The American Community Survey

Your Guide for
THE

American
Community
Survey
Group Quarters

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

USCENSUSBUREAU

ACS-30(GQ)(2008)

(5-5-2007)

This guide gives helpful information on completing
your survey form. This guide is bilingual. The
Spanish text begins on the back cover of this
booklet. If you need more help, call the number
that the Census Field Representative provided for
you. After you have completed your survey form,
please place the form in the envelope provided.
A Census Field Representative will return to pick
it up.
Ésta guía está disponible en español e inglés. Para
la versión en español, vire la guída y comience en
la parte posterior.
Page
Your
Answers are Confidential and Required by Law

4

What
the Survey is About — Some Questions and Answers 4
Why
the Census Bureau Asks Certain Questions

5

How
to Fill Out the Survey Form

5

Instructions
for Completing the Survey Questions

6

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Your Answers are Confidential and Required
by Law.
The law, Title 13, Sections 9, 141, 143, 193, 214, and 221 requires that your
answers are kept confidential. No one except Census Bureau employees may
see your completed form and they can be fined and/or imprisoned for any
disclosure of your answers.
The same law that protects the confidentiality of your answers requires
that you provide the information asked for in this survey to the best of your
knowledge.

What the Survey is About – Some Questions
and Answers
Why are we taking a survey?
The Census Bureau is conducting the American Community Survey to provide
more timely data than data we typically collect only once every 10 years
during the 10 year or decennial census.
What does the Census Bureau do with the information I provide?
The American Community Survey will be the source of data that we make
available to Federal, state, and local governments, and also to the public. The
data will enable your community leaders from government, businesses and
non-profit organizations to plan more effectively.
Why did you select this GQ facility and how did I get selected?
This GQ was selected from a list of all GQs in your area. The GQs and
individuals are randomly selected from this list each year, so we cannot
substitute another GQ for this one. One of the advantages of a random
sample is that we can use it to measure the whole population without
having to actually interview every person at every GQ. But in order for it to
work, we cannot substitute sampled facilities or individuals — the sample
has to be truly random. Your participation is very important if we’re going
to be able to produce accurate statistics from this survey.

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Why the Census Bureau Asks Certain Questions
Here are other reasons we ask some of the questions on the survey.
Name
Names help make sure that we don’t duplicate persons selected at this place for
the survey. Individual identities are kept confidential.
Place of birth
This question provides information used to study long-term trends about where
people move and to study migration patterns and differences in growth patterns.
Job
Answers to the questions about the employments people hold provide
information on the extent and types of employment in different areas of the
country. From this information, communities can develop training programs, and
businesses and local governments can determine the need for new employment
opportunities.
Income
Income helps determine how well families or persons live. Income information
makes it possible to compare the economic levels of different areas and how
economic levels for a community change over time. Funding for many government
programs is based on the answers to these questions.
Education
Responses to the education questions help to determine the number of new
public schools, education programs, and daycare services required in a community.
Disability
Questions about disability provide the means to allocate Federal funding for
healthcare services and new hospitals in many communities.

How to Fill Out the Survey Form
Please mark the category or categories as they apply to you. Some questions ask
you to print the information. See Examples below.
Make sure you answer all the questions that apply to you. Read these Instructions
and also follow the instructions provided throughout the questionnaire. These
instructions will help you understand the questions and to answer them correctly.
If you need assistance, call the number that the field representative has provided
to you.

Examples of Printed and Marked Entries
6.

Where were you born?

In the United States – Print name of state.

OHIO
32. What time did you usually leave this address
to go to work LAST WEEK?
Minute

Hour

:
ACS-30(GQ)(2008) (5-5-2007)

a.m.
p.m.

Page 5

Instructions for Completing the Survey Questions
The questionnaire is a bilingual form. One side is in English the
other is Spanish.
Qt. 1. Print your last name, first name, and middle initial in the space provided.
Enter your telephone number, including area code, and today’s date. Print
the numbers in the boxes provided.
Qt. 2. Mark one box to indicate if you are male or female.
Qt. 3. Print your age in years at your last birthday. (Print "00" for babies less
than 1 year old.) Print the month, day, and year of your birth.

