2005-2007 Census Instructions to Respondents
Your answers are confidential and required by law. The law, Title 13, Sections 141, 193, and 221 of the U.S. Code, authorizing the American Community Survey, also provides that your answers are confidential. No one except Census Bureau employees may see your completed form and they can be fined and imprisoned for any disclosure of your answers. The same law that protects the confidentiality of your answers requires that you provide the information asked in this survey to the best of your knowledge.
How to fill out the American Community Survey form
[Information omitted on the physical details of filling out the form]
Instructions for the survey questions
List of Residents:
List the name of each person who lives at this address.
If you are not sure if you should list a person, see the guidelines on page 2 of the form.
In the space labeled Person 1, print the name of the household member living or staying there who owns the house or apartment, or who's name the house is rented in.
If there is no such person, any adult household member can be Person 1 on the List of Residents.
If there are more than five people in your household, please list the names of the additional people on the lines at the bottom of pages 2 and 3.
Complete this form for the five people listed on the List of Residents, and mail it back in the enclosed envelope as soon as possible. An interviewer will telephone to obtain the information for the additional persons.
Questions 1 through 6
Answer person questions 1-6 for the first five people on the list of residents
Â If a person is a stepchild or an adopted child of Person 1, mark the "Son or daughter" box.
If a person is not related to Person 1, mark the applicable box. A "Roomer or boarder" is someone renting a room/space in the house. A "Housemate or roommate" is someone sharing the house/apartment (but who is not romantically involved) with Person 1. An "Unmarried partner," also know as a domestic partner, is a person who shares a close personal relationship with Person 1. A "Foster child" is someone under the age of 18 who is involved in the formal foster care system. For all other people who are not related to Person 1 mark the "Other non-relative" box.
The term Mexican American refers to persons of Mexican origin or ancestry.
If you mark the "Yes, other Spanish/Hispanic/Latino" box, print the name of the specific group.
If a person is not of Spanish/Hispanic/Latino origin, answer this question by marking the "No, not Spanish/Hispanic/Latino" box.
This question should be answered for ALL persons, regardless of citizenship status.
6. Mark one or more categories to indicate [the ethnicity] each person considers himself or herself to be.
Â If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.
If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.
The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.
The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.
If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.
This question should be answered for ALL persons, regardless of citizenship status.
Answer Housing Questions 1-25 for the address on the mailing label
Count both 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 house in a row of houses attached to one another, sometimes referred to as a townhouse.
A mobile home that has had one or more rooms added or built onto it should be considered as a one-family house detached from any other house. If only a porch or shed has been added to a mobile home, it should be considered as a mobile home.
If you live on a boat or in a mobile home, enter the year corresponding to the model year in which it was manufactured.
If you do not know the year the building was first built, enter your best estimate.
3. Enter the month and year that Person 1 on the List of Residents on page 2 last moved into this house, apartment, or mobile home.
The number of cuerdas is the land area on which the house or mobile home is located; include adjoining land you rent for your use.
Solar energy is provided by a system that collects, stores, and distributes heat from the sun. Other fuel includes any fuel not listed separately, such as purchased steam, fuel briquettes, and waste material.
If your house, apartment, or mobile home is rented, enter the costs for utilities and fuels only if you pay for them in addition to the monthly rent.
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 included in your rent or condominium fee, mark the "Included in rent or in condominium fee" box. DO NOT enter any dollar amounts.
For items 14a and 14b, report last month's costs. For items 14c and 14d, report total costs for the past 12 months.
Estimate as closely as possible if you do not know exact costs. If you have lived in this house, apartment, or mobile home less than one year, estimate the costs for the past 12 months in 14c and 14d.
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 house or apartment only. If gas and electricity are billed together, enter the combined amount in 14a and mark the "Included in electricity payment entered above" box in item 14b.
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 instruction for question 18a on how to change it to a monthly amount.
If any money rent is paid, even if the rent is paid by people who are not members of your household, or paid by a Federal, state, or local government agency, mark the "Rented for cash rent" box.
If the unit is not owned or being bought by the occupants and if money rent is not paid or contracted, mark the "Occupied without payment of cash rent" box. The unit may be owned by friends or relatives who live elsewhere and who allow you to occupy this house, apartment, or mobile home without charge. A house or apartment may be provided as part of wages or salary. Examples are: caretaker or janitor's house or apartment; parsonages; tenant farmer or sharecropper houses for which the occupants do not pay cash rent; or military housing.
18a. 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.
By week: multiply by 4
Every other week: multiply by 2
2 times a year: divide by 6
Once a year: divide by 12
18b. 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 house, apartment, or mobile home, mark the "Yes" box.
