Mail Survey Questionnaire

Survey Questionnaire

United States Department of Labor Bureau of Labor Statistics

The Gallup Organization

Who currently lives at this address? Mark the one answer that best fits your situation.

c Owner(s)

c Renter(s)

c Vacant (such as a house, condo, apartment for sale or rent)

c Assisted living or some type of residential care facility

c No one lives here; it is a business or other non-residential structure

c Something else (specify):

__________________________________________________________

Your participation is voluntary. The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent.

Paperwork Reduction Act Notice. The time needed to complete this survey is estimated to be less than 5 minutes. If you have comments concerning the accuracy of this time estimate or suggestions for making the survey simpler, you can write to: Office of Prices and Living Conditions, 2 Massachusetts Ave., NE, Rm. 3655, Washington, DC 20212.

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