2012 National Census Test

Attachment E
2012 National Census Test (NCT)
Instruction/FAQ/Help Text
DRAFT
A. SURVEY INSTRUCTIONS
Who should complete the survey: This survey should be completed by the person who owns or rents
the living quarters or any other person who is at least 15 years of age with knowledge of the household.
Navigation: Use only the “Next” or “Previous” buttons on the bottom of each screen. Do NOT use
the Forward or Back buttons on your browser.
Changing Responses: For questions where you must choose a single response from a list, clicking a
different response will change your answer to the newly clicked response. If it is a “check all that
apply” question, you may click on a selected check box to unselect the box and remove it as one of
your answers.
Session Time Limits and Login/Logout: For your security, you will be logged out after 15 minutes
of inactivity. If you need to leave the survey for more than 15 minutes, please click “Logout” so you
may return to the survey at a later time. All of your information will be saved. You will need to enter
your PIN in resume the survey. Your PIN will be provided to you during the survey.
Help with Survey Questions: If you need assistance on a specific survey question, use the “Help”
link that appears with that question.
Submitting your Survey: Once you have submitted your survey and are shown the confirmation page
you may close the web browser.

B. FAQS
Display a list of hyperlinks for each topic with the expanded text below. A clicked hyperlink will scroll
the person to that specific topic, with the remaining content still visible above and below.
Q. Do I have to complete this survey? This survey is mandatory, but will only take about 10 minutes to
complete. We are conducting this survey under the authority of Title 13 United States Code Section 193. This
survey has been approved by the Office of Management and Budget (OMB). For this survey, the OMB
approval number is XXXX-XXXX.

Q. Why was I selected for this survey? The U.S. Census Bureau chose your address, not you
personally, as part of a randomly selected sample. Your address was selected to represent a cross
section of other households in your community.
Q. Who should complete the survey? This survey should be completed by the person who owns or rents the
living quarters or any other person who is at least 15 years of age with knowledge of the household.
Q. How do I change my answers? For questions where you must choose a single response from a list, clicking
the correct response will change your answer to that response.
If it is a “check all that apply” question, you may click on a selected check box to unselect the box and remove it
as one of your answers.

1

Attachment E
Q. How long will it take to complete this survey? The U.S. Census Bureau estimates that, for the average
household, this survey will take about 10 minutes to complete, including the time for reviewing the instructions
and answers.
Send comments regarding this burden estimate or any other aspect of this burden to: Paperwork Reduction
Project XXXX-XXXX-X, U.S. Census Bureau, AMSD-3K138, 4600 Silver Hill Road, Washington, DC
20233. You may e-mail comments to [email protected]; use “Paperwork Project XXXX-XXXX-X”
as the subject.
Respondents are not required to respond to any information collection unless it displays a valid approval number
from the Office of Management and Budget. The OMB approval number for this survey is XXXX-XXXX.
Q. What types of questions will I be asked? This survey will ask if the housing unit is rented or owned, it will
ask for the names of everyone living in the household and, for each person living in the household, we ask
name, relationship to householder, sex, age/date of birth, Hispanic origin, race, and whether or not the person
sometimes lives or stays somewhere else.
Q. Do you share my data with other agencies such as Immigration and Customs Enforcement, the Federal
Bureau of Investigations, the Internal Revenue Service, courts, or the police? No, individual responses are not
shared with anyone, including government agencies or private organizations. It is against the law to disclose
or publish any private information (names, telephone numbers, etc.) that identifies an individual or business.
We use your information to produce statistics. Your personal information cannot be used against you by any
government agency or court.
Q. How does the Census Bureau protect my survey data? Federal law protects your information, and we have
developed policies and statistical safeguards to help us follow the law and further ensure the confidentiality of
your information.
Federal Law: Title 13 of the United States Code protects the confidentiality of all your information. Violating
this law is a crime with severe penalties.
Privacy Principles: Our Privacy Principles are guidelines that cover all of our activities. These principles
encompass both our responsibilities to protect your information and your rights as a respondent. They apply
to the information we collect and the statistics we publish.
Statistical Safeguards: Statistical methods ensure that the statistics we release do not identify individuals or
businesses. These methods include extensive review and analysis of all our data products, as well as disclosure
avoidance methodologies such as data suppression and modification.
Your information is confidential and we will never identify you individually. For more information, visit the
Census Bureau’s Data Protection and Privacy Policy webpage (http://www.census.gov/privacy/).
Q. Is it safe to complete this survey online? In addition to the three guidelines above (Federal Law, Privacy
Principles, and Statistical Safeguards), the following additional policies apply to personally-identifiable
information provided in an online survey. More information on this topic can be found on the Data Protection
and Privacy Policy webpage (http://www.census.gov/privacy/).
For each online survey, we are required to provide an explanation to respondents about the confidentiality of the
data and the laws that protect those data (e.g., Title 13, United States Code Section 9 (a)).
All web data submissions are encrypted in order to protect your privacy, even in the remote chance that your
survey responses are intercepted.

