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U.S. DEPARTMENT OF COMMERCE
D-1302
FORM
(10-2-2008)
Section 1 – IDENTIFICATION
Economics and Statistics Administration
U.S. CENSUS BUREAU
APPLY LABEL HERE
CENSUS COVERAGE MEASUREMENT (CCM)
INDEPENDENT LISTING BOOK (ILB)
2010 Census
1. Cluster No.
BOOK
CENSUS CONFIDENTIAL: RESTRICTED DATA FOR OFFICIAL USE ONLY. Information contained in this report is for
use by the Census Bureau and is confidential by law (Title 13, U.S.C.). It may be seen only by persons sworn to protect the
confidentiality of the data and may be used only for statistical purposes. 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
7. Description and notes
8. Cluster situations – Also make entry
on "Notes Page."
Safety
1
4
No mailboxes
2
Restricted
Road
5
access
conditions
Other
3
6
Language
10. Total number of HUs
listed in the cluster.
9. Other maps
12. DQC random start
number
1
2
Sketch map
Auxiliary map
11. Number of lines used
in Section 4 of all
ILBs for cluster.
Section 2 – ASSIGNMENT INFORMATION
Dates
Position
CLD
Name
FR Code
Telephone Number
Assigned
Completed
(f)
(a)
(b)
(c)
(d)
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 D-1302, Cover page – Prints black ink (30% and 100%)
OR
mail to:
Field Division
US Census Bureau
4600 Silver Hill Road
Washington DC 20233-5700
Attn: Coverage Measurement Branch
Month
(e)
–
–
–
–
–
–
–
–
–
–
–
–
(g)
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 D-1302, Cover page Overlay – prints Yellow PMS 129 (20% and 100%)
Section 3 – QUALITY ASSURANCE
Hello, I am (Your name) from the U.S. Census Bureau. Here is my identification. Recently, Census employees checked addresses in this area as part of the 2010 Census. I am here to check the quality of their work.
My questions should take about 2 minutes.
1. LISTING OFFICE EDIT
6. DQC OFFICE EDIT
Result
Date (mm/dd/yy)
Office editor
Result
Date (mm/dd/yy)
Office editor
name
name
1
Pass
1
Pass
–
–
–
–
Fail – Send
for
repair
2
2
FR Code
Fail – Send
for
repair
FR Code
2. DQC OFFICE STAFF
Start DQC in book
, on line number
, and continue with next 11 BSAs with HUs on ground.
3. DQC LISTER
Listing Incorrect: Types of Corrections
Section 5
Cover page (interior)
Section 4
ILB
Line
No.
Listing
correct
(1)
(2)
Added
a BSA
(3)
Deleted
a BSA
Corrected a BSA’s
• Map Spot No.
• Type of unit
• Unit status
• Address (exclude spelling and street-type errors)
Each BSA must have:
• A House No. and Road/Street name OR
• A Rural Rte. No. and Box No. OR
• A Physical location description or E-911 address
• Structure Identifier, if required
Added
one or
more
units
Deleted
one or
more
units
(4)
(5)
(6)
(7)
Corrected one or more of the following:
• Unit designation
• Unit status
(8)
Section 6
Added
one or
more
units/sites
(9)
Corrected one or more of the following:
• Map Spot No.
• Unit status
Deleted • Unit Identifier
one or
Each Housing unit/site must have:
more
• A House No. and Road.Street name OR
units/sites
• A Lot No. and Road/Street name OR
• A Rural Rte. No. and Box No. or
• A Physical description (exclude spelling errors)
(10)
(11)
Total
4. DQC Result – Mark (X) only one.
1
2
3
Pass – No errors in columns (3)–(11)
Fail – One or more errors in columns (3)–(11)
Rectify ILB(s) for entire cluster
Fail/Redo – Lister listed wrong block(s)
STOP DQC – Turn in ILB(s) for Redo
5. RECTIFICATION
1. Block number
2. Number of addresses added
3. Number of addresses deleted
4. Number of addresses corrected
FORM D-1302 (10-2-2008)
FORM D-1302, Cover page – Prints black ink (30% and 100%)
FORM D-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.
DEFINITIONS
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
• occupied or vacant at the time of your visit, but must be 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)
• a seasonal or weekend cottage, condominium, or a vacation home (vacant or occupied)
• a housing unit within, above, or behind a commercial building, church, or school, etc. (vacant or occupied)
• a boarded up housing unit (vacant or occupied)
• a future construction housing unit (with a sign indicating future construction, a building permit, or stakes in
the ground, etc.)
• a housing unit under construction (with a foundation laid and building materials present)
• a housing unit that is partially torn down, condemned, or determined to be unfit for habitation where
someone is living or could be living at that time
• a housing unit to be demolished if it is occupied at the time of your visit
• a 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.)
