NRFU Instrument NRFU Instrument

22

Questionnaire Content Document for the Enumerator Instrument

Question name	VERIFY DIALED NUMBER
Question wording for telephone housing unit respondent	Hello. My name is <fill enumerator name> and I am from the U.S. Census Bureau. Have I reached <insert phone number selected from NUMBER CALLED>?
Spanish question wording for telephone housing unit respondent	Buenos días (Buenas tardes). Mi nombre es <fill enumerator name> y soy de la Oficina del Censo de los Estados Unidos. ¿Me he comunicado con el <insert phone number selected from NUMBER CALLED>?

Question name	INTRO PHONE
Question wording for telephone housing unit respondent	If OUTBOUND CALL DISPLAY: I am calling about a very important survey. If INBOUND CALL DISPLAY: Thank you for returning my call. My name is <fill enumerator name> from the U.S. Census Bureau. I contacted your household concerning a very important survey. Both: Are you the lady or gentleman of the house? May I speak with someone at least 15 years old who lives here and knows about the people in the household? Would that be you?
Spanish question wording for telephone housing unit respondent	Si MUESTRA LLAMADA QUE SE HACE: Estoy llamando acerca de una encuesta muy importante. Si MUESTRA LLAMADA QUE SE RECIBE: Gracias por devolverme la llamada. Mi nombre es <fill enumerator name> de la Oficina del Censo de los Estados Unidos. Me he comunicado con su hogar en relación con una encuesta muy importante. Ambos: ¿Es usted la señora o el señor de la casa? ¿Podría hablar con alguien que tenga al menos 15 años de edad que viva aquí y conozca a las personas del hogar? ¿Sería usted la persona indicada?

Question name	ADDRESS VERIFY
Question wording for telephone housing unit respondent	I’m calling to complete a Census questionnaire for <PARTIALADDRESS>. This survey is authorized by Title 13 of the United States Code and your response is required by law. Our approval number from the Office of Management and Budget is <OMBNUMBER>. All of the information you provide will remain confidential. The interview will take about 10 minutes. Is this: <fill CENSUSADDRESS>?
Spanish question wording for telephone housing unit respondent	Estoy llamando para completar un cuestionario del Censo para <PARTIALADDRESS>. Esta encuesta está autorizada por el Título 13 del Código de los Estados Unidos y su respuesta es requerida por la ley. Nuestro número de aprobación de la Oficina de Administración y Presupuesto es <OMBNUMBER>. Toda la información que usted proporcione se mantendrá confidencial. La entrevista tomará unos 10 minutos. ¿Es esta: <fill CENSUSADDRESS>?

Question name	KNOW ADDRESS
Question wording for in person housing unit respondent	Do you know where <FULLCENSUSADDRESS> is?
Spanish question wording for in person housing unit respondent	¿Sabe usted dónde es <FULLCENSUSADDRESS>?

Question name	PHONE INBOUND
Question wording for telephone housing unit respondent	In case we get disconnected, what phone number are you calling from?
Spanish question wording for telephone housing unit respondent	En caso de que se desconecte la llamada, ¿de qué número de teléfono está llamando?

Question name	INTRO
Question wording for in person housing unit respondent	Hello, I’m <fill enumerator name> from the U.S. Census Bureau. (Show ID). I’m here to complete a Census questionnaire for <PARTIALADDRESS>. The interview should take about 10 minutes. (Hand respondent Information Sheet.) This notice explains that your answers are confidential. Is this <PARTIALADDRESS>?
Spanish question wording for in person housing unit respondent	Buenos días (Buenas tardes), soy <fill enumerator name> de la Oficina del Censo de los Estados Unidos. (Show ID). Estoy aquí para completar un cuestionario del Censo para <PARTIALADDRESS>. La entrevista deberá tomar alrededor de 10 minutos. (Hand respondent Information Sheet.) Esta nota explica que sus respuestas son confidenciales. ¿Es esta la dirección <PARTIALADDRESS>?

