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U.S. DEPARTMENT OF COMMERCE
DX-1302
FORM
(2-28-2007)
Section 1 – IDENTIFICATION
Economics and Statistics Administration
U.S. CENSUS BUREAU
APPLY LABEL HERE
CENSUS COVERAGE MEASUREMENT (CCM)
INDEPENDENT LISTING BOOK (ILB)
1. Cluster No.
BOOK
2008 Census Dress Rehearsal
NOTICE – Your response to the Census Bureau is confidential by law (title 13 of the United States Code) and in no way
identifies people or their places of residence. Only persons sworn to protect census confidentiality may see your answer. The
information will be used for statistical purposes only. Access restricted to authorized CCM staff.
6. Sample block(s) to be listed (after listing enter number of HUs in each block)
2. LCO name
Code
3. County
Code
OF
4. State
Code
______
BOOKS
______
5. TEA
APPLY LABEL HERE
Blocks
HUs
Blocks
HUs
Blocks
HUs
Blocks
HUs
8. Cluster situations – Also make entry on
"Notes Page."
Safety
1
4
No mailboxes
2
Restricted
Other
5
access
3
Language
7. Description and notes
9. Total number of HUs
listed in the cluster:
Section 2 – ASSIGNMENT INFORMATION
Dates
Position
Name
Telephone number
Applicant ID
Assigned
Completed
(e)
(a)
(b)
(c)
1. Crew leader
2. Lister
3. Lister
4. QC Crew leader
5. DQC Lister
6. DQC Lister
Cover page
If found, please either call
NOTICE
TO
FINDER
1–301–763–3301
to arrange for pickup
FORM DX-1302, Cover page – Prints black ink (30% and 100%)
OR
mail to:
Census Coverage Measurement
U.S. Census Bureau
4600 Silver Hill Road
Washington, DC 20233
Attn: CCM Field Staff.
Month
(d)
–
–
–
–
–
–
–
–
–
–
–
–
(f)
Day
Month
Day
CENSUS USE ONLY
To be completed by the National Processing Center
Cover
Page(s)
......
Section 4
Page(s)
......
Section 5
Page(s) . . . . . .
Section 6
Page(s)
......
FORM DX-1302, Cover page Overlay – prints Yellow PMS 129 (20% and 100%)
Section 3 – QUALITY ASSURANCE
Office Edit Sub-section
Result
1
2
1. Listing
Office editor
name
Date (mm/dd/yy)
Pass
Fail – Send
for
repair
–
Result
1
–
2
Applicant ID
2. DQC
Office editor
name
Date (mm/dd/yy)
Pass
Fail – Send
for
repair
–
–
Applicant ID
DQC Sub-section – Filled by office staff
Mark (X) one
1
Initial listing
2
Redo listing
Total number of lines used in
Section 4 of all books for cluster
Random start number
Start DQC in book
, on line number
, and continue with next 11 BSAs with HUs on ground.
Critical Errors – Residential Units
ILB
Line
No.
Listing
correct
(1)
(2)
Lister missed a BSA in
Section 4
Lister missed unit(s) in
multiunit or
mobile-home park in
Section 5 or 6
(3)
(4)
•
•
•
•
Lister omitted/entered wrong information for following critical items
Section 4
Section 5
Section 6
• Unit designation
• Map Spot No.
Map Spot No.
• Unit status
• House #/Lot #/Physical Location
Required address items*
Type of unit
• Unit status
Unit status
(5)
(6)
Critical Error –
Nonresidential Units
Lister did not map spot
BSA
Lister listed
nonresidential unit(s) in
multiunit or mobilehome park in Section 5
or 6
Lister listed a nonresidential
address as a BSA in
Section 4 –Enter ILB Line
Number of BSA
(8)
(9)
(10)
(7)
Cover page (interior)
Total
DQC Result – Mark (X) one.
*Required address items for column (4)
BSA must have one of the following:
Pass 2 Fail 3 Fail/Redo
• House No. and Road/street name (exclude
• Mark (X) "Pass" if there are no errors recorded in
spelling errors and street type errors):
columns (3)–(10)
if blank, then
• Mark (X) "Fail" if there is one or more errors recorded • Rural route No. and Box No.: if blank, then
in columns (3)–(10) and rectify ILB(s) for cluster.
• Physical location description/E-911 address
• Mark (X) "Fail/Redo" if the lister listed the wrong
(exclude spelling errors and street type errors).
block(s).
1
Rectification Sub-section
1. Block number
2. Correct block listed?
Mark (X) Y or N – Redo
Number
of units
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Y
N – Redo
Total
3. Added
4. Deleted
5. Number of addresses corrected
FORM DX-1302 (2-28-2007)
FORM DX-1302, Cover page – Prints black ink (30% and 100%)
FORM DX-1302, Cover page Overlay – prints Yellow PMS 129 (20% and 100%)
Section 4 – SUMMARY LISTING PAGE INSTRUCTIONS
It is your job to canvass, to list, and to map spot all Housing Units in the block(s) shown in Section 1,
item 6, on the front cover of this book. You must finish all three of these activities in each block before
starting the next.
In addition, fill the following items depending on the type of Housing Unit:
a. Single-family houses – List each Housing Unit on a separate line of the Listing Page, except for
multiunits, mobile homes, and trailers (see b, c, and d below for these Housing Units). Fill item 3, mark (X)
box 1 in item 11a, and fill items 11b through 13b as appropriate.
DEFINITIONS
b. Multiunits – Complete one line on the Listing Page for the multiunit Basic Street Address; do not list
individual apartments on the Listing Page. Fill item 3, mark (X) box 2 in item 11a, and fill items 13a and 13b.
NOTE: You will list the individual apartments at the multiunit Basic Street Address in Section 5, Multiunit
Basic Street Address Page. For more information, see the instructions in Section 5.
