DD-1302 (CFU) Coverage Followup Questionnaire

OMB No. 0607-0923: Approval Expires 12/31/2006
U.S. DEPARTMENT OF COMMERCE

DD-1302(CFU)

FORM
(4-7-2006)

Economics and Statistics Administration

COVERAGE FOLLOWUP QUESTIONNAIRE
2008 Census Test
1. ADDRESS INFORMATION
a. LCO

b. Tract

U.S. CENSUS BUREAU

NOTES

c. AA

d. Block

f. MAFID

e. Map Spot

g. House number and street name

h. Apt/Unit No.

i. Physical location description

k. State

j. City

l. ZIP Code

m. Telephone
NPC
USE
ONLY

2. PERSONAL VISIT INTERVIEW RECORD
Visit
No.

Date
(a)

Month

Time started

Outcome

Comments

(b)

(c)

(d)

Day

1
2

1

3

a.m.
p.m.

4

1
2

2

3

a.m.
p.m.

4

1
2

3

3

a.m.
p.m.

4

1
2

4

3

a.m.
p.m.

4

1
2

5

3

a.m.
p.m.

4

1
2

6

3

a.m.
p.m.

(e) Initial interview attempt

4

1
2
3
4

–
–
–
–

Complete interview
Partial interview
Noninterview – Occupied
Noninterview – Not
occupied

5

1
2
3
4

–
–
–
–

Complete interview
Partial interview
Noninterview – Occupied
Noninterview – Not
occupied

5

1
2
3
4

–
–
–
–

Complete interview
Partial interview
Noninterview – Occupied
Noninterview – Not
occupied

5

1
2
3
4

–
–
–
–

Complete interview
Partial interview
Noninterview – Occupied
Noninterview – Not
occupied

5

1
2
3
4

–
–
–
–

Complete interview
Partial interview
Noninterview – Occupied
Noninterview – Not
occupied

5

1
2
3
4

–
–
–
–

Complete interview
Partial interview
Noninterview – Occupied
Noninterview – Not
occupied

5

6
7

6
7

6
7

6
7

6
7

6
7

5 – Unable to locate
Callback appointment
Other – Explain in
Comments
5 – Unable to locate
Callback appointment
Other – Explain in
Comments
5 – Unable to locate
Callback appointment
Other – Explain in
Comments
5 – Unable to locate
Callback appointment
Other – Explain in
Comments
5 – Unable to locate
Callback appointment
Other – Explain in
Comments
5 – Unable to locate
Callback appointment
Other – Explain in
Comments

(f) Final personal visit outcome (Code 1, 2, 3, 4, or 5 from above)
1

2

3

4

5

3. CERTIFICATION
I certify that the entries I have made on this questionnaire are true and correct to the best of my knowledge.
a. Name – Please print

b. Signature

c. Date

f. Signature

g. Date

Enumerator
d. Employee ID
e. Name – Please print
Crew
Leader
h. Crew Leader No.

USCENSUSBUREAU

Section A – CONTACTING THE HOUSEHOLD
A1.

Hello, my name is (Specify name) and I’m from the U.S. Census Bureau. Here is my
identification. Also, hand respondent a Privacy Act Notice, DD-31.

A2.

Is this the

1

household?
A3.

2

2

Yes – SKIP to A4a
No – Continue to A3

Is this

1
2

A4a. Do you know who completed the census
form or interview?

1
2

Yes – SKIP to Section B
No – Stop Interview. Find correct address and start over.
Yes – Continue to A4b
No – SKIP to A5

⎫
⎬
⎭

A4b. Who is that person?
1
2
3
4
5
6
7
8
9
10

A5.

May I speak to

May I speak to (read name selected in A4)?

Yes,

2

is available – SKIP to Section C
No, respondent no longer lives here
No, respondent is currently not available

1
2
3

A7.

Can I speak with an adult member of the

⎫
⎬
⎭

1

3

A6.

Respondent who filled out census
form is not living at household
Respondent who filled out census
form is 15 or under
Refuse . . . . . . . . . . . . . . . . . . .

1
2

Continue to A5

⎫
⎬ SKIP
⎭

to A7

Yes, (name selected in A4) is available – SKIP to Section C
⎫
No, respondent no longer lives here
⎬ Continue to A7
No, respondent is currently not available ⎭
Yes – Continue to A8
No one is available – Attempt to schedule
callback appointment
Callback date(s)
Month

household who was living here on
May 1, 2008?

SKIP
to A6

Day

Year

Callback
time(s)
a.m.
p.m.

Month

Day

Year

a.m.
p.m.
Month

Day

Year

a.m.
p.m.

3

If an adult member is NOT available after 3rd successful contact –
SKIP to Section H
Refuse – End interview

Introduce yourself, if necessary. Hand respondent a Privacy Act Notice, DD-31.
A8. What is your name?

Enter name of new respondent
– SKIP to
Section C

FORM DD-1302(CFU) (4-7-2006)

Section B – IDENTIFYING THE CORRECT HOUSEHOLD
3

Introduce yourself, if necessary. Hand respondent a Privacy Act Notice, DD-31.
B1. The purpose of my visit is to help the Census Bureau take the most accurate census. We
need to be sure that we counted everyone at the right address.
B2.

Do you know the

1

household?
B3.

2

Yes – Continue to B3
No – SKIP to B6

Did the

household move out, are they neighbors
who live nearby, or do you know them some
other way?
B4a. When did they move
out?

1
2
3

Month

2

1
2
3

household move out before, on, or after
May 1, 2008?