Screen name	INTRO PROXY
Question wording for in person proxy respondent	Hello, I’m <fill enumerator name> from the U.S. Census Bureau. (Show ID). I’m here to complete a Census questionnaire for <PARTIALADDRESS>. The interview should take about 10 minutes. (Hand respondent Information Sheet.) This notice explains that your answers are confidential. May I ask you some questions about <PARTIALADDRESS>?
Question wording for telephone proxy respondent	Inbound: Hello, I’m <fill enumerator name> from the U.S. Census Bureau. Thank you for returning my call. I was previously calling to complete a Census questionnaire for <PARTIALADDRESS>. This survey is authorized by Title 13 of the United States Code and your response is required by law. Our approval number from the Office of Management and Budget is XXXX-XXXX. All of the information you provide will remain confidential. The interview will take about 10 minutes. May I ask you some questions about <PARTIALADDRESS>? Outbound: I’m calling to complete a Census questionnaire for <PARTIALADDRESS>. This survey is authorized by Title 13 of the United States Code and your response is required by law. Our approval number from the Office of Management and Budget is XXXX-XXXX. All of the information you provide will remain confidential. The interview will take about 10 minutes. May I ask you some questions about <PARTIALADDRESS>?
Spanish question wording for in person proxy respondent	Buenos días (Buenas tardes), soy <fill enumerator name> de la Oficina del Censo de los Estados Unidos. (Show ID). Estoy aquí para completar un cuestionario del Censo para <PARTIALADDRESS>. La entrevista deberá tomar alrededor de 10 minutos. (Entregue al respondedor la Hoja de Información.) Esta nota explica que sus respuestas son confidenciales. ¿Puedo hacerle unas preguntas sobre <PARTIALADDRESS>?
Spanish question wording for in person proxy respondent	Llamada que se recibe: Buenos días (Buenas tardes), soy <fill enumerator name> de la Oficina del Censo de los Estados Unidos. Estoy llamando para completar un cuestionario del Censo para <PARTIALADDRESS>. La encuesta está autorizada en conformidad con el Título 13 del Código de los Estados Unidos y su respuesta es requerida por ley. Nuestro número de aprobación de la Oficina de Administración y Presupuesto es XXXX-XXXX. Toda la información que usted nos dé será confidencial. La entrevista tomará aproximadamente 10 minutos. ¿Puedo hacerle algunas preguntas sobre <PARTIALADDRESS>? Llamada que se hace: Estoy llamando para completar un cuestionario del Censo para <PARTIALADDRESS>. La encuesta está autorizada en conformidad con el Título 13 del Código de los Estados Unidos y su respuesta es requerida por ley. Nuestro número de aprobación de la Oficina de Administración y Presupuesto es XXXX-XXXX. Toda la información que usted nos dé será confidencial. La entrevista tomará aproximadamente 10 minutos. ¿Puedo hacerle algunas preguntas sobre <PARTIALADDRESS>?

Question name	CONTACT RESP
Question wording for in person housing unit respondent	I’m doing a quality check to verify that a census interviewer contacted you recently. The interview should take approximately 5 minutes. (Hand respondent the Information Sheet.) Were you contacted on or about <ORIGINAL ENUMERATION DATE> by an interviewer asking questions about <CENSUS PARTIALADDRESS>?
Question wording for telephone housing unit respondent	I’m doing a quality check to verify that a census interviewer contacted you recently. The survey is authorized by Title 13 of the United States Code and your response is required by law. Our approval number from the Office of Management and Budget is XXXX-XXXX. All the information you provide will remain confidential. The interview should take approximately 5 minutes. Were you contacted on or about <ORIGINAL ENUMERATION DATE> by an interviewer asking questions about <CENSUS PARTIALADDRESS>?
Spanish question wording for in person housing unit respondent	Estoy haciendo una verificación de calidad para confirmar que un entrevistador del censo se comunicó con usted recientemente. La entrevista debe tardar aproximadamente 5 minutos. (Hand respondent the Information Sheet.) ¿Un entrevistador se comunicó con usted el <ORIGINAL ENUMERATION DATE> o cerca de esa fecha para hacerle preguntas sobre <CENSUS PARTIALADDRESS>?
Spanish question wording for telephone housing unit respondent	Estoy llevando a cabo una verificación de calidad para confirmar que un entrevistador del censo se comunicó con usted recientemente. La encuesta está autorizada en conformidad con el Título 13 del Código de los Estados Unidos y su respuesta es requerida por ley. Nuestro número de aprobación de la Oficina de Administración y Presupuesto es XXXX-XXXX. Toda la información que usted nos proporcione será confidencial. La entrevista debe tomar aproximadamente unos 5 minutos. ¿Un entrevistador se comunicó con usted el <ORIGINAL ENUMERATION DATE> o cerca de esa fecha para hacerle preguntas sobre <CENSUS PARTIALADDRESS>?