A Housing Unit (HU) is a:
• separate living quarters – that is, the occupants live separately from all other people in the building and
have direct access from the outside of the building or through a common hall
• vacant at the time of your visit, but intended for occupancy as a separate living quarters
Examples of Housing Units are a:
• house, an apartment, a mobile home, a trailer, a group of rooms, or a single room (vacant or occupied)
• seasonal or weekend cottage, condominium, or a vacation home (vacant or occupied)
• Housing Unit within, above, or behind a commercial building, church, or school, etc. (vacant or occupied)
• Boarded up Housing Unit
• Housing Unit under construction (foundation and building materials present)
• hotel or motel room if it is occupied at the time of your visit by person(s) with no other "usual residence."
(Usual residence is defined as the place where a person lives AND sleeps most of the time. A vacant
hotel or motel room is never a Housing Unit.)
• RV, camper, houseboat, lean-to, tent, train car, bus, or automobile only if it is occupied at the time of
your visit by person(s) with no other usual residence. (Campers or trailers only used for temporary
overflow sleeping are NOT Housing Units.)
• independent or assisted living unit if the unit is NOT provided with 24-hour skilled nursing care
A Basic Street Address (BSA) is the house number (including any letters and fractions) and street name
portion of an address. For example: 11 Main Street, 11½ Main Street and 11A Main Street are all BSAs. In
multiunits where the apartment or unit designation comes after the street name – such as 11 Main Street Apt.
A, 11 Main Street Apt. B, and 11 Main Street Apt. C – all individual units share the same BSA (11 Main
Street).
d. Mobile home or trailer parks – Complete only one line on the Listing Page for the park office. If there
is no office, fill the line for the owner’s or manager’s home. Do not list individual mobile homes, trailers,
and/or empty trailer lots/sites at parks on the Listing Pages. Do not fill item 3 (that is, do not assign a
map spot number to this listing). In item 11a mark boxes 3 and b.
NOTE: You will list the individual mobile homes, trailers and/or empty trailer lot/site at the park in
Section 6, Mobile Home Park Page. For more information, see the instructions in Section 6.
e. Other Housing Units – Other Housing Units are Housing Units not covered in a through d above,
such as campers, tents, vans, or houseboats, if presently occupied as an usual place of residence. Fill
item 3, mark box 4 in item 11a, and enter a description of the Housing Unit (occupied tent or occupied
van, etc.) and its location in item 14, (Remarks).
Unit Status – Item 11b
a. In item 11b, if you mark (X) box 3, also mark (X) all reasons that apply from items a through e. The
description you enter must conform to the category definition in Appendix B of your Lister Manual.
b. Whenever you mark (X) box 2, 3, 4, 5 or 8 in Item 11b, also describe the place in item 14, (Remarks).
Remarks – Item 14
Describe any unusual situations in item 14. (If appropriate, also go to the front cover of this book, Section 1,
and fill item 8, Cluster situations, and go to the back of this book and fill a line on the Notes Page. Refer
to Chapter 2 of your Lister Manual and the Notes Page of the ILB for detailed instructions.)
CANVASSING
SPECIAL LISTING SITUATIONS
Begin at a convenient corner in any block, and travel clockwise around the block. Travel each court, alley,
side road, and passageway as you come to it within the block, but always return to the point where you
turned off the main road.
a. Commercial Buildings – Be sure to inquire at commercial buildings to see if they contain any
Housing Units. However, do not list the address for any buildings that contain only business(es).
LISTING
As you canvass, look for and list all Housing Units on your right within the block. If you are in doubt, list;
then explain the situation in item 14, Remarks, on the Listing Page. For all types of Housing Units complete
the following fields:
Address Section
• Fill item 2, and items 3 through 8 as appropriate.
• For non-city style address, fill items 9 and 10 as well.
Page 3
c. Mobile homes or trailers not in a park – Fill item 3, mark boxes 3 and a in item 11a, and mark (X)
the appropriate boxes in 11b.
Remarks and Contact Information Section
• Fill item 14, if there are any remarks.
• Fill item 15, mark (X) appropriate box and fill in the respondent’s name and telephone number.
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 3 prints black ink (100%)
b. No Housing Units in a block – If a block contains no Housing Units, enter the block number in
item 2 on the first unused line, enter 0 in item 3, and enter ’No LQs in this BLK’ (for ’No Living Quarters
in this Block’) in item 14, (Remarks).
c. Missed a Basic Street Address – If you discover that you missed a Basic Street Address earlier
in your canvass, list it on the next available line of the Listing Pages. Do NOT assign the next available map spot number to the address. Proceed as follows:
1. Go to the line on the Listing Pages that precedes the line where the missed address should have
been listed.
2. Assign the map spot number entered in item 3 on that line – followed by the next available letter – to
the missed address.
Example: You assigned map spot number 12 to the preceding address; therefore, you enter map
spot number 12A for the missed address, both on the map and in item 3 of the Listing Page. (If two
or more addresses were missed at that same point, you would assign map spot number 12B to the
second missed address, 12C to the third, etc.)
Section 4 – SUMMARY LISTING PAGE INSTRUCTIONS – Continued
MAP SPOTTING
LIST OF ABBREVIATIONS
Show the location of each Housing Unit and multiunit Basic Street Address you list in Section 4 – and each
mobile home, trailer, and/or empty trailer lot/site you list in Section 6 – by entering a spot (•) followed by the
next available map spot number, on the CCM Block Cluster Map. Assign map spot number 1 to the first such
listing for the block cluster, 2 to the second, etc.
Use the abbreviations shown below when entering information on any of the pages in this book and on the
CCM block cluster map. However, remember:
After you finish canvassing, listing, and map spotting the first block, begin with another block (if there’s more
than one) on the next available line, etc., until all of the sample blocks are finished. Be sure to continue the
map spot numbering sequence from each block to the next within the block cluster. Do not start with 1 in
each block.
a. Multiunits – If a map spot is for a multiunit Basic Street Address, also enter the number of apartments
(Housing Units) at that address in parentheses after the map spot number.