20. Report taxes for all taxing jurisdictions (city or town, municipality, 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.
22a. The word mortgage indicates all types of loans secured by real estate.
22b. 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 18a to change it to a monthly amount.
Include payments on first mortgages and contracts to purchase only. Report payments on second or junior mortgages and home equity loans in 23b.Â
If this is a mobile home, report payments on installment loans but do not include personal property taxes, site rent, registration fees, and license fees on the mobile home and site. Report these fees in item 24.
23a. A second mortgage or home equity loan is also secured by real estate. You must have a first mortgage in order to have a second mortgage. You may have a home equity loan and other mortgages on the property or the home equity loan may be the only mortgage.
23b. 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 18a to change it to a monthly amount. Include payments on all second or junior mortgages or home equity loans.
Include payments for personal property taxes, land or site rent, registration fees and license fees. Do not include real estate taxes already reported in 20. Report the total annual amount even if you make it in two or more installments. Estimate as closely as possible when you don't know exact costs.
25a. Answer this question if you have listed at least one person on page 2 of the form. Mark the "Yes" box if any of the persons listed on pages 2 and 3 of the form live year round at the address on the front of the form. Then continue with the questions on page 7.
If all of the persons listed on page 2 or 3 DO NOT live or stay at this address year round, mark the "No" box and continue with question 25b.
25b. Indicate how many months a year members of this household stay at this address (print "01" if it is less than one month).
25c. Mark the box that identifies the main reason why members of this household are staying at the house, apartment, or mobile home that uses the address on the front of the questionnaire.
[Housing Question 7-42 are a continuation of the questions for each person. (Questions 1-6 appear on pages 2 and 3 of the questionnaire.)]
Mark the "In the United States" box and then print the name of the state in which the person was born. If the person was born in Washington, D.C., print District of Columbia.
For people born outside the United States:
Mark the "Outside the United States" box, and then print Puerto Rico or the name of the foreign country or area where the person was born. Use current boundaries, not boundaries at the time of the person's birth. For example, specify whether Northern Ireland or the Republic of Ireland (Eire); North or South Korea; England, Scotland, or Wales (not Great Britain or United Kingdom). Specify the particular country or island in the Caribbean (for example, Jamaica, not West Indies).
10a. A public school is any school or college that is controlled and supported primarily by the Puerto Rico or Federal government. Schools are private if supported and controlled primarily by religious organizations or other private groups.
10b. Answer this question only if the person attended regular school or college in the last three months. Mark the box that corresponds to the grade level or college level the person was attending.
Mark only one box to indicate the highest grade or level of schooling the person has completed or the highest degree the person received.
Report schooling completed in foreign or ungraded schools as the equivalent level of schooling completed in the regular American school system.
For persons who completed high school by passing an equivalency test, such as the General Educational Development (GED) examination, and did not attend college, mark the "High School Graduate" box.
Some of the examples of Professional school degrees include medicine, dentistry, chiropractic, optometry, osteopathic medicine, pharmacy, podiatry, veterinary medicine, law, and theology.
Do not include certificates, diplomas or degrees for training on specific trades such as computer and electronics technology, auto repair, medical assistant, cosmetology, and other fields at vocational, technical or business schools.
Do not include honorary degrees awarded by colleges and universities to individuals for their accomplishments. Include only "earned" degrees.
Persons who have more than one origin and cannot identify with a single ancestry group may report two ancestry groups (for example, German-Irish).
Do not report a religious group as a person's ancestry.
13a. Mark the "Yes" box if the person sometimes or always speaks a language other than English at home. Mark the "No" box if the person speaks only English, or if a non-English language is spoken only at school or is limited to a few expressions or slang.
13b. 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 one the person first learned to speak.
If the person lived in the same house or apartment one year ago, mark the "Yes, this house" box and then go to instruction F.
If the person did not live in Puerto Rico or the United States one year ago, mark the "No, outside Puerto Rico or the United States" box and print the name of the foreign country, or U.S. Virgin Islands, Guam, etc., where the person lived. Be specific when printing the name of foreign countries, for example, specify whether Northern Ireland or the Republic of Ireland (Eire); 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 instruction F.
If the person lived somewhere else in Puerto Rico or the United States one year ago, mark the "No, different house in Puerto Rico or the United States" box. Then in items 14b and 14c, provide the city, municipality in Puerto Rico or U.S. county, state, and ZIP code where the person lived one year ago.
14b. If the person did not live inside the city limits, print the name of the post office.