Question name	CONTACT RESP HH
Question wording for in person housing unit respondent	I’m doing a quality check to verify that a census interviewer contacted your household recently. The interview should take approximately 5 minutes. (Hand respondent the Information Sheet.) Was < PRODUCTION RESPONDENT NAME> or someone else in your household contacted on or about <ORIGINAL ENUMERATION DATE> by an interviewer from the Census Bureau asking questions about <CENSUS PARTIALADDRESS>?
Question wording for in person proxy respondent	I’m doing a quality check to verify that a census interviewer contacted your household recently. The interview should take approximately 5 minutes. (Hand respondent the Information Sheet.) Was < PRODUCTION RESPONDENT NAME> or someone else in your household contacted on or about <ORIGINAL ENUMERATION DATE> by an interviewer from the Census Bureau asking questions about <CENSUS PARTIALADDRESS>?
Spanish question wording for in person housing unit respondent	Estoy llevando a cabo una verificación de calidad para confirmar que un entrevistador del censo estuvo aquí recientemente. La entrevista debe tardar aproximadamente 5 minutos. (Hand respondent the Information Sheet.) ¿Un entrevistador de la Oficina del Censo se comunicó con < PRODUCTION RESPONDENT NAME> o alguna otra persona en su hogar el <ORIGINAL ENUMERATION DATE> o cerca de esa fecha para hacerle preguntas sobre <CENSUS PARTIALADDRESS>?
Spanish question wording for in person proxy respondent	Estoy llevando a cabo una verificación de calidad para confirmar que un entrevistador del censo estuvo aquí recientemente. La entrevista debe tardar aproximadamente 5 minutos. (Hand respondent the Information Sheet.) ¿Un entrevistador de la Oficina del Censo se comunicó con < PRODUCTION RESPONDENT NAME> o alguna otra persona en su hogar el <ORIGINAL ENUMERATION DATE> o cerca de esa fecha para hacerle preguntas sobre <CENSUS PARTIALADDRESS>?

Screen name	RESP NAME
Question wording for in person housing unit respondent	What is your name?
Spanish question wording for in person housing unit respondent	¿Cuál es su nombre?

Screen name	RESP PHONE
Question wording for in person housing unit respondent	What is the best phone number to reach you?
Spanish question wording for in person housing unit respondent	¿Cuál es el mejor número de teléfono para comunicarnos con usted?

Screen name	ANYONE
Question wording for in person housing unit respondent	Did anyone live at this address on <CENSUSDAY>?
Question wording for in person proxy respondent	Did anyone live at <PARTIALADDRESS> on <CENSUSDAY>?
Question wording for telephone proxy respondent	(Same as in person proxy respondent)
Spanish question wording for in person housing unit respondent	¿Vivía alguien en esta dirección el <CENSUSDAY>?
Spanish question wording for telephone housing unit respondent	(Same as in person housing unit respondent)
Spanish question wording for in person proxy respondent	¿Vivía alguien en <PARTIALADDRESS> el <CENSUSDAY>?
Spanish question wording for telephone proxy respondent	(Same as in person proxy respondent)
Spanish response options	(Radio buttons) Sí No

Question name	OCCUPANCY
Question wording for in person housing unit respondent	On <CENSUSDAY>, was this unit vacant or occupied by a different household?
Question wording for in person proxy respondent	On <CENSUSDAY>, was <PARTIALADDRESS> vacant or occupied by a different household?
Spanish question wording for in person housing unit respondent	El <CENSUSDAY>, ¿estaba vacante esta unidad o estaba ocupada por otro hogar?
Spanish question wording for in person proxy respondent	El <CENSUSDAY>, ¿estaba <PARTIALADDRESS> vacante o estaba ocupada por otro hogar?

Question name	VACANT DESCRIPTION
Question wording for in person housing unit respondent	Which category best describes this vacant unit as of <CENSUSDAY>?
Spanish question wording for in person housing unit respondent	¿Qué categoría describe mejor esta unidad vacante al <CENSUSDAY>?

Screen name	WHO
Question wording for in person housing unit respondent	Do you know who lived at <PARTIALADDRESS> on <CENSUS DAY>?
Spanish question wording for in person housing unit respondent	¿Sabe usted quién vivía en <PARTIALADDRESS> el <CENSUS DAY>?