Example: You assign map spot number 4 to a multiunit Basic Street Address with 8 apartments, so you
enter •4(8) on the map. (You also enter the map spot number only – 4 in this case – in item 3 on the
Listing Page.)
b. Two or more Basic Street Addresses at one structure – If there are two or more Basic Street
Addresses at one structure – such as a duplex at 106 Pine Street and 108 Pine Street – with one or more
Housing Units at each address, assign a separate map spot number to each Basic Street Address. Also
draw a circle around the map spots on the map only, not on the Listing Page to show that those Basic
Street Addresses are located in the same building.
Example:
•7 •8
or
•9(3) •10(3)
or
•11(3) •12(3) •13
c. Different structures using the same Basic Street Address – If Housing Units in different
structures use the same Basic Street Address – such as an occupied trailer behind a house, both using
the address 110 Pine St., or two multiunits in the same complex, both using the address 224 Foss
Dr. – assign separate map spot numbers to the structures. Show their address as indicated in the
following example.
Example: On the Listing Page, show the addresses as 110 Pine ST * HSE and 110 Pine ST * TRLR,
and as 224 Foss DR * LEFT and 224 Foss DR * RGHT.
For buildings using different building designations, such as BLDG A, BLDG B, etc., show as 224 Foss
DR * BLDG A and 224 Foss DR * BLDG B. Note that the asterisk (*) is required between the street
address and the unit definer for computer processing reasons.
REVIEWING YOUR WORK
a. Leave the OFFICE USE ONLY space blank.
b. Before you turn in this listing book as complete, review the Listing Pages to assure that all entries
are complete and that the following four problems do not exist:
•
•
•
•
Wrong or missing block numbers – (item 2)
Heading information in Section 5 or 6 does not match the corresponding Section 4 entries
Wrong, missing, or duplicate map spot numbers – (item 3)
Missing type of Basic Street Address – (item 11a)
Page 4
c. You must also look for and correct other types of problems; see your Lister Manual for details.
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 3 prints black ink (100%)
• Do not abbreviate actual road names. For example, enter Green ST, not GR ST
• You may write an abbreviation in all capital letters or you may capitalize only the first letter. For example,
both EXWY and Exwy are acceptable.
and
apartment(s)
attic
avenue
back
basement
black/block
blue
boarded up
boulevard
box
brick
brown
building
circle
county
court
downstairs
drive
east
expressway
first, second...
floor
freeway
front
garage
general delivery
green
highway
highway contract route
house
household storage
intersection
interstate highway
lane
left
living quarters
lockbox
lower
migrant living quarters
mile
No living quarters
&
APT (APTS)
ATC
AVE
BK
BSMT
BLK
BL
BU
BLVD
BOX
BRK
BRN
BLDG
CIR
CO
CT
DWNSTR
DR
E
EXWY
1st, 2nd... (see floor)
FL (or 1FL, 2FL...)
FWY
FRNT
GRG
GEN DEL
GR
HWY
HCR
HSE
HS
INT
ILN
LEFT
LQS
LB
LOWR
MIG LQS
MI
No LQS
north
north east
north west
number
office
parkway
penthouse
place
porch
post office
postal service center
private road
railroad/rural route
refuse(al)
right
road
route
rural route
school
seasonally vacant
south
south east
south west
split level
state route
street/state
suite
terrace
trail
trailer
township
under construction
unnamed road
upper
vacant
vacant storage
vehicular trail
west
white
with
yellow
N
NE
NW
#
OFC
PKWY
PH
PL
PRCH
PO
PSC
PR RD
RR
R
RGHT
RD
RTE
RR
SCHL
SV
S
SE
SW
SL
SR
ST
STE
TER
TR
TRLR
TWP
UC
UN RD
UPPR
V
VS
VE TR
W
WHT
W/
YLW
Section 4 – SUMMARY LISTING PAGE INSTRUCTIONS – Continued
SAMPLE LISTING OF SINGLE-FAMILY HOUSE IN CITY STYLE ADDRESS AREA
Hello, I’m (Your name) from the U.S. Census Bureau. Here’s my identification. We are listing addresses as part of the 2008 Census Dress Rehearsal, and I have a few questions to ask you.
Section 4 – LISTING PAGE
(1) Line No.
(2) Block No.
4 1 6 3
1
(4) House No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
Number
1 2
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
Letter
(5a) Road/Street name
321
1
2
(6a) Rural Rte. No.
✘ Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
N Pine St
(6b) Box No.
(7) PO Box No.
(8) ZIP Code
4 3 2 7 7
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
3
(10) Physical location description or E-911 address
4
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
(11b) Unit status
1
Occupied or vacant and intended for occupancy – Go to 11c
Under construction (foundation and building materials present) . . .
2
✘
Future construction – Mark (X) all that apply.
a
A sign indicating future construction is planned,
b
A building permit,
Stakes in the ground,
c
A zoning change sign from commercial use to residential use
d
3
e
Other – Specify
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
(13a) Canvass the multiunit and enter the number of units on each floor.
7th floor
8th floor
2nd floor
9th floor
Yes – Specify name if available
1
2
SKIP
(12)
to
14
✘ No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
1
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
✘
(14) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
3rd floor
4th floor
10th floor
11th floor
5th floor
12th floor
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
Example: "5 APTS 14th FLR"
6th floor
Total number of Housing
Units (occupied or vacant)
Attic
Other –
(15) Information
obtained
from:
OFFICE
USE
ONLY
✘ HH member*
1
Manager*
3
Proxy*
2
Observation
4
*Respondent name
Telephone No.
Ann Colby
(618)555–1211
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
SAMPLE LISTING OF SINGLE-FAMILY HOUSE IN NON-CITY STYLE ADDRESS AREA
Hello, I’m (Your name) from the U.S. Census Bureau. Here’s my identification. We are listing addresses as part of the 2008 Census Dress Rehearsal, and I have a few questions to ask you.
