Form H-108 Reinterview Questionnaire

OMB No. XXXX-XXXX: Approval Expires XX/XX/XXXX
FORM H-108
(1-12-2010)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

REINTERVIEW QUESTIONNAIRE – 2011
NEW YORK CITY HOUSING AND VACANCY SURVEY

Section I – IDENTIFICATION AND ORIGINAL INTERVIEW INFORMATION
Borough Segment Serial No.

Expected HUs

Name and FR code of original interviewer

Name of original respondent

Respondent address

Telephone
(

Original interview date

)

Original interview outcome (Enter complete or B/C.
If B/C, enter code and reason.)

Beginning interview time Ending interview time
a.m.
p.m.

a.m.
p.m.

Section II – REINTERVIEW INFORMATION
Best time to call

Reinterview
mode (T or P)

Date

Date

Reinterview
callbacks

Time

a.m.
p.m.

Time

Date

a.m.
p.m.

Time

Date

a.m.
p.m.

Time

a.m.
p.m.

Section III – REINTERVIEW QUESTIONS
1. Is this . . . (read respondent address B)?
Yes
1
No
2
2. May I speak with . . . (original respondent)?
1
2
3

Yes
No – Not available, arrange for callback
No – No longer is available at address.
Go to item 3

3. Do you remember if a representative of the
Census Bureau visited on or about . . . (read
date)?
Yes
1
No
2
4. Did a representative of the Census Bureau visit
regarding . . . (read sample unit address A)?
Yes
1
No
2
5. Did a representative of the Census Bureau visit
regarding the New York City Housing and
Vacancy Survey?
Yes
1
No
2

USCENSUSBUREAU

6. How long did the interview last?
Less than 1⁄2 hour
1
1
⁄2–2 hours
2
More than 2 hours
3
7. Was the unit occupied or vacant as of
(original interview date)?
Occupied
1
Vacant – Go to 8
2
Don’t remember
3
8. Was the unit –
Available for rent?
1
Available for sale only?
2
Not available for rent or sale?
3

}

Q71 must match.
Fix H-100
if necessary.

Reinterviewer assessment
Original interview status correct (B/C or complete)
1
Suspected falsification
2
Original interview status not correct but
3
falsification not suspected
4
Reinterview refused
Noninterview in the reinterview
5
6

Other