[The 1990 census was completed via self-enumeration, as in 1980 and 2000. (The 1960 and 1970 censuses also employed self-enumeration to varying degrees; see the discussion for those years, above.) The 1990 census sample consists entirely of households that completed the "long-form" sample questionnaire; as in 1980, there was only one version of this questionnaire. (In 1960 and 1970, the census distributed more than one type of sample questionnaire.) We reproduce here the text of the long-form questionnaire, beginning with a general introduction, followed by the population questions and then the housing questions. Each question and set of possible answers (with FOSDIC circles) are worded as they were on the original questionnaire. Material in quotes represents additional instructions that did not appear on the questionnaire itself, but that respondents instead received on a separate instruction section, as in 1970 and 1980.]
Thank you for taking time to complete and return this census questionnaire. It's important to you, your community, and the Nation.
The law requires answers but guarantees privacy.
By law (Title 13, U.S. Code), you're required to answer the census questions to the best of your knowledge. However, the same law guarantees that your census form remains confidential. For 72 years -- or until the year 2062 -- only Census Bureau employees can see your form. No one else -- no other government body, no police department, no court system or welfare agency -- is permitted to see this confidential information under any circumstances.
How to get started -- and get help.
Start by listing on the next page the names of all the people who live in your home. Please answer all questions with a black lead pencil. You'll find detailed instructions for answering the census in the enclosed guide. If you need additional help, call the toll-free telephone number to the left, near your address.
Please answer and return your form promptly.
Complete your form and return it by April 1, 1990 in the postage-paid envelope provided. Avoid the inconvenience of having a census taker visit your home.
Again, thank you for answering the 1990 Census.
Remember: Return the completed form by April 1, 1990.
Para personas de habla hispana --
(For Spanish-speaking persons)
Si usted desea un cuestionario del censo en espa?ol, llame sin cargo alguno al siguiente n?mero: 1-800-cuentan?
How to fill out your census form
Please us a black lead pencil only. Black lead pencil is better to use than ballpoint or other pens. Most questions ask you to fill in the circle, or to print the information. See example below [example omitted].
Make sure you print answers for everyone in this household. If someone in the household, such as a roomer or boarder, does not want to give you all the information for the form, print at least the person's name and answer question 2 and 3. A census taker will call to get the other information directly from the person.
There may be a question you cannot answer exactly. For example, you might not know the age of an elderly person or the price for which your house would sell. Ask someone else in your household; if no one knows, give your best estimate.
Instructions for individual questions begin on page 3 of this guide [this refers to the separate instruction section preceding the questionnaire]. They will help you to understand the questions and answer them correctly.
If you have a question about filling out the census form or need assistance, call the local U.S. census office. The telephone number is given on the cover of the questionnaire [omitted].
If you do not mail back your census form, a census taker will be sent out to assist you. But it saves time and your taxpayer dollars if you fill out the form yourself and mail it back.
Your answers are confidential
The law authorizing the census (Title 13, U.S. Code) also provides that your answers are confidential. No one except census workers may see your completed form and they can be fined and/or imprisoned for any disclosure of your answers. Only after 72 years can your individual census form become available to other government agencies (whether federal, state, county, or local). Until then, no other person or business can see your individual report.
The same law that protects the confidentiality of your answers requires that you provide the information asked in this census to the best of your knowledge.
Information collected from the decennial census is used for a variety of statistical purposes. Census information is used to find out where funding is most needed for schools, health centers, highways, and other services. Census results are used by members of public and private groups--including community organizations--and by businesses and industries, as well as by agencies at all levels of government.
1a. List on the numbered lines below the name of each person living here on Sunday, April 1, including all persons staying here who have no other home. If everyone at this address is staying here temporarily and usually lives somewhere else, follow the instructions given in question 1b below.
-- Persons who are temporarily away on a business trip, on vacation, or in a general hospital
-- College students who stay here while attending college
-- Persons in the Armed Forces who live here
-- Newborn babies still in the hospital
-- Children in boarding schools below the college level
-- Persons who stay here most of the week while working even if they have a home somewhere else
-- Persons with no other home who are staying here on April 1
-- Persons who are away in an institution such as a prison, mental hospital, or a nursing home
-- College students who live somewhere else while attending college
-- Persons in the Armed Forces who live somewhere else
-- Persons who stay somewhere else most of the week while working
Print last name, first name, and middle initial for each person. Begin on line 1 with the household member (or one of the household members) in whose name this house or apartment is owned, being bought, or rented [the head of household]. If there is no such person, start on line 1 with any adult household member.