NOTE: PLEASE ANSWER BOTH QUESTIONS 4 ABOUT
HISPANIC ORIGIN AND QUESTION 5 ABOUT RACE. FOR
THIS SURVEY HISPANIC ORIGINS ARE NOT RACES.
Qt. 4. You are of Hispanic, Latino, or Spanish origin if your origin is Mexican,
Mexican-American, Chicano, Puerto Rican, Cuban, Argentinean,
Colombian, Costa Rican, Dominican, Ecuadoran, Guatemalan,
Honduran, Nicaraguan, Peruvian, Salvadoran, from other
Spanish-speaking countries of the Caribbean or Central or South
America, or from Spain.
The term Mexican-Am. refers to persons of Mexican origin or ancestry.
If you mark the "Yes, another Hispanic, Latino or Spanish origin"
box category, print the name of the specific group.
If you are not of Spanish /Hispanic /Latino origin, answer this question
by marking the "No, not or Hispanic, Latino, or Spanish origin"
box.
Answer this question regardless of your citizenship status.
Qt. 5. Mark one or more categories what you consider yourself to be.
If you mark the "American Indian or Alaska Native" box, also print
the name of the tribe in which you are enrolled. If you are not enrolled
in a tribe, print the name of the principal tribe.
If you mark the "Other Asian" or the "Other Pacific Islander"
category, print the name of the specific group(s) in the space provided.
The category "Other Asian" includes persons who identify
themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai,
Cambodian, Sri Lankan, and so on.
The category "Other Pacific Islander" includes persons who identify
themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.
If you mark "Some other race," print the race(s) or group(s) in the
space provided.
Answer this question regardless of your citizenship status.

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Qt. 6.

For persons born in the United States:
Mark the "In the United States" box and then print the name of the
state in which you were born. If you were born in Washington, D.C., print
District of Columbia.
For persons born outside the United States:
Mark the "Outside the United States" box, and then print the name of
the foreign country or area where you were born. Use current boundaries,
not boundaries at the time of your birth. For example, specify whether
Northern Ireland or the Republic of Ireland (Eire); North or South Korea;
England, Scotland, or Wales (not Great Britain or United Kingdom).
Specify the particular country or island in the Caribbean (for example,
Jamaica, not West Indies).

Qt. 7.

If you were born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern
Marianas, mark the "YES, born in Puerto Rico, Guam, the U.S. Virgin
Islands, or Northern Marianas" box. If you were born outside the
United States (or at sea) and have at least one American parent, mark the
"Yes, born abroad of American parent or parents" box. Mark the
"Yes, U.S. citizen by naturalization" box only if you have completed
the naturalization process and are now a United States citizen.

Qt. 8.

If you entered the United States (that is, the 50 states and the District of
Columbia) more than once, enter the latest year you came to live in the
United States.

Qt. 9a. A public school is any school or college that is controlled and supported
primarily by a local, county, state, or Federal government. Schools are
private if supported and controlled primarily by religious organizations
or other private groups. Home schooling is included with the private
school category.
Qt. 9b. Answer this question only if you were attending school or college in the
last 3 months. Mark the box that corresponds to the grade level or
college level you were attending.
Qt. 10.

Mark only one box to indicate the highest grade or level of schooling
you have completed or the highest degree you received.
Report schooling completed in foreign or ungraded schools as the
equivalent level of schooling in the regular American school system.
If you completed high school by passing an equivalency test, such as the
General Educational Development (GED) examination, and did not
attend college, mark the category for "High School Graduate."box.
Some of the examples of Professional school degrees include medicine,
dentistry, chiropractic, optometry, osteopathic medicine, pharmacy,
podiatry, veterinary medicine, law, and theology.
DO NOT include certificates, diplomas, or degrees for training on
specific trades, such as computer and electronics technology, auto
repair, medical assistant, cosmetology, and other fields at vocational,
technical, or business schools.
DO NOT include honorary degrees awarded by colleges and universities
to individuals for their accomplishments. Include only "earned" degrees.

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Qt. 11.

Print the ancestry group(s). Ancestry refers to your ethnic origin or
descent, "roots," or heritage. Ancestry also may refer to your country
of birth or your parents or ancestors before their arrival in the United
States. Answer this question regardless of your citizenship status.
If you have more than one origin and cannot identify with a single
ancestry group, report two ancestry groups (for example, German-Irish).
Do not report a religious group as your ancestry.

