areas also

See (Mathews & Phelan, DRAFT) for more information.

receive a FAQ insert. These same FAQs are provided on the back of the English letters in nonbilingual areas.
2.2.2.4 Fifth Mailing (Fourth Mailing Universe)
About 10 days after receiving the fourth mailing, the remaining nonresponding addresses receive a
final reminder postcard. About two weeks later, responding addresses are removed to create the
initial universe of addresses eligible for the NRFU operation.9
See Appendix C for the Internet Choice mail materials.
For more information about the 2020 Internet Self-Response operation, see the 2020 Census
Detailed Operational Plan (U.S. Census Bureau, 2018a).

3
3.1

RESEARCH QUESTIONS AND METHODOLOGY
Sample Design

For the 2019 Census Test, we will compare two treatments via a randomized controlled experiment.
Half of the sample will receive the control treatment questionnaire, which will include the
citizenship question. The other half of the sample will receive the experimental treatment
questionnaire, which will not include the citizenship question.
The sample size for this test is approximately 480,000 mailable housing unit addresses. This sample
size is designed to detect a difference of approximately 0.5 percentage points between the overall
self-response rates of the experimental and control treatments at the national level (80 percent
power and α=0.1). Each treatment will be assigned approximately 240,000 addresses. The sample
will allow for additional analysis of subgroups (see Section 3.3 for more information about
subgroups). 10
The sample will be geographically stratified into three strata (high, medium, and low) for the
purpose of oversampling areas with high proportions of non-citizens and low self-response. The
strata were defined by the percent of non-citizens and low response scores (LRS), a response
propensity measure, at the census tract level. The “High Stratum” is comprised of all tracts where
the percent of non-citizens is greater than 11.1 percent. The “Medium Stratum” is comprised of all
tracts where the percent of non-citizens is between 7.22 and 11.1 percent or an LRS score greater
than 24.0 and not covered in the “High Stratum.” 11 All remaining tracts were assigned to the “Low
Stratum” group. The cut-offs were chosen so that the percent of occupied housing units in each

Note that the 2019 Census Test will not include the NRFU operation.
Subgroup analyses will not be able to detect differences between treatments at the same level as the overall analysis.
11
The Low Response Score indicates the propensity to self-respond. Higher scores mean there is a lower response
propensity (Erdman & Bates, 2016).
10

stratum were such that the Low stratum has more than the Medium stratum, which has more than
the High stratum. This resulted in the following allocation:
•
•
•

The “High Stratum” accounts for 19.6% of the occupied housing units.
The “Medium Stratum” accounts for 27.9% of the occupied housing units.
The “Low Stratum” accounts for 52.5% of the occupied housing units.

Within each stratum, the housing unit addresses are sorted geographically and then systematically
sampled. Sampled housing unit addresses will be assigned to one of the treatments, alternating the
assignment between the control and the experimental treatment as selections are made. For more
details on the stratification, see (Poehler, 2019).
Table 1 provides the sample size for each stratum by treatment. Table 2 provides the expected
sample size by contact strategy and language of the materials.
Table 1. Expected Sample Size by Strata
Control Treatment Experimental Treatment
Sample
(With Citizenship
(Without Citizenship
Stratum
Question)
Question)
High
80,000
80,000
Medium
80,000
80,000
Low
80,000
80,000
Total
240,000
240,000
Table 2. Expected Sample Size by Contact Strategy and Language of Materials
Control Treatment Experimental Treatment
Contact Strategy by
(With Citizenship
(Without Citizenship
Language
Question)
Question)
Internet First – English
165,000
165,000
Internet First – Bilingual
22,200
22,200
Internet Choice – English
38,500
38,500
Internet Choice – Bilingual
14,300
14,300
Total
240,000
240,000
3.2

2019 Census Test Operational Plan

The 2019 Census Test will be conducted using a July 1, 2019 Census Day. Nonresponse Followup will
not be conducted for this test. Data collection will begin on June 13, 2019 and will end on August 15,
2019 following the mailing schedule outlined in Table 3. This mailing schedule follows the general
plan for the 2020 Census mailings, but is adjusted to accommodate the July 4th holiday and the
National Processing Center (NPC) work schedule. Following the strategy planned for the 2020
Census, sampled addresses in areas designated to receive Internet Choice mailing materials will
receive mailings following that approach. Sampled addresses in areas designated to receive Internet
7

First mailing materials will receive mailings following that approach. This test will not stagger
Internet First mailings as will be done for the 2020 Census. During the 2020 Census, the mailings in
this contact strategy will be delivered in four cohorts to more evenly distribute expected workloads
for the Census Questionnaire Assistance operation and the processing systems. This staggered mail
delivery approach will not be employed in the 2019 Census Test because the volume of the mailings
and workload for Telephone Questionnaire Assistance (TQA) is not a concern. 12
Table 3. 2019 Census Test Self-Response Contact Strategy Mail Materials and Mailout Dates
Initial
Mailing
6/13/20191

Second
Mailing
6/17/2019

Third
Mailing2
6/27/2019

INTERNET
FIRST
(English or
bilingual)

Invitation Letter,
Language Assistance
Sheet,
FAQ Insert3

Reminder
Letter

Reminder
Postcard

INTERNET
CHOICE
(English or
bilingual)

Invitation Letter,
Paper Questionnaire,
Language Assistance
Sheet,
FAQ Insert3

Reminder
Letter

Reminder
Postcard

Strategy

Fourth
Mailing2
7/10/2019
Reminder Letter,
Paper Questionnaire,
Language Assistance
Sheet,
FAQ Insert3
Reminder Letter,
Paper Questionnaire,
Language Assistance
Sheet
FAQ Insert3

Fifth
Mailing2
7/22/2019
Reminder
Postcard

Reminder
Postcard

Date indicates the day the mail materials will be mailed from the National Processing Center.
Sent to remaining nonresponding addresses after the creation of a new mailing universe following the previous
mailing.
3
FAQ Inserts are only included in bilingual areas. The FAQ information is available on the back of the letter in Englishonly materials.
2