2

Attachment E
Q. Will the results be published? The Census Bureau plans to make results of this study available to the general
public.
Information quality is an integral part of the pre-dissemination review of the information disseminated by the
Census Bureau (fully described in the Census Bureau’s Information Quality Guidelines at
http://www.census.gov/quality/quality_guidelines.htm). Information quality is also integral to the information
collection conducted by the Census Bureau and is incorporated into the clearance process by the Paperwork
Reduction Act.

C. QUESTION SPECIFIC HELP
When a person clicks the “Help” link on a specific question screen, only the text for that question
should be displayed. Questions for which there is no help text are not listed below.
CONFIRM – Are you completing the NCT for the address below?
We need to make sure that you are completing this survey for the correct address. The address in this
question should match the one to which we mailed your survey invitation letter. If this address is not
the same, please answer "no" to this question.

ADDRESS – Were you living or staying at on ?
Answer “yes” if you were living or staying at the address in this question on September 5, 2012.
Otherwise, answer “no.”

ANYONE – Did anyone live at on ?
Answer “yes” if anyone other than yourself was also living and sleeping at that address on September
5, 2012.
Otherwise, answer “no.”

WHO – Do you know who lived at on ?
Answer “yes” if you know something about the person or people who lived at that address. For
example, their names and approximate ages.

NEW – Where did you live on ?
Please type in the street address of the place where you sometimes lived on September 5, 2012.
If there is no address, please type a description of the location for this place in the box provided at the
bottom of the screen. For example: "The apartment on the top floor above the post office near
intersection of Main St. and First Ave., in Anytown, PA."

3

Attachment E
OTHERS – Was there anyone else living or staying at on ?
Answer “yes” if anyone other than yourself was also living and sleeping at that address on September
5, 2012.
Otherwise, answer “no.”

POPCOUNT – Count the people who live at using our guidelines.
Enter the number of people that live or stay at this address most of the time as of September 5, 2012.
If your situation is not covered by the guidelines, look here:
http://www.census.gov/population/www/cen2010/resid_rules/resid_rules.html
or here http://2010.census.gov/partners/pdf/langfiles/qrb_English.pdf for additional help.

PEOPLE – Please list the name of each person living and sleeping at on ?
In the spaces provided, type in the name (first, middle initial, and last) of every person who was living
and sleeping at the address in this question on September 5, 2012.
Enter the person's legal name. If a person uses a first initial and a middle name, enter the initial and
name in the First Name field and leave the Middle Initial field blank. If the person uses Junior or
Senior, enter the last name and the suffix in the Last Name field.
If you have more people to report than the number of spaces provided, click on the link directly below
the last space to add more names.

MISS – Were there any additional people that you did not already list?
Answer "yes" to this question if you need to add more names to the list of people who lived or stayed
at the address in this question on September 5, 2012.
The list of examples in this question contains the types of people that are sometimes forgotten or not
included because:
 They are not related to you.
 They are distant relatives.
 They did not normally live there, but they were there on September 5, 2012 and had no
permanent place to live.
 They normally lived there on September 5, 2012, but have moved out since then.

STAY – List those additional people below.
In the spaces provided, type in the name (first, middle initial, last) of the additional people who were
living or staying there on September 5, 2012.
If you have more people to report than the number of spaces provided, click on the link directly below
the last space to add more names.

4

Attachment E
ADD1 – Were there any additional people that you did not already list?
The purpose of this question is to collect the name(s) of people living or staying at this address that
you have NOT already listed in the previous screen.
Answer “yes” or “no” to EACH of the four types of people listed. For each “yes” answer, you will be
prompted to provide the name of the person who you have not already listed, and asked if there is
anyone else, not already listed, who is the same type of person.
After answering about all four types of person (babies, foster children, other relatives, and roommates
or people not related to you), select “Next” to go to the next screen.

ADD2 – Was there anyone else staying at who had no permanent place to live?
The purpose of this question is to collect the name(s) of people living at this address that you have
NOT already listed in the previous screens.
Answer “yes” to this question if someone NOT already listed is staying at and has no other
permanent place to stay on September 5, 2012. You will be prompted to provide the name of the
person who you have not already listed, and asked if there is anyone else, not already listed, who is the
same type of person.

ADD3 – Was there anyone else who usually lives or stays at but was away on ?
The purpose of this question is to collect the name(s) of people living at this address that you have
NOT already listed in the previous screens.
Answer “yes” to this question if someone NOT already listed usually lives and stays at but
was away on September 5, 2012. You will be prompted to provide the name of the person who you
have not already listed, and asked if there is anyone else, not already listed, who is the same type of
person.