Qt. 12a. Mark the "Yes" box if you sometimes or always speak a language
other than English at home.
Mark the "No" box if you speak only English, or if a non-English language
is spoken only at school or is limited to a few expressions or slang.
Qt. 12b. Print the name of the language spoken. If you speak more than one
non-English language and cannot determine which is spoken more
often, report the one you first learned to speak.
Qt. 12a. Mark one box to indicate how well you speek English.
Qt. 13a. If the person is a baby under 1 year of age, mark the "Person is
under 1 year old" box. Do not complete any more questions for
the baby and skip to item H on page 5.
If you lived at this address, mark the "Yes, at this address" box and
then skip to question 15.
If you did not live in the United States 1 year ago, mark the "No,
outside the United States and Puerto Rico" box and print the name
of the foreign country, or Puerto Rico, Guam, etc., where you lived. Be
specific when printing the name of foreign country, for example, specify
whether Northern Ireland or the Republic of Ireland (Eire); North or
South Korea; England, Scotland or Wales (not Great Britain or United
Kingdom). Specify the particular country or island in the Caribbean.
Then skip to question 15.
If you lived somewhere else in the United States 1 year ago, mark the
"No, at a different address in the United States or Puerto Rico"
box.
Qt. 13b. Print the street address, city, county, state, and ZIP code where you lived
1 year ago.
Qt. 14.

Mark the "Yes" or "No" box to indicate whether you received Food
Stamps or Food Stamps benefit card during the past 12 months.

Qt. 15.

Mark the "Yes" or "No" box for each part of question 15. Mark "Yes" if
this person currently has the type of health insurance or health coverage
listed. Mark "No" if this person does not have the type of health insurance
or health coverage listed. These categories include health insurance
obtained through a job, and insurance company, or governmental health
care plans that only cover a person in case of an accident or disability.
If the person reports another type of coverage plan in 15h, specify the
type of coverage or name of plan in the write-in box.

ANSWER QUESTION 17 ONLY IF YOU ARE 5 YEARS
OLD OR OVER.
Qt. 16.

Mark the "Yes" or "No" box for both parts a and b of question 16 to
indicate whether you have any of the conditions listed.

Qt. 17.

Mark the "Yes" or "No" box for parts a, b, and c of question 17 to
indicate whether you have any difficulty doing any of the activities listed.

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ANSWER QUESTION 18 ONLY IF YOU ARE 15 YEARS OLD
OR OVER.
Qt. 18.
Qt. 19.
Qt. 20.
Qt. 21.
Qt. 22.
Qt. 23.

Qt. 24a.
Qt. 24b.

Qt. 24c.
Qt. 25.

Qt. 26.
Qt. 27a.
Qt. 27b.

Qt. 28.

Mark the "Yes" or "No" box for question 18 to indicate if you have any
difficulty doing any of the activities listed.
Mark one box to indicate your current marital status. If you have never
been married, SKIP to question 23.
Mark the "Yes" or "No" box for parts a, b, and c of question 20.
Indicate whether this person has been married once, twice, or three or
more times. Do not count marriages that ended in annulment.
Write the four-digit year when the person last got married, even if the
person is now widowed, divorced, or separated.
Answer this question if you are a female who is at least 15 years old and
younger than 51 years old. Mark the "Yes" box if you have given birth
to at least one child born alive in the past 12 months, even if the child
died or no longer lives with the mother. Do not include miscarriages, or
stillborn children, or any adopted, foster, or step-children.
Mark the "Yes" box if you have at least one of your own grandchildren
younger than 18 years old living in this place.
Answer this question if you have at least one of your own grandchildren
younger than 18 years old living in this place. Mark the "Yes" box if you
are currently responsible for the basic needs of the grandchild or
grandchildren.
Mark one box to indicate the length of time you have been providing for
the basic needs of your grandchild(ren).
If you served in the U.S. Armed forces, Military Reserves, or National
Guard, mark the "Yes" category that applies only if you have ever been
called up for active duty other than for training. If your only service was
as a civilian employee or civilian volunteer for the Red Cross, USO, Public
Health Service, or War or Defense Department, mark "No, never served
in the military" box. Count World War II Merchant Marine service as
active duty; DO NOT count other Merchant Marine service as active duty.
Mark a box for EACH period served, even if service in the period was brief.
If this person has a Department of Veteran Affairs (VA) service-connected
disability rating, mark the"Yes" box.
Mark one box that shows the person’s service-connected disability rating.
Mark the "0 percent" box if the person has received a service-connected
disability rate of zero. Do not mark the box showing "0 percent to indicate
no rating.
Count as work – Mark the "Yes" box if you performed —
• Work for someone else for wages, salary, piece rate, commission,
tips, or payments "in kind" (for example, food or lodging received
as payment for work performed).
• Work in own business, professional practice, or farm.
• Any work in a family business or farm, paid or not.
• Any part-time work including babysitting, paper routes, etc.
• Active duty in Armed Forces.
Do not count as work – Mark the "No" box if you performed —
• Housework or yard work at home.
• Unpaid volunteer work.
• School work done as a student.
• Work done as a resident or inmate of an institution.