Self-response will be accepted via internet, paper questionnaire, or Telephone Questionnaire
Assistance (TQA). The internet instrument will be available in English and Spanish; the test will also
use English and bilingual mail materials. 13 In addition to English, TQA will support 10 non-English
languages: Spanish, Chinese, Vietnamese, Korean, Russian, Arabic, Tagalog, French, Haitian Creole,
and Portuguese. 14 TQA will utilize the same internet instrument for data collection that respondents
will use. TQA interviewers will be trained to utilize the self-response instrument for an intervieweradministered interview.
The internet instrument for the 2019 Census Test has some differences from the planned 2020
internet instrument, as noted below:

TQA is similar to Census Questionnaire Assistance, which will be used in the 2020 Census.
The 2020 Census will include an internet instrument in eleven additional non-English languages; questionnaire guides
will also be available in 59 non-English languages, plus braille and large print. For more information about the 2020
Census non-English language support see (Kim, 2018).
14
Two languages that will be supported for the 2020 Census (Japanese and Polish) will not be supported for the 2019
Census Test.
13

•

•
•

When responding online, respondents will be asked to enter a “Census ID” found in the mail
materials sent to them. Without this ID, they will not be able to respond online. In the 2020
Census, a “non-ID” response option will be available that allows respondents to complete
the Census without an ID. This “non-ID” option will not be available for this test.
An automated check for consistency in responses to the sex and relationship questions will
not be included.
Users who start to respond but do not finish will be able to log back in and continue
responding from where they left off. The 2020 Census instrument requires respondents to
start over if they do not finish.

This section has highlighted some of the differences between the 2019 Census Test and the plans for
the 2020 Census, which may result in some limitations to extending the conclusions drawn from this
analysis to the 2020 Census (see Section 4.2 for limitations). However, these limitations would
impact both treatments the same and therefore any differences observed between the treatments
can be concluded to be the result of the experiment. Another noteworthy distinction between this
test and the 2020 Census is that, although this test is being conducted to inform the 2020 Census
program, it is being implemented using the infrastructure and resources of the American
Community Survey program.
3.3

Research Questions

The 2019 Census Test will answer the following research questions (RQ). Details about how the
metrics are defined can be found in Sections 3.4 and 3.5.
RQ1. What is the impact on unit self-response rates between treatments?
RQ2. What is the impact on unit self-response rates between treatments for subgroups of
interest? Self-response rate comparisons will be conducted between the control and
experimental treatments within the following subgroups:
a. Over time, at various points in time of data collection
b. Self-response mode
c. Contact and language strategy areas (Internet First/Internet Choice by
English/bilingual)
d. Areas with high, medium, and low proportions of non-citizens
e. Areas with high and low self-response
f. Areas with high, medium, and low proportions of foreign-born populations
g. Areas with high, medium, and low proportions of Hispanics
h. Regional census center
i. Urban areas and rural areas

RQ3. How do selected demographic characteristics compare between treatments for the
responses received?
a.
b.
c.
d.
e.
f.
g.

Relationship
Sex
Age groups
Hispanic origin
Race
Tenure
Average household size

RQ4. What is the impact on item nonresponse between the treatments?
RQ5. What is the impact on form completeness between the treatments?
RQ6. How do breakoff rates between treatments compare for internet returns?
RQ7. For the Control treatment, what is the item nonresponse rate for the citizenship question?
3.4

Unit Response Analysis

All unit self-response rates computed for this report will be weighted. The weight is the inverse of
the probability of selection. A significance level of α=0.1 will be used when determining significant
differences between treatments. Unless otherwise specified, comparisons will be made using a
two-sided t-test. For analyses that involve multiple comparisons, the Type I familywise error rate will
be adjusted using the Hochberg method to further ensure the validity of the statistical inferences
based on simulataneous comparisons (Hochberg, 1988).
3.4.1 Overall Self-Response Rates (RQ1)
To evaluate the impact of the experiment on self-response (SR) between the treatments, selfresponse rates will be calculated. 15
This will test the following hypotheses: H0: SRControl = SRExperiment; HA: SRControl ≠ SRExperiment
The self-response rates will be calculated for each treatment, using the following formula:

Undeliverable as addressed (UAA) rates are not expected to be different between treatments. However, the UAA
rates will be compared between treatments to validate this assumption. If the UAA rates are unexpectedly
significantly different, an alternative metric that removes UAAs from the calculations will be used.

Self– Response Rate =

Unduplicated, sufficient internet, mail, and TQA responses16
Mailout Universe

If more than one sufficient response from an address is received, only the first sufficient response
received will be used in the calculations of self-response rates. See (U.S. Census Bureau, 2016a) for
the definition of a sufficient response.17
The denominator (i.e., the mailout universe) is comprised of sampled addresses. The definitions of
unduplicated, sufficient returns and the mailout universe will be used for all self-response rate
calculations.
3.4.2 Self-Response Rates Over Time (RQ2a)
Changes to self-response impact each subsequent phase of the mailing process. An increase in selfresponse decreases the number of subsequent mailing pieces that need to be sent out, reducing
costs. A decrease in self-response increases the mailing costs. A significant increase in self-response
before the start of the NRFU operation decreases the number of NRFU interviews required (which is
more costly than self-response). Likewise, a significant decrease in self-response increases the NRFU
workload and associated costs. To understand any potential impacts, cumulative self-response rates
will be calculated at selected points in time in the data collection cycle and compared between
treatments.
The selected points in time reflect the dates of additional mailings or key dates related to the timing
of NRFU for the 2020 Census:
1. All returns received through close of business on 6/20, when the mail file will be created for
the 3rd mailing 18
2. All returns received through close of business on 7/2, when the mail file will be created for
the 4th mailing
3. All returns received through close of business on 7/15, when the mail file will be created for
the 5th mailing
4. All returns received through close of business on 8/13, when a hypothetical NRFU universe
would be created (mirroring the 2020 Census process)
5. All returns received through closeout on 8/15, when a hypothetical NRFU operation would
start (mirroring the 2020 Census process)

The internet response instrument will also include an option to report an address as being a vacant housing unit. This
will be considered a valid response in our response rate calculations.
17
Note that the definition of a sufficient response for internet responses for the 2019 Census Test is different than the
2020 Census if using internet status codes.
18
Because the second mailing is sent so soon after the initial mailing and is sent to everyone, self-response rates will not
be compared before the second mailing.