• an RV, camper, houseboat, lean-to (a building sharing a wall with a larger building and having a roof that
leans against that wall), tent, train car, bus or automobile if it is occupied at the time of your visit
by person(s) with no other usual residence. In other words, these types of places are not housing
units unless they are occupied as a usual residence when you visit. (Campers or trailers only used for
temporary overflow sleeping are NOT housing units.)
• an 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).
Page 3
CANVASSING
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.
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 15, Remarks, on the Listing Page. For all types of Housing Units complete
the following fields:
Address Section
• Fill item 2, and items 3 through 9 as appropriate.
• For a non-city style address, fill items 10 and 11 as well.
Remarks and Contact Information Section
• Fill item 15, if there are any remarks.
• Fill item 16, mark (X) the appropriate box and fill in the respondent’s name and telephone number.
FORM D-1302 (10-2-2008)
FORM D-1302, Page 3 prints black ink (100%)
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 12a, and fill items 12b through 14b as appropriate.
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 12a, and fill items 14a and 14b.
NOTE: You will list the individual apartments at the multiunit Basic Street Address in Section 5, Multiunit
Address Page. For more information, see the instructions in Section 5.
c. Mobile homes or trailers not in a park – Fill item 3, mark (X) box 3 in item 12a, and fill 12b through
14b as appropriate.
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 12a mark (X) box 4.
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 5 in item 12a, and enter a description of the Housing Unit (occupied tent or occupied
van, etc.) and its location in item 15, Remarks.
Unit Status – Item 12b
a. In item 12b, if you mark (X) box 3, also mark (X) all reasons that apply from items a through e.
b. Whenever you mark (X) box 2, 3, 4, 5 or 8 in Item 12b, also describe the place in item 15, (Remarks).
Remarks – Item 15
Describe any unusual situations in item 15. (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.)
SPECIAL LISTING SITUATIONS
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).
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 15, 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 appropriate CCM Block 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 map(s). 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 building/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/structure.
Example:
•7 •8
or
•9(3) •10(3)
or
•11(3) •12(3) •13
c. Different buildings/structures using the same Basic Street Address – If Housing Units in
different buildings/structures use the same Basic Street Address – such as an occupied trailer behind a
house, both using the address 110 W Pine St., or two buildings in the same complex, both using the
address 224 Palmer Rd – assign separate map spot numbers to the buildings/structures and complete
one line on the Listing Page for each building/structure. Remember to fill structure identifier for each line
completed. Show their address as indicated in the following example.
Example: On the Listing Page, show the addresses as
(4) House No.
(5a) Road/Street name
(5b) Structure Identifier
110
W Pine ST
HSE
110
W Pine ST
TRLR
224
Palmer Rd
LEFT
224
Palmer Rd
RGHT
For buildings using different designations, such as BLDG A, BLDG B, etc., write the building designation
in the Structure Identifier, item 5b.
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:
Page 4
•
•
•
•
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 12a)
c. You must also look for and correct other types of problems; see your Lister Manual for details.
FORM D-1302 (10-2-2008)
FORM D-1302, Page 4 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
northeast
northwest
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
southeast
southwest
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 is my identification. We are listing addresses as part of the 2010 Census, and I have a few questions to ask you. It should take us about 2 minutes. What is this address?
(1) Line No.
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
1 4 1 6 3
1
(4) House No.
(5a) Road/Street name
241
Star Rte
1 2
Number
(12a) Is this a single-family house,
multiunit, mobile home, or trailer?
Letter
1
✗
2
(5b) Structure Identifier
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(9) ZIP Code
(8) City
Atown
4 4 4 4 4
Complete items 10 and 11 for areas with non-city style addresses.
(10) Householder name
First
MI
Last
(12b) Unit status
1 ✗ Occupied or vacant and intended for occupancy – Go to 13
Single-family house (including townhouse,
rowhouse, etc. if each has its own basic street
address (BSA)) – Go to 12b
Multiunit – two or more housing units in a structure
sharing a single BSA (such as an apartment house or
building, or a house with attached basement or attic
apartment) – SKIP to 14a
3
Mobile home or trailer, NOT in a park – Go to 12b
4
Mobile home or trailer, IN a park – SKIPto
Section 6, Mobile Home Park Page
5
Other (occupied camper, tent, van, boat, etc.) –
SKIP to 15
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, . . . . . . . . . . . . . . . . . . . . . . . . .