Section 4 – LISTING PAGE
(1) Line No.
(2) Block No.
5 1 2 8
1
(4) House No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
Number
2 3
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
Letter
(5a) Road/Street name
1
✘ Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
2
(6a) Rural Rte. No.
(6b) Box No.
3
(7) PO Box No.
(8) ZIP Code
190
2 1 3 1 1
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
Michael
B
3
Fowler
(10) Physical location description or E-911 address
1/4 mi S of County Rd 231, down Long driveway W of Whiterock Rd.
4
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
(11b) Unit status
1
Occupied or vacant and intended for occupancy – Go to 11c
Under construction (foundation and building materials present) . . .
2
✘
3
Future construction – Mark (X) all that apply.
a
A sign indicating future construction is planned,
b
A building permit,
Stakes in the ground,
c
A zoning change sign from commercial use to residential use
d
e
Other – Specify
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
MULTIUNIT ADDRESS
Page 5
7th floor
8th floor
2nd floor
9th floor
3rd floor
10th floor
Yes – Specify name if available
1
SKIP
(12)
to
14
2
✘ No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
1
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
✘
(14) Remarks – Do not use this space for location description.
(13a) Canvass the multiunit and enter the number of units on each floor.
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
4th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
Other –
FORM DX-1302, Page 5, prints black ink (10%, 30%, 50%, and 100%)
(15) Information
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
FORM DX-1302 (2-28-2007)
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
Mary Fowler
1
2
✘ HH member*
Proxy*
OFFICE
USE
ONLY
3
4
Manager*
Observation
Telephone No.
(715)555–2112
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
Section 4 – SUMMARY LISTING PAGE INSTRUCTIONS – Continued
SAMPLE LISTING OF MULTIUNIT BASIC STREET ADDRESS IN CITY STYLE ADDRESS AREA
Hello, I’m (Your name) from the U.S. Census Bureau. Here’s my identification. We are listing addresses as part of the 2008 Census Dress Rehearsal, and I have a few questions to ask you.
Section 4 – LISTING PAGE
(1) Line No.
(2) Block No.
5 3 4 4
1
(4) House No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
6
Number
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
Letter
(5a) Road/Street name
112
2
(6a) Rural Rte. No.
Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
1
Oakton Ave
(6b) Box No.
(7) PO Box No.
3
✘ Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
(8) ZIP Code
3 0 6 7 8
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
(11b) Unit status
1
Occupied or vacant and intended for occupancy – Go to 11c
Under construction (foundation and building materials present) . . .
2
3
(10) Physical location description or E-911 address
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
4
Future construction – Mark (X) all that apply.
a
A sign indicating future construction is planned,
b
A building permit,
Stakes in the ground,
c
A zoning change sign from commercial use to residential use
d
e
Other – Specify
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
(13a) Canvass the multiunit and enter the number of units on each floor.
2nd floor
2
7th floor
8th floor
3rd floor
4th floor
5th floor
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
Example: "5 APTS 14th FLR"
6th floor
2
9th floor
SKIP
(12)
to
14
1
Yes – Specify name if available
2
No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
1
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
(14) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
10th floor
11th floor
12th floor
4
Attic
Total number of Housing
Units (occupied or vacant)
Other –
(15) Information
obtained
from:
1
HH member*
3
2
Proxy*
4
*Respondent name
✘ Manager*
OFFICE
USE
ONLY
Observation
Telephone No.
Rose Hewitt
(809)555–0621
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
SAMPLE LISTING OF MOBILE HOME OR TRAILER PARK OFFICE
Hello, I’m (Your name) from the U.S. Census Bureau. Here’s my identification. We are listing addresses as part of the 2008 Census Dress Rehearsal, and I have a few questions to ask you.
Section 4 – LISTING PAGE
(1) Line No.
(2) Block No.
3 2 6 3
1
(4) House No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
Number
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
Letter
(5a) Road/Street name
618
Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
1
Canyon Blvd
2
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(8) ZIP Code
2 1 4 1 8
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
3
✘
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
(11b) Unit status
1
Occupied or vacant and intended for occupancy – Go to 11c
Under construction (foundation and building materials present) . . .
2
3
Future construction – Mark (X) all that apply.
a
A sign indicating future construction is planned,
b
A building permit,
Stakes in the ground,
c
A zoning change sign from commercial use to residential use
d
e
Other – Specify
✘
(10) Physical location description or E-911 address
4
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
MULTIUNIT ADDRESS
Page 6
7th floor
8th floor
2nd floor
9th floor
3rd floor
10th floor
SKIP
(12)
to
14
1
Yes – Specify name if available
2
No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
1
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
(14) Remarks – Do not use this space for location description.
(13a) Canvass the multiunit and enter the number of units on each floor.
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
4th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
Other –
FORM DX-1302, Page 6, prints black ink (10%, 30%, 50%, and 100%)
(15) Information
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
FORM DX-1302 (2-28-2007)
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
OFFICE
USE
ONLY
1
HH member*
3
2
Proxy*
4
Manager*
Observation
Telephone No.
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
Hello, I’m (Your name) from the U.S. Census Bureau. Here’s my identification. We are listing addresses as part of the 2008 Census Dress Rehearsal, and I have a few questions to ask you.
Section 4 – LISTING PAGE
(1) Line No.
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
1
(4) House No.
Number
Letter
(5a) Road/Street name
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
1
2
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(8) ZIP Code
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
3
(10) Physical location description or E-911 address
4
(11b) Unit status
Occupied or vacant and intended for occupancy – Go to 11c
1
Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
2
Under construction (foundation and building materials present) . . .
3
Future construction – Mark (X) all that apply.