This will test the following hypotheses, where the date is as specified above.
H0: SR through DateControl = SR through DateExperiment
HA: SR through DateControl ≠ SR through DateExperiment
3.4.3 Self-Response Rates by Mode (RQ2b)
Self-response will be compared between treatments within each mode of response: internet and
mail. The expected small number of returns obtained from TQA will be classified as internet returns
for the calculations since they will be collected using the internet instrument. This will test the
following hypotheses:
H0: Internet SRControl = Internet SRExperiment; HA: Internet SRControl ≠ Internet SRExperiment
H0: Mail SRControl = Mail SRExperiment; HA: Mail SRControl ≠ Mail SRExperiment
The denominator for these calculations will be the mailout universe.
3.4.4 Self-Response Rates by Contact and Language Strategy Areas (RQ2c)
To assess the effect of the experimental changes on self-response for each contact strategy, selfresponse rates will be compared between treatments for each contact strategy, Internet First and
Internet Choice as defined in Sections 2.1 and 2.2, respectively. 19 The following hypotheses will be
tested:
H0: Internet First English SRControl = Internet First English SRExperiment
HA: Internet First English SRControl ≠ Internet First English SRExperiment
H0: Internet First Bilingual SRControl = Internet First Bilingual SRExperiment
HA: Internet First Bilingual SRControl ≠ Internet First Bilingual SRExperiment
H0: Internet Choice English SRControl = Internet Choice English SRExperiment
HA: Internet Choice English SRControl ≠ Internet Choice English SRExperiment
H0: Internet Choice Bilingual SRControl = Internet Choice Bilingual SRExperiment
HA: Internet Choice Bilingual SRControl ≠ Internet Choice Bilingual SRExperiment
The denominator for these calculations will be the mailout universe for the contact strategy.

In this section, “English” stands for areas sent English mail materials and “Bilingual” stands for areas sent mail
materials in English and Spanish. These terms do not reflect the language of response.

3.4.5 Self-Response Rates in Areas with Different Non-Citizen Rates (RQ2d)
To assess the effect of the experimental changes on self-response for areas that have different
proportions of non-citizens, self-response rates will be compared between treatments. First, tracts
will be classified as high, medium, or low in terms of the percent of non-citizens in a tract: 20
•
•
•

High: tracts where the percent of non-citizens is 11.1 or higher
Medium: tracts where the percent of non-citizens is higher than 4.87 and less than or equal
to 11.1
Low: tracts where the percent of non-citizens is less than or equal to 4.87 or if the percent of
non-citizens is unknown

All sampled housing units within the tract will then be classified as being in an area with a high
percent of non-citizens, medium percent of non-citizens, or low or unknown percent of non-citizens.
The denominator for these calculations will be the mailout universe within that area.
This will test the following hypotheses:
H0: SR in High % Non-Cit. AreasControl = SR in High % Non-Cit. AreasExperiment
HA: SR in High % Non-Cit. AreasControl ≠ SR in High % Non-Cit. AreasExperiment
H0: SR in Medium % Non-Cit. AreasControl = SR in Medium % Non-Cit. AreasExperiment
HA: SR in Medium % Non-Cit. AreasControl ≠ SR in Medium % Non-Cit.AreasExperiment
H0: SR in Low % Non-Cit. AreasControl = SR in Low % Non-Cit. AreasExperiment
HA: SR in Low % Non-Cit. AreasControl ≠ SR in Low % Non-Cit. AreasExperiment
3.4.6 Self-Response Rates by Low Response Score (RQ2e)
To assess the effect of the experimental changes on self-response for areas that have different
response propensities, self-response rates will be calculated and compared for each treatment in
historically high and low self-response areas as defined below.
•
•

High Response Area (HRA): tract where the low response score (LRS) > 24.0
Low Response Area (LRA): tract where the LRS ≤ 24.0 or missing

This will test the following hypotheses:
H0: SR of HRAControl = SR of HRAExperiment; HA: SR of HRAControl ≠ SR of HRAExperiment
H0: SR of LRAControl = SR of LRAExperiment; HA: SR of LRAControl ≠ SR of LRAExperiment
20

The data to determine the tracts come from the 2018 Census Planning Database (PDB) using the 5-year (2012-2016)
estimates from the American Community Survey.

The LRS is obtained from a response propensity model that uses variables on the 2018 Census
Planning Database (PDB) (Erdman & Bates, 2016).
3.4.7 Self-Response Rates in Areas with Different Rates of Foreign-Born Residents in the Tract
(RQ2f)
To assess the effect of the experimental changes on self-response for areas that have different
proportions of foreign-born residents, we will compare self-response rates between treatments by
high, medium, and low proportions. The tracts will be classified as high, medium, or low in terms of
the percent of foreign-born residents in a tract: 21
•
•
•

High: tracts where the percent of foreign-born residents is higher than 15.0
Medium: tracts where the percent of foreign-born residents is higher than 5.0 and less than
or equal to 15.0
Low: tracts where the percent of foreign-born residents is less than or equal to 5.0 or if the
percent of foreign-born residents is unknown

All sampled housing units within the tract will then be classified as being in an area with a high
percent of foreign-born residents, medium percent of foreign-born residents, or low or unknown
percent of foreign-born residents. The denominator for these calculations will be the mailout
universe within that area.
•

This will test the following hypotheses:

H0: SR in High % Foreign Born AreasControl = SR in High % Foreign Born AreasExperiment
HA: SR in High % Foreign Born AreasControl ≠ SR in High % Foreign Born AreasExperiment
H0: SR in Medium % Foreign Born AreasControl = SR in Medium % Foreign Born AreasExperiment
HA: SR in Medium % Foreign Born AreasControl ≠ SR in Medium % Foreign Born AreasExperiment
H0: SR in Low % Foreign Born AreasControl = SR in Low % Foreign Born AreasExperiment
HA: SR in Low % Foreign Born AreasControl ≠ SR in Low % Foreign Born AreasExperiment
3.4.8 Self-Response Rates in Areas with Different Rates of Hispanic Residents in the Tract (RQ2g)
To assess the effect of the experimental changes on self-response for areas that have different
proportions of Hispanic residents, we will compare self-response rates between treatments by high,
medium, and low proportions. The cut-off points for defining the tracts will be determined prior to
conducting the analysis, based on existing data.