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Qt. 29. Include the building or structure number, street name; street type (for
example, St., Road, Ave.) and the street direction (if a direction such as
"North" is part of the address). For example, print 1239 N. Main St. or 1239
Main St., N.W. not just 1239 Main.
If the only known address is a post office box , give a description of the work
location (such as building number, building name, nearest street or
intersecton). For example, print the name of the building or shopping center
where you work, the nearest intersection, or the nearest street where the
workplace is located, etc. DO NOT GIVE A POST OFFICE BOX NUMBER.
If you worked at a military installation or military base that has no street
address, report the name of the military installation or base, and a
description of the work location (such as nearest street or intersection).
If you worked at several locations, but reported to the same location each
day to begin work, print the street address of the location where you
reported. If you did not report to the same location each day to begin
work, print the address of the location where you worked most of the
time last week.
If your employer operates in more than one location (such as a grocery
store chain or public school system), print the street address of the location
or branch where you worked. If the street address of a school is not
known, print the name of the school, and a description of the location
(such as the nearest street intersection).
If you worked on a college or university campus and the street address
of the workplace is not known, print the name of the building where
you worked and a description of the location (such as the nearest
street or intersection).
If you worked in a foreign country or Puerto Rico, Guam, etc., print the
name of the country and then go to question 30.
Qt. 30. If you usually used more than one type of transportation to get to work
(for example, drove to public transportation), mark the category of the
one method of transportation that you used for most of the distance
during the trip.

ANSWER QUESTION 31 ONLY IF YOU MARKED ’CAR,
TRUCK, OR VAN" IN QUESTION 30
Qt. 31. If you were driven to work by someone who then drove back home or to a
non-work destination, enter "1" in the box labeled "Person(s)."
DO NOT include persons who rode to school or some other non-work
destination in the count of persons who rode in the vehicle.
Qt. 32. Give the time of day you usually left to go to work. DO NOT give the time
that you usually began your work.
If you usually left to go to work sometime between 12:00 o’clock
midnight and 12:00 o’clock noon, mark "a.m."
If you usually left to go to work sometime between 12:00 o’clock noon and
12:00 o’clock midnight, mark "p.m."
Qt. 33. Travel time is from door to door. Include time waiting for public
transportation or picking up passengers in a carpool.
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ANSWER QUESTIONS 34a THROUGH 37 ONLY IF YOU DID
NOT WORK LAST WEEK.
Qt. 34a. You are on layoff if you are waiting to be recalled to a job from
which you were temporarily separated for business-related reasons.
Qt. 34b. If you work only during certain seasons or on a day-by-day basis when
work is available, mark the "No" box.
Qt. 34c. if you were informed by your employer, either formally or informally,
that you will be recalled within the next 6 months, mark the "Yes"
box. Also mark the "Yes" box if you have been given formally or
informally, a specific date to return to work, even if that date is more
than 6 months away.
Qt. 35. Mark the "Yes" box if you tried to get a job or start a business or
professional practice at any time in the last 4 weeks; for example,
registered at an employment office, went to a job interview, placed or
answered ads, or did anything toward starting a business or
professional practice.
Qt. 36. If you expected to report to a job within 30 days, mark the "Yes,
could have gone to work" box.
Mark the "No, because of own temporary illness" box only if you
expected to be to work within 30 days.
If you could not have gone to work because you were going to school,
taking care of children, etc., mark the "No, because of all other
reasons" box.
Qt. 37. Refer to the instructions for question 28 for what to count as
work. Mark the "Over 5 years ago or never worked" box if
you: (1) never worked at any kind of job or business, either full or
part time, (2) never worked, with or without pay, in a family
business or farm, and (3) never served on active duty in the Armed
Forces.
Qt. 38a. Refer to the instructions for question 28 to determine what to count
as work. Include paid vacation, paid sick leave, and military service.
Count every week in which you worked at all, even for an hour.
Qt. 38b. Count every week in which you worked at all, even for an hour.
Qt. 39. If the hours worked each week varied considerably in the past 12
months, give an approximate average of the hours worked each week.

ANSWER QUESTIONS 40 THROUGH 45 ONLY IF YOU WORKED
IN THE PAST 5 YEARS; OTHERWISE, SKIP TO QUESTION 46.
Qt. 40.