Screen name	OTHERS
Question wording for in person housing unit respondent	Was there anyone else living or staying at <partial address> on <CENSUSDAY>?
Spanish question wording for in person housing unit respondent	¿Había alguien más viviendo o quedándose en <partial address> el <CENSUSDAY>?

Screen name	RESIDENCE
Question wording for in person housing unit respondent	Where did you live on <CENSUSDAY>?
Response options	Please provide a physical address such as: An address you would give to a shipping company if you wanted a package delivered to your home, or An address you would provide if you were requesting emergency services such as a 911 call, or A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”. Please provide a physical address such as: An address you would give to a shipping company if you wanted a package delivered to your home, or An address you would provide if you were requesting emergency services such as a 911 call, or A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”.
Spanish question wording for in person housing unit respondent	¿Dónde vivía usted el <CENSUSDAY>?
Spanish response options	Haga el favor de proporcionar una dirección física, tal como: Una dirección que usted le daría a una compañía de envíos si quisiera que le enviaran un paquete a su casa, o Una dirección que usted daría si estuviera solicitando servicios de emergencia como una llamada al 911, o Una descripción de la localización, tal como “El apartamento en los altos de la Oficina del Correo en la Ruta rural 5” o “La casa azul en la esquina noreste de la Calle Principal y la Quinta Avenida”. Haga el favor de proporcionar una dirección física, tal como: Una dirección que usted le daría a una compañía de envíos si quisiera que le enviaran un paquete a su casa, o Una dirección que usted daría si estuviera solicitando servicios de emergencia como una llamada al 911, o Una descripción de la localización, tal como “El apartamento en los altos de la Oficina del Correo en la Ruta rural 5” o “La casa azul en la esquina noreste de la Calle Principal y la Quinta Avenida”.
Screen name	PEOPLE
Question wording for in person housing unit respondent	Please list the name of each person who was living and sleeping at <PARTIALADDRESS> on <CENSUSDAY>. Enter names until you have listed everybody who was living or staying there.
Spanish question wording for in person housing unit respondent	Por favor, haga una lista con los nombres de todas las personas que estaban viviendo o quedándose en <PARTIALADDRESS> el <CENSUSDAY>. Enter names until you have listed everybody who was living or staying there, then click next.

Screen name	BABIES
Question wording for in person housing unit respondent	There are certain types of people that are sometimes left out of the census. So far, you have told me about the following people: <Name(s) from PEOPLE> OR <Name from RESP NAME> Were there any additional babies staying at <PARTIALADDRESS> on <CENSUSDAY> that you didn’t think of?
Spanish question wording for in person housing unit respondent	Hay cierto tipos de personas que a veces no se incluyen en el censo. Hasta ahora, usted me ha mencionado a las siguientes personas: <Name(s) from PEOPLE> O <Name from RESP NAME> ¿Se quedaban aquí algunas otras personas el <CENSUSDAY> en las cuales usted no haya pensado, como por ejemplo: Bebés?

Screen name	FOSTER CHILDREN
Question wording for in person housing unit respondent	Any foster children?
Response options	If “Yes”, prompt respondent for a name. Text boxes: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Then ask “Any other foster children?” If yes, prompt respondent for another name. Then ask “Any other foster children?” Ask for another name until the response to “Any other foster children?” is “No”
Spanish question wording for in person housing unit respondent	¿Algún hijo de crianza (foster)?
Spanish response options	If “Yes”, prompt respondent for a name. Text boxes: Nombre: 20-character text box Segundo nombre: 20-character text box Apellido: 20-character text box Then ask: “¿Alguien más?” If yes, prompt respondent for another name. Then ask: “¿Alguien más?” Ask for another name until the response to “¿Alguien más?” is “No”