The data to determine the tracts come from the 2018 Census Planning Database (PDB) using the 5-year (2012-2016)
estimates from the American Community Survey.

All sampled housing units within the tract will then be classified as being in an area with a high
percent of Hispanic residents, medium percent of Hispanic residents, or low or unknown percent
of Hispanic residents. The denominator for these calculations will be the mailout universe within
that area.
•

This will test the following hypotheses:

H0: SR in High % Hispanic AreasControl = SR in High % Hispanic AreasExperiment
HA: SR in High % Hispanic AreasControl ≠ SR in High % Hispanic AreasExperiment
H0: SR in Medium % Hispanic AreasControl = SR in Medium % Hispanic Areas Experiment
HA: SR in Medium % Hispanic AreasControl ≠ SR in Medium % Hispanic Areas Experiment
H0: SR in Low % Hispanic AreasControl = SR in Low % Hispanic AreasExperiment
HA: SR in Low % Hispanic AreasControl ≠ SR in Low % Hispanic AreasExperiment
3.4.9 Self-Response Rates by Regional Census Center (RQ2h)
The sample was not designed to support state-level estimates, but lower-level geographical
differences may be of interest. Therefore, we will look at the effect of the experimental changes on
self-response for the six different areas served by the Census Bureau’s regional census centers
(RCCs). Self-response rates will be calculated and compared for each treatment separately for each
region: Atlanta, Chicago, Dallas, Los Angeles (includes Alaska and Hawaii), New York (excluding
Puerto Rico), and Philadelphia.22 See Appendix D for more details on the boundaries for each RCC.
This will test the following hypotheses for each region:
H0: SR in the RCCControl = SR in the RCCExperiment; HA: SR in the RCCControl ≠ SR in the RCCExperiment
The denominator for these calculations will be the mailout universe within the RCC.
3.4.10 Self-Response Rates by Urban/Rural Areas (RQ2i)
To assess the effect of the experimental changes on self-response for different types of geographic
areas self-response rates will be calculated and compared for each treatment by designated urban
and rural areas. The Census Bureau definition of “urban” will be used to include urbanized areas
(areas with 50,000 or more people) and urban clusters (areas with at least 2,500 but fewer than
50,000) (Ratcliffe, Burd, Holder, & Fields, 2016). All other areas will be considered rural.
This will test the following hypotheses:
H0: SR in Urban AreasControl = SR in Urban AreasExperiment
22

Puerto Rico will not be a part of the mailout universe for the 2020 Census and therefore will not be a part of this test.

HA: SR in Urban AreasControl ≠ SR in Urban AreasExperiment
H0: SR in Rural AreasControl = SR in Rural AreasExperiment
HA: SR in Rural AreasControl ≠ SR in Rural AreasExperiment
The denominator for these calculations will be the mailout universe within each of the areas.
3.5

Item-Level Analysis

Item response analysis metrics computed for this report will be weighted. The weight is the inverse
of the probability of selection. A significance level of α=0.1 will be used when determining significant
differences between treatments. Other than response distributions, comparisons will be made using
a two-sided t-test. For response distributions, Rao-Scott chi-square tests will be used. For analyses
that involve multiple comparisons, the Type I familywise error rate will be adjusted using the
Hochberg method (Hochberg, 1988). Item data will not be edited or imputed for this analysis.
3.5.1 Demographic Analyses
The sample design for this test allocates housing unit addresses for each treatment to ensure
similarities, to the extent possible, between the two treatments. As such, a working assumption is
that respondents in both treatments will have similar demographic characteristics. Thus, similar
distributions are expected when response data are analyzed. Any differences in the demographic
distributions may be attributed to the experimental difference in the treatments. Demographic
distributions for data will be analyzed from the following response categories: relationship, sex, age,
Hispanic origin, race, and tenure. The average household size for each treatment will also be
calculated and compared.
There are two metrics that may be used to analyze the demographic characteristics: category
response distributions and a ratio metric. If the overall unit self-response rates are not significantly
different, the category response distributions will be used. If there is a significant difference in the
unit self-response rates the ratio metric will be used. This is to account for the potential impact
differential unit response may have on the response distributions. The calculations for these two
metrics follows.
3.5.1.1 Category Response Distributions (RQ3a-g)
Response distributions between treatments will be compared overall and by mode for the following
items.
Person Level Items
a. Relationship (RQ3a): The response categories will be collapsed into two categories,
Related and Unrelated (to Person 1).
b. Sex (RQ3b): The response categories are male and female.
16

Age Groups (RQ3c): The responses will be grouped into the following categories –
under 5 years old, 5 to 20 years old, 21 to 29 years old, 30 to 39 years old, 40 to 52
years old, 53 to 64 years old, and 65 years old or older.23
Hispanic Origin (RQ3d): The response categories will be collapsed into two categories,
Hispanic and not Hispanic. We will also look at the different Hispanic groups (Mexican,
Puerto Rican, Cuban, and Other) as there is potential for the impact to vary by group,
for example people born in Puerto Rico are citizens of the U.S.
Race (RQ3e): The response categories will be collapsed into the following categories –
White alone, Black or African American alone, American Indian or Alaska Native alone,
Asian alone, Native Hawaiian or Other Pacific Islander alone, Some Other Race alone,
Two or more races.