A sign indicating future construction is planned,
a
A building permit,
b
Stakes in the ground,
c
A zoning change sign from commercial use to residential use
d
e
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
Other – Specify
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
(13a) Canvass the multiunit and enter the number of units on each floor.
7th floor
8th floor
2nd floor
9th floor
SKIP
(12)
to
14
1
Yes – Specify name if available
2
No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
1
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
(14) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
3rd floor
4th floor
10th floor
11th floor
5th floor
12th floor
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
Example: "5 APTS 14th FLR"
6th floor
Total number of Housing
Units (occupied or vacant)
Attic
(15) Information
obtained
from:
OFFICE
USE
ONLY
1
HH member*
3
2
Proxy*
4
*Respondent name
Other –
Manager*
Observation
Telephone No.
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
Section 4 – LISTING PAGE
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
2
(4) House No.
Number
Letter
(5a) Road/Street name
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
1
2
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(8) ZIP Code
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
3
(10) Physical location description or E-911 address
4
(11b) Unit status
Occupied or vacant and intended for occupancy – Go to 11c
1
Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
2
Under construction (foundation and building materials present) . . .
3
Future construction – Mark (X) all that apply.
A sign indicating future construction is planned,
a
b
A building permit,
d
Stakes in the ground,
A zoning change sign from commercial use to residential use
e
Other – Specify
c
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
(13a) Canvass the multiunit and enter the number of units on each floor.
Page 7
7th floor
8th floor
2nd floor
9th floor
3rd floor
10th floor
SKIP
(12)
to
14
1
Yes – Specify name if available
2
No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
1
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
(14) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
0001
(1) Line No.
4th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
(15) Information
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
Other –
OFFICE
USE
ONLY
1
HH member*
3
Manager*
2
Proxy*
4
Observation
Telephone No.
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 7, prints black ink (30%, 50%, and 100%)
Use this page to generate pages 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 49, 51, 53, and 55
FORM DX-1302, Page 7, Overlay – prints Pantone Cyan (20% and 100%)
Hello, I’m (Your name) from the U.S. Census Bureau. Here’s my identification. We are listing addresses as part of the 2008 Census Dress Rehearsal, and I have a few questions to ask you.
Section 4 – LISTING PAGE
(1) Line No.
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
3
(4) House No.
Number
Letter
(5a) Road/Street name
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
1
2
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(8) ZIP Code
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
3
(10) Physical location description or E-911 address
4
(11b) Unit status
Occupied or vacant and intended for occupancy – Go to 11c
1
Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
2
Under construction (foundation and building materials present) . . .
3
Future construction – Mark (X) all that apply.
A sign indicating future construction is planned,
a
A building permit,
b
Stakes in the ground,
c
A zoning change sign from commercial use to residential use
d
e
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
Other – Specify
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
(13a) Canvass the multiunit and enter the number of units on each floor.
7th floor
8th floor
2nd floor
9th floor
SKIP
(12)
to
14
1
Yes – Specify name if available
2
No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
1
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
(14) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
3rd floor
4th floor
10th floor
11th floor
5th floor
12th floor
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
Example: "5 APTS 14th FLR"
6th floor
Total number of Housing
Units (occupied or vacant)
Attic
(15) Information
obtained
from:
OFFICE
USE
ONLY
1
HH member*
3
2
Proxy*
4
*Respondent name
Other –
Manager*
Observation
Telephone No.
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
Section 4 – LISTING PAGE
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
4
(4) House No.
Number
Letter
(5a) Road/Street name
(11a) Is this a single-family
house, multiunit, mobile
home, or trailer?
1
2
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(8) ZIP Code
Complete items 9 and 10 for areas with non-city style addresses.
(9) Householder name
First
MI
Last
3
(10) Physical location description or E-911 address
4
(11b) Unit status
Occupied or vacant and intended for occupancy – Go to 11c
1
Single-family house
(including townhouse,
rowhouse, etc.) – Go to 11b
Multiunit
• Apartments, condominium
• House with attached
apartment (e.g., basement
or attic apartment)
SKIP to 13a
Mobile home or trailer
Not in a park – Go to
a
11b
Park – SKIP to Section
b
6, Mobile Home
Park Page
Other (occupied camper, tent,
van, boat, etc.) – SKIP to 14
2
Under construction (foundation and building materials present) . . .
3
Future construction – Mark (X) all that apply.
A sign indicating future construction is planned,
a
b
A building permit,
d
Stakes in the ground,
A zoning change sign from commercial use to residential use
e
Other – Specify
c
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 15
Other – Skip to 14
6
8
(13a) Canvass the multiunit and enter the number of units on each floor.
Page 8
7th floor
8th floor
2nd floor
9th floor
3rd floor
10th floor
SKIP
(12)
to
14
1
Yes – Specify name if available
2
No
At (address), are there any basement or garage apartments
or other residences, even if no one is living there now?
1
Yes – How many?
Change item 11a to multiunit.
Is/Are the other residence(s) attached to the main
residence (e.g., basement apartment) and/or detached
(e.g., mobile home, carriage house)?
Attached – Go to 13a
Detached – SKIP to 15 then go to the next line number
and record other residence.
No – SKIP to 15
a
b
2
(14) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(11c) Could this place be a group quarters? (Examples include a group home
providing room, board, and supportive services; a residential treatment
center; a migrant farm-work camp; a construction worker camp; etc.)
0002
(1) Line No.
4th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
(13b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
(15) Information
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
Other –
OFFICE
USE
ONLY
1
HH member*
3
Manager*
2
Proxy*
4
Observation
Telephone No.
If multiunit (answered 13b), then go to Section 5, Multiunit Address Page.
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 8, prints black ink (30%, 50%, and 100%)
Use this page to generate pages 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, 42, 44, 46, 48, 52, 54, and 56
FORM DX-1302, Page 8, Overlay – prints Pantone Cyan (20% and 100%)
Section 5 – SUMMARY MULTIUNIT ADDRESS PAGE INSTRUCTIONS
1. Complete the heading items – These are the seven items directly above each set of lines on
the Multiunit Address Page. You must fill the appropriate heading items for each completed set of
lines, to identify the Basic Street Address for the apartments you will be listing on that set of lines.