Stakes in the ground, . . . . . . . . . . . . . . . . . . . . . . .
c
A zoning change sign from commercial use to residential use
d
e
Reminder: If two or more buildings or structures (like an
HU and a trailer) share the same BSA, list each
building/structure on a separate line and enter a
description in the "Structure Identifier" field to distinguish
between buildings/structures.
(11) Physical location description or E-911 address
2
Other – Specify
4
Unfit for habitation
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 16
Other – Skip to 15
6
8
. . . . . . . . . . . . . . . . . . . . . . . . . . .
(14a) Canvass the multiunit and enter the number of units on each floor.
7th floor
8th floor
2nd floor
3rd floor
9th floor
Yes – How many?
1
Is/Are the other residence(s)
attached to the main residence (e.g.,
basement apartment) and/or detached
(e.g., mobile home, carriage house)?
SKIP
to
15
Attached – Change item 12a to multiunit,
then go to 14a.
Detached – SKIP to 16 then go to the
b
next line number and record other
residence.
No – SKIP to 16
a
2
✗
(15) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(13) At (address), are there any basement or
garage apartments, trailers, or other
residences even if no one is living there
now?
4th floor
10th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
(14b) (Ask if an apartment or a condominium)
How many apartments,
occupied or vacant, are
(16) Information
there at (address)?
obtained
from:
1
✗
2
HH member*
3
Manager*
Proxy*
4
Observation
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
CL
Telephone No.
Ana Conte
Other –
OFFICE EDIT
IL
QC
QC CL
DQC
(991)555–1211
If multiunit (answered 14b), 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 is my identification. We are listing addresses as part of the 2010 Census, and I have a few questions to ask you. It should take us about 2 minutes. What is this address?
(1) Line No.
(2) Block No.
1 5 1 2 8
1
(4) House No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
2 3
Number
(12a) Is this a single-family house,
multiunit, mobile home, or trailer?
Letter
1
(5a) Road/Street name
2
(5b) Structure Identifier
(6a) Rural Rte. No.
(6b) Box No.
3
(7) PO Box No.
190
(9) ZIP Code
(8) City
Atown
4 4 4 4 4
Complete items 10 and 11 for areas with non-city style addresses.
(10) Householder name
First
MI
Last
Jean
B
✗
(12b) Unit status
1 ✗ Occupied or vacant and intended for occupancy – Go to 13
Single-family house (including townhouse,
rowhouse, etc. if each has its own basic street
address (BSA)) – Go to 12b
Multiunit – two or more housing units in a structure
sharing a single BSA (such as an apartment house or
building, or a house with attached basement or attic
apartment) – SKIP to 14a
3
Mobile home or trailer, NOT in a park – Go to 12b
4
Mobile home or trailer, IN a park – SKIPto
Section 6, Mobile Home Park Page
5
Other (occupied camper, tent, van, boat, etc.) –
SKIP to 15
Reminder: If two or more buildings or structures (like an
HU and a trailer) share the same BSA, list each
building/structure on a separate line and enter a
description in the "Structure Identifier" field to distinguish
between buildings/structures.
Doe
(11) Physical location description or E-911 address
1/4 mi S of County Rd 231, down long driveway W of Maple Rd.
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, . . . . . . . . . . . . . . . . . . . . . . . . .
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Storage of household goods – SKIP to 16
Other – Skip to 15
8
Page 5
(14a) Canvass the multiunit and enter the number of units on each floor.
7th floor
8th floor
2nd floor
9th floor
3rd floor
10th floor
Yes – How many?
1
Is/Are the other residence(s)
attached to the main residence (e.g.,
basement apartment) and/or detached
(e.g., mobile home, carriage house)?
SKIP
to
15
Attached – Change item 12a to multiunit,
then go to 14a.
Detached – SKIP to 16 then go to the
b
next line number and record other
residence.
No – SKIP to 16
a
2
✗
(15) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(13) At (address), are there any basement or
garage apartments, trailers, or other
residences, even if no one is living there
now?
4th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
Other –
FORM D-1302, Page 5, prints black ink (10%, 30%, 50%, and 100%)
(16) Information
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
FORM D-1302 (10-2-2008)
(14b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
Jean Doe
1
2
✗
OFFICE EDIT
IL
QC
HH member*
3
Manager*
Proxy*
4
Observation
Telephone No.
(991)555–2112
If multiunit (answered 14b), then go to Section 5, Multiunit Address Page.
CL
QC CL
DQC
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 is my identification. We are listing addresses as part of the 2010 Census, and I have a few questions to ask you. It should take us about 2 minutes. What is this address?
(1) Line No.
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
1 5 3 4 4
1
(4) House No.
(5a) Road/Street name
7913
Jones Rd
6
Number
(12a) Is this a single-family house,
multiunit, mobile home, or trailer?