14c. Mark the "Yes" box if the city or town is now inside the city/town limits even if it was not inside the limits one year ago; that is, if the area was annexed by the city/town during the last year.
If the person lived in Louisiana, print the parish name in the "Name of municipality or U.S. county" space. If the person lived in Alaska, print the borough or census area name if known. 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 the "Name of municipality or U.S. county" space blank.
Mark the "Yes" or "No" box for both parts 15a. and 15b. of question 15 to indicate whether the person has any of the conditions listed.
19a. Mark the "Yes" box if the person has at least one of his or her own grandchildren who are under 18 years of age, living in the house, apartment, or mobile home.
19b. Answer this question if the person has at least one of his or her own grandchildren living in the house, apartment, or mobile home. Mark the "Yes" box if the person is currently responsible for the basic needs of the grandchild or grandchildren.
19c. Mark one box to indicate the length of time the person has been providing for the basic needs of his or her grandchild or grandchildren.
Count as work:
Work for someone else for wages, salary, piece rate, commission, tips, or payments "in kind" (for example, food or lodging received as payment for work performed).
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 the Armed Forces.
Do not count as work:
Housework or yard work at home.
Unpaid volunteer work.
School work done as a student.
Work done as a resident of an institution.
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, or 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, and a description of the work location (such as building number, building name, nearest street or intersection).
If the person worked at several locations, but reported to the same location each day to begin work, print the street address of the location where 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 of the time 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 development or condominium name and street address of the location or branch where the person worked. If the street address of a school is not known, print the name of the school, and a description of the location (such as nearest street or intersection).
If the person worked on a college or university campus and the street address of the workplace is not known, print the name of the building where he or she worked, and a description of the location (such as nearest street or intersection).
If the person worked in a foreign country or Guam, U.S. Virgin Islands, etc., print the name of the country on the state or foreign country line and then go to question 25.
Do not include persons who rode to school or some other non-work destination in the count of persons who rode in the vehicle.
If the person usually left home to go to work sometime between 12:00 o'clock midnight and 12:00 o'clock noon, mark "a.m."
If the person usually left home to go to work sometime between 12:00 o'clock noon and 12:00 o'clock midnight, mark "p.m."
29a. Persons are on layoff if they are waiting to be recalled to a job from which they were temporarily separated for business-related reasons.
29b. If the person works only during certain seasons or on a day-by-day basis when work is available, mark the "No" box.
30. Mark the "Yes" box if the person tried to get a job or 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.
31. If the person was expecting to report to a job within 30 days, mark the "Yes, could have gone to work" box.
Mark the "No, because of own temporary illness" box only if the person expects to be able to work within 30 days.
If the person could not have gone to work because he or she was going to school, taking care of children, etc., mark the "No, because of all other reasons (in school, etc.)" box.
Employees of foreign governments, the United Nations, and other international organizations should mark the "A Federal GOVERNMENT employee" box.
If the person worked at a public school, college or university, mark the appropriate government category; for example, mark the "a state GOVERNMENT employee" box for a state university, or mark the "a local GOVERNMENT employee" box for a municipio agency.
37. Print one or more words to describe the business, industry, or individual employer named in question 36. 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.
38. Check one of the industry type boxes.
Enter descriptions like the following: metal furniture manufacturing, retail grocery store, petroleum refining, cattle ranch. DO NOT enter: furniture company, grocery store, oil company, ranch
40. Print one or more words to describe the type of work this person does.
Enter descriptions like the following: registered nurse, personnel manager, high school teacher.
Do not enter single words such as: nurse, manager, teacher
Mark the "Yes" or "No" box for each part, and enter the amount received in the past 12 months for each "Yes" response.
If the 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 mark the "No" box for the other person.
When reporting income received jointly, do not include the amount for a person not listed on the List of Residents.
41a. Include wages and salaries before deductions from all jobs. 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.
41b. Include nonfarm 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.
41c. Include interest received or credited to checking and saving 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 question 41b above. Include regular payments from an estate or trust fund.
41d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.
41e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.
41f. Include any public assistance or welfare payments the person receives from the Puerto Rico government or the municipio welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.
41g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, Puerto Rico and municipio governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.
41h. 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.
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
Add the total entries (subtracting losses) for 41a. through 41h. for the past 12 months and enter that number in the space provided.
What the survey is about: some questions and answers
Why are we taking a survey?
What does the Census Bureau do with the information you provide?
How was this address selected?
Why the Census Bureau asks certain questions: here are reasons we ask some of the questions on the survey.
Value or rent
Place of birth
Journey to work