Day

Year

If any part of date fields are missing –
Continue to B4b, else SKIP to B5a
1

B4b. Did the

Moved out – Continue to B4a
They are our neighbors ⎫
⎬ SKIP to B5a
Other . . . . . . . . . . . ⎭

4
5

Don’t know – Continue to B4b
Refuse – SKIP to B5a
Before May 1, 2008
On May 1, 2008
After May 1, 2008
Don’t know
Refuse

⎫
⎬ Continue to B5a
⎭

B5a. Do you know how to contact the

1

household?
B5b. What is the address and phone number?

2

Yes – Continue to B5b
No – SKIP to B6

House number and street

Apt/Unit No.

State

City

Area code

Telephone
B6.

ZIP Code

Number

—

Were you living at

1

on May 1, 2008?

2

Yes ⎫
⎬ Continue to B7a
No ⎭

B7a. Is there another address that people might
use to refer to this place such as a different
street name, apartment number, or a 911
address?

1

B7b. What is that address?

House number and street

2

Yes – Continue to B7b
No – SKIP to B8a

City

B8a. How would you describe this building?
Is it –
(Enumerator: Read response categories.)

1
2
3
4

B8b. Does this house have an apartment, such
as a basement or garage apartment?

1

B8c. From the following categories, how many
apartments are in your building?
(Enumerator: Read response categories.)

1

2

2
3
4
5

FORM DD-1302(CFU) (4-7-2006)

Apt/Unit No.

State

ZIP Code

A mobile home? – SKIP to Section H
A house? – Continue to B8b
An apartment? – SKIP to B8c
A boat, RV, van, etc? – SKIP to Section H
Yes ⎫
⎬ SKIP to Section H
No ⎭
1, such as an apartment over a
business or connected to a house
2
.........................
3 or 4 . . . . . . . . . . . . . . . . . . . . . .
5 to 9 . . . . . . . . . . . . . . . . . . . . . .
10 or more . . . . . . . . . . . . . . . . . .

⎫
⎬ SKIP to Section H
⎭

Section C – HOUSING UNIT QUESTIONS
Introduce yourself, if necessary. Hand respondent a Privacy Act Notice, DD-31.
C1. The purpose of my visit is to help the Census Bureau take the

we counted everyone at the right address.

C2.

Have I reached

1
2

C3.

4

most accurate Census. We need to be sure that

Yes – SKIP to C4
No – Continue to C3

The

household was reported in the census as
living at

1
2

on May 1, 2008. Did they live here on that
date?
C4.

3
4

Yes – Continue to C4
No – SKIP to Section H
Don’t know ⎫
⎬ Continue to C4
⎭
Refuse

In the rest of the interview, whenever I say "this place," or "here,"
I am referring to

C5a. Is there another address that people might
use to refer to this place, such as a
different street name, apartment number,
or 911 address?

1

C5b. What is that address?

House number and street

2

Yes – Continue to C5b
No – SKIP to C6

City

C6.

How would you describe this building?
Is it —
(Enumerator: Read response categories.)

1
2
3
4

C7.

Does this house have an apartment, such
as a basement or garage apartment?

C8. How many
apartments are in your building?
(Enumerator: Read response categories.)

1
2
1
2
3
4
5

NOTES

FORM DD-1302(CFU) (4-7-2006)

Apt/Unit No.

State

ZIP Code

A mobile home? – SKIP to Section D
A house? – Continue to C7
An apartment? – SKIP to C8
A boat, RV, van, etc? – SKIP to Section D
Yes ⎫
⎬ SKIP to Section D
No ⎭
1, such as an apartment over a
business or connected to a house
2
.........................
3 or 4 . . . . . . . . . . . . . . . . . . . . . .
5 to 9 . . . . . . . . . . . . . . . . . . . . . .
10 or more . . . . . . . . . . . . . . . . . .

⎫
⎬ SKIP to Section D
⎭

Section D – REVIEW OF ROSTER
5

ENUMERATOR – If respondent immediately changes the roster – Do the following:
• Write spelling changes in a Notes section, if volunteered by the respondent.
• If there is information printed for a person but no name, you may probe for the name and record it
in the roster in D1. Also, add this name to the same person number line in question D5 and
Sections E, F, and G.
• DO NOT add a person if there is no other information listed in the roster . . . tell the respondent
"We’ll talk about changes to the list in a minute."
D1.

Now, let’s review the list of people we counted here on May 1, 2008. I have listed:
Read only the names. Do not read ages. Ages should only be used to clarify between names if necessary.
Name
(a)

Person
number

D2.

D3.

D4.

D5.

Is there anyone I've
mentioned that you
don't know?

1
2

Age
(b)

Person
number

Name
(c)

Yes – Continue to D3
No – SKIP to D4

Who is the person(s)
you don’t know?

Enumerator: Please print person number(s) below.
Person number Person number Person number Person number

Is there anyone on
this list more than
once?

1
2

Yes – Continue to D5
No – SKIP to D6

Who is the person listed more than once?
Please cross out the person who is listed more than once and cross out the same person’s
name and number in Sections E, F, and G.
Person
number

FORM DD-1302(CFU) (4-7-2006)

Age
(d)

Name
(a)

Age
(b)

Person number

Person number

Section D – REVIEW OF ROSTER – Continued
D6.

6

I’d like to make sure we are not missing anyone who lived or stayed here at

on May 1, 2008. Here’s a calendar for your reference. (Hand respondent flashcard A.)
Other than the people we’ve already mentioned, were there —
D6a. Any newborns or
babies?

1
2

D6b. Any foster children?

1
2

D6c. Any non-related
children?

1
2

D6d. Any other relatives
who lived or stayed
here?

1

D6e. Any nonrelatives,
roommates, or
boarders?