Letter
1
2
(5b) Structure Identifier
(6a) Rural Rte. No.
(6b) Box No.
✗
(7) PO Box No.
(9) ZIP Code
(8) City
Bigtown
7 7 7 7 7
Complete items 10 and 11 for areas with non-city style addresses.
(10) Householder name
First
MI
Last
(12b) Unit status
Occupied or vacant and intended for occupancy – Go to 13
1
Single-family house (including townhouse,
rowhouse, etc. if each has its own basic street
address (BSA)) – Go to 12b
Multiunit – two or more housing units in a structure
sharing a single BSA (such as an apartment house or
building, or a house with attached basement or attic
apartment) – SKIP to 14a
3
Mobile home or trailer, NOT in a park – Go to 12b
4
Mobile home or trailer, IN a park – SKIPto
Section 6, Mobile Home Park Page
5
Other (occupied camper, tent, van, boat, etc.) –
SKIP to 15
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, . . . . . . . . . . . . . . . . . . . . . . . . .
Stakes in the ground, . . . . . . . . . . . . . . . . . . . . . . .
c
A zoning change sign from commercial use to residential use
d
e
Reminder: If two or more buildings or structures (like an
HU and a trailer) share the same BSA, list each
building/structure on a separate line and enter a
description in the "Structure Identifier" field to distinguish
between buildings/structures.
(11) Physical location description or E-911 address
2
Other – Specify
4
Unfit for habitation
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 16
Other – Skip to 15
6
8
. . . . . . . . . . . . . . . . . . . . . . . . . . .
(14a) Canvass the multiunit and enter the number of units on each floor.
7th floor
2nd floor
2
2
8th floor
9th floor
Yes – How many?
1
Is/Are the other residence(s)
attached to the main residence (e.g.,
basement apartment) and/or detached
(e.g., mobile home, carriage house)?
SKIP
to
15
Attached – Change item 12a to multiunit,
then go to 14a.
Detached – SKIP to 16 then go to the
b
next line number and record other
residence.
No – SKIP to 16
a
2
(15) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(13) At (address), are there any basement or
garage apartments, trailers, or other
residences even if no one is living there
now?
3rd floor
4th floor
10th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
(14b) (Ask if an apartment or a condominium)
How many apartments,
occupied or vacant, are
(16) Information
there at (address)?
obtained
from:
4
Attic
1
HH member*
3
2
Proxy*
4
*Respondent name
Total number of Housing
Units (occupied or vacant)
✗
Manager*
CL
QC CL
Observation
Telephone No.
Rose Loe
Other –
OFFICE EDIT
IL
QC
DQC
(991)555–0621
If multiunit (answered 14b), 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 is my identification. We are listing addresses as part of the 2010 Census, and I have a few questions to ask you. It should take us about 2 minutes. What is this address?
(1) Line No.
(2) Block No.
1 3 3 6 3
1
(4) House No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
Number
1 2
(12a) Is this a single-family house,
multiunit, mobile home, or trailer?
Letter
Kelsey Point Cir
2
(5b) Structure Identifier
(6a) Rural Rte. No.
Single-family house (including townhouse,
rowhouse, etc. if each has its own basic street
address (BSA)) – Go to 12b
Multiunit – two or more housing units in a structure
sharing a single BSA (such as an apartment house or
building, or a house with attached basement or attic
apartment) – SKIP to 14a
1
(5a) Road/Street name
(6b) Box No.
(7) PO Box No.
4
Btown
6 6 6 6 6
Complete items 10 and 11 for areas with non-city style addresses.
(10) Householder name
First
MI
Last
5
✗
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, . . . . . . . . . . . . . . . . . . . . . . . . .
Stakes in the ground, . . . . . . . . . . . . . . . . . . . . . . .
c
A zoning change sign from commercial use to residential use
d
e
Mobile home or trailer, IN a park – SKIPto
Section 6, Mobile Home Park Page
Other – Specify
Other (occupied camper, tent, van, boat, etc.) –
SKIP to 15
Reminder: If two or more buildings or structures (like an
HU and a trailer) share the same BSA, list each
building/structure on a separate line and enter a
description in the "Structure Identifier" field to distinguish
between buildings/structures.
(11) Physical location description or E-911 address
2
Mobile home or trailer, NOT in a park – Go to 12b
3
(9) ZIP Code
(8) City
(12b) Unit status
Occupied or vacant and intended for occupancy – Go to 13
1
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Storage of household goods – SKIP to 16
Other – Skip to 15
8
Page 6
(14a) Canvass the multiunit and enter the number of units on each floor.
2nd floor
3rd floor
4th floor
5th floor
Example: "5 APTS 14th FLR"
6th floor
FORM D-1302 (9-5-2008)
7th floor
8th floor
9th floor
10th floor
Yes – How many?