1. ____ ____ ____
2. ____ ____ ____
3. ____ ____ ____
4. ____ ____ ____
5. ____ ____ ____
6. ____ ____ ____
7. ____ ____ ____
8. ____ ____ ____
9. ____ ____ ____
10. ____ ____ ____
11. ____ ____ ____
12. ____ ____ ____
[List everyone who lives at this address in question 1a. If you are not sure if you should list a person, see the rules on page 1 of the census form. If you are still not sure, answer as best you can and fill in "yes" for question H1a or H1b, as appropriate. If there are more than seven people in your household, please list all the persons in question 1a, complete the form for seven people, and mail it back in the enclosed envelope. A census taker will call to obtain the information for the additional persons.]
1b. If everyone is staying here only temporarily and usually lives somewhere else, list the name of each person on the numbered lines above, fill this circle ? O [brackets used in this document instead] and print their usual address below. Do not print the address listed on the front cover.
____ Street or road/Rural route and box number
____ Apartment number
____ ZIP code
____ Country or foreign country
____ Names of nearest intersecting streets or roads
[If everyone listed in questions 1a usually lives at another address(es), print the address(es) in 1b.]
[The form provides a column for each person within the household to answer each of the following person questions.]
____ First name
_ Middle initial
[Person 1 was not to answer this question.]
If a relative of person 1:
 Natural-born or adopted son/daughter
 Other relative:
 Housemate, roommate
 Unmarried partner
 Other nonrelative
[Fill one circle to show how each person is related to the person in column 1. If other relative of the person in column 1, print the exact relationship such as son-in-law, daughter-in-law, grandparent, nephew, niece, mother-in-law, father-in-law, cousin, and so on. If the stepson/stepdaughter of the person in column 1 also has been legally adopted by the person in column 1, mark stepson/stepdaughter but do not mark natural-born or adopted son/daughter. In other words, stepson/stepdaughter takes precedence over adopted son/daughter.]
If Indian (Amer.), print the name of the enrolled or principal tribe.
If Other Asian or Pacific Islander (API), print one group, for example: Hmong, Fijian, Laotian, Thai, Tongan, Pakistani, Cambodian, and so on.
If Other race, print race.
 Black or Negro
 Indian (Amer.) (Print the name of the enrolled or principal tribe.)
 Asian Indian
 Other API
[Fill one circle for the race each person considers himself/herself to be. If you fill the Indian (Amer.) circle, print the name of the tribe or tribes in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe(s). If you fill the Other API circle [under Asian or Pacific Islander (API)], only print the name of the group to which the person belongs. For example, the Other API category includes persons who identify as Burmese, Fijian, Hmong, Indonesian, Laotian, Bangladeshi, Pakistani, Tongan, Thai, Cambodian, Sri Lankan, and so on. If you fill the Other race circle, be sure to print the name of the race. If the person considers himself/herself to be White, Black or Negro, Eskimo or Aleut, fill one circle only. Please do not print the race in the boxes. The Black or Negro category also includes persons who identify as African-American, Afro-American, Haitian, Jamaican, West Indian, Nigerian, and so on. All persons, regardless of citizenship status, should answer this question.]
_ _ _ a. Age b. Year of birth
b. Print each person's year of birth and fill the matching circle below each box.
1 _ _ _ b. Year of birth
[Print age at last birthday in the space provided (print "00" for babies less than 1 year old). Fill in the matching circle below each box. For an illustration of how to complete question 5, see the Example on page 2 of this guide [omitted].]
 Now married
 Never married
[If the person's only marriage was annulled, mark never married.]
If yes, other Spanish/Hispanic, print one group.
 No (not Spanish/Hispanic)
 Yes, Mexican, Mexican-Am., Chicano
 Yes, Puerto Rican
 Yes, Cuban
 Yes, other Spanish/Hispanic
[A person is of Spanish/Hispanic origin if the person's origin (ancestry) is Mexican, Mexican-Am., Chicano, Puerto Rican, Cuban, Argentinean, Colombian, Costa Rican, Dominican, Ecuadoran, Guatemalan, Honduran, Nicaraguan, Peruvian, Salvadoran, from other Spanish-speaking countries of the Caribbean or Central or South America, or from Spain. If you fill the Yes, other Spanish/Hispanic circle, print one group. A person who is not of Spanish/Hispanic origin should answer this question by filling the No (not Spanish/Hispanic) circle. Note that the term "Mexican-Am." refers only to persons of Mexican origin or ancestry. All persons, regardless of citizenship status, should answer this question.]
____ First name
_ Middle initial
(Name of State or foreign country; or Puerto Rico, Guam, etc.)
