|
|
2000-2002
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
Please mark the category or categories in pencil as they apply
to your household. Some questions ask you to print the information.
See Example below.
Make sure you answer questions for each person in this household.
If anyone in the household, such as a roomer or boarder, does not
want to give you his or her personal information, print at least
the person’s name and answer questions 1 and 3. An
interviewer will telephone to get the information from that person.
There may be a question you cannot answer exactly. For example,
you may 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.
Follow the steps through the questionnaire and read the instructions.
Instructions for completing the individual questions begin on page
5 of this guide. These instructions will help you understand
the questions and to answer them correctly. If you need assistance,
call 1-800-354-7271 . The telephone call is free.
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. If you are still
not sure, call 1-800-354-7271 for help.
In the space labeled Person 1, print the name
of the household member living or staying here in whose name the
house or apartment is owned, being bought, or rented.
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.
ANSWER PERSON QUESTIONS 1 THROUGH 6 FOR THE FIRST FIVE PEOPLE
ON THE LIST OF RESIDENTS.
1. Mark one box to indicate whether
the person is male or female.
2. For each person, print the
age at last birthday (print "00" for babies less than
1 year old). Also print the month, day, and year of birth.
3. Mark the appropriate category
to describe the relationship of each person to Person 1.
If the person is related to Person 1 by birth,
marriage, or adoption, but is not the Husband or wife, Son
or daughter, Brother or sister, Father or mother, Grandchild, or
In-law, of Person 1, mark the "Other relative"
box. Therefore, a niece or nephew of Person 1 would be categorized
as "Other relative." A parent in-law
or son/daughter in-law of Person 1 would be categorized as an "in
law."
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 known 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 "Other nonrelative".
4. Mark the "Now
married" box for a married person regardless of whether
his or her spouse is living in the household unless they are separated.
If the person’s only marriage was annulled, mark the "Never
married" box.
5. A person is of Spanish/Hispanic/Latino
origin if the person’s origin (ancestry) is Mexican, Mexican
American, 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.
The term Mexican Am. refers to persons of Mexican-American
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 what each person considers himself or herself to be.
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 THROUGH 28 FOR THE ADDRESS ON THE
MAILING LABEL.
1. Mark only one category.
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.
2. Mark the box that corresponds
to the year in which the original construction was completed, not
the time of any later remodeling, additions, or conversions.
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.
4. Complete this question only
if you live in a one-family house or in a mobile home; include only
land that you own or rent.
5. Complete this item only if
this one-family house or mobile home is on 1 or more acres of land.
The number of acres is the acreage on which the house
or mobile home is located; include adjoining land you rent for your
use.
6. Complete this question only
if you live in a one-family house or mobile home. A business, such
as a grocery store or barber shop, is easily recognized from the
outside and usually has a separate entrance. A medical office is
a doctor’s or dentist’s office regularly visited by
patients.
7. 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.
8. 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.
9. If you have all of the facilities
listed, mark the "Yes, has all three facilities"
box. 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. If any of the
three facilities is not present, mark the "No"
box.
10. The kitchen sink, stove,
and refrigerator must be in your house, apartment, or mobile home
but do not have to be in the same room. Portable cooking equipment
is not considered a range or stove.
11. Mark the "Yes"
box if 1) there is a telephone in working order, and you receive
service at your house, apartment, or mobile home. If
service has been discontinued because of nonpayment or any other
reason, mark the "No" box.
12. Count company cars (including
police cars and taxicabs) and company trucks of one-ton (2,000 pounds)
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.
13. Mark the category 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 listed separately, such as purchased steam,
fuel briquettes, and waste material.
14a-14d.
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.
17. A condominium is
housing in which the apartments, houses, or mobile homes in a building
or development are individually owned, but the common areas, such
as lobbies and halls, are jointly owned. Occupants of a cooperative
should mark the "No" box.
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 19a on
how to change it to a monthly amount.
18. Housing is owned if the
owner or co-owner lives in it.
If the house, apartment, or mobile home is mortgaged or there
is a contract to purchase, mark the "Owned by you or
someone in this household with a mortgage or loan?"
box. If there is no mortgage or other debt, mark the "Owned
by you or someone in this household free and clear (without a mortgage
or loan)?" box. If the house, apartment, or mobile
home is owned but the land is rented, mark one of the "owned"
categories. If the mobile home is owned without an installment loan,
but there is a mortgage on the land, mark the "Owned by you
or someone in this household with a mortgage or loan?" box.
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’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.
19a. 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: |
|
If rent is paid: |
Divide rent by: |
| By the day........ |
30 |
|
4 times a year...... |
3 |
| By the week ...... |
4 |
|
2 times a year ...... |
6 |
| Every other week ..... |
2 |
|
Once a year ....... |
12 |
19b. 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.
ANSWER HOUSING QUESTIONS 22 –26 ONLY IF
YOU OR ANY MEMBER OF THIS HOUSEHOLD OWNS OR IS BUYING THIS HOUSE.
22. Mark the
box that corresponds to the value of the property. 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 the condominium, 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.
23. 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.
24. When premiums
are paid other than on a yearly basis, convert to a yearly basis.