In addition to completing one line on a Listing Page for each multiunit Basic Street Address, you
must also list all apartments at that Basic Street Address on a Multiunit Address Page. Each Multiunit
Address Page contains three sets of 40 lines. This provides room to list three multiunit Basic Street
Addresses with up to 40 apartments at each address. If there are 40 or fewer apartments at a Basic
Street Address, list them all on the first unused set of lines; if there are 41 or more apartments, list 40 on
the first unused set of lines and continue the listing on the following set(s) of lines.
For items 1 through 6, you already entered this information on the Listing Pages (Section 4), where
you completed one line for the Basic Street Address. Copy the information from items 3 through 8 on
the Listing Page to these items. If there are more than 40 apartments at the Basic Street Address,
enter the same information at the top of each set of lines that contains listing(s) for the Basic Street
Address.
Example: Assume you find two multiunit Basic Street Addresses while canvassing your block cluster; the
first address has 12 apartments and the other has 54 apartments. In this case you would:
• list the address with the 12 apartments on the first set of lines on the Multiunit Address Pages,
If there is a complex name for the apartments being listed, enter the name in item 7.
• list the first 40 apartments of the address with the 54 apartments on lines 1 through 40 of the
second set of lines, and
2. List the apartments – List each apartment at the Basic Street Address in the Unit designation
column; then indicate its status in the Unit Status column, by entering the appropriate code from the
bottom of the page. If the apartments are numbered or lettered, list them in numeric or alphabetic
order – i.e., 101, then 102, 201, 202; or 101A, then 101B, 201A, 201B; or A, then B, C, D.
Otherwise, list the apartments by describing their locations, from the lowest floor at the Basic Street
Address to the highest – e.g., BSMT FRNT, BSMT BK, 1FL LEFT, 1FL RGHT.
• list the remaining apartments on lines 1 through 14 of the third set of lines.
NOTE: If a particular apartment does not qualify as a Housing Unit, do not list that apartment. (For
more information see Definition of a Housing Unit at the beginning of the summary instructions for
Section 4, Listing Page.)
SAMPLE LISTING OF APARTMENTS AT A MULTIUNIT BASIC STREET ADDRESS
Ask the manager of an apartment complex – Do you have any maps of the apartment complex that I can take with me?
Section 5 – MULTIUNIT ADDRESS PAGE
(1) Map Spot No.
6
Number
(2) House No.
(1) Map Spot No.
Letter
(3a) Road/street name
112
Number
(1) Map Spot No.
Letter
(2) House No.
(3a) Road/street name
Number
Letter
(2) House No.
(3a) Road/street name
Oakton Ave
(4a) Rural Rte. No.
(5) PO Box No.
(4b) Box No.
(6) ZIP Code
(4a) Rural Rte. No.
30 6 7 8
(7) Name of complex (if applicable)
(4b) Box No.
(5) PO Box No.
(6) ZIP Code
(4a) Rural Rte. No.
(7) Name of complex (if applicable)
(4b) Box No.
(5) PO Box No.
(6) ZIP Code
(7) Name of complex (if applicable)
Towers Apartments
Line
No.
1
2
3
4
Unit designation
(a)
Apt
Apt
Apt
Apt
101
102
201
202
20
Page 57
UNIT STATUS:
Unit status
(b)
1
1
6
1
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(a)
Unit status
(b)
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(a)
Unit status
(b)
Line
No.
21
1
21
1
21
22
2
22
2
22
23
3
23
3
23
24
4
24
4
24
40
20
40
20
40
1 – Occupied or vacant and intended for occupancy
2 – Under construction (started)
3 – Future construction (not started)
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
Unit designation
(c)
Unit status
(d)
8 – Other
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 57 prints black ink (10%, 30%, 50%, and 100%)
Page 58 – BLANK (no folio)
Ask the manager of an apartment complex – Do you have any maps of the apartment complex that I can take with me?
Section 5 – MULTIUNIT ADDRESS PAGE
Number
(2) House No.
(1) Map Spot No.
Letter
(3a) Road/street name
(4a) Rural Rte. No.
(5) PO Box No.
(4b) Box No.
(6) ZIP Code
Page 59
Unit designation
(a)
(1) Map Spot No.
Letter
(3a) Road/street name
(4a) Rural Rte. No.
(5) PO Box No.
(4b) Box No.
Unit status
(b)
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(a)
Number
(2) House No.
(6) ZIP Code
Letter
(3a) Road/street name
(4a) Rural Rte. No.
(7) Name of complex (if applicable)
(7) Name of complex (if applicable)
Line
No.
Number
(2) House No.
(5) PO Box No.
(4b) Box No.
(7) Name of complex (if applicable)
Unit status
(b)
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(a)
Unit status
(b)
Line
No.
1
21
1
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40
1 – Occupied or vacant and intended for occupancy
2 – Under construction (started)
UNIT STATUS:
(6) ZIP Code
3 – Future construction (not started)
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
Unit designation
(c)
Unit status
(d)
0003
(1) Map Spot No.
8 – Other
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 59 Base copy – Prints black ink (30%, 50%, and 100%)
Use this page to generate pages 61, 63, 65, 67, 69, 71, 73, 75,and 77
FORM DX-1302, Page 59 Overlay – prints Red PMS 189 (20%)
Ask the manager of an apartment complex – Do you have any maps of the apartment complex that I can take with me?
Section 5 – MULTIUNIT ADDRESS PAGE
Number
(2) House No.
(1) Map Spot No.
Letter
(3a) Road/street name
(4a) Rural Rte. No.
(5) PO Box No.
(4b) Box No.
(6) ZIP Code
Page 60
Unit designation
(a)
(1) Map Spot No.