1
Is/Are the other residence(s)
attached to the main residence (e.g.,
basement apartment) and/or detached
(e.g., mobile home, carriage house)?
SKIP
to
15
Attached – Change item 12a to multiunit,
then go to 14a.
Detached – SKIP to 16 then go to the
b
next line number and record other
residence.
No – SKIP to 16
a
2
✗
(15) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(13) At (address), are there any basement or
garage apartments, trailers, or other
residences, even if no one is living there
now?
11th floor
12th floor
Other –
FORM D-1302, Page 6, prints black ink (10%, 30%, 50%, and 100%)
(16) Information
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
FORM D-1302 (10-2-2008)
(14b) (Ask if an apartment or condominium)
How many apartments,
occupied or vacant, are
there at (address)?
OFFICE EDIT
IL
QC
1
HH member*
3
Manager*
2
Proxy*
4
Observation
Telephone No.
If multiunit (answered 14b), then go to Section 5, Multiunit Address Page.
CL
QC CL
DQC
Section 4 – LISTING PAGE
Hello, I’m (Your name) from the U.S. Census Bureau. Here is my identification. We are listing addresses as part of the 2010 Census, and I have a few questions to ask you. It should take us about 2 minutes. What is this address?
(1) Line No.
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
1
(4) House No.
Number
Letter
(12a) Is this a single-family house,
multiunit, mobile home, or trailer?
1
(5a) Road/Street name
2
(5b) Structure Identifier
(6a) Rural Rte. No.
(6b) Box No.
(7) PO Box No.
(9) ZIP Code
(8) City
Complete items 10 and 11 for areas with non-city style addresses.
(10) Householder name
First
MI
Last
(12b) Unit status
Occupied or vacant and intended for occupancy – Go to 13
1
Single-family house (including townhouse,
rowhouse, etc. if each has its own basic street
address (BSA)) – Go to 12b
Multiunit – two or more housing units in a structure
sharing a single BSA (such as an apartment house or
building, or a house with attached basement or attic
apartment) – SKIP to 14a
3
Mobile home or trailer, NOT in a park – Go to 12b
4
Mobile home or trailer, IN a park – SKIP
to Section 6, Mobile Home Park Page
5
Other (occupied camper, tent, van, boat, etc.) –
SKIP to 15
Reminder: If two or more buildings or structures (like an
HU and a trailer) share the same BSA, list each
building/structure on a separate line and enter a
description in the "Structure Identifier" field to distinguish
between buildings/structures.
(11) Physical location description or E-911 address
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 – Specify
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 16
Other – Skip to 15
6
8
(14a) Canvass the multiunit and enter the number of units on each floor.
7th floor
8th floor
2nd floor
3rd floor
9th floor
1
Yes – How many?
Is/Are the other residence(s)
attached to the main residence (e.g.,
basement apartment) and/or detached
(e.g., mobile home, carriage house)?
SKIP
to
15
Attached – Change item 12a to multiunit,
then go to 14a.
Detached – SKIP to 16 then go to the
b
next line number and record other
residence.
No – SKIP to 16
a
2
(15) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(13) At (address), are there any basement or
garage apartments, trailers, or other
residences, even if no one is living there
now?
4th floor
10th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
(14b) (Ask if an apartment or a condominium)
How many apartments,
occupied or vacant, are
(16) Information
there at (address)?
obtained
from:
1
HH member*
3
Manager*
2
Proxy*
4
Observation
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
Other –
OFFICE EDIT
IL
QC
CL
Telephone No.
QC CL
DQC
If multiunit (answered 14b), then go to Section 5, Multiunit Address Page.
Hello, I’m (Your name) from the U.S. Census Bureau. Here is my identification. We are listing addresses as part of the 2010 Census, and I have a few questions to ask you. It should take us about 2 minutes. What is this address?
(1) Line No.
(2) Block No.
(3) Map Spot No. – Do not fill for Mobile Home Park.
2
(4) House No.
Number
Letter
(12a) Is this a single-family house,
multiunit, mobile home, or trailer?
1
(5a) Road/Street name
2
(5b) Structure Identifier
(6a) Rural Rte. No.
(6b) Box No.
(9) ZIP Code
Complete items 10 and 11 for areas with non-city style addresses.