1

2

2

D6f. Anyone else who
stayed here often?

1
2

D6g. Anyone else who had
no other place to
live?
D7.

1
2
3
4

1
2

72

3
4

1
2

73

2

⎫
⎬ Continue to D6b
⎭

Yes – SKIP to D7, complete name and age for each
added person, then mark (X) 6b in column (a)
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

⎫
⎬ Continue to D6c
⎭

Yes – SKIP to D7, complete name and age for each
added person, then mark (X) 6c in column (a)
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

⎫
⎬ Continue to D6d
⎭

Yes – SKIP to D7, complete name and age for each
added person, then mark (X) 6d in column (a)
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

⎫
⎬ Continue to D6e
⎭

Yes – SKIP to D7, complete name and age for each
added person, then mark (X) 6e in column (a)
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

⎫
⎬ Continue to D6f
⎭

Yes – SKIP to D7, complete name and age for each
added person, then mark (X) 6f in column (a)
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

⎫
⎬ Continue to D6g
⎭

Yes – Continue to D7, complete name and age for each ⎫
added person, then mark (X) 6g in column (a)
⎬ SKIP to Section E
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ⎭

ADDED PEOPLE ROSTER

Person
number

71

1

Yes – SKIP to D7, complete name and age for each
added person, then mark (X) 6a in column (a).
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3
4

Mark (X)
appropriate
question
number

What is his/her name?

(a)

(b)

6a
6b
6c
6d

5

6a
6b
6c
6d

5

6a
6b
6c
6d

5

6
7

6
7

6
7

6e
6f
6g

6e
6f
6g

6e
6f
6g

First name

FORM DD-1302(CFU) (4-7-2006)

(c)

MI

1
2

74

Last name

First name

3
4

MI

1
2

75

Last name

First name

3
4

MI

1
2

Last name

ENUMERATOR INSTRUCTION:

NOTES

What is
his/her Person
age?
number

76

3
4

Mark (X)
appropriate
question
number

What is his/her name?

What is
his/her
age?

(a)

(b)

(c)

6a
6b
6c
6d

5

6a
6b
6c
6d

5

6a
6b
6c
6d

5

6
7

6
7

6
7

6e
6f
6g

6e
6f
6g

6e
6f
6g

First name

MI

Last name

First name

MI

Last name

First name

MI

Last name

Before continuing to Section E, make sure D6a through D6g have been answered.
After completing this section, add all persons from D7 to their appropriate person
number line in Sections E, F, and G.

Section E – MOVERS
E1. In April or May, did anyone
move out (including those
people you just added)?
Person
number
and name

E2.

1
2
3
4

E3.

Who moved out? What date did (Name)
move out?
Please list all
people who
moved out
around May 1, 2008?
Yes – Continue
to E3

Month

Day

E4.
Did (Name) move out
before, on, or after
May 1, 2008?

Year
1
2

If any date field blank – Continue
to E4
If date fields complete – SKIP to
E5
Continue
1
Don’t know ⎫
⎬
Refuse
⎭ to E4
2

Yes – Continue
to E3

Month

Day

Month

Day

4
5

Day

3
4
5

Year
2

Day

3
4
5

Year
2

Day

2
3

Before May 1
On May 1
After May 1
Don’t know
Refuse

⎫ SKIP
⎬ to
⎭ E6

1
2
3

Before May 1
On May 1
After May 1
Don’t know
Refuse

⎫ SKIP
⎬ to
⎭ E6

1
2
3

Before May 1
On May 1
After May 1
Don’t know
Refuse

⎫ SKIP
⎬ to
⎭ E6

1
2
3
4

1

Month

1

4

1

Month

⎫ SKIP
⎬ to
⎭ E6

4

2

3
4
5

Before May 1
On May 1
After May 1
Don’t know
Refuse

⎫ SKIP
⎬ to
⎭ E6

1
2
3
4

Year
1
2

If any date field blank – Continue
to E4
If date fields complete – SKIP to
E5
Continue
1
Don’t know ⎫
⎬
Refuse
⎭ to E4
2

FORM DD-1302(CFU) (4-7-2006)

3

1

Month

Before May 1
On May 1
After May 1
Don’t know
Refuse

E5.
How certain
are you about
the date of
the move?
(Enumerator:
Read response
categories.)

4

Year

If any date field blank – Continue
to E4
If date fields complete – SKIP to
E5
Continue
1
Don’t know ⎫
⎬
Refuse
⎭ to E4
2

Yes – Continue
to E3

5

2

If any date field blank – Continue
to E4
If date fields complete – SKIP to
E5
Continue
1
Don’t know ⎫
⎬
Refuse
⎭ to E4
2

Yes – Continue
to E3

4

1

If any date field blank – Continue
to E4
If date fields complete – SKIP to
E5
Continue
1
Don’t know ⎫
⎬
Refuse
⎭ to E4
2

Yes – Continue
to E3

3

Year

If any date field blank – Continue
to E4
If date fields complete – SKIP to
E5
Continue
1
Don’t know ⎫
⎬
Refuse
⎭ to E4
2

Yes – Continue
to E3

7

Yes – Continue to E2
No
⎫
Don’t know ⎬ SKIP to Section F
⎭
Refuse

3
4
5

Before May 1
On May 1
After May 1
Don’t know
Refuse

⎫ SKIP
⎬ to
⎭ E6

1
2
3
4

Very
certain

E6.
Do you
expect
(Name) to
move back
here?