Letter
(3a) Road/street name
(4a) Rural Rte. No.
(5) PO Box No.
(4b) Box No.
Unit status
(b)
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(a)
Number
(2) House No.
(6) ZIP Code
Letter
(3a) Road/street name
(4a) Rural Rte. No.
(7) Name of complex (if applicable)
(7) Name of complex (if applicable)
Line
No.
Number
(2) House No.
(5) PO Box No.
(4b) Box No.
(7) Name of complex (if applicable)
Unit status
(b)
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(a)
Unit status
(b)
Line
No.
1
21
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39
20
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20
40
20
40
1 – Occupied or vacant and intended for occupancy
2 – Under construction (started)
UNIT STATUS:
(6) ZIP Code
3 – Future construction (not started)
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
Unit designation
(c)
Unit status
(d)
0004
(1) Map Spot No.
8 – Other
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 60 Base copy – Prints black ink (30%, 50%, and 100%)
Use this page to generate pages 62, 64, 66, 68, 70, 72, 74, 76, and 78
FORM DX-1302, Page 60 Overlay – prints Red PMS 189 (20%)
Section 6 – SUMMARY MOBILE HOME PARK PAGE INSTRUCTIONS
• Third park – List the first four mobile homes or trailers located in the first block of this park on lines 1
through 4 of the fourth page. List the eight mobile homes or trailers located in the different block on
lines 1 through 8 of the fifth page.
In addition to completing one line on a Listing Page for each mobile home or trailer park office (see the
instructions for Section 4) – or for the owner’s or manager’s home if there is no office – you must also list the
mobile homes, trailers, and/or empty trailer lots/sites in the park on the Mobile Home Park Pages. Each
Mobile Home Park Page contains 15 lines, or room to list up to 15 mobile homes, trailers, and/or empty trailer
lots/sites. If there are 15 or fewer mobile homes, trailers, and/or empty trailer lots/sites in a park – and in
one block within a park – list them all on the first unused Mobile Home Park Page; or, if there are 16 or
more, list 15 on the first unused page and continue the listing on the following page(s).
IMPORTANT: If a particular mobile home or trailer is temporarily sitting somewhere other than at a
lot/site – such as in a For Sale area or storage area at a park – do not list that mobile home or trailer.
1. Complete the heading items – These are items 1 through 11, at the top of each Mobile Home Park
Page. You must fill the appropriate heading items at the top of each completed page, to identify the
park containing the mobile homes, trailers, and/or empty trailer lots/sites listed on that page.
NOTE: If the mobile homes, trailers, and/or empty trailer lots/sites at any park are spread out over two or
more blocks, you must complete separate Mobile Home Park Page(s) for each of those blocks that is
located within your block cluster.
Most of this information should already be entered on a Listing Page (in Section 4), where you completed
one line for the park office (or for the owner’s or manager’s home). Copy the corresponding information
from the Listing Page to these items 1–11 of the Mobile Home Park Page. If you are filling separate
page(s) for each block within a multi-block park, be sure to enter the correct block
number in item 1 on each page.
Example: Assume you find three mobile home/trailer parks while canvassing your block cluster. The first
park you find has 4 mobile homes or trailers and 2 empty trailer lots/sites, all located within one block. The
second park has 19 mobile homes or trailers and 3 empty trailer lots/sites, all located within one block. The
third park has 12 mobile homes or trailers and no empty trailer lots/sites; the first 4 are located in one block,
and the remaining 8 are in another block. (All the blocks are located within your block cluster.) For this block
cluster, you would do the following:
2. List the mobile homes, trailers, and/or empty trailer lots/sites – Spot the location of each
mobile home, trailer, and/or empty trailer lot/site in the park – and in each block within the park – on the
CCM Block Cluster Map. Copy the map spot number from the map to column (a); fill columns (b) through
(f) as appropriate; fill columns (g) and (h), and also fill column (i) if the block cluster is located in a non-city
style address area.
• First park – List the entire park on lines 1 through 6 of the first Mobile Home Park Page.
• Second park – List the first 15 mobile homes, trailers, or empty trailer lots/sites in this park on lines 1
through 15 of the second page, and list the remaining mobile homes, trailers, or empty trailer
lots/sites on lines 1 through 7 of the third page.
SAMPLE LISTING OF MOBILE HOMES, TRAILERS, OR SITES IN A PARK (OR BLOCK WITHIN A PARK)
Ask the contact person of the mobile home park – Do you have any maps of the mobile home park that I can take with me?
Section 6 – MOBILE HOME PARK PAGE
Mobile home park address
(2) House No.
3263
(1) Block No.
(3a) Road/street name
618
(7) What is the total number of mobile homes, trailers, AND empty trailer lots/sites in the park?
Canyon Blvd
(9) Name of park
(10) Name/Title/Phone No. of
contact person for park
(4a) Rural Rte. No.
(4b) Box No.
(5) PO Box No.
Line
No.
House/Lot No./Physical description
Map Spot No.
(b)
(a)
Number
1
Number
2
Number
3
Number
Page 79
4
28
29
30
31
UNIT STATUS:
Letter
Letter
Letter
Letter
Lot
Lot
Lot
Lot
1
2
3
4
1 – Occupied or vacant and intended for occupancy
Canyon
Canyon
Canyon
Canyon
(11) Information obtained from
1
HH member
2
Proxy
3
✗ Manager
Road/street name
Rural
Rte. No.
Box No.
PO Box No.