(10) Householder name
First
MI
Last
Single-family house (including townhouse,
rowhouse, etc. if each has its own basic street
address (BSA)) – Go to 12b
Multiunit – two or more housing units in a structure
sharing a single BSA (such as an apartment house or
building, or a house with attached basement or attic
apartment) – SKIP to 14a
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
3
Mobile home or trailer, NOT in a park – Go to 12b
d
4
Mobile home or trailer, IN a park – SKIP
to Section 6, Mobile Home Park Page
e
Other – Specify
5
Other (occupied camper, tent, van, boat, etc.) –
SKIP to 15
Reminder: If two or more buildings or structures (like an
HU and a trailer) share the same BSA, list each
building/structure on a separate line and enter a
description in the "Structure Identifier" field to distinguish
between buildings/structures.
(11) Physical location description or E-911 address
2
Stakes in the ground, . . . . . . . . . . . . . . . . . . . . . . .
A zoning change sign from commercial use to residential use
(7) PO Box No.
(8) City
(12b) Unit status
Occupied or vacant and intended for occupancy – Go to 13
1
c
4
Unfit for habitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Boarded up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage of household goods – SKIP to 16
Other – Skip to 15
6
8
(14a) 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
1
Yes – How many?
Is/Are the other residence(s)
attached to the main residence (e.g.,
basement apartment) and/or detached
(e.g., mobile home, carriage house)?
SKIP
to
15
Attached – Change item 12a to multiunit,
then go to 14a.
Detached – SKIP to 16 then go to the
b
next line number and record other
residence.
No – SKIP to 16
a
2
(15) Remarks – Do not use this space for location description.
MULTIUNIT ADDRESS
Basement 1st floor
⎫
⎬
⎭
(13) At (address), are there any basement or
garage apartments, trailers, or other
residences, even if no one is living there
now?
4th floor
11th floor
5th floor
12th floor
Example: "5 APTS 14th FLR"
6th floor
(14b) (Ask if an apartment or a condominium)
How many apartments,
occupied or vacant, are
(16) Information
there at (address)?
obtained
from:
*Respondent name
Total number of Housing
Units (occupied or vacant)
Attic
Other –
OFFICE EDIT
IL
QC
1
HH member*
3
Manager*
2
Proxy*
4
Observation
Telephone No.
CL
QC CL
DQC
If multiunit (answered 14b), then go to Section 5, Multiunit Address Page.
FORM D-1302 (10-2-2008)
FORM D-1302, Page 7, prints black ink (30%, 50%, and 100%)
FORM D-1302, Page 7, Overlay – prints Pantone Cyan (20% and 100%)
Section 5 – SUMMARY MULTIUNIT ADDRESS PAGE INSTRUCTIONS
1. Complete the heading items – These are the ten items directly above each set of lines on the
Multiunit Address Page. You must fill the appropriate heading items for each used 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 for a total of 120 lines per page. 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.
You already entered the information for these items on the Listing Pages (Section 4), where you
completed one line for the Basic Street Address. Copy the information from items 3 through 9 on the
Listing Page to the appropriate items in this section. 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 the last header item,
Name of complex (if applicable), item 8, 16, or 24, respectively.
• list the first 40 apartments of the address with the 54 apartments on lines 41 through 80 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 14 apartments on lines 81 through 94 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
Section 5 – MULTIUNIT ADDRESS PAGE
Ask the manager of an apartment complex – Do you have any maps of the apartment complex that I can take with me?
(1) Map Spot No.
6
Number
(9) Map Spot No.
Letter
(3a) Road/Street name
(2) House No.
7913
(3b) Structure Identifier
(10) House No.
Jones Rd
(4a) Rural Rte. No.
(4b) Box No.
(5) PO Box No.
1
2
3
4
Apt
Apt
Apt
Apt
101
102
201
202
20
Page 57
UNIT STATUS:
(18) House No.
777 7 7
Unit status
(b)
1
1
6
1
Line
No.
Unit designation
(c)
Unit status
(d)
(12b) Box No.
(13) PO Box No.
Letter
(20a) Rural Rte. No.
(15) ZIP Code
(14) City
Unit designation
(e)
(20b) Box No.
(21) PO Box No.
(23) ZIP Code
(22) City
(16) Name of complex (if applicable)
Line
No.
Number
(19a) Road/Street name
(19b) Structure Identifier
(12a) Rural Rte. No.
(7) ZIP Code
Bigtown
(8) Name of complex (if applicable)
Towers Apartments
Unit designation
(a)
(17) Map Spot No.
Letter
(11b) Structure Identifier
(6) City
Line
No.
Number
(11a) Road/Street name
(24) Name of complex (if applicable)
Unit status
(f)
Line
No.
Unit designation
(g)
Unit status
(h)
Line
No.
Unit designation
(i)
Unit status
(j)
Line
No.
