Local Update of Census Addresses (LUCA) -- Feedback and Appeals Process

2010 Decennial Census
Local Update of Census Addresses Program

APPEAL ADDRESS ADD PAGE
Page: _____________ of ____________
Date: ___________________________
Entity ID Code: ____________________

Entity Name: ________________________________________________________________
Census Geography
(2)
Line
#
(1)

State
Code
(2a)

Form D-1739
OMB No. 0607-0795

County
Code
(2b)

Census
Tract
Number
(2c)

Mailing Address
(3)
Census
Block
Number
(2d)

House Number
(3a)

Street or Road Name or
RR#, HCR#, or PO Box#
(3b)
Physical Location Description
(3c)

Apt/
Unit#
(3d)

ZIP Code
(3e)

U.S. Department of Commerce
U.S. Census Bureau

Appeal
Code
(4)
(For
Appeal
Staff
Use
Only)