Housing-Unit Level Items
f. Tenure (RQ3f): The response categories will be collapsed into two categories, Owners
and Renters. The fourth category “Occupied without payment of rent” will be included
in the renter category.
g. Average Household Size (RQ3g): Household size will be determined by the total count
of data-defined persons (DDP) for each sufficient, unduplicated return. A person
response is considered a DDP if two or more person-level data items are considered
sufficient.24 This number will be divided by the number of sufficient, unduplicated
returns in the treatment. To determine statistical differences for average household
size between treatments, we will perform two-tailed hypothesis tests.
Recognizing that household size could affect response levels for items on the questionnaire (i.e. we
could expect a higher item nonresponse from larger households due to response fatigue), we will
compare the average household size between treatments. If there is a significant difference
between treatments, this will be taken into account for analyses involving item response (item nonresponse, form completion, and internet breakoff rates). If no significant difference is detected
between the two treatments then any respondent fatigue will be assumed to be the same for each
treatment and should not be a factor when analyzing differences between the treatments for the
item response analyses.
The numerator for these calculations will include all valid response categories. Missing and invalid
responses will be analyzed separately as part of item nonresponse analysis (see Section 3.5.2).
The denominator for person-level item calculations will include all DDPs with a valid response for
the question of interest from unduplicated, sufficient returns. A person response is considered a

This age grouping aligns with data that shows a higher proportion of non-citizens relative to the general population for
persons age 21 to 52.
24
This is defined in the Decennial Response File Specification (U.S. Census Bureau, 2016b).

DDP if two or more person-level data items are determined to be sufficient, as defined in (U.S.
Census Bureau, 2016b)
The denominator for housing-unit level item calculations will include all unduplicated, sufficient
returns with a valid response for the question of interest.
In the case of bilingual forms, questions are presented in English and Spanish. While the intent of
the bilingual form is for a respondent to answer the questions in either English or Spanish, it is
possible for a respondent to answer questions in both languages. If there is housing-unit level data
reported in both the English and Spanish, the data will be evaluated to determine whether there are
more housing-level responses in English or in Spanish. The data that are more complete will be used
in the analysis. In the event of a tie, the English data will be used for the analysis. For person level
data, respondents could answer in both languages as a way to include a large household or they
could be confused and duplicate their household, answering once in Spanish and again in English.
Therefore, for person level data, all DDP’s will be processed regardless of whether the data was
answered in English or Spanish, however, duplicate people will be removed. 25
For response distributions, Rao-Scott chi-square tests of independence will be used to determine
statistical differences between treatments at the 0.1 level of significance (Rao & Scott, 1987).
The following hypotheses will be tested:
H0: Distribution of ResponsesControl = Distribution of ResponsesExperiment
HA: Distribution of ResponsesControl ≠ Distribution of ResponsesExperiment
To control for the overall Type I error rate for the hypotheses tested simultaneously, the Hochberg
multiple-comparison procedure will be used (Hochberg, 1988). A family for the response distribution
analyses will be defined as the seven demographic items (a through g from above) being compared.
The resulting p-value from each of the seven response distributions will be used in the Hochberg
procedure.
For distributions with more than two categories, race and age groups: if the distributions are
significantly different we will perform additional tests on the differences for each response category
using two-tailed hypothesis t-tests to determine which category proportions are causing the
differences in the distributions. The following hypotheses will be tested:
H0: Category ProportionControl = Category ProportionExperiment
HA: Category ProportionControl ≠ Category ProportionExperiment

Established Census Bureau matching techniques will be used to identify duplicate people within the form and remove
them from the analysis.

The Hochberg multiple-comparison procedure will be performed within each distribution, with the
family defined by the number of category proportions being compared (Hochberg, 1988).
3.5.1.2 Ratio Metric (RQ3a-g)
As indicated, the ratio metric will be used instead of the category response distributions if the
overall unit self-response rate is significantly different between the treatments. The ratio will be
calculated for the same demographic items identified above, but only for overall self-response, not
by mode. The following hypotheses will be tested:
H0: Category Ratio MetricControl = Category Ratio MetricExperiment
HA: Category Ratio MetricControl ≠ Category Ratio MetricExperiment
The category ratio metric is defined as follows, for each demographic category of interest:
Category Ratio Metric =

Observed proportion of the demographic category
National estimate of the demographic category

For example, the percent of Hispanics who responded in the control treatment divided by the
percent of Hispanics estimated to be in the country. The denominator, the national-level estimate,
will be an estimate based on the most recently five-year ACS estimates. 26
The Hochberg multiple-comparison procedure will be used (Hochberg, 1988). A family for the ratio
metric analyses will be defined as the seven demographic items being compared.
3.5.2

Item Nonresponse and Form Completeness (RQ4 and RQ5)

Respondents leave items blank for a variety of reasons including not understanding the question
(clarity), unwillingness to answer a question as presented (sensitivity), and lack of knowledge of the
data needed to answer the question. Two metrics will be used to assess this: item nonresponse and
form completeness.
The item nonresponse rate (for a given item) is the proportion of eligible units, housing units for
household-level items or persons for person-level items, for which a required response is missing.
The question concerning citizenship will not be included in these calculations because it is only
included in one treatment. See Section 3.5.4 for analysis of that question.

The resulting ratio comes with several limitations based on differences in how the national-level estimate was
calculated and obtained. For example, the current ACS estimate applied imputation, nonresponse weighting
adjustments, and raking and is for all areas of the country. The observed 2019 Census Test data will not be imputed,
adjusted for nonresponse, nor raked, and is only representative of self-response mailout areas of the country.

The following formula will be used to calculate the item nonresponse rate:
Item Nonresponse Rate =

Number of missing or invalid responses to the item of interest
Universe for the item of interest

A response is missing if no answer is given for a particular question (blank for mail, skipped for
internet or TQA). A response is invalid if it is not allowed according to Census Bureau rules, for
example an age of 145 years old or a response on a paper questionnaire that has multiple boxes
checked when only one marked box is allowed.
The following items will be assessed: 27
Housing items:
1. Number of people living or staying in the housing unit
2. Housing unit owned or rented
3. Contact telephone number
Person items:
1. Name (First, Middle, and Last combined)
2. Relationship
3. Sex
4. Age and Date of Birth
5. Hispanic Origin
6. Race

The denominator for housing items is all sufficient, unduplicated returns. The denominator for
person items is all DDPs to whom the question is asked. The person level items are not asked of
everyone on the paper questionnaires due to space limitations. All questions are asked of everyone
rostered on the internet and in TQA. Table 4 shows the questions asked on the paper questionnaire.

The coverage questions (“additional people staying at home” and “person staying somewhere else”) will not be
included as part of the item nonresponse rates or the form completeness rates.