21
41
61
81
101
22
42
62
82
102
23
43
63
83
103
24
44
64
84
104
40
60
80
100
120
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
(k)
Unit status
(l)
8 – Other
FORM D-1302 (10-2-2008)
FORM D-1302, Page 57 prints black ink (10%, 30%, 50%, and 100%)
Page 58 – BLANK (no folio)
Section 5 – MULTIUNIT ADDRESS PAGE
Ask the manager of an apartment complex – Do you have any maps of the apartment complex that I can take with me?
Number
(9) Map Spot No.
Letter
(3a) Road/Street name
(2) House No.
(10) House No.
(3b) Structure Identifier
(17) Map Spot No.
Letter
(4b) Box No.
(5) PO Box No.
Unit designation
(a)
(12b) Box No.
(13) PO Box No.
(20a) Rural Rte. No.
(15) ZIP Code
(14)
City of complex (if applicable)
(7) Name
(8) Name of complex (if applicable)
Unit designation
(c)
Unit status
(d)
Unit designation
(e)
(20b) Box No.
(21) PO Box No.
(23) ZIP Code
(22)
City of complex (if applicable)
(7) Name
(16) Name of complex (if applicable)
Unit status
(b)
Letter
(19b) Structure Identifier
(12a) Rural Rte. No.
(7) ZIP Code
(6)
(7) City
Name of complex (if applicable)
Number
(19a) Road/Street name
(18) House No.
(11b) Structure Identifier
(4a) Rural Rte. No.
Page 59
Number
(11a) Road/Street name
(24) Name of complex (if applicable)
Unit status
(f)
Line
No.
Unit designation
(g)
Unit status
(h)
Line
No.
Unit designation
(i)
Unit status
(j)
Line
No.
1
21
41
61
81
101
2
22
42
62
82
102
3
23
43
63
83
103
4
24
44
64
84
104
5
25
45
65
85
105
6
26
46
66
86
106
7
27
47
67
87
107
8
28
48
68
88
108
9
29
49
69
89
109
10
30
50
70
90
110
11
31
51
71
91
111
12
32
52
72
92
112
13
33
53
73
93
113
14
34
54
74
94
114
15
35
55
75
95
115
16
36
56
76
96
116
17
37
57
77
97
117
18
38
58
78
98
118
19
39
59
79
99
119
20
40
60
80
100
120
1 – Occupied or vacant and intended for occupancy
2 – Under construction (started)
UNIT STATUS:
3 – Future construction (not started)
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
Unit designation
(k)
Unit status
(l)
0003
(1) Map Spot No.
8 – Other
FORM D-1302 (10-2-2008)
FORM D-1302, Page 59 Base copy – Prints black ink (30%, 50%, and 100%)
FORM D-1302, Page 59 Overlay – prints Red PMS 189 (20%)
Section 5 – MULTIUNIT ADDRESS PAGE
Ask the manager of an apartment complex – Do you have any maps of the apartment complex that I can take with me?
Number
(9) Map Spot No.
Letter
(3a) Road/Street name
(2) House No.
(10) House No.
(3b) Structure Identifier
(4b) Box No.
(5) PO Box No.
Unit designation
(a)
(12b) Box No.
(13) PO Box No.
Line
No.
Unit designation
(c)
Unit status
(d)
Line
No.
Unit designation
(e)
(20b) Box No.
(21) PO Box No.
(23) ZIP Code
(22) City
(16) Name of complex (if applicable)
Unit status
(b)
Letter
(20a) Rural Rte. No.
(15) ZIP Code
(14) City
(8) Name of complex (if applicable)
Number
(19a) Road/Street name
(18) House No.
(19b) Structure Identifier
(12a) Rural Rte. No.
(7) ZIP Code
(6) City
Page 78
(17) Map Spot No.
Letter
(11b) Structure Identifier
(4a) Rural Rte. No.
Line
No.
Number
(11a) Road/Street name
(24) Name of complex (if applicable)
Unit status
(f)
Line
No.
Unit designation
(g)
Unit status
(h)
Line
No.
Unit designation
(i)
Unit status
(j)
Line
No.
1
21
41
61
81
101
2
22
42
62
82
102
3
23
43
63
83
103
4
24
44
64
84
104
5
25
45
65
85
105
6
26
46
66
86
106
7
27
47
67
87
107
8
28
48
68
88
108
9
29
49
69
89
109
10
30
50
70
90
110
11
31
51
71
91
111
12
32
52
72
92
112
13
33
53
73
93
113
14
34
54
74
94
114
15
35
55
75
95
115
16
36
56
76
96
116
17
37
57
77
97
117
18
38
58
78
98
118
19
39
59
79
99
119
20
40
60
80
100
120
1 – Occupied or vacant and intended for occupancy
2 – Under construction (started)
UNIT STATUS:
3 – Future construction (not started)
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
Unit designation
(k)
Unit status
(l)
0004
(1) Map Spot No.