ADD4 – Was there anyone else living or staying at on who is no longer there?
The purpose of this question is to collect the name(s) of people living at this address that you have
NOT already listed in the previous screens.
Answer “yes” to this question if someone NOT already listed usually lives and stays at but
was away on September 5, 2012. You will be prompted to provide the name of the person who you
have not already listed, and asked if there is anyone else, not already listed, who is the same type of
person.

HOME – Tenure
Owned by you or someone in this household with a mortgage or loan
Select this response option to describe any house, apartment, or mobile home that has any type of loan
secured by real estate. These liens may be called mortgages, deeds of trust, trust deeds, or contracts to
purchase. Owner-occupied units with reverse mortgages and home equity loans are considered to be
"owned with a mortgage or loan" as are owner-occupied mobile homes with installment loans.
5

Attachment E
Owned by you or someone in this household free and clear (without a mortgage or loan)
Select this response option to describe owner-occupied properties without any loans secured by real
estate.
Rented
Select this response option to describe units where money rent is paid or contracted.
Occupied without payment or rent
Select this response option if the house or apartment is not owned or being bought by a member of the
household and if money rent is not paid or contracted. For example - a house or apartment that is
provided free to a janitor, caretaker, or superintendent in exchange for services.

OWNER – Of the people who lived at who owned the house, apartment, etc. on ?
Please select the person who owns the residence at the address in this question.


If more than one person owns this residence you may select multiple people.



If nobody on the list owns this residence, please select the "None of the above" response
option.

RENTER – Of the people who lived at who rented the house, apartment, etc. on ?
Please indicate the person who pays the rent for the residence at the address in this question.


If more than one person pays the rent for this place, you may select multiple people.



If nobody on the list pays rent for this residence, please select the "None of the above"
response option.

RELATION
Other relative
Related by birth, marriage, or adoption, but NOT one of the options listed. For example, niece or
nephew. If a foster child is related to the householder, include in the appropriate relative category,
such as grandchild, or include in the "Other relative" category.
Roomer or boarder
Occupies room(s) AND makes cash or non-cash payment(s)
Housemate or roommate
15 years old or over AND shares living quarters primarily to share expenses BUT does not share a
close personal relationship
Unmarried partner
Shares close personal relationship, such as domestic partner

6

Attachment E
Other nonrelative
Not related AND not one of the options listed. If a foster child is not related to the householder,
include in the "Other nonrelative" category.

SEX
Select the box that indicates the person’s biological sex.

AGE
This question consists of two parts: the first part asks for the date of birth, and the second part asks for
the age of the person.
 If you know the date of birth, enter it. The person's age will be automatically calculated.
 If you do not know the exact date of birth, enter as much as you know.
 If you do not know the date of birth at all, leave it blank and fill in the person's age. If you don't
know the age, please estimate.
Date of Birth
Select the month, day, and year of birth. If you do not know at least part of the date of birth (month,
day, or year) please leave it blank and enter or confirm the age in the age box.
Age
Enter the person's age on September 5, 2012. Do not round the age up if the person was close to having
a birthday. If you do not know the exact age, an estimate will do. For babies who were not yet one
year old on September 5, 2012, enter “0.”

RACE1 and RACE2 (The help is the same for both screens)
Race
The Census Bureau collects race data in accordance with guidelines provided by the U.S. Office of
Management and Budget and these data are based on self-identification. The racial categories included
in the census questionnaire generally reflect a social definition of race recognized in this country, and
not an attempt to define race biologically, anthropologically or genetically.
Origin
Origin can be considered as the heritage, nationality group, lineage, or country of birth of the person or
the person's parents or ancestors before their arrival in the United States.
Category
White

Black or African Am.

Definition
The category 'White' refers to a person having origins in any
of the original peoples of Europe, the Middle East, or North
Africa. It includes people who identify as 'White' or report
entries such as Irish, German, Italian, Lebanese, Near
Easterner, Arab, or Polish.
The category 'Black or African American' refers to a person
having origins in any of the black racial groups of Africa.
Terms such as 'Haitian' or 'Negro' can be used in addition to
'Black or African American.'
7

Attachment E
Hispanic, Latino, or Spanish origin People of Hispanic, Latino, or Spanish origin are those who
trace their origin or descent to Mexico, Puerto Rico, Cuba,
the Spanish-speaking countries of Central or South America,
and other Spanish cultures.
American Indian or Alaska Native The category 'American Indian or Alaska Native' refers to a
person having origins in any of the original peoples of North
and South America (including Central America), and who
maintains tribal affiliation or community attachment.