Screen name	RELATIVES
Question wording for in person housing unit respondent	Any other relatives?
Response options	If “Yes”, prompt respondent for a name. Text boxes: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Then ask “Any other relatives?” If yes, prompt respondent for another name. Then ask “Any other relatives?” Ask for another name until the response to “Any other relatives?” is “No”
Spanish question wording for in person housing unit respondent	¿Algún otro pariente?
Spanish question wording for telephone housing unit respondent	(same as in person housing unit respondent)
Spanish question wording for in person proxy respondent	(same as in person housing unit respondent)
Spanish question wording for telephone proxy respondent	(same as in person housing unit respondent)
Spanish response options	If “Sí”, prompt respondent for a name. Text boxes: Nombre: 20-character text box Segundo nombre: 20-character text box Apellido: 20-character text box Then ask: “¿Alguien más?” If “sí”, prompt respondent for another name. Then ask: “¿Alguien más?” Ask for another name until the response to “¿Alguien más?” is “No”

Screen name	ROOMMATES
Question wording for in person housing unit respondent	Any roommates or people not related to you?
Response options	If “Yes”, prompt respondent for a name. Text boxes: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Then ask “Any other roommates or people not related to you?” If yes, prompt respondent for another name. Then ask “Any other roommates or people not related to you?” Ask for another name until the response to “Any other roommates or people not related to you?” is “No”
Spanish question wording for in person housing unit respondent	¿Algún otro compañero de cuarto o personas que no sean parientes suyos? (pause)
Spanish response options	(Radio buttons) Sí No If “Sí”, prompt respondent for a name. Text boxes: Nombre: 20-character text box Segundo nombre: 20-character text box Apellido: 20-character text box Then ask: “¿Alguien más?” If “sí”, prompt respondent for another name. Then ask: “¿Alguien más?” Ask for another name until the response to “¿Alguien más?” is “No”

Screen name	NO PERMANENT PLACE
Question wording for in person housing unit respondent	Was there anyone else staying here on <CENSUSDAY> who had no permanent place to live?
Response options	(Radio buttons) Yes No If “Yes”, prompt respondent for a name. Text boxes: First Name: 20-character text box ****Middle Name: 20-character text box**** Last Name: 20-character text box Then ask “Was there anyone else staying here on <CENSUSDAY> who had no permanent place to live?” If yes, prompt respondent for another name. Then ask “Was there anyone else staying here on <CENSUSDAY> who had no permanent place to live?” Ask for another name until the response to “Was there anyone else staying here on <CENSUSDAY> who had no permanent place to live?” is “No”
Spanish question wording for in person housing unit respondent	¿Había alguien más que se quedaba aquí el <CENSUSDAY> que no tuviera un lugar permanente donde vivir?
Spanish response options	(Radio buttons) Sí No If “Sí”, prompt respondent for a name. Textboxes: Nombre: 20-character text box ****Segundo nombre: 20-character text box**** Apellido: 20-character text box Then ask “¿Alguien más?” If yes, prompt respondent for another name. Then ask “¿Alguien más?” Ask for another name until the response to “¿Alguien más?” is “No”

Screen name	NO LONGER HERE
Question wording for in person housing unit respondent	Was there anyone else living or staying here on <CENSUSDAY> who is no longer here?
Response options	(Radio buttons) Yes No If “Yes”, prompt respondent for a name. Text boxes: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Then ask “Was there anyone else living or staying here on <CENSUSDAY> who is no longer here?” If yes, prompt respondent for another name. Then ask “Was there anyone else living or staying here on <CENSUSDAY> who is no longer here?” Ask for another name until the response to “Was there anyone else living or staying here on <CENSUSDAY> who is no longer here?” is “No”
Spanish question wording for in person housing unit respondent	¿Había alguien más que vivía o se quedaba aquí el <CENSUSDAY> que ya no está aquí?
Spanish response options	(Radio buttons) Sí No If “Sí”, prompt respondent for a name. Textboxes: Nombre: 20-character text box Segundo nombre: 20-character text box Apellido: 20-character text box Then ask “¿Alguien más?” If yes, prompt respondent for another name. Then ask “¿Alguien más?” Ask for another name until the response to “¿Alguien más?” is “No”

Demographic Screens

The demographic screens include two household-level questions, determining if the home is owned or rented and, if so, who owns or rents the home. Following the household-level screens are person-level screens asking for relationship, sex, age, and race/origin of each person on the roster.

