2010, 2011 & 2012 Forms

American Community Survey Methods Panel Tests

Attachment B ACS Questions for Internet Follow-up

2010, 2011 & 2012 Forms

OMB: 0607-0936

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Attachment B


ACS Questions to be Re-asked in Internet Follow-up Interview


ACS Question Number

Question Description

Internet Question Type

H14

Tenure

Mark One

H15a

Rent amount

Dollar write-in

H15b

Meals included

Yes/No

H19a

Have a mortgage

Mark One

H19b

Mortgage amount

Dollar write-in

H19c

Real Estate tax included

Yes/No

H19d

Insurance included

Yes/No

P7

Place of Birth

Mark one plus character write-in

P8

Citizenship

Mark one plus numeric write-in

P9

Year of Entry

Numeric write-in

P10a

School Enrollment

Mark One

P10b

Grade Enrolled

Mark one plus numeric write-in

P11

Education Attainment

Mark one plus numeric write-in but also has the headers

P13

Ancestry

Character write-in

P16

Health Insurance

Yes/No - Multiple parts




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