OMB Package Internet Self-Response Data Collection Instrument Slides_v2

DRAFT Screenshots
Internet Self-Response
September 2018

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LANDING PAGE

DRAFT Screenshots - Internet Self-Response September 2018

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LANGUAGE TOGGLE

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CAPTCHA

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LOGIN (EN)

You will need the materials we mailed to you in order to start. All the information that you provide will
remain confidential.

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CONFIRM

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VERIFY

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VERIFY_ADDRESS

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ANYONE

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VACANCY

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OTHER_COMPLETE

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STATE

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RESIDENCE

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STAN_RESIDENCE

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RURAL_ROUTE & RR_ADDRESS

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STAN_RR_ADDRESS

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HOMELESS

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OTHER_ADDRESS

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STAN_OTHER_ADDRESS

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RESIDENCE2

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APT

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APT_ADDRESS

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URB

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URB_ADDRESS

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AREANM

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AREANM_ADDRESS

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HOMELESS_PR

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GEN_ADDRESS

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OTHER_ADDRESS_PR

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HOUSEHOLD DASHBOARD

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RESPONDENT

What is your name, phone number, and
email address? We will only contact you if
needed for official Census Bureau business.
(Help)
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POPCOUNT

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POPCOUNT (Help)

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PEOPLE

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UC (1)

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HOME

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OWNER (rented)

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OWNER (owned)

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DEMOGRAPHIC DASHBOARD

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DEMOGRAPHIC DASHBOARD (Edit)

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DEMOGRAPHIC DASHBOARD (Resume)

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ADD_PERSON

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RELATIONSHIP

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DRAFT Screenshots - Internet Self-Response September 2018

SEX

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SEXRELEDIT (PTRSEXCONFIRM)

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SEXRELEDIT (REFSEXCONFIRM and REFSEX2)

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SEXRELEDIT (RELATION2)

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DOB

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HISPANIC ORIGIN

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RACE

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DASHBOARD Final Questions

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OC

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OC_HH

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OC_P

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SUBMIT

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DASHBOARD (SUBMIT)

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CONFIRMATION

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NO_COMPLETE

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NO_COMPLETE_AUTH

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GOOD_BYE

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