[For persons born in the United States:
[For persons born outside the United States:
 Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas
 Yes, born abroad of American parent or parents
 Yes, U.S. citizen by naturalization
 No, not a citizen of the United States
[A person should fill the yes, U.S. citizen by naturalization circle only if he/she has completed the naturalization process and is now a United States citizen. If the person was born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas, he/she should fill the yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas circle. If the person was born outside the United States (or at sea) and has at least one American parent, he/she should fill the yes, born abroad of American parent or parents circle.]
 1985 or 1986
 1982 to 1984
 1980 or 1981
 1975 to 1979
 1970 to 1974
 1965 to 1969
 1960 to 1964
 1950 to 1959
 Before 1950
[If the person has entered the United States (that is, the 50 states and the District of Columbia) more than once, fill the circle for the latest year he/she came to stay.]
 No, has not attended since February 1
 Yes, public school, public college
 Yes, private school, private college
[Do not include enrollment in a trade or business school, company training, or tutoring unless the course would be accepted for credit at a regular elementary school, high school, or college. A public school is any school or college that is controlled and supported primarily by a local, county, State, or Federal Government. Schools are private if supported and controlled primarily by religious organizations or other private groups.]
 No school completed
 Nursery school
 1st, 2nd, 3rd, or 4th grade
 5th, 6th, 7th, or 8th grade
 9th grade
 10th grade
 11th grade
 12th grade, no diploma
 High school graduate -- high school diploma or the equivalent (For example: GED)
 Some college but no degree
 Associate degree in college -- Occupational program
 Associate degree in college -- Academic program
 Bachelor's degree (For example: BA, AB, BS)
 Master's degree (For example: MA, MS, MEng, MEd, MSW, MBA)
 Professional school degree (For example: MD, DDS, DVM, LLB, JD)
 Doctorate degree (For example: PhD, EdD)
[Mark the category for the highest grade or level of schooling the person has successfully completed or the highest degree the person received. If the person is enrolled in school, mark the category containing the highest grade completed (the grade previous to the grade in which enrolled). Schooling completed in foreign or ungraded schools should be reported as the equivalent level of schooling in the regular American school system. Persons who completed high school by passing an equivalency test, such as the General Education Development (GED) examination, and did not attend college, should fill the circle for high school graduate. Do not include vocational certificates or diplomas from vocational, trade, or business schools or colleges unless they were college level associate degrees or higher. Some examples of professional school degrees include medicine, dentistry, chiropractic, optometry, osteopathic medicine, pharmacy, podiatry, veterinary medicine, law, and theology. Do not include barber school, cosmetology, or other training for a specific trade. Do not include honorary degrees awarded by colleges and universities to individuals for their accomplishments. Include only "earned" degrees.]
(For example: German, Italian, Afro-Amer., Croatian, Cape Verdean, Dominican, Ecuadorean, Haitian, Cajun, French Canadian, Jamaican, Korean, Lebanese, Mexican, Nigerian, Irish, Polish, Slovak, Taiwanese, Thai, Ukrainian, etc.)
[Print the ancestry group. Ancestry refers to the person's ethnic origin or descent, "roots," or heritage. Ancestry also may refer to the country of birth of the person or the person's parents or ancestors before their arrival in the United States. All persons, regardless of citizenship status, should answer this question. Persons who have more than one origin and cannot identify with a single ancestry group may report two ancestry groups (for example, German-Irish). Be specific. For example, print whether West Indian, Asian Indian, or American Indian. West Indian includes persons whose ancestors came from Jamaica, Trinidad, Haiti, etc. Distinguish Cape Verdean from Portuguese; French Canadian from Canadian; and Dominican Republic from Dominica Island. A religious group should not be reported as a person's ancestry.]
 Yes -- Skip to 15a
[Mark yes if this person lived in this same house or apartment on April 1, 1985, even if he/she moved away and came back since then. Mark no if this person lived in the same building but in a different apartment (or in the same mobile home or trailer but on a different lot or trailer site).]
(If outside U.S., print answer above and skip to 15a.)
[If this person lived in a different house or apartment on April 1, 1985, give the location of this person's usual home at that time.]
[If the person lived in the United States on April 1, 1985, print the name of the State (or District of Columbia) where he or she lived. Continue with parts (2) through (4). If the person lived in a U.S. territory or commonwealth, print the name of the territory or commonwealth, such as Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, or Northern Marianas. Then go to question 15a. If the person lived outside the United States, print the name of the foreign country or area where he or she lived. Specify whether Northern Ireland or the Republic of Ireland (Eire); East or West Germany; North or South Korea; England, Scotland or Wales (not Great Britain or United Kingdom). Specify the particular country or island in the Caribbean (not, for example, West Indies). Then go to question 15a.]