Asian

Native Hawaiian or Other Pacific
Islander

Some other race or origin

A person is enrolled in a tribe if he or she has met the
membership requirements of a tribe and is included on the
tribal roll. If not enrolled in a tribe, a person's principal tribe
is the major or most significant tribal affiliation with which
he or she most closely identifies. A person can report one or
more enrolled or principal tribes.
The category 'Asian' refers to a person having origins in any
of the original peoples of the Far East, Southeast Asia, or the
Indian subcontinent including, for example, Cambodia,
China, India, Japan, Korea, Malaysia, Pakistan, the
Philippine Islands, Thailand, and Vietnam.
The category 'Native Hawaiian or Other Pacific Islander'
refers to a person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific Islands,
such as Tahiti or the Mariana Islands.
The category 'Some other race or origin' includes all other
responses not included in the race and origin categories
above.

ELSEWHERE – Did sometimes live or stay at an address other than on ?
Answer “no” if this person lived or stayed only at the address we have been asking about, and they did
not live or stay at another address around September 5, 2012.
Answer “yes” if this person sometimes lived or stayed at another address around September 5, 2012.
Choose the option that best describes the person’s alternate residence. Or, choose “Yes, for another
reason” (at the end of the list) if none of the options apply. For example, choose “Yes, in college
housing” if this person was living away in college housing around September 5, 2012. You may
choose all the options that apply.

DELETE1 – Do you/Does anyone sometimes live or stay at another home like a seasonal residence?
Answer "yes" if anyone sometimes lives or stays at a different address because they have a second
home where they sometimes live. For example, some people leave their northern homes and spend the
winter living at a different address farther south.

8

Attachment E
DELETE2 – Do you/Does anyone sometimes live or stay elsewhere with a parent or other person?
Answer "yes" if anyone sometimes lives or stays at a different address because they are in a child
custody situation. This situation could occur for children under the age of 18 who stay at multiple
addresses to be with another parent, grandparent, or another guardian.

DELETE3 – Were you/Was anyone staying away from while living in college housing?
Answer "yes" if anyone sometimes lives or stays at a different address because they are attending
college. This includes dorm rooms, sorority and fraternity houses, off campus apartments, etc.

DELETE4 – Were you/Was anyone staying away from to be closer to a job?
Answer "yes" if anyone sometimes lives or stays at a different address because they have a second
home where they sometimes live. For example, military members staying away in barracks, on ships,
or in on-base or off-base housing. Others examples include someone who stays in another place
during the week to be closer to a job but comes home on the weekends.

DELETE5 – Do you/Does anyone sometimes stay in a place like a nursing home or group home?
Answer "yes" if anyone sometimes lives or stays at a nursing home or group home. Include people
who sometimes stay in skilled nursing facilities and residential treatment centers, as well as anyone in
a mental health institution or psychiatric unit (hospital) for long-term non-acute care.

DELETE6 – Were you/Was anyone recently in jail or prison?
Answer "yes" if anyone has been in a correctional facility recently. Consider adults or juveniles in
federal, state and local jails and prisons.

DELETE7 – Do you/Does anyone sometimes live away from for any other reason?
Answer "yes" if anyone sometimes lives or stays at a different address for any reason not covered in
the previous group of questions. Then enter the reason why this person stays at the other place.

FULLSTAY – Please provide the full address where sometimes lived or stayed.
Please type street address of the other place where this person sometimes lived or stayed around
September 5, 2012.
If there is no address, please type a description of the location for this place in the box provided at the
bottom of the screen. For example: "The apartment on the top floor above the post office near
intersection of Main St. and First Ave., in Anytown, PA."

9

Attachment E
MOST – Where does live and sleep most of the time?
Choose the option that best describes where this person was living and sleeping MOST OF THE TIME
as of September 5, 2012.
Here are some examples of what we mean by MOST OF THE TIME:
 If, around the time of September 5, 2012, a person lived and slept at one residence for part of
each week and at another residence for the other part of each week, then that person was on a
“weekly cycle,” and you should select the residence where that person stayed most of the time
during each week (e.g., commuter workers).


The same concept applies to someone who was on a “monthly cycle” (e.g., children in shared
custody) or a “yearly cycle” (e.g., people with a seasonal residence). You should select the
residence where that person lived and slept most of the time during each cycle (e.g., most of
each month, or most of each year).

If the person stayed equal amounts of time at each place during each cycle, then you should select
“Equal time at all places.”

WHERE – Where was staying on ?
Choose the option that best describes where this person was staying on September 5, 2012.

EMAIL – Please provide your email address.
We are collecting your email address in case we need to contact you for additional information. The
email address you provide here will not be shared with anyone, including other government agencies
or private organizations. All of your survey responses are confidential.

10