Screen name	HOME
Question wording for in person housing unit respondent	Do you or does someone in this household own this “<house, apartment, or mobile home>” with a mortgage or loan (including home equity loans), own it free and clear, rent it, or occupy it without having to pay rent?
Question wording for in person proxy respondent	Does someone in this household own this “<house, apartment, mobile home>” with a mortgage or loan (including home equity loans), own it free and clear, rent it, or occupy it without having to pay rent?
Spanish question wording for in person housing unit respondent	Es <esta casa, este apartamento, esta casa móvil> propiedad suya o de alguna otra persona en este hogar con una hipoteca o préstamo (incluyendo préstamos sobre el valor líquido de la casa), propiedad libre y sin deuda; alquilada; u ocupada sin pago de alquiler?
Spanish question wording for in person proxy respondent	Es “<esta casa, este apartamento, esta casa móvil>” propiedad de alguien en este hogar con una hipoteca o préstamo (incluso préstamos sobre el valor líquido de la casa), propiedad libre y sin deuda, alquilada u ocupada sin pago de alquiler?
Spanish response options	(Radio buttons) ¿Propiedad suya o de alguna otra persona en este hogar con una hipoteca o préstamo? Incluya préstamos sobre el valor líquido de la casa. ¿Propiedad suya o de alguna otra persona en este hogar libre y sin deuda (sin hipoteca o préstamo)? ¿Alquilada? ¿Ocupada sin pago de alquiler?

Screen name	OWNER
Question wording for in person housing unit respondent	Of the people who lived at <PARTIALADDRESS>, who owned the “<house, apartment, or mobile home>” on <CENSUSDAY>?
Spanish question wording for in person housing unit respondent	De las personas que vivían en <PARTIAL ADDRESS>, ¿quién era el dueño de <la casa, el apartamento o la casa móvil>” el <CENSUSDAY>?

Screen name	RENTER
Question wording for in person housing unit respondent	Of the people who lived at <PARTIALADDRESS>, who rented the “<house, apartment, or mobile home>” on <CENSUSDAY>?
Spanish question wording for in person housing unit respondent	De las personas que vivían en <PARTIALADDRESS>, ¿quién alquiló “<la casa, el apartamento o la casa móvil>” el <CENSUSDAY>?

Question name	RELATIONSHIP RESP
Question wording for in person housing unit respondent	Next, we need to record each person’s relationship to you. Looking at the screen, <roster name> is your _______. Interviewer Note – Show screen to respondent or read if necessary
Response options	(Radio buttons) Opposite-sex husband/wife/spouse Opposite-sex unmarried partner Same-sex husband/wife/spouse Same-sex unmarried partner Biological son or daughter Adopted son or daughter Stepson or stepdaughter Brother or sister Father or mother Grandchild Parent-in-law Son-in-law or daughter-in-law Other relative Roomer or boarder Housemate or roommate Foster child Other nonrelative
Spanish question wording for in person housing unit respondent	A continuación, necesitamos indicar el parentesco de cada persona con usted. Mirando a la pantalla, <roster person> es su ____________. Show screen to respondent or read if necessary
Spanish response options	(Radio buttons) Esposo/esposa/cónyuge del sexo opuesto Pareja no casada del sexo opuesto Esposo/esposa/cónyuge del mismo sexo Pareja no casada del mismo sexo Hijo(a) biológico(a) Hijo(a) adoptivo(a) Hijastro(a) Hermano(a) Padre o madre Nieto(a) Suegro(a) Yerno o nuera Otro pariente Inquilino(a) o pupilo(a) Compañero(a) de casa o de cuarto Hijo(a) de crianza (foster) Otra persona que no es pariente

Question name	RELATIONSHIP OTHER
Question wording for in person housing unit respondent	Next, we need to record each person’s relationship to <reference person>. Looking at the screen, <you are/roster person is> <reference person>’s _______. Interviewer Note – Show screen to respondent or read if necessary
Response options	(Radio buttons) Opposite-sex husband/wife/spouse Opposite-sex unmarried partner Same-sex husband/wife/spouse Same-sex unmarried partner Biological son or daughter Adopted son or daughter Stepson or stepdaughter Brother or sister Father or mother Grandchild Parent-in-law Son-in-law or daughter-in-law Other relative Roomer or boarder Housemate or roommate Foster child Other nonrelative
Spanish question wording for in person housing unit respondent	A continuación, necesitamos indicar el parentesco de cada persona con <reference person>. Mirando a la pantalla, <usted/roster person> es la/el ____________ de <reference person> Interviewer Note – Show screen to respondent or read if necessary
Spanish response options	Esposo/esposa/cónyuge del sexo opuesto Pareja no casada del sexo opuesto Esposo/esposa/cónyuge del mismo sexo Pareja no casada del mismo sexo Hijo(a) biológico(a) Hijo(a) adoptivo(a) Hijastro(a) Hermano(a) Padre o madre Nieto(a) Suegro(a) Yerno o nuera Otro pariente Inquilino(a) o pupilo(a) Compañero(a) de casa o de cuarto Hijo(a) de crianza (foster) Otra persona que no es pariente

Question name	SEX
Question wording for in person housing unit respondent	What is <your/roster name’s> sex?
Spanish question wording for in person housing unit respondent	¿Cuál es el sexo de <usted/roster name>?

