Form H-105 Record of Returning Losses

OMB No. 0607-0757: Approval Expires xxxxxxxxx

H-105

FORM
(2-1-2007)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
ACTING AS COLLECTING AGENT FOR
NEW YORK CITY

RECORD OF
RETURNING LOSSES
2008 NEW YORK CITY HOUSING
AND VACANCY SURVEY
1. Interviewer name

2. Date prepared

OFFICE USE ONLY
a. Stat–99

b.

USCENSUSBUREAU

c.

3. 2008 Status
1
Occupied unit
2
Vacant unit
3
Rehabilitation or new construction in progress
4
Demolished
5
Condemned
6
Building boarded up to prevent entry
7
Unit damaged by fire
8
Nonresidential
9
Merged with another unit
10
New construction on site
11
Hu/occ status unknown
12
Special place/Transient hotel
13
Other – Specify