Table 4. Person Level Items Collected on Paper Questionnaires
Date of Hispanic
Name
Sex
Relationship* Age
Race
Birth
Origin
Person 1
Persons 2- 6

Yes
Yes

Persons 7-10

Yes

No
Full Question
Shortened
Question

Citizenship

Yes
Yes

Yes

*The relationship question determines the relationship of each person to Person 1. Person 1 is designated as the
reference person and no relationship question is asked. Persons 2 through 6 are asked the full relationship question.
Persons 7 through 10 are asked a shortened relationship question to indicate if the person is related to Person 1 or not,
but the specifics of the relationship are not obtained.

Only persons that are asked a question will be included in the calculations and this varies by mode
of data collection. For example, Persons 7 through 10 are not asked about race on the paper
questionnaire, so they will not be included in item nonresponse rate for race. For mail returns,
relationship responses for Persons 2 through 10 will be included in the analysis and responses will
be assessed based on the question asked (either the full question or shortened question).
The following hypotheses will be tested:
H0: Item Nonresponse RateControl = Item Nonresponse RateExperiment
HA: Item Nonresponse RateControl ≠ Item Nonresponse RateExperiment
Form completeness is the number of questions on the form that were answered among those that
should have been answered. The formula to calculate form completeness rates is:

Overall Form Completeness Rate = �

Number of questions answered
� × 100
Number of questions that
should have been answered

The universes for form completeness will be similar to the universes used for item nonresponse, as
appropriate for each mode of response and each type of question (housing or person).
The following hypotheses will be tested:
H0: Form Completeness RateControl = Form Completeness RateExperiment
HA: Form Completeness RateControl ≠ Form Completeness RateExperiment
The item nonresponse and form completeness rates will be calculated for each treatment for overall
self-response, by response mode, and by strata. The comparisons between treatments will use twotailed hypothesis tests with a significance level of 0.1. To control for the overall Type I error rate for
the hypotheses tested simultaneously, the Hochberg multiple-comparison procedure will be used

(Hochberg, 1988). A family for the response distribution analyses will be defined as the nine
demographic items being analyzed.
3.5.3 Internet Breakoff Rate (RQ6)
The internet breakoff rates for the control and experimental treatments will be calculated and
compared.
The denominator for the calculations will include all addresses that began to respond on the
internet by logging on and do not respond in any other mode.28 Note that this means both sufficient
and insufficient returns will be included in this analysis, which is different than other sections of this
report.
An overall breakoff rate is calculated by including in the numerator all housing units that began to
respond via the internet but did not complete and confirm the response via the internet. 29 Breakoffs
will also reviewed at various points in the internet instrument as follows:
•

Started the interview but did not reach the demographic dashboard (i.e., did not begin to
answer any demographic items for anyone in the household). 30

•

Reached the demographic dashboard but exited before responding to the
SUBMIT_Census_Questionnaire screen. 31

•

Went through all of the demographic screens for each person (regardless of whether they
were answered), but did not respond to the CONFIRMATION screen.32
o If the data can indicate it, we will also try to break this down further to identify the
rate that respondents went through all of the demographic screens for one person
(regardless of whether they were answered), but did not respond for any other
people in the household and did not reach later portions of the interview. 33

Status codes are set at various points in the internet instrument to indicate progress. For now, we have defined the
breakoff points based on these status codes. Instead of using status codes we may use paradata, that may identify
slightly different breakoff points, but will be similar to what is presented here. Status codes of 15, 35, 45, 50 and 55
indicate that a respondent began the instrument and got to various points in the interview.
29
Status codes 15, 35, and 50 indicate a breakoff at various points prior to the respondent reaching the CONFIRMATION
screen.
30
Status code 15.
31
Status code 35.
32
Status code 50.
33
Status code 35 or 50, with additional assessment of the data based on paradata or response data. If response data is
used there is a limitation put on the results as respondents can chose the order in which they answer for the persons
listed in the household (i.e., they do not have the follow the order they were rostered).

The following hypotheses, overall at the points indicated above, will be tested:
H0: Breakoff RateControl = Breakoff RateExperiment
HA: Breakoff RateControl ≠ Breakoff RateExperiment
3.5.4

Citizenship Question Item Nonresponse Rate (RQ7)

The item nonresponse rate for the citizenship question on the control questionnaire will be
calculated (overall, by response mode, and by strata) using the following formula:
Number of invalid or missing responses
to the citizenship question
Citizenship Item Nonresponse Rate =
Data defined person for
whom the citizenship question is asked

The denominator for these calculations will include all DDPs, for whom the question is asked, from
unduplicated, sufficient returns. The internet instrument and the TQA instrument will ask questions
for up to 99 people in each household, and the citizenship question will be asked for everyone. The
paper questionnaire will ask questions for up to 10 people in each household. As is the case for the
Hispanic origin and race questions, the citizenship question will only be asked for the first six of
those people, as it is more costly to include more questions on paper due to increased costs for ink,
paper, and postage.
A response will be considered missing if no checkboxes are marked and no year of naturalization has
been provided. Invalid responses (such as more than one box checked for a paper questionnaire)
will be considered a nonresponse.
Although a direct comparison cannot be made, item nonresponse from self-responses for the ACS
(for the same month of data collection as this test) may be used as a general ballpark estimate for
what might be expected for nonresponse to the question.
3.6

Standard Errors

All variances will be estimated using the Successive Differences Replication method with replicate
weights. The variance for each rate and difference will be calculated using the formula below.
80

4
Var (X0 ) =
� (Xr - X0 )2
80
r=1

Where:

Xr = the estimate calculated using the rth replicate
X0 = the estimate calculated using the full sample

The standard error of the estimate (X0) is the square root of the variance.
23

4
4.1

ASSUMPTIONS AND LIMITATIONS
Assumptions

For this test, we assume that there is no difference in mail delivery timing or subsequent response
time across samples of similar size using the same postal sort and mailout procedures, as the chosen
sample sizes for the treatments considered postal procedures.
4.2