1
2

Yes
No

Somewhat
certain
Somewhat
uncertain
Very
uncertain

Very
certain
Somewhat
certain
Somewhat
uncertain
Very
uncertain

1

Very
certain
Somewhat
certain
Somewhat
uncertain
Very
uncertain

1

Very
certain
Somewhat
certain
Somewhat
uncertain
Very
uncertain

1

Very
certain
Somewhat
certain
Somewhat
uncertain
Very
uncertain

1

Very
certain
Somewhat
certain
Somewhat
uncertain
Very
uncertain

1

2

2

2

2

2

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Section F – OTHER ADDRESSES
F1. Some people live or stay in more than one place and we would like to make sure
everyone was only counted once.
F2. In the spring of 2008, was anyone attending college? 1
Yes – Continue to F3
Ask for persons 17 to 25 years old, including added persons.
No
2
⎫
Don’t know ⎬ SKIP to F7
3
Refuse
4
⎭
Person
number
and name

F3.

Who was
attending
college?
Yes – Continue
to F4

F4.
Where did (Name)
stay while attending
college: at this
address or some
other address?
1
2

3
4

At this address –
SKIP to F7
Some other address –
Continue to F5
Don’t know ⎫ SKIP
⎬
Refuse
⎭ to F6

F5.
What is the address where
(you/he/she) was staying while
attending college?
(Enumerator: Probe for dorm/complex name.)

F6.
What college or
university did
(you/he/she)
attend?

House number and street

Apt./Unit No.

University name

Apt./Unit No.

University name

Apt./Unit No.

University name

Apt./Unit No.

University name

Apt./Unit No.

University name

Apt./Unit No.

University name

City

State

ZIP Code

Dorm/Complex name

Yes – Continue
to F4

1
2

3
4

At this address –
SKIP to F7
Some other address –
Continue to F5
Don’t know ⎫ SKIP
⎬
Refuse
⎭ to F6

House number and street

City

State

ZIP Code

Dorm/Complex name

Yes – Continue
to F4

1
2

3
4

At this address –
SKIP to F7
Some other address –
Continue to F5
Don’t know ⎫ SKIP
⎬
Refuse
⎭ to F6

House number and street

City

State

ZIP Code

Dorm/Complex name

Yes – Continue
to F4

1
2

3
4

At this address –
SKIP to F7
Some other address –
Continue to F5
Don’t know ⎫ SKIP
⎬
Refuse
⎭ to F6

House number and street

City

State

ZIP Code

Dorm/Complex name

Yes – Continue
to F4

1
2

3
4

At this address –
SKIP to F7
Some other address –
Continue to F5
Don’t know ⎫ SKIP
⎬
Refuse
⎭ to F6

House number and street

City

State

ZIP Code

Dorm/Complex name

Yes – Continue
to F4

1
2

3
4

At this address –
SKIP to F7
Some other address –
Continue to F5
Don’t know ⎫ SKIP
⎬
Refuse
⎭ to F6

House number and street

City

State

Dorm/Complex name

FORM DD-1302(CFU) (4-7-2006)

ZIP Code

8

Section F – OTHER ADDRESSES – Continued
9

F7. In April or May, was any child living or staying part of the time with someone else?
Ask for persons younger than 18, including added persons.
1
Yes – Continue to F8
2
No
⎫
Don’t know ⎬ SKIP to F10
3
Refuse
4
⎭
F8.
Person
F9.
What is the
number
What is the address where (Name) stayed?
and name
child's

name?
Yes – Continue
to F9

House number and street

Apt./Unit No.

City

State

Yes – Continue
to F9

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F9

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F9

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F9

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F9

House number and street

ZIP Code

Apt./Unit No.

City

State

FORM DD-1302(CFU) (4-7-2006)

ZIP Code

Section F – OTHER ADDRESSES – Continued
F10. Was anyone away from here because of military service? Ask for
1
Yes – Continue to F11
No
2
⎫
Don’t know ⎬ SKIP to F15
3
Refuse
4
⎭
F11.
Person
F12.
F13.
Who was away Was (Name)
number
What type of
and name
overseas?
place did (Name)
in the
stay?
military?
Was it —

persons age 17 and older, including added persons.

10

F14.
What is the address where
(you/he/she) stayed?

(Enumerator: Read
response categories.)

Yes – Continue
to F12

1
2
3
4

Yes – SKIP
to F15
No
⎫
Don’t
Continue
know ⎬to F13
Refuse ⎭

1
2
3

5

Yes – Continue
to F12

1
2
3
4

Yes – SKIP
to F15
No
⎫
Don’t
Continue
know ⎬to F13
Refuse ⎭

1
2
3

5

Yes – Continue
to F12

1
2
3
4

Yes – SKIP
to F15
No
⎫
Don’t
Continue
know ⎬to F13
Refuse ⎭

1
2
3

5

Yes – Continue
to F12

1
2
3
4

Yes – SKIP
to F15
No
⎫
Don’t
Continue
know ⎬to F13
Refuse ⎭

1
2
3

5

Yes – Continue
to F12

1
2
3
4

Yes – SKIP
to F15
No
⎫
Don’t
Continue
know ⎬to F13
Refuse ⎭

1
2
3

5

Yes – Continue
to F12

1
2
3
4

Yes – SKIP
to F15
No
⎫
Don’t
Continue
know ⎬to F13
Refuse ⎭

1
2
3

5

FORM DD-1302(CFU) (4-7-2006)

Military
barracks House number and street
Military
or barracks
dormitories
A ship,
A ship
A military
Other housing City
treatment
facility,
either on-base
or
off-base
Disciplinary
Don’t ⎫
State
barracks
jail,
know or
⎬ SKIP
to F15
Other
housing
Refuse ⎭
either on-base or
off-base?
Don't Know
Refuse
Military
barracks
Military
or barracks
dormitories
or dormitories
A ship,
A military
A ship
A military
treatment
facility,
treatment
facility
Disciplinary
Disciplinary
barracks
or
jail
barracks or jail,
Otherhousing
housing
Other
either on-base or
off-base?
Don't Know
Refuse
Military
barracks
Military
barracks
or dormitories
A ship
A ship,
A military
Other housing
either on-base
treatment
facility,
or
off-base
Disciplinary
Don’t
⎫
SKIP
know or
barracks
⎬ jail,
to F15
Refuse
⎭
Other
housing
either on-base or
off-base?
Don't Know
Refuse

ZIP Code

House number and street

Apt./Unit No.