[If the person lived in Louisiana, print the parish name. If the person lived in Alaska, print the borough name. If the person lived in New York city and the county name is not known, print the borough name. If the person lived in an independent city (not in any county) or in Washington, D.C. leave blank and enter the city name in part (3).]
 No, lived outside the city/town limits
 No -- [Go on to question 16]
[Mark yes if the location is now inside the city/town limits even if it was not inside the limits on April 1, 1985; that is, if the area was annexed by the city/town since that time.]
(For example: Chinese, Italian, Spanish, Vietnamese)
[Mark yes if the person sometimes or always speaks a language other than English at home. Do not mark yes for a language spoken only at school or if speaking is limited to a few expressions or slang.]
 Not well
 Not at all
[Print the name of the language spoken at home. If this person speaks more than one non-English language and cannot determine which is spoken more often, report the first language the person learned to speak.]
 Born April 1, 1975 or later -- go to questions for the next person
 Yes, now on active duty
 Yes, on active duty in past, but not now
 Yes, service in Reserves or National Guard only -- Go to 18
 No -- Go to 18
[For a person with service in the National Guard or a military reserve unit, fill one of the two yes, active duty circles if and only if the person has ever been called up for active duty other than training; otherwise, mark yes, service in Reserves or National Guard only. For a person whose only service was as a civilian employee or volunteer for the Red Cross, USO, Public Health Service, or War or Defense Department, mark no. Count World War II Merchant Marine Seaman service as active duty; do not count other Merchant Marine service as active duty.]
 September 1980 or later
 May 1975 to August 1980
 Vietnam era (August 1964 - April 1975)
 February 1955 - July 1964
 Korean conflict (June 1950 - January 1955)
 World War II (September 1940 - July 1947)
 World War I (April 1917 - November 1918)
 Any other time
[Mark yes to part (a) if a health condition substantially limits this person in his or her choice of occupation or if the condition limits the amount of work that can be accomplished in a given period of time.]
[Mark yes to part (b) if the health condition prevents this person from holding any significant employment.]
[Consider a person to have difficulty with these activities if any of the following situations apply: (1) it takes extra time or extra effort for the person to perform one or more of the activities, (2) there are times when the person cannot perform one or more of the activities, or (3) the person is completely unable to perform one more of the activities.]
 12 or more
[Count all children born alive, including any who have died (even shortly after birth) or who no longer live with you. Do not include miscarriages or stillborn children or any adopted, foster, or stepchildren.]
 No -- Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. -- Skip to 25.
[Count as work - Mark yes:
- Work in own business, professional practice, or farm.
- Any work in a family business or farm, paid or not.
- Any part-time work including babysitting, paper routes, etc.
- Active duty in Armed Forces.
Do not count as work - Mark no:
- Unpaid volunteer work.
- School work.
- Work done as a resident of an institution.]
If this person worked at more than one location, print where he or she worked most last week.
(If the exact address is not known, give a description of the location such as the building name or the nearest street or intersection.)
[Include the street type (for example, St., Road, Ave.) and the street direction (if a direction such as "North" is part of the address). For example, print 1239 N. Main St. or 1239 Main St., N.W. not just 1239 Main. If the only known address is a post office box, give a description of the work location. For example, print the name of the building or shopping center where the person works, the nearest intersection, the nearest street where the workplace is located, etc. Do not give a post office box number. If the person worked at a military installation or military base that has no street address, report the name of the military installation or base. If the person worked at several locations, but reported to the same location each day to begin work, print the address of the location here he or she reported. If the person did not report to the same location each day to begin work, print the address of the location where he or she worked most last week. If the person's employer operates in more than one location (such as a grocery store chain or public school system), print the exact address of the location or branch where the person worked. If the exact address of a school is not known, print the name of the school. If the person worked on a college or university campus and the exact address of the workplace is not known, print the name of the building where he or she worked.]
 No, outside the city/town limits
[If the person worked in New York city and the county is not known, print the name of the borough where the person worked. If the person worked in Louisiana, print the name of the parish where the person worked. If the person worked in Alaska, print the name of the borough where the person worked. If the person worked in a foreign country or Puerto Rico, Guam, etc., print the name of the country in 22e and leave the other parts of question 22 blank.]
 Bus or trolley bus
 Streetcar or trolley car
 Subway or elevated
 Worked at home -- Skip to 28
 other method
[If the person usually used more than one type of transportation to get to work (for example, rode the bus and transferred to the subway), fill the circle of the one method of transportation that he/she used for most of the distance during the trip.]