Limitations

The following are the known limitations of the 2019 Census Test, in no particular order:
1. The results of this test apply only to self-response mailout areas.
2. The focus of this analysis is to understand how the citizenship question affects self-response
rates prior to NRFU. As such, the results of this test are limited to the self-response
timeframe prior to the start of NRFU. The self-response rates discussed in this analysis do
not try to mimic the final overall self-response of a census, which includes self-response
received during NRFU and other field operations.
3. The 2019 Census Test does not provide the same level of language support as will be
available in the 2020 Census, as described in Section 3.2. To the degree that needing nonEnglish language materials to self-response is correlated with citizenship status, the results
of this test will be impacted.
4. The test also does not include a non-ID operation, which allows for self-response by
collecting a person’s address in lieu of providing a Census ID. In the 2019 Census Test, a
Census ID is required to respond. This could mean that some people who try to respond
online will not be able to respond for this test or will respond using a different mode than
what they would use in the 2020 Census.
5. The environment in which this test is conducted may differ from the 2020 Census, which
includes advertising and typically more media attention than is experienced during tests. For
instance, the 2020 Census is projecting a national-level self-response rate of 60.5 percent
prior to NRFU, which is about ten percentage points higher than seen in mid-decade census
tests. Additionally, Census Bureau advertising may mitigate some differences observed in
this test. There has also been media coverage of the citizenship question being added to the
2020 Census. Public awareness of the topic may influence behavior for this test as well as the
2020 Census. The degree to which public awareness is different between this test and the
2020 Census may influence the reliability of the results of this test.

6. Self-response may be lower for a census test with a July 1st Census Day, as many people are
on vacation in the summer, compared to the 2020 Census with an April 1st Census Day.
Additionally, the coverage of people may be different due to different living situations in the
summer months (i.e. college students are less likely to be living in a dorm in the summer and
would be counted elsewhere; migrant workers are more likely to be in southern states in the
spring and northern states in the summer). However, these differences between this test
and the 2020 Census will not affect conclusions drawn between the control and
experimental treatments in this test.

TABLE SHELLS

Below are samples of tables that will be used in the final report to show results from this test.
Table 5. Self-Response Rates Over Time
Point in Data
Collection Cycle
Before the Third Mailing
Before the Fourth Mailing
Before the Fifth Mailing

Control
Treatment
(with Citizenship)
#.# (#.#)
.
.

Experimental
Treatment
(no Citizenship) Difference
#.# (#.#)
#.# (#.#)
.
.
.
.

P-Value
#.##
.
.

Source: U.S. Census Bureau, 2019 Census Test
Note: Minor additive discrepancies are due to rounding. Standard errors are in parentheses. An asterisk (*) indicates a statistically
significant result. Significance was tested based on a two tailed t-test at the α=0.1 level.

Table 2. Self-Response Rates by Response Mode

Overall Response
Internet and TQA†
Mail

Control
Treatment
(with Citizenship)
#.# (#.#)
.
.

Experimental
Treatment
(no Citizenship)
#.# (#.#)
.
.

Difference
#.# (#.#)
.
.

P-Value
#.##
.
.

Table 3. Self-Response Rates by Designated High and Low Response Areas

High Response Area
Low Response Area
Difference

Control
Treatment
(with Citizenship)
#.# (#.#)
.
.

Experimental
Treatment
(no Citizenship)
#.# (#.#)
.
.

Difference
#.# (#.#)
.
.

P-Value
#.##
.
.

Table 4. Item Nonresponse Rates (Housing Items)
Item
Number of People
Tenure
Phone Number

Control
Treatment
(with Citizenship)
#.# (#.#)
.
.

Experimental
Treatment
(no Citizenship)
#.# (#.#)
.
.

Difference
#.# (#.#)
.
.

Adjusted
P-Value
#.##
.
.

Table 5. Response Distributions (in Percents) for Select Items
Item
TENURE
SEX

Owner
Renter

Male
Female
RELATIONSHIP TO PERSON 1
Related
Not Related
AGE
Under 5 years
5 to 17 years
18 to 24 years
25 to 44 years
45 to 64 years
65 years and over
HISPANIC ORIGIN
Hispanic
Not Hispanic
RACE
White alone
Black alone
AIAN† alone
Asian alone
NHOPI† alone
Some Other Race alone
Two or more races

Control
Experimental
Treatment
Treatment
(with Citizenship) (no Citizenship)
(n=##,###)
(n=##,###)
#.# (#.#)
#.# (#.#)
.
.
(n=##,###)
(n=##,###)
#.# (#.#)
#.# (#.#)
.
.
(n=##,###)
(n=##,###)
#.# (#.#)
#.# (#.#)
.
.
(n=##,###)
(n=##,###)
#.# (#.#)
#.# (#.#)
.
.
.
.
.
.
.
.
.
.
(n=##,###)
(n=##,###)
#.# (#.#)
#.# (#.#)
.
.
(n=##,###)
(n=##,###)
#.# (#.#)
#.# (#.#)
.
.
.
.
.
.
.
.
.
.
.
.

Adjusted
P-Value
#.##

#.##

Source: U.S. Census Bureau, 2019 Census Test
Note: Standard errors are shown in parentheses. Minor additive discrepancies are due to rounding. Significant at α=0.1 level. Pvalues have been adjusted for multiple comparisons using the Hochberg method. †AIAN stands for American Indian or Alaska
Native and NHOPI stands for Native Hawaiian or Other Pacific Islander.

POTENTIAL IMPACTS

The results of this test will help inform the plan for the NRFU operation in 2020 and the Integrated
Partnership and Communications Campaign, should the citizenship question appear on the 2020
Census form.