City

State

ZIP Code

House number and street

Apt./Unit No.

City

State

Military
barracks House number and street
Military
barracks
or dormitories
A ship
A ship,
City
Other housing
A military
either on-base
treatment
facility,
or
off-base
Disciplinary
Don’t
⎫
State
SKIP
know or
⎬ jail,
barracks
to F15
Refuse
⎭
Other
housing
either on-base or
off-base?
Don't Know
Refuse
Military
barracks
Military
or barracks
dormitories
A ship
A ship,
Other housing
A military
either on-base
treatment
facility,
or
off-base
Don’t
⎫
Disciplinary
know or
⎬ SKIP
barracks
jail,
to
F15
Refuse
⎭
Other
housing
either on-base or
off-base?
Don't Know
Refuse
Military
Military
barracks
or barracks
dormitories
A ship
A ship,
Other housing
A military
either on-base
treatment
facility,
or
off-base
Don’t
⎫
Disciplinary
know or
⎬ SKIP
barracks
jail,
to
F15
Refuse
⎭
Other
housing
either on-base or
off-base?
Don't Know
Refuse

Apt./Unit No.

ZIP Code

Apt./Unit No.

ZIP Code

House number and street

Apt./Unit No.

City

State

ZIP Code

House number and street

Apt./Unit No.

City

State

ZIP Code

Section F – OTHER ADDRESSES – Continued
11

F15. In April or May, did anyone live or stay away from here because of a job or business?
Ask for persons age 16 and older, including added persons.
Yes – Continue to F16
1
No
2
⎫
Don’t know ⎬ SKIP to F19
3
Refuse
4
⎭
Person
F16.
F17.
F18.
Who was living or Did (Name) have another What is the address of that place?
number
and name
staying away from place where
here because of a (you/he/she) stayed
regularly for that job or
job or business? business?
Yes – Continue
to F17

1
2
3
4

Yes – Continue to F18
No
⎫
Don’t know ⎬ SKIP
to F19
Refuse
⎭

House number and street

City

State

Yes – Continue
to F17

1
2
3
4

Yes – Continue to F18
No
⎫
Don’t know ⎬ SKIP
to F19
Refuse
⎭

1
2
3
4

Yes – Continue to F18
No
⎫
Don’t know ⎬ SKIP
to F19
Refuse
⎭

1
2
3
4

Yes – Continue to F18
No
⎫
Don’t know ⎬ SKIP
to F19
Refuse
⎭

1
2
3
4

Yes – Continue to F18
No
⎫
Don’t know ⎬ SKIP
to F19
Refuse
⎭

1
2
3
4

Yes – Continue to F18
No
⎫
Don’t know ⎬ SKIP
to F19
Refuse
⎭

ZIP Code

House number and street

Apt./Unit No.

City

ZIP Code

House number and street

Apt./Unit No.

City

ZIP Code

House number and street

Apt./Unit No.

City

State

FORM DD-1302(CFU) (4-7-2006)

Apt./Unit No.

City

State

Yes – Continue
to F17

ZIP Code

House number and street

State

Yes – Continue
to F17

Apt./Unit No.

City

State

Yes – Continue
to F17

ZIP Code

House number and street

State

Yes – Continue
to F17

Apt./Unit No.

ZIP Code

Section F – OTHER ADDRESSES – Continued
12

F19. Did anyone have a seasonal home or second home? Ask for all persons, including added persons.
1
Yes – Continue to F20
No
2
⎫
Don’t know ⎬ SKIP to F22
3
Refuse
4
⎭
Person
number
and name

F20.

Who had a
seasonal or
second home?
Yes – Continue
to F21

F21. For (Name)
What is the address of that place?

House number and street

Apt./Unit No.

City

State

Yes – Continue
to F21

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F21

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F21

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F21

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F21

House number and street

ZIP Code

Apt./Unit No.

City

State

FORM DD-1302(CFU) (4-7-2006)

ZIP Code

Section F – OTHER ADDRESSES – Continued
13

F22. In April or May, did anyone stay somewhere else for an extended time or live
part of the time at another residence? Ask for all persons, including added persons.
1
Yes – Continue to F23
No
2
⎫
Don’t know ⎬ SKIP to Enumerator Check Item
3
Refuse
4
⎭
Person
F23.
F24. For (Name),
number
What is the address of that place?
Who was staying
and name
elsewhere for an
extended time
during April or May?
Yes – Continue
to F24

House number and street

Apt./Unit No.

City

State

Yes – Continue
to F24

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F24

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F24

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F24

House number and street

ZIP Code

Apt./Unit No.

City

State

Yes – Continue
to F24

House number and street

ZIP Code

Apt./Unit No.

City

State

FORM DD-1302(CFU) (4-7-2006)

ZIP Code

Section F – OTHER ADDRESSES – Continued
Person
number
and name

Enumerator
Check Item:
DO NOT READ
For questions:
F3 (college),
F8 (custody),
F11 (military),
F16 (job),
F20 (second home), and
F23 (stay elsewhere),
are any marked yes?
1
2

Yes – Continue
to F25
No – SKIP to F27a

F25.
In April or May, where did
(Name) live or stay most
of the time?