Enter the yearly amount even if no payment was made during the
past year.
25a. The word
mortgage indicates all types of loans secured by real
estate.
25b. 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 19a
to change it to a monthly amount.
Include payments on first mortgages and contracts
to purchase only. Report payments for second or junior mortgages
and home equity loans in 26b.
Report payments on installment loans for mobile homes in items 27b.
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.
26a. 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.
26b. 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 19a
to change it to a monthly amount. Include payments on all second
or junior mortgages or home equity loans.
ANSWER HOUSING QUESTION 27a and 27bONLY IF THIS IS A MOBILE
HOME THAT YOU OWN OR ARE BUYING.
27b. Report an
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 fees. DO NOT
include real estate taxes already reported in 23.
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.
28a. Answer this
question if you have listed at least one person on page 2 of the
form. Mark the "Yes" box if all of
the persons listed on pages 2 and 3 of the form live or stay year
round at the address on the front of the form. Then continue with
the questions on page 7.
If at least one of the persons listed on page 2 or 3 lives somewhere else during the year, mark the "No" box and continue with question 28b.
28b. Indicate the number of persons who live somewhere else during the year. Mark the “All persons listed” if all persons listed on pages 2 and 3 live somewhere else. If only some of the persons listed on pages 2 and 3 live somewhere else, enter the count of persons who live somewhere else during the year. For example, if there are 4 persons listed on page 2 of the form and 2 of those persons live somewhere else during the year, enter 2 in the space provided.
28c. Mark the box that indicates how you would classify the house, apartment, or mobile home that uses the address on the front of the questionnaire.
ANSWER PERSON QUESTIONS 7 THROUGH 13 FOR ALL PERSONS ON THE
LIST OF RESIDENTS.
Questions 7-41 are a continuation of the questions for each
person. (Questions 1-6 appear on pages 2 and 3 of the questionnaire.)
7. For people born in the
United States:
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 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).
8. If the person was born
in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas,
mark the "Yes, born in Puerto Rico, Guam, the U.S.
Virgin Islands, or Northern Marianas" box. If
the person was born outside the United States (or at sea) and
has at least one American parent, mark the "Yes,
born abroad of American parent or parents" box.
Mark the "Yes, U.S. citizen by naturalization"
box only if the person has completed the naturalization process
and is now a United States citizen.
9. If the person entered
the United States (that is, the 50 states and the District of
Columbia) more than once, enter the latest year he or she came
to live in the United States.
10a. 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.
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.
11. 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 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.
12. Print the ancestry group(s).
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. Answer
this question for ALL persons, regardless of
citizenship status.
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. If the person is a
baby under one year of age, mark the "Person is
under 1 year old" box. Then skip to the questions
for the next person. Do not complete any more questions for
the baby.
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 the United States one year ago,
mark the "No, outside the United States"
box and print the name of the foreign country, or Puerto Rico,
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 the United States one
year ago, mark the "No, different house in the
United States" box. Then in items 13b
and 13c, provide the city, county, state and
ZIP code where the person lived one year ago.
13b. If the person did not live inside the
city limits, print the name of the post office.
13c. 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 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 county" space blank.
ANSWER PERSON QUESTIONS 14 AND 16 ONLY IF THIS PERSON
IS 5 YEARS OLD OR OVER.
14a. 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.
14b. 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.
15. Mark the "Yes"
or "No" box for both parts a and
b of question 15 to indicate whether the person has any of the
conditions listed.
16. If the person is 16 years old or over, mark the “Yes” or “No” box for parts a, b, c, and d of question 16, If the person is under 16 years old, only complete parts a and b of question 16.
ANSWER PERSON QUESTIONS 17 THROUGH 41 ONLY IF THIS PERSON
IS 15 YEARS OLD OR OLDER.
17.Answer this question
if the person is a female who is at least 15 years old and younger
than 51 years old. Mark the "Yes"
box if the person has given birth to at least one child born
alive in the past 12 months, even if the child died or no longer
lives with the mother. Do not consider miscarriages, or stillborn
children, or any adopted, foster, or step children.
18a. Mark the "Yes"
box if the person has at least one of his or her own grandchildren,
living in the house, apartment,
or mobile home.
18b. 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.
18c. 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.
19. For a person with service
in the National Guard or military Reserves, mark a Yes
category only if the person has ever been called up for active
duty other than for training. For a person whose only service
was as a civilian employee or civilian volunteer for the Red
Cross, USO, Public Health Service, or War or Defense Department,
mark the "No, never served in the military"
box. Count World War II Merchant Marine service as active duty;
DO NOT count other Merchant Marine service as active duty.
20. Mark a box for EACH
period served, even if service in the period was brief.
21. Do not round the answer.
For example, if total service is 1 year and 10 months, mark
the "Less than 2 years" box.
22. Count as work –
Mark the "Yes" box if this person
performed:
-
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 – Mark the "No"
box if this person performed:
- Housework or yard work at home.
- Unpaid volunteer work.
- School work done as a student.
- Work done as a resident of an institution.