Qt. 41.

Mark the "an employee of a PRIVATE NOT-FOR-PROFIT . . .
organization" box if you worked for a cooperative, credit union,
mutual insurance company, or similar organization.
Employees of foreign governments, the United Nations, U.S. Armed
Forces, and other international organizations should mark the "a
Federal GOVERNMENT employee" box.
If you worked at a public school, college, or university, mark the
appropriate government category; for example, mark the "a state
GOVERNMENT employee" box for a state university, or mark the
"a local GOVERNMENT employee" box for a county-run
community college or a city-run public school.
If you worked for a company, business, or government agency, print
the name of the company, not the name of your supervisor. If you
worked for an individual or a business that had no company name,
print the name of the individual you worked for. If you worked in
your own business, print "self-employed."

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Qt. 42.

Print one or more words to describe the business, industry, or individual
employer named in question 41. If there is more than one activity,
describe only the major activity at the place where you worked. Enter
what is made, what is sold, or what service is given.
Enter descriptions like the following: Metal furniture manufacturing,
Retail grocery store, Petroleum refining, Cattle ranch.
Do not enter: Furniture company, Grocery store, Oil company, Ranch.

Qt. 43.

Mark one box to indicate the main type of business or industry where
you work.

Qt. 44.

Print one or more words to describe the kind of work you did. If you
were a trainee, apprentice, or helper, include that in the description.
Enter descriptions like the following: Registered nurse,
Personnel manager, High school teacher.
Do not enter single words such as: Nurse, Manager, Teacher.

ANSWER QUESTIONS 46 AND 47 ONLY IF YOU ARE 15
YEARS OLD OR OVER.
Mark the "Yes" or "No" category for each part of the income
questions and enter the amount received in the past 12 months for
each "Yes" response.
If income from any source was received jointly, report the amount you
earned or received, not the total amount you and the other person
received jointly.
Qt. 46a. Include wages and salaries before deductions from ALL jobs. Be sure to
include any tips, commissions, or bonuses. Owners of incorporated
businesses should enter their salary here. Military personnel should
include base pay plus cash housing and/or subsistence allowance, flight
pay, uniform allotments, and re-enlistment bonuses.
Qt. 46b. Include NONFARM profit (or loss) from self-employment in sole
proprietorships and partnerships. Exclude profit (or loss) of
incorporated businesses you own.
Include FARM profit (or loss) from self-employment in sole
proprietorships and partnerships. Exclude profit (or loss) of incorporated
farm businesses you own. Also, exclude amounts from land rented for
cash but include amounts from land rented for shares.
Qt. 46c. Include interest received or credited to checking and saving accounts,
money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and
government bonds.
Include dividends received, credited, or reinvested from ownership of
stocks or mutual funds.
Include profit (or loss) from royalties and the rental of land, buildings, or
real estate, or from roomers or boarders. Income received by
self-employed persons whose primary source of income is from renting
property or from royalties should be included in question 46b above.
Include regular payments from an estate or trust fund.

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Qt. 46d. Include amounts, before Medicare deductions, of Social Security
and/or Railroad Retirement payments you received as a retired
person, as a dependent of a deceased insured worker, and as a
disabled worker.
Qt. 46e. Include Supplemental Security Income (SSI) received as an elderly,
blind, or disabled person.
Qt. 46f. Include any public assistance or welfare payments you receive from the
state or county welfare office. Do not include assistance received from
private charities. Do not include assistance to pay heating or cooling
costs.
Qt. 46g. Include retirement, survivor, or disability benefits received from
companies and unions, Federal, state, and local governments, and the
U.S. military. Include regular income from annuities and IRA or KEOGH
retirement plans.
Qt. 46h. Include Veterans’ (VA) disability compensation and educational
assistance payments (VEAP); unemployment compensation, child
support or alimony; and all other regular payments such as Armed
Forces transfer payments, assistance from private charities, and regular
contributions from persons not living in the household.
Do Not include the following as income in any item:
•
•
•
•
•
•
Qt. 47.

Refunds or rebates of any kind
Withdrawals from savings of any kind
Capital gains or losses from the sale of homes, or shares of stock, etc.
Inheritances or insurance settlements
Any type of loan
Pay in-kind such as food, free rent

Add the total entries (subtracting losses) for 46a through 46h for the
past 12 months and enter that number in the space provided. Mark
the loss box if there is a loss. Print the total amount in dollars.

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