F26a.
Which of the following
categories most accurately
describes the amount of time
(you/he/she) stay(s) at the
(Enumerator: Read response categories.) other place?
(Enumerator: Read response categories.)

1
2
3
4
5

This address,
⎫ SKIP
⎬
The other place, or⎭ to F27a
Both places equally⎫
Don’t know
⎬ Continue
⎭ to F26a
Refuse

1
2
3
4
5
6

1
2

Yes – Continue
to F25
No – SKIP to F27a

1
2
3
4
5

This address,
⎫ SKIP
⎬
The other place, or⎭ to F27a
Both places equally⎫
Don’t know
⎬ Continue
⎭ to F26a
Refuse

1
2
3
4
5
6

1
2

Yes – Continue
to F25
No – SKIP to F27a

1
2
3
4
5

This address,
⎫ SKIP
⎬
The other place, or⎭ to F27a
Both places equally⎫
Don’t know
⎬ Continue
⎭ to F26a
Refuse

1
2
3
4
5
6

1
2

Yes – Continue
to F25
No – SKIP to F27a

1
2
3
4
5

This address,
⎫ SKIP
⎬
The other place, or⎭ to F27a
Both places equally⎫
Don’t know
⎬ Continue
⎭ to F26a
Refuse

1
2
3
4
5
6

1
2

Yes – Continue
to F25
No – SKIP to F27a

1
2
3
4
5

This address,
⎫ SKIP
⎬
The other place, or⎭ to F27a
Both places equally⎫
Don’t know
⎬ Continue
⎭ to F26a
Refuse

1
2
3
4
5
6

1
2

Yes – Continue
to F25
No – SKIP to F27a

1
2
3
4
5

This address,
⎫ SKIP
⎬
The other place, or⎭ to F27a
Both places equally⎫
Don’t know
⎬ Continue
⎭ to F26a
Refuse

1
2
3
4
5
6

FORM DD-1302(CFU) (4-7-2006)

A few days each week –
Continue to F26b
A few weeks each month –
SKIP to F26c
Months at a time – SKIP to F26d
Some other ⎫
period of time
⎬ SKIP to F26e
Don’t know
⎭
Refuse

A few days each week –
Continue to F26b
A few weeks each month –
SKIP to F26c
Months at a time – SKIP to F26d
Some other ⎫
period of time
⎬ SKIP to F26e
Don’t know
⎭
Refuse

A few days each week –
Continue to F26b
A few weeks each month –
SKIP to F26c
Months at a time – SKIP to F26d
Some other ⎫
period of time
⎬ SKIP to F26e
Don’t know
⎭
Refuse

A few days each week –
Continue to F26b
A few weeks each month –
SKIP to F26c
Months at a time – SKIP to F26d
Some other ⎫
period of time
⎬ SKIP to F26e
Don’t know
⎭
Refuse

A few days each week –
Continue to F26b
A few weeks each month –
SKIP to F26c
Months at a time – SKIP to F26d
Some other ⎫
period of time
⎬ SKIP to F26e
Don’t know
⎭
Refuse

A few days each week –
Continue to F26b
A few weeks each month –
SKIP to F26c
Months at a time – SKIP to F26d
Some other ⎫
period of time
⎬ SKIP to F26e
Don’t know
⎭
Refuse

14

Section F – OTHER ADDRESSES – Continued
Person
number
and name

15

Ask for all persons who marked "Both places equally," "Don’t know," or "Refuse" to F25.
F26b.
During a typical
week, did (you/Name)
spend more days at
this place or the other
place?

FORM DD-1302(CFU) (4-7-2006)

F26c.
During a typical
month, did
(you/Name) spend
more weeks at this
place or the other
place?

F26d.
Last year, did
(you/Name) spend
more months at this
place or the other
place?

This place - to F27a
The other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This place - to F27a
The other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This place - to F27a
The other place -to
F27a
Both places equallyto F26e F27a
Don't Know - to 26e
Refuse - to 26e

1

This place - to F27a
The other place -to
⎫SKIP
F27a
⎬to F27a
Both places equally⎭
F27a
t know
⎫SKIP
Don't
Know -⎬to
26e
Refuse
⎭to F26e
Refuse - to 26e

This place - to F27a
The other place -to
⎫SKIP
F27a
⎬to F27a
Both places equally⎭
F27a
⎫SKIP
Don't Know -⎬to
26e
⎭to F26e
Refuse - to 26e

1

This
place- to F27a
This
place
The
otherplace
place-to
The
other
⎫Skip
Don’t know F27a
⎬to F27a
Both
places equally⎭
Refuse
F27a
⎫SKIP
Don't Know -⎬to
26e
⎭to F26e
Refuse - to 26e

1

This place - to F27a
The other place -to
F27a
⎫SKIP
Both places equally⎬to F27a
F27a
⎭
Don't
Know
26e
Don’t
know-⎫to
SKIP
⎬to F26e
Refuse
- to 26e
Refuse
⎭

This place - to F27a
The other place -to
F27a
⎫SKIP
Both places equally⎬to F27a
F27a
⎭
Don't Know - to 26e
⎫SKIP
Refuse - to 26e
⎬to F26e

1

This
place- to F27a
This
place
The
otherplace
place-to
The
other
Don’t know F27a
⎫Skip
Refus
Both
places equally⎬to F27a
⎭
F27a
Don't Know -⎫to
26e
SKIP
⎬to F26e
Refuse - to 26e
⎭