Unit status
ZIP Code
(c)
(d)
(e)
(f)
(g)
(h)
1
7
1
1
Blvd
Blvd
Blvd
Blvd
4 – Unfit for habitation
5 – Boarded up
(8) Mobile home park number
2
Ames Mobile Home Park
Myra Ames-Owner/Manager, (701) 555–3813
(6) ZIP Code
21418
4
2
2
2
2
6 – Storage of household goods
1
1
1
1
4
4
4
4
4
Observation
Obtain householder name for areas with non-city style addresses
(i)
First
1
1
1
1
MI
Last
8
8
8
8
7 – Empty trailer lot/site
8 – Other
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 79 prints black ink (10% 30%, 50%, and 100%)
Page 80 – BLANK (no folio)
Ask the contact person of the mobile home park – Do you have any maps of the mobile home park that I can take with me?
Section 6 – MOBILE HOME PARK PAGE
Mobile home park address
(7) What is the total number of mobile homes, trailers, AND empty trailer lots/sites in the park?
(1) Block No.
(3a) Road/street name
(2) House No.
(8) Mobile home park number
(9) Name of park
(10) Name/Title/Phone No. of
contact person for park
(4a) Rural Rte. No.
(4b) Box No.
(5) PO Box No.
(6) ZIP Code
(11) Information obtained from
Line
No.
Map Spot No.
House/Lot No./Physical description
(b)
(a)
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
1
HH member
2
Proxy
3
Manager
4
Road/street name
Rural
Rte. No.
Box No.
PO Box No.
Unit status
ZIP Code
(c)
(d)
(e)
(f)
(g)
(h)
Observation
Obtain householder name for areas with non-city style addresses
(i)
First
MI
Last
1
2
3
4
5
6
7
0005
8
9
10
11
12
13
14
Page 81
15
UNIT STATUS:
1 – Occupied or vacant and intended for occupancy
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
7 – Empty trailer lot/site
8 – Other
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 81 Base copy – Prints black ink (30%, 50%, and 100%)
Use this page to generate pages 83, 85, 87, 89, 91, 93, 95, 97, and 99
FORM DX-1302, Page 81 Overlay – Prints Yellow PMS 123 (20%)
Ask the contact person of the mobile home park – Do you have any maps of the mobile home park that I can take with me?
Section 6 – MOBILE HOME PARK PAGE
Mobile home park address
(7) What is the total number of mobile homes, trailers, AND empty trailer lots/sites in the park?
(1) Block No.
(3a) Road/street name
(2) House No.
(8) Mobile home park number
(9) Name of park
(10) Name/Title/Phone No. of
contact person for park
(4a) Rural Rte. No.
(4b) Box No.
(5) PO Box No.
(6) ZIP Code
(11) Information obtained from
Line
No.
Map Spot No.
House/Lot No./Physical description
(b)
(a)
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
Number
Letter
1
HH member
2
Proxy
3
Manager
4
Road/street name
Rural
Rte. No.
Box No.
PO Box No.
Unit status
ZIP Code
(c)
(d)
(e)
(f)
(g)
(h)
Observation
Obtain householder name for areas with non-city style addresses
(i)
First
MI
Last
1
2
3
4
5
6
7
0006
8
9
10
11
12
13
14
Page 82
15
UNIT STATUS:
1 – Occupied or vacant and intended for occupancy
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
7 – Empty trailer lot/site
8 – Other
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 82 Base copy – Prints black ink (30%, 50%, and 100%)
Use this page to generate pages 84, 86, 88, 90, 92, 94, 96, 98, 99, and 100
FORM DX-1302, Page 82 Overlay – Prints Yellow PMS 123 (20%)
NOTES PAGE
1. Cluster No.
2. County name
3. State
INSTRUCTIONS
Use the descriptions below to mark the correct box(es) in Section 1, item 8 on the cover of this listing
book. Then, following the instructions below, write notes for each box marked.
If the situation applies to a particular address, for example a suspected drug house, fill in the map spot number
of the address in column (a), and then write a note. If most or all addresses in the cluster are affected, for
example the cluster is in a Spanish speaking neighborhood, leave the map spot number blank.
WHAT TO INCLUDE IN NOTES FOR THE COVER PAGE ITEM 8 ENTRIES
1. Safety – Describe conditions that could affect interviewer personal safety, such as dark
streets/hallways, suspected drug houses, dangerous dogs, etc.
2. Restricted access – Describe situations such as gated communities, security high-rise buildings,
posted no trespassing areas, etc., which could prevent the next interviewer from completing his/her
work on time.
3. Language – If it is necessary or useful for the next interviewer to speak a language other than
English to work in this cluster, enter the name of the language. You may also enter the name,
Page 101
Line
No.
address, and telephone number of someone you located who is willing to be an interpreter in the
future.
4. No mailboxes – Indicate units that don’t have a mailbox at the listed location, and would not get
a letter delivered at the unit if we needed to contact a future resident.
5. Other – Explain any other situation that could affect another interviewer’s ability to locate the
cluster or its boundaries, locate units within the cluster, or, once a unit is found, get to a
respondent.
Map Spot No.
Notes
(a)
(b)
1
Number
Letter
2
Number
Letter
3
Number
Letter
4
Number
Letter
5
Number
Letter
6
Number
Letter
7
Number
Letter
8
Number
Letter
9
Number
Letter
10
Number
Letter
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 101 prints black ink (100%)
FORM DX-1302, Page 101, Overlay – prints Pantone Purple 264 (20%)
NOTES PAGE – Continued
Page 102
Line
No.
Map spot No.
Notes
(a)
(b)
11
Number
Letter
12
Number
Letter
13
Number
Letter
14
Number
Letter
15
Number
Letter
16
Number
Letter
17
Number
Letter
18
Number
Letter
19
Number
Letter
20
Number
Letter
21
Number
Letter
22
Number
Letter
23
Number
Letter
24
Number
Letter
25
Number
Letter
26
Number
Letter
27
Number
Letter
FORM DX-1302 (2-28-2007)
FORM DX-1302, Page 102 prints black ink (100%)
FORM DX-1302, Page 102, Overlay – prints Pantone Purple 264 (20%)
| File Type | application/pdf |
| File Modified | 2007-03-05 |
| File Created | 2007-02-28 |