REFERENCES

Bentley, M. (2008). Specifications for Bilingual Form Distribution in the 2010 Census. DSSD 2010
Decennial Census Memorandum Series #B-4. U.S. Census Bureau.
Brown, D., Heggeness, M., Dorinski, S., Lawrence, W., & Yi, M. (2018). Understanding the Quality of
Alternative Citizenship Data Sources for the 2020 Census. Washington, D.C.: U.S. Census
Bureau.
Erdman, C., & Bates, N. (2016). The Low Response Score (LRS): A Metric to Locate, Predict, and
Manage Hard-to-Survey Populations. Public Opinion Quarterly, 81(1), 144-156. Retrieved
from https://academic.oup.com/poq/article/81/1/144/2649123
Hochberg, Y. (1988). A Sharper Bonferroni Procedure for Multiple Tests of Significance. Biometrika,
75(4), 800-802. Retrieved January 17, 2017, from
http://www.jstor.org/stable/2336325?seq=1#page_scan_tab_contents
Kim, J. (2018). 2020 Census Non-English Language Support. 2020 Census Program Memorandum
Series: 2018.06. U.S. Census Bureau.
Mathews, K., & Phelan, J. (DRAFT). Determining Internet Choice Areas for the 2020 Census. U.S.
Census Bureau.
Poehler, E. (2019). Sample Design Requirements for the 2019 Census Test. DSSD 2019 American
Community Survey Memorandum Series #ACS19-MP-01. U.S. Census Bureau.
Rao, J. N., & Scott, A. J. (1987). On Simple Adjustments to Chi-Square Tests with Sample Survey Data.
The Annal of Statistics, 15(1), 385-397. Retrieved 26 2018, December, from
http://projecteuclid.org/euclid.aos/1176350273
Ratcliffe, M., Burd, C., Holder, K., & Fields, A. (2016). Defining Rural at the U.S. Census Bureau.
Retrieved December 26, 2018, from American Community Survey and Geography Brief:
https://www2.census.gov/geo/pdfs/reference/ua/Defining_Rural.pdf
U.S. Census Bureau. (2014). American Community Survey Design and Methodology. Washington,
D.C.: U.S. Census Bureau. Retrieved February 1, 2018, from
https://www.census.gov/programs-surveys/acs/methodology/design-and-methodology.html
U.S. Census Bureau. (2016a). Technical Specifications Document: 2017 Identification of Sufficient
Self Response Returns.
27

U.S. Census Bureau. (2016b). Technical Specifications Document: Decennial Response File
Specification.
U.S. Census Bureau. (2018a). 2020 Census Detailed Operational Plan for 12. Internet Self-response
(ISR) Operation. Retrieved October 2018, from https://www.census.gov/programssurveys/decennial-census/2020-census/planning-management/planning-docs/ISR-detailedop-plan.html
U.S. Census Bureau. (2018b). Questions Planned for the 2020 Census and American Community
Survey. Washington, D.C.: U.S. Census Bureau. Retrieved January 4, 2019, from
https://www2.census.gov/library/publications/decennial/2020/operations/plannedquestions-2020-acs.pdf

Appendix A. Images of the Paper Questionnaires
Figure 2. Control Questionnaire (in English) with the Citizenship Question

Figure 3. Control Questionnaire (in Spanish) with the Citizenship Question in Spanish

Figure 4. Experimental Questionnaire (in English) without the Citizenship Question

Figure 5. Experimental Questionnaire (in Spanish) without the Citizenship Question

Appendix B. Internet First Mail Materials
Table B-1. Internet First Mail Materials by Mailing and Language Strategy
Mailing
English Materials
Bilingual Materials
Initial
• Outgoing Envelope DM-EO-F1(E/S)
• Outgoing Envelope DM-EO-F1(E/S)
Mailing
• Invitation Letter DM-LF1
• Invitation Letter DM-LF1(E/S)
• Language Assistance Sheet DM-LI
• Language Assistance Sheet DM-LI
• FAQ Insert DM-FL(E/S)
Reminder
• Outgoing Envelope DM-EO2(E/S)
• Outgoing Envelope DM-EO2(E/S)
Letter
• Letter DM-LF2
• Letter DM-LF2(E/S)
Reminder
• Postcard DM-PF3
• Postcard DM-PF3(E/S)
Postcard
Questionnaire • Outgoing Envelope DM-EO4(E/S)
• Outgoing Envelope DM-EO4(E/S)
Package
• Letter DM-L4
• Letter DM-L4(E/S)
• Control Questionnaire DM-QA or
• Control Questionnaire DM-QA(E/S)
Test Questionnaire DM-QB
or Test Questionnaire DM-QB(E/S)
• Language Assistant Sheet DM-LI
• Language Assistant Sheet DM-LI
• Return Envelope DM-ER-IN(E/S)
• Return Envelope DM-ER-IN(E/S)
• FAQ Insert DM-FA(E/S)
Final
• Postcard DM-P5
• Postcard DM-P5(E/S)
Reminder
Postcard

Appendix C. Internet Choice Mail Materials
Table C-1. Internet Choice Mail Materials by Mailing and Language Strategy
Mailing
English Materials
Bilingual Materials
Initial
• Outgoing Envelope DM-EO-C1(E/S)
• Outgoing Envelope DM-EO-C1(E/S)
Questionnaire • Invitation Letter DM-LC1
• Invitation Letter DM-LC1(E/S)
Package
• Control Questionnaire DM-QA or
• Control Questionnaire DM-QA(E/S)
Test Questionnaire DM-QB
or Test Questionnaire DM-QB(E/S)
• Language Assistant Sheet DM-LI
• Language Assistant Sheet DM-LI
• Return Envelope DM-ER-IN(E/S)
• Return Envelope DM-ER-IN(E/S)
• FAQ Insert DM-FA(E/S)
Reminder
• Outgoing Envelope DM-EO2(E/S)
• Outgoing Envelope DM-EO2(E/S)
Letter
• Letter DM-LC2
• Letter DM-LC2(E/S)
Reminder
• Postcard DM-PC3
• Postcard DM-PC3(E/S)
Postcard
Replacement • Outgoing Envelope DM-EO4(E/S)
• Outgoing Envelope DM-EO4(E/S)
Questionnaire • Letter DM-L4
• Letter DM-L4(E/S)
Package
• Control Questionnaire DM-QA or
• Control Questionnaire DM-QA(E/S)
or Test Questionnaire DM-QB(E/S)
Test Questionnaire DM-QB
• Language Assistant Sheet DM-LI
• Language Assistant Sheet DM-LI
• Return Envelope DM-ER-IN(E/S)
• Return Envelope DM-ER-IN(E/S)
• FAQ Insert DM-FA(E/S)
Final
• Postcard DM-P5
• Postcard DM-P5(E/S)
Reminder
Postcard

Appendix D. Census Bureau 2020 Regional Census Center Boundaries
Figure 6. Map of the 2020 Regional Census Center Boundaries

File Type	application/pdf
Author	Kathryn A Cheza (CENSUS/ACSO FED)
File Modified	2019-02-25
File Created	2019-02-13