1

This place - to F27a
The other place -to
F27a
Both places equally⎫F27a
SKIP
Don't Know -⎬
to 26e
F26e
⎭to
Refuse - to 26e

This place - to F27a
The other place -to
⎫
F27a
⎬to F27a
⎭
Both places equallyF27a
⎫SKIP
Don't Know -⎬
to 26e
F26e
⎭to
Refuse - to 26e

1

This
place- to F27a
This
place
The
otherplace
place-to
The
other
⎫Skip
Don’t kno F27a
⎬to F27a
⎭
Both places equallyF27a
⎫SKIP
Don't Know -⎬
to 26e
F26e
⎭to
Refuse - to 26e

1

This place - to F27a
The other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This place - to F27a
The other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

1

This
place- to F27a
This
place
The
otherplace
place-to
The
other
⎫F27a
D
⎬6e
⎭
Both places equally-

1

This place - to F27a
The other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This place - to F27a
The other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

1

2

2

⎭

2

2

F26e.
(Were you/Was
(Name)) staying at
this place or at the
other place on May 1?

2

2

2

2

2

F27a
Don't Know - to 26e
Refuse - to 26e

2

This
place- to F27a
This
place
⎫SKIP
otherplace
place-to
TheThe
other
⎬to F26
⎭
Don’t k
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

1

place
ThisThis
place
- to F27a
other
place-to
TheThe
other
place
Both places F27a
equally
Both
places
Don't
knowequallyF27a
Don't Know - to 26e
Refuse - to 26e

This
place- to F27a
This
place
The
otherplace
place-to
The
other
Don’t know F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This
place- to F27a
This
place
other
place-to
TheThe
other
place
Don’t know F27a
Refuse
Both
places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This
place- to F27a
This
place
other
place-to
TheThe
other
place
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

This
place
This
place
- to F27a
other
place-to
TheThe
other
place
Don’t know F27a
Both
Replaces equallyF27a
Don't Know - to 26e
Refuse - to 26e

This
place- to F27a
This
place
Thew other place -to
F27a
Both places equallyF27a
Don't Know - to 26e
Refuse - to 26e

Section F – OTHER ADDRESSES – Continued
F27a. The Census Bureau does a special count of people staying in group facilities. Next, we will
check to be sure no one in your household was counted in one of those places on May 1.
Ask for those who
Person
F27b.
Ask if any of the answers 1 through 6
marked "Some
number
Was (Name) staying in any of
are marked in F27b.
other facility (6)."
and name
the following places on
May 1, 2008?

(Hand respondent flashcard B.)
F28a.
(Enumerator: Read response categories.) What kind of
place is it?
1
3
4
5
6
7
8
9

3
4
5
6
7
8
9

3
4
5
6
7
8
9

3
4
5
6
7
8
9

3
4
5
6
7
8
9

3
4
5
6
7
8
9
FORM DD-1302(CFU) (4-7-2006)

Indepedent or assisted living facility
Nursing home or skillied nursing facility
Correctional facility, such as jail, prison
Emergency, transitional, or domestic
violence shelter
Group home
Some other group facility
No
Don’t know
Refuse

⎫
⎬ SKIP to Section G
⎭

Independent or assisted living facility
Nursing home or skilled nursing facility
Correctional facility, such as jail, prison
Emergency, transitional, or domestic
violence shelter
Group home
Some other group facility
No
Don’t know
Refuse

⎫
⎬ SKIP to Section G
⎭

Indepedent or assisted living facility
Nursing home or skilled nursing facility
Correctional facility, such as jail, prison
Emergency, transitional, or domestic
violence shelter
Group home
Some other group facility
No
Don’t know
Refuse

⎫
⎬ SKIP to Section G
⎭

Independent or assisted living facility
Nursing home or skilled nursing facility
Correctional facility, such as jail, prison
Emergency, transitional, or domestic
violence shelter
Group home
Some other group facility
No
Don’t know
Refuse

⎫
⎬ SKIP to Section G
⎭

Independent or assisted living facility
Nursing home or skilled nursing facility
Correctional facility, such as jail, prison
Emergency, transitional, or domestic
violence shelter
Group home
Some other group facility
No
Don’t know
Refuse

⎫
⎬ SKIP to Section G
⎭

Independent or Assisted living facility
Nursing home or skilled nursing facility
Correctional facility, such as jail, prison
Emergency, transitional, or domestic
violence shelter
Group home
Some other group facility
No
Don’t know
Refuse

⎫
⎬ SKIP to Section G
⎭

F28b.
What is the
name of that
place?

F28c.
What is the address of that
place?
House number and street
Apt./Unit No.
City
State

ZIP Code

House number and street
Apt./Unit No.
City
State

ZIP Code

House number and street
Apt./Unit No.
City
State

ZIP Code

House number and street
Apt./Unit No.
City
State

ZIP Code

House number and street
Apt./Unit No.
City
State

ZIP Code

House number and street
Apt./Unit No.
City
State

ZIP Code

16

Section G – DEMOGRAPHICS
17

G1. Now, I’m going to ask you about information that we don’t have from your census form.
Person
number
and name

G2.
(How are you/How is (Name) ) related to

you?
(Hand respondent flashcard C.)

G3.
Are you/
Is (Name)
male or
female?
Mark (X)
one box.

1
2

Male
Female

G4.
What was your/
(Name)’s age
on May 1, 2008?
Do not enter age in
months. For babies less
than 1 year old enter zero
(0) as the age. Do not
round up.

G5.
What is your/
(Name)’s date
of birth?

Age

Month

Print numbers
in boxes.

Day

Year of birth

N/A

1
2
3
4
5
6
7
8
9

1
2
3
4
5
6
7
8
9

1
2
3
4
5
6
7
8
9

1
2
3
4
5
6
7
8
9

1
2
3
4
5
6
7
8
9

FORM DD-1302(CFU) (4-7-2006)

Husband or wife
Biological son or daughter
Adopted son or daughter
Stepson or stepdaughter
Brother or sister
Father or mother
Grandchild
Parent in-law
Son-in-law or
daughter-in-law

10
11
12
13
14
15

Husband or wife
Biological son or daughter
Adopted son or daughter
Stepson or stepdaughter
Brother or sister
Father or mother
Grandchild
Parent in-law
Son-in-law or
daughter-in-law

10

Husband or wife
Biological son or daughter
Adopted son or daughter
Stepson or stepdaughter
Brother or sister
Father or mother
Grandchild
Parent in-law
Son-in-law or
daughter-in-law

10

Husband or wife
Biological son or daughter
Adopted son or daughter
Stepson or stepdaughter
Brother or sister
Father or mother
Grandchild
Parent in-law
Son-in-law or
daughter-in-law

10

Husband or wife
Biological son or daughter
Adopted son or daughter
Stepson or stepdaughter
Brother or sister
Father or mother
Grandchild
Parent in-law
Son-in-law or
daughter-in-law

10

11
12
13
14
15

11
12
13
14
15

11
12
13
14
15

11
12
13
14
15

Other relative
Roomer
or boarder
Housemate
or roommate
Unmarried partner
Foster child
or foster adult
Other nonrelative

1

Other relative
Roomer
or boarder
Housemate
or roommate
Unmarried partner
Foster child
or foster adult
Other nonrelative

1

Other relative
Roomer
or boarder
Housemate
or roommate
Unmarried partner
Foster child
or foster adult
Other nonrelative

1

Other relative
Roomer
or boarder
Housemate
or roommate
Unmarried partner
Foster child
or foster adult
Other nonrelative

1

Other relative
Roomer
or boarder
Housemate
or roommate
Unmarried partner
Foster child
or foster adult
Other nonrelative

1

2

Male
Female

Age

Month

Day

Year of birth

2

Male
Female

Age

Month

Day

Year of birth

2

Male
Female

Age

Month

Day

Year of birth

2

Male
Female

Age

Month

Day

Year of birth

2

Male
Female

Age

Month

Day

Year of birth

Section G – DEMOGRAPHICS – Continued
Person
number
and name

G6.
(Are you/
Is (Name) )
of
Hispanic,
Latino, or
Spanish
origin?

G7.
What is your/(Name)’s race?
You may choose one or
more races. For this
census, Hispanic origins are
not races.

18

G8.
If G6 = "yes" Are you Mexican, Mexican American, or Chicano;
Puerto Rican; Cuban; or of another Hispanic, Latino, or Spanish
Origin: for example Argentinean; Columbian; Dominican;
Nicaraguan; Salvadorean; Spaniard; and so on?

(Enumerator: Read response
categories.)
(Hand respondent flashcard D.)

1
2

Yes
No

1
2
3
4
5
6

1
2

Yes
No

1
2
3
4
5
6

White
Black, African American,
or Negro
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Some other race

White
Black, African American,
or Negro
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Some other race

Mexican, Mexican American, or Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin (for
example, Argentinean, Colobian, Dominican,
Nicaraguan, Salvadorean, Spaniard, and so on)
Don’t
Whatknow
is that

origin? [for another origin]

Mexican, Mexican American, or Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin (for
example, Argentinean, Colobian, Dominican,
Nicaraguan, Salvadorean, Spaniard, and so on)
Don’t know

What is that origin? [for another origin]

1
2

Yes
No

1
2
3
4
5
6

1
2

Yes
No

1
2
3
4
5
6

1
2

Yes
No

1
2
3
4
5
6

1
2

Yes
No

1
2
3
4
5
6

White
Black, African American,
or Negro
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Some other race

White
Black, African American,
or Negro
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Some other race

White
Black, African American,
or Negro
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Some other race

White
Black, African American,
or Negro
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Some other race

Mexican, Mexican American, or Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin (for
example, Argentinean, Colobian, Dominican,
Nicaraguan, Salvadorean, Spaniard, and so on)
Don’t
Whatknow
is that

origin? [for another origin]

Mexican, Mexican American, or Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin (for
example, Argentinean, Colobian, Dominican,
Nicaraguan, Salvadorean, Spaniard, and so on)
Don’t
know
What
is that

origin? [for another origin]

Mexican, Mexican American, or Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin (for
example, Argentinean, Colobian, Dominican,
Nicaraguan, Salvadorean, Spaniard, and so on)
Don’t
Whatknow
is that

origin? [for another origin]

Mexican, Mexican American, or Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin (for
example, Argentinean, Colobian, Dominican,
Nicaraguan, Salvadorean, Spaniard, and so on)
Don’t know

What is that origin? [for another origin]

FORM DD-1302(CFU) (4-7-2006)

Section H – EXIT
19

H1. What is your name?
First name

Middle name

Last name

Area code

Number

H2. In case we need to contact you again, may I
please have your telephone number?

—

H3. Those are all the questions that I have for you.
Thank you for your time and cooperation. You’ve been very helpful.
DO NOT ASK —
H4. In what language did you conduct most of this
interview?

1
2
3

H5. How was this interview conducted?

1
2

ENUMERATOR: Go to page 1, Personal Visit Interview Record.
NOTES

FORM DD-1302(CFU) (4-7-2006)

English
Spanish
Some other language
In person
Over the phone