8 – Other
FORM D-1302 (10-2-2008)
FORM D-1302, Page 78 Base copy – Prints black ink (30%, 50%, and 100%)
FORM D-1302, Page 78 Overlay – prints Red PMS 189 (20%)
Section 6 – SUMMARY MOBILE HOME PARK PAGE INSTRUCTIONS
• Third park (12 total units in two different blocks) – 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. If there is no
park office and the owner’s/manager’s mobile home or trailer is within the block cluster, it should also be listed in
this section as a separate unit. 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 12, at the top of each Mobile Home Park
Page. You must fill in the appropriate heading items at the top of each page with one or more listings, 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 1–12 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 on the appropriate CCM Block Map that the park is
located within. Copy the map spot number from the map to column (a); fill columns (b) through (h) as
appropriate; fill columns (i) and (j), and also fill column (k) if the block cluster is located in a non-city style
address area.
• First park (6 total units in one block) – List the entire park on lines 1 through 6 of the first
Mobile Home Park Page.
• Second park (6 total units in one block) – 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)
Section 6 – MOBILE HOME PARK PAGE
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?
1 3263
Kelsey Point Cir
Mobile home park address
(8) 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.
618
(4a) Rural Rte. No.
(6) City
Line
No.
(11) Name/Title/Phone No. of
contact person for park
(7) ZIP Code
Btown
(a)
1
Number
2
Number
3
Number
Page 79
2
2
3
3
8
9
0
1
UNIT STATUS:
2
(12) Information obtained from
1
HH member
2
Proxy
3
✗ Manager
4
Observation
6 66 6 6
Map Spot No.
Number
4
(5) PO Box No.
(4b) Box No.
(9) Mobile home park number
Marco Mobile Home Park
Marco De Tal-Owner/Manager, (991) 555–3813
(10) Name of park
(3b) Structure Identifier
4
Letter
Letter
Letter
Letter
House No.
Lot No.
Physical location description
Road/Street name
Rural
Rte. No.
Box No.
PO Box No.
Unit status
ZIP Code
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
Lot
Lot
Lot
Lot
1
2
3
4
1 – Occupied or vacant and intended for occupancy
Kelsey Point Cir
Captains Ln
Captains Ln
Captains Ln
4 – Unfit for habitation
5 – Boarded up
6 – Storage of household goods
1
7
1
1
6
6
6
6
6
6
6
6
7 – Empty trailer lot/site
6
6
6
6
Obtain householder name for areas with non-city style addresses
(k)
First
6
6
6
6
MI
Last
6
6
6
6
8 – Other
FORM D-1302 (10-2-2008)
FORM D-1302, Page 79 prints black ink (10% 30%, 50%, and 100%)
Page 80 – BLANK (no folio)
Section 6 – MOBILE HOME PARK PAGE
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?
Mobile home park address
(8) What is the total number of mobile homes, trailers, AND empty trailer lots/sites in the park?
(1) Block No.
(10) Name of park
(3b) Structure Identifier
(11) Name/Title/Phone No. of
contact person for park
(4a) Rural Rte. No.
(4b) Box No.
(5) PO Box No.
(12) Information obtained from
(7) ZIP Code
(6) City
Line
No.
(9) Mobile home park number
(3a) Road/Street name
(2) House No.
Map Spot No.
House No.
(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
Observation
Lot No.
Physical location description
Road/Street name
Rural
Rte. No.
Box No.
PO Box No.
Unit status
ZIP Code
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
Obtain householder name for areas with non-city style addresses
(k)
First
MI
Last
1
2
3
4
5
6
7
0005
8
9
10
11
12
13
Page 81
14
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 D-1302 (10-2-2008)
FORM D-1302, Page 81 Base copy – Prints black ink (30%, 50%, and 100%)
FORM D-1302, Page 81 Overlay – Prints Yellow PMS 123 (20%)
NOTES PAGE
1. Cluster No.
2. CLD
3. County name
4. 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.
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.
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.
5. Road conditions – Describe the situation such as mudslide, bridge out, street flooded, and
so forth.
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, address,
and telephone number of someone you located who is willing to be an interpreter in the future.
6. 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.
Page 101
Line
No.
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 D-1302 (10-2-2008)
FORM D-1302, Page 101 prints black ink (100%)
FORM D-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 D-1302 (10-2-2008)
FORM D-1302, Page 102 prints black ink (100%)
FORM D-1302, Page 102, Overlay – prints Pantone Purple 264 (20%)
| File Type | application/pdf |
| File Modified | 2008-10-15 |
| File Created | 2008-10-04 |