 2 people
 3 people
 4 people
 5 people
 6 people
 7 to 9 people
 10 or more people
[If the person was driven to work by someone who then drove back home or to a non-work destination, fill the circle for drove alone. Do not include persons who rode to school or some other non-work destination in the count of persons who rode in the vehicle.]
[Give the time of day the person usually left home to go to work. Do not give the time that the person usually began his or her work. If the person usually left home to go to work sometime between 12:00 o'clock midnight and 12:00 o'clock noon, fill the a.m. circle. If the person usually left home to go to work sometime between 12:00 o'clock noon and 12:00 o'clock midnight, fill the p.m. circle.]
[Travel time is from door to door. Include time taken waiting for public transportation or picking up passengers in a car pool.]
 Yes, on vacation, temporary illness, labor dispute, etc.
[If the person works only during certain seasons or on a day-by-day basis when work is available, mark no.]
 No -- Skip to 27
[Mark yes if the person tried to get a job or to start a business or professional practice at any time in the last 4 weeks; for example, registered at an employment office, went to a job interview, placed or answered ads, or did anything toward starting a business or professional practice.]
 No, temporarily ill
 No, other reasons (in school, etc.)
 Yes, could have taken job
[Mark no, already has a job if the person was on layoff or was expecting to report to a job within 30 days. Mark no, temporarily ill if the person expects to be able to work within 30 days. Mark no, other reasons if the person could not have taken a job because he or she was going to school, taking care of children, etc.]
 1989 -- Go to 28
 1988 -- Go to 28
 1980 to 1984 -- Skip to 32
 1979 or earlier -- Skip to 32
 Never worked -- Skip to 32
 1985 to 1987 -- Go to 28
[Look at the instructions for question 21a to see what to count as work. Mark never worked if the person: (1) never worked at any kind of job or business, either full or part time, (2) never did any work, with or without pay, in a family business or farm, and (3) never served in the Armed Forces.]
28 - 30. Current or most recent job activity. Describe clearly this person's chief job activity or business last week. If this person had more than one job, describe the one at which this person worked the most hours. If this person had no job or business last week, give information for his/her last job or business since 1985.
(Name of company, business, or other employer)
[If the person worked for a company, business, or government agency, print the name of the company, not the name of the person's supervisor. If the person worked for an individual or a business that had no company name, print the name of the individual worked for. If the person worked in his/her own business, print 'self-employed.']
(For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, retail bakery)
[Print two or more words to tell what the business, industry, or individual employer named in 28a did. If there is more than one activity, describe only the major activity at the place where the person worked. Enter what is made, what is sold, or what service is given. Some examples of what to enter:
Enter a description like the following / Do not enter:
Retail grocery store / Grocery store
Petroleum refining / Oil company
Cattle ranch / Ranch]
 Wholesale trade
 Retail trade
 Other (agriculture, construction, service, government, etc.)
(For example: registered nurse, personnel manager, supervisor of order department,
gasoline engine assembler, cake icer)
[Print two or more words to describe the kind of work the person did. If the person was a trainee, apprentice, or helper, include that in the description. Some examples of what to enter:
Enter a description like the following / Do not enter:
Carpenter's helper / Helper
Auto engine mechanic / Mechanic
Registered nurse / Nurse]
(For example: patient care, directing hiring policies, supervising order clerks, assembling engines, icing cakes)
 Employee of a private not-for-profit, tax-exempt, or charitable organization
 Local government employee (city, county, etc.)
 State government employee
 Federal government employee
 Self-employed in own not incorporated business, professional practice, or farm
 Self-employed in own incorporated business, professional practice, or farm
 Working without pay in family business or farm
[Mark Employee of a private not-for-profit organization if the person worked for a cooperative, credit union, mutual insurance company, or similar organization. Employees of foreign governments, the United Nations, and other international organizations should mark private not-for-profit organization. For persons who worked at a public school, college or university, mark the appropriate government category; for example, mark State government employee for a state university, or mark Local government employee for a county-run community college or a city-run public school.]
 No -- Skip to 32
[Look at the instructions for question 21a to see what to count as work.]
[Count every week in which the person did any work at all, even for an hour.]
Fill the "yes" circle below for each income source received during 1989. Otherwise, fill the "no" circle. If "yes," enter the total amount received during 1989. For income received jointly, see instruction guide. If exact amount is not known, please give best estimate. If net income was a loss, write "loss" above the dollar amount.
[Fill the yes or no circle for each part and enter the amount received during 1989. If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and fill the no circle for the other person.]
