Form D6-QFE-GA Group Quarters Advance Contact Instrument (in-office and

2026 Census Test Group Quarters Advance Contact

Instrument Screenshots

6/18/25

Note: On each screen, “GQ” will be changed to “group quarters” in the question wording, as applicable, and shown in the final screenshots.

Screenshot 1:

Screenshot 2:

Screenshot 3:

Screenshot 4:

Screenshot 5:

Screenshot 6:

Screenshot 7:

Screenshot 8 (1 of 3):

Note: The GQ name is not displaying on this screen, however, it will be shown in the final screenshot.

Screenshot 8 (2 of 3) – “Yes” selected:

Screenshot 8 (3 of 3) – “No” selected:

Screenshot 9:

Screenshot 10:

Screenshot 11:

Screenshot 12:

Screenshot 13 (1 of 2):

Note: The text box is split because these are two separate screenshots to capture the entire screen.

Screenshot 13 (2 of 2) – On GQ DETAILS, “I am not responsible for or do not manage this GQ” selected:

Screenshot 14:

Screenshot 15:

Screenshot 16 (1 of 3):

Screenshot 16 (2 of 3) – “Refusal by GQ Contact” selected:

Screenshot 16 (3 of 3) – For the purpose of showing the wording below the text box regarding out-of-scope GQ Types in the 2026 Census Test, this group quarters was created as GQ Type Code 705 = Community Meal Kitchens under “Census Facility”; thus, this group quarters does not fall under “Test Facility” shown on Screenshot 10 – SELECT GQ, which includes GQ Type Code 802 = Residential Treatment Centers for Adults (Noncorrectional).:

Screenshot 17:

Screenshot 18:

Screenshot 19 (1 of 3):

Note: The Help hyperlink is not positioned correctly. A defect has been logged to address this issue.

Screenshot 19 (2 of 3) – “Internet Self-Response (Census Emails Link to Residents)” selected:

Screenshot 19 (3 of 3) – “Electronic Response Data Transfer (eResponse)” selected:

Screenshot 20:

Note: The Help hyperlink is not positioned correctly. A defect has been logged to address this issue.

Screenshot 21 (1 of 2):

Note: The Help hyperlink is not positioned correctly. A defect has been logged to address this issue.

Screenshot 21 (2 of 2) – “Yes” selected:

See next page for drop down list of languages

List of Languages

English	Igbo
Spanish	Ilocano
Mandarin	Indonesian
Cantonese	Italian
Vietnamese	Khmer
Korean	Lao
Russian	Lithuanian
Arabic	Malayalam
Tagalog	Marathi
Polish	Navajo
French	Nepali
Haitian Creole	Punjabi
Portuguese	Romanian
Japanese	Serbian
Albanian	Sinhala
American Sign Language	Slovak
Amharic	Somali
Armenian	Swahili
Bengali	Tamil
Bosnian	Telugu
Bulgarian	Thai
Burmese	Tigrinya
Croatian	Turkish
Czech	Twi/Akan
Dutch	Ukrainian
Farsi	Urdu
German	Yiddish
Greek	Yoruba
Gujarati	Other
Hebrew
Hindi
Hmong
Hungarian

Screenshot 22:

Screenshot 23:

Note: The Help hyperlink is not positioned correctly. A defect has been logged to address this issue.

Screenshot 24:

Screenshot 25:

Note: The GQ address is not displaying on this screen, however, it will be shown in the final screenshot.

Screenshot 26:

Screenshot 27:

Note: This screen is under development and will be shown in the final screenshot.

Screenshot 28:

Screenshot 29:

Screenshot 30:

Note: This screen is under development, as a dropdown list of group quarters needs to be added, so it will be shown the final screenshot.

Screenshot 30:

Note: The text box is split because these are two separate screenshots to capture the entire screen.

Screenshot 31: