Questionnaire Text

Questionnaire form view entire document:  text  image
8. Is this person a citizen of the United States?

[] Yes, born in Puerto Rico - Skip to question 10a
[] Yes, born in a U.S. state, District of Columbia, Guam, the U.S. Virgin Islands, or Northern Marianas
[] Yes, born abroad of U.S. citizen parent or parents
[] Yes, U.S. citizen by naturalization - Print year of naturalization - _ _ _ _
[] No, not a U.S. citizen
Questionnaire instructions view entire document:  text  image
Person questions 1-6

Answer questions 1-6 for the first five people living or staying at this address.

  • Include everyone who is living or staying here for more than 2 months.
  • Include yourself if you are living here for more than 2 months.
  • Include anyone else staying here who does not have another place to stay, even if they are here for 2 months or less.
  • Do not include anyone who is living somewhere else for more than 2 months, such as a college student living away or someone in the Armed Forces on deployment.

P5. Please answer "both" question 5 about Hispanic origin and question 6 about race. For this survey, Hispanic origin is not a race.