[Include wages and salaries from all jobs before deductions. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses, etc.]
[Include non-farm profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses you own.]
[Include farm profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.]
[Include interest received or credited to checking and savings accounts, money market funds, certificates of deposit (CDS), IRAs, KEOGHs, and government bonds. Include dividends received, credited, or reinvested from ownership of stocks or mutual funds. Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in questions 32b or 32c above. Include regular payments from an estate or trust fund.]
[Include Social Security (and/or Railroad Retirement) payments to retired persons, to dependents of deceased insured workers, and to disabled workers before Medicare deductions.]
[Include Supplemental Security Income received by aged, blind, or disabled persons, Aid to Families with Dependent Children, or income from other government programs such as general or emergency assistance. Do not include assistance received from private charities. Exclude assistance to pay for heating (cooling) costs.]
[Include retirement, disability, or survivor benefits received from companies and unions; Federal, State, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.]
[Include Veterans' (VA) disability compensation and educational assistance payments (VEAP), unemployment compensation, child support or alimony, and all other regular payments such as Armed Forces transfer payments; assistance from private charities; regular contributions from persons not living in the household, etc.
[Do not include the following as income in any item:
- Withdrawals from savings of any kind
- Capital gains or losses from the sale of homes, shares of stock, etc.
- Inheritances or insurance settlements
- Any type of loan
- Pay in-kind such as food, free rent, etc.]
H1a. Did you leave anyone out of your list of persons for Question 1a on page 1 [that is, the first population question] because you were not sure if the person should be listed -- for example, someone temporarily away on a business trip or vacation, a newborn baby still in the hospital, or a person who stays here once in a while and has no other home?
[Refer to the list of persons you entered in question 1a on page 1. If you left anyone out of your list because you were not sure if the person(s) should be listed, answer questions H1a as yes. Then enter the name(s) and reason(s) why you did not list the person(s) on the lines provided. Otherwise, answer question H1a as no.]
H1b. Did you include anyone in your list of person for question 1a on page 1 even though you were not sure that the person should be listed -- for example, a visitor who is staying here temporarily or a person who usually lives somewhere else?
[If you included anyone on your list even though you were not sure that you should list the person(s), answer question H1b as yes. Then enter the name(s) and reason(s) why you listed the person(s) on the lines provided. Otherwise, answer question H1b as no.]
 A one-family house detached from any other house
 A one-family house attached to one or more houses
 A building with 2 apartments
 A building with 3 or 4 apartments
 A building with 5 to 9 apartments
 A building with 10 to 19 apartments
 A building with 20 to 49 apartments
 A building with 50 or more apartments
[Fill only one circle. Count all occupied and vacant apartments in the house or building. Do not count stores or office space. Detached means there is open space on all sides, or the house is joined only to a shed or garage. Attached means that the house is joined to another house or building by at least one wall that goes from ground to roof. An example of a one-family house attached to one or more houses is a row of houses attached to one another. A mobile home or trailer that has had one or more rooms added or built onto it should be counted as a one-family detached house; a porch or shed is not considered a room.]
 1 room
 2 rooms
 3 rooms
 4 rooms
 5 rooms
 6 rooms
 7 rooms
 8 rooms
 9 or more rooms
[Count only whole rooms in your house, apartment, or mobile home used for living purposes, such as living rooms, dining rooms, kitchens, bedrooms, finished recreation rooms, family rooms, etc. Do not count bathrooms, kitchenettes, strip or pullman kitchens, utility rooms, foyers, halls, half-rooms, porches, balconies, unfinished attics, unfinished basements, or other unfinished space used for storage.]
 Owned by you or someone in this household free and clear (without a mortgage)?
 Rented for cash rent?
 Occupied without payment of cash rent?
[Housing is owned if the owner or co-owner lives in it. Mark owned by you or someone in this household with a mortgage or loan if the house, apartment, or mobile home is mortgaged or there is a contract to purchase. Mark owned by you or someone in this household free and clear (without a mortgage) if there is no mortgage or other debt. If the house, apartment, or mobile home is owned but the land is rented, mark this question to show the status of the house, apartment, or mobile home. Mark rented for cash rent if any money rent is paid, even if the rent is paid by persons who are not members of your household, or by a federal, state, or local government agency. Mark occupied without payment of cash rent if the unit is not owned or being bought by the occupants and if money rent is not paid or contracted. The unit may be owned by friends or relatives who live elsewhere and who allow occupancy without charge. A house or apartment may be provided as part of wages or salary. Examples are: caretaker's or janitor's house or apartment; parsonages; tenant farmer or sharecropper houses for which the occupants do not pay cash rent; or military housing.]
[Answer H5a and H5b if you live in a one-family house or a mobile home; include only land that you own or rent.]
[A business is easily recognized from the outside; for example, a grocery store or barber shop. A medical office is a doctor's or dentist's office regularly visited by patients.]
What is the value of this property; that is, how much do you think this house and lot or condominium unit would sell for if it were for sale?
 $10,000 to $14,999
 $15,000 to $19,999
 $20,000 to $24,999
 $25,000 to $29,999
 $30,000 to $34,999
 $35,000 to $39,999
 $40,000 to $44,999
 $45,000 to $49,999
 $50,000 to $54,999
 $55,000 to $59,999
 $60,000 to $64,999
 $65,000 to $69,999
 $70,000 to $74,999
 $75,000 to $79,999
 $80,000 to $89,999
 $90,000 to $99,999
 $100,000 to $124,999
 $125,000 to $149,999
 $150,000 to $174,999
 $175,000 to $199,999
 $200,000 to $249,999
 $250,000 to $299,999
 $300,000 to $399,999
 $400,000 to $499,999
 $500,000 or more
[If this is a house, include the value of the house, the land it is on, and any other structures on the same property. If the house is owned but the land is rented, estimate the combined value of the house and the land. If this is a condominium unit, estimate the value for your house or apartment including your share of the common elements. If this is a mobile home, include the value of the mobile home and the value of the land. If you rent the land, estimate the value of the rented land and add it to the value of the mobile home.]
H7a. What is the monthly rent?
 $80 to $99
 $100 to $124
 $125 to $149
 $150 to $174
 $175 to $199
 $200 to $224
 $225 to $249
 $250 to $274
 $275 to $299
 $300 to $324
 $325 to $349
 $350 to $374
 $375 to $399
 $400 to $424
 $425 to $449
 $450 to $474
 $475 to $499
 $500 to $524
 $525 to $549
 $550 to $599
 $600 to $649
 $650 to $699
 $700 to $749
 $750 to $999
 $1,000 or more
[Report the rent agreed to or contracted for, even if the rent for your house, apartment, or mobile home is unpaid or paid by someone else.
[If rent is paid...........................Multiply rent by:
By the week....................................4
Every other week............................2
If rent is paid.............................Divide rent by:
2 times a year................................. 6
Once a year...................................12]
[Answer yes if meals are included in the monthly rent payment, or you must contract for meals or a meal plan in order to live in this building.]
 1985 to 1988
 1980 to 1984
 1970 to 1979
 1960 to 1969
 1959 or earlier
[The person listed in column 1 refers to the person listed in the first column on page 2 [the head of household; the first person listed in question 1]. This person should be the household member (or one of the members) in whose name the house, apartment, or mobile home is owned, being bought, or rented. If there is no such person, any adult household member can be the person in column 1. Mark when this person last moved into this house, apartment, or mobile home.]
 1 bedrooms
 2 bedrooms
 3 bedrooms
 4 bedrooms
 5 or more bedrooms
[Include all rooms intended to be used as bedrooms in this house, apartment, or mobile home, even if they are currently being used for other purposes.]
[Mark yes, have all three facilities if you have all the facilities mentioned; all facilities must be in your house, apartment, or mobile home, but not necessarily in the same room. Consider that you have hot water even if you have it only part of the time. Mark no if any of the three facilities is not present.]
[The kitchen sink, stove, and refrigerator must be located in the building but do not have to be in the same room. Portable cooking equipment is not considered as a range or cookstove.]
[Answer yes only if the telephone is located in your house, apartment, or mobile home.]
 7 or more
[Count company cars (including police cars and taxicabs) and company trucks of one-ton capacity or less that are regularly kept at home and used by household members for nonbusiness purposes. Do not count cars or trucks permanently out of working order.]
 Gas: bottled, tank, or LP
 Fuel oil, kerosene, etc.
 Coal or coke
 Solar energy
 Other fuel
 No fuel used
[Fill the circle for the fuel used most to heat your house, apartment, or mobile home. In buildings containing more than one apartment you may obtain this information from the owner, manager, or janitor. Solar energy is provided by a system that collects, stores, and distributes heat from the sun. Other fuel includes any fuel not separately listed; for example, purchased steam, fuel briquettes, waste material, etc.]
 An individual drilled well?
 An individual dug well?
 Some other source such as a spring, creek, river, cistern, etc.?
[If a well provides water for five or more houses, apartments, or mobile homes, mark A public system. If a well provides water for four or fewer houses, apartments, or mobile homes, fill one of the circles for Individual well. Drilled wells, or small diameter wells, are usually less than 1? feet in diameter. Dug wells are generally hand dug and are larger than 1? feet wide.]
 No, connected to septic tank or cesspool
 No, use other means
[A public sewer may be operated by a government body or private organization. A septic tank or cesspool is an underground tank or pit used for disposal of sewage.]
 1985 to 1988
 1980 to 1984
 1970 to 1979
 1960 to 1969
 1950 to 1959
 1940 to 1949
 1939 or earlier
 Don't know
[Fill the circle corresponding to the period in which the original construction was completed, not the time of any later remodeling, additions, or conversions. In buildings containing more than one apartment, the owner, manager, or janitor may be of help in determining when the building was built. If you live in a houseboat or a trailer or mobile home, fill the circle corresponding to the model year in which it was manufactured. If you do not know the period when the building was first constructed, fill the circle for don't know.]
[A condominium is a type of ownership in which the apartments, houses, or mobile homes in a building or development are individually owned, but the common areas, such as lobbies, halls, etc., are jointly owned. Cooperative occupants should mark no.]
If you live in an apartment building, skip to H20.
 $1 to $999
 $1,000 to $2,499
 $2,500 to $4,999
 $5,000 to $9,999
 $10,000 or more
If you have lived here less than 1 year, estimate the yearly cost.
[If your house or apartment is rented, enter the costs for utilities and fuels only if you pay for them in addition to the rent entered in H7a. If you live in a condominium, enter the costs for utilities and fuels only if you pay for them in addition to your condominium fee. If your fuel and utility costs are already included in your rent or condominium fee, fill the Included in rent or in condominium fee circle. Do not enter any dollar amounts. The amounts to be reported should be the total amount for the past 12 months. Estimate as closely as possible when exact costs are not know. If you have lived in this house or apartment less than 1 year, estimate the yearly cost. Report amounts even if your bills are unpaid or paid by someone else. If the bills include utilities or fuel used also by another apartment or a business establishment, estimate the amounts for your own house or apartment. If gas and electricity are billed together, enter the combined amount on the electricity line and bracket  the two utilities.]
 Included in rent or in condominium fee
 No charge or electricity not used
 Included in rent or in condominium fee
 No charge or gas not used
 Included in rent or in condominium fee
 No charge
 Included in rent or in condominium fee
 No charge or these fuels not used
Instruction: Answer questions H21 toH26, if this is a one-family house, a condominium, or a mobile home that someone in this household owns or is buying; otherwise, go to page 6 [that is, to complete the population questions].
[Report taxes for all taxing jurisdictions (city or town, county, state, school district, etc. ) Even if they are included in your mortgage payment, not yet paid or paid by someone else, or are delinquent. Do not include taxes past due from previous years.]
[When premiums are paid on other than a yearly basis, convert to a yearly basis. Enter the yearly amount even if no payment was made during the past 12 months.]
 Yes, contract to purchase -- [Go on to question H23b]
 No -- [Go on to question H24a]
[The word mortgage is used as a general term to indicate all types of loans that are secured by real estate.]
 No regular payment required -- [Go on to question H24a]
[Enter a monthly amount even if it is unpaid or paid by someone else. If the amount is paid on some other periodic basis, see the instructions for H7a to change it to a monthly amount. Include payments on first mortgages and contracts to purchase only. Payments for second or junior mortgages and home equity loans should be reported in H24b.]
 No, taxes paid separately or taxes not required
 No, insurance paid separately or no insurance
 No -- [Go on to question H25]
[A second or junior mortgage or home equity loan is secured by real estate.]
 No regular payment required
[Enter a monthly amount even if it is unpaid or paid by someone else. If the amount is paid on some other periodic basis, see instructions for H7a and change it to a monthly amount. Include payments on all second or junior mortgages or home equity loans.]
[A condominium fee is normally assessed by the condominium owners' association for the purpose of improving and maintaining the common areas. Enter a monthly amount even if it is unpaid or paid by someone else. If the amount is paid on some other periodic basis, see the instructions for H7a on how to change it to a monthly amount.]
H26. Answer only if this is a mobile home --
What was the total cost for personal property taxes, site rent, registration fees, and license fees on this mobile home and its site last year? Exclude real estate taxes.
[Report amount even if your bills are unpaid or paid by someone else. Include payments for personal property taxes, land or site rent, registration fees and license feels. Do not include real estate taxes already reported in H21. The amount to be reported should be the total amount for an entire 12-month billing period even if made in two or more installments. Estimate as closely as possible when exact costs are not known.]