23.Include the house or
structure number; street name; 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, 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 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 Puerto Rico,
Guam, etc., print the name of the country on the state
or foreign country line and then go to question 24.
24. If the person usually
used more than one type of transportation to get to work
(for example, drove to public transportation), mark the category
of the one method of transportation that he or she used for
most of the distance during the trip.
25. If the person was
driven to work by someone who then drove back home or to a nonwork
destination, enter 1 in the box labeled
Person(s).
DO NOT include persons who rode to school
or some other nonwork destination in the count of persons who
rode in the vehicle.
26. 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, 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.
27. Travel time is from
door to door. Include time waiting for public transportation
or picking up passengers in a carpool.
ANSWER PERSON QUESTIONS 28a THROUGH 31 ONLY IF THE PERSON
DID NOT WORK LAST WEEK.
28a. Persons are on layoff
if they are waiting to be recalled to a job from which they
were temporarily separated for business-related reasons.
28b. If the person works only during certain
seasons or on a day-by-day basis when work is available, mark
the "No" box.
29. Mark Yes 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.
30. 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"
box.
31. Refer to the instructions
for question 22 to determine what to count
as work. Mark the "Over 5 years ago or never worked"
box if the person: (1) never worked at any kind of job or business,
either full or part time, (2) never worked, with or without
pay, in a family business or farm, and (3) never served on active
duty in the Armed Forces.
32. Refer to the instructions
for question 23 to determine what to count
as work. Include paid vacation, paid sick leave, and military
service. Count every week in which the person worked at all,
even for an hour.
33. If the hours worked each week varied considerably
in the past 12 months, give an approximate average of the hours
worked each week.
ANSWER PERSON QUESTIONS 34 THROUGH 39 ONLY IF THE PERSON
WORKED IN THE PAST 5 YEARS.
34. Mark the " An
employee of a PRIVATE NOT FOR PROFIT, . . . organization"
box 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 the "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 county-run community
college or a city-run public school.
If the person works in a gambling casino owned or operated
by American Indians, mark the "a local GOVERNMENT
employee" box.
35. 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 or her own un-named business, print
"self-employed."
36. Print one or more words
to describe the business, industry, or individual employer named
in question 35. If there is more than one activity, desciribe only the major activity at the place where the person worked. Enter what is made, what is sold, or what service is given.
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.
38. Print one 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.
Enter descriptions like the following: Registered
nurse, Personnel manager, High school teacher.
Do not enter single words such as: Nurse,
Manager, Teacher.
ANSWER PERSON QUESTIONS 40 THROUGH 41 ONLY IF THIS PERSON
IS 15 YEARS OLD OR OVER.
Mark the "Yes" or "No"
box for each part, and enter the amount received in the past
12 months for each "Yes" response.
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 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.
40a. 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.
40b. 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.
40c. 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 40b above. Include regular payments
from an estate or trust fund.
40d. 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.
40e. Include Supplemental Security Income (SSI)
received by elderly, blind, or disabled persons.
40f. Include any public assistance or welfare
payments the person receives from the state or county welfare
office. Do not include assistance received from private charities.
Do not include assistance to pay heating or cooling costs.
40g. Include retirement, survivor or disability
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.
40h. 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:
- Refunds or rebates of any kind
- 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
41. Add the total entries
(subtracting losses) for 40a through 40h
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?
The Census Bureau is conducting the American Community Survey
to provide more timely data than data we typically collect only
once every 10 years during the decennial census.
What does the Census Bureau do with the information
you provide?
The American Community Survey will be the source of summarized
data that we make available to federal, state, and local governments,
and also to the public. The data will enable your community
leaders from government, business, and non-profit organizations
to plan more effectively.
How was this address selected?
Your address was scientifically selected to represent a cross
section of other households in your community. Households in
the sample are required to complete the survey form. Please
return it in the postage-paid envelope as soon as possible.
Why the Census Bureau Asks Certain Questions --
Here are reasons we ask some of the questions on the survey.
Name
Names help make sure that everyone in a household is included
on the List of Residents, but that no one is listed twice.
Value or rent
Government and planning agencies use answers to these questions
in combination with other information to develop housing programs
to meet the needs of people at different economic levels.
Complete plumbing
This question helps provide information on the quality of housing.
The data are used with other statistics to show how the "level
of living" compares in various areas and how it changes
over time.
Place of birth
This question provides information used to study long-term trends
about where people move and to study migration patterns and
differences in growth patterns.
Job
Answers to the questions about the jobs people hold provide
information on the extent and types of employment in different
areas of the country. From this information, communities can
develop training programs, and business and local governments
can determine the need for new employment opportunities.
Income
Income helps determine how well families or persons live. Income
information makes it possible to compare the economic levels
of different areas, and how economic levels for a community
change over time. Funding for many government programs is based
on the answers to these questions.
Education
Responses to the education questions in the survey help to determine
the number of public schools, education programs, and daycare
services required in a community.
Disability
Questions about disability provide the means to allocate Federal
funding for healthcare services and new hospitals in many communities.
Journey to work
Answers to these questions help communities plan road improvements,
develop public transportation services, and design programs
to ease traffic problems.
Go Back to Enumeration Forms Index
|