Question name	DATE OF BIRTH
Question wording for in person housing unit respondent	What is <your/ roster name’s> date of birth?
Spanish question wording for in person housing unit respondent	¿Cuál es la fecha de nacimiento de <usted/roster name>?

Question name	AGE
Question wording for in person housing unit respondent	What was <your/roster name’s> age on <CENSUSDAY>? If you don’t know the exact age, please estimate.
Spanish question wording for in person housing unit respondent	¿Cuál era la edad de <usted/roster name> el <CENSUSDAY>? Optional Text – Si no sabe la edad exacta, por favor indique la edad aproximada.

Question name	CONFIRM AGE
Question wording for in person housing unit respondent	For the Census, we need to record age as of <CENSUSDAY>. So, just to confirm <you were/ ROSTER NAME was> <AGE/less than one year old> on <CENSUSDAY>?
Spanish question wording for in person housing unit respondent	Para el Censo, necesitamos registrar la edad cumplida al <CENSUSDAY>. De modo que, solo para confirmar, ¿tenía <usted/roster name> <AGE años/menos de un año> el <CENSUSDAY>?

Question name	CHANGE AGE
Question wording for in person housing unit respondent	What was <your/ROSTERNAME’s> age on <CENSUSDAY>? If you don’t know the exact age, please estimate.
Spanish question wording for in person housing unit respondent	¿Cuál era la edad de <usted/roster name> el <CENSUSDAY>? Si no sabe la edad exacta, por favor indique la edad aproximada.
Question name		CHANGE DATE OF BIRTH
Question wording for in person housing unit respondent		Since <your/ROSTERNAME’s> age as of <CENSUSDAY> was <CHANGE AGE>, can you help me correct <your/ROSTERNAME’s> date of birth? I have <DOB – Convert to Month Day, Year>. What should it be?
Spanish question wording for in person housing unit respondent		Como la edad de <usted/ROSTERNAME> el <CENSUSDAY> era <CHANGE AGE>, ¿puede ayudarme a corregir su fecha de nacimiento? Tengo el <DOB – Convert to Month Day, Year>. ¿Cuál debe ser la fecha?

Question name	BABY FLAG
Question wording for in person housing unit respondent	For the Census, we need to record age as of <CENSUSDAY>. So, just to confirm, <ROSTER NAME> was born after <CENSUSDAY>?
Spanish question wording for in person housing unit respondent	Para el censo, necesitamos registrar la edad al <CENSUSDAY>. De modo que, solo para confirmar, ¿<ROSTER NAME> nació después del <CENSUSDAY>?

Question name	RELATIONSHIP CHECK
Question wording for in person housing unit respondent	Respondent is Reference Person -- I have recorded that <ROSTER NAME> is your < Father or mother /Parent-in-law>. Is that correct? Respondent is not Reference Person and asking about Non-Respondent – OR Proxy) -- I have recorded that <ROSTER NAME > is <REFERENCE PERSON>’s <Father or mother/Parent-in-law>. Is that correct? Respondent is not Reference Person and asking about Respondent) -- I have recorded that you are <REFERENCE PERSON>’s < Father or mother /Parent-in-law>. Is that correct?
Spanish question wording for in person housing unit respondent	Respondent is Reference Person -- He anotado que <ROSTER NAME> es su <Padre o madre/suegro(a)>. ¿Es eso correcto? Respondent is not Reference Person and asking about Non-Respondent – OR Proxy) – He anotado que <ROSTER NAME > es <el padre o la madre/el suegro o la suegra> de<REFERENCE PERSON>. ¿Es eso correcto? Respondent is not Reference Person and asking about Respondent) – He anotado que usted es <el padre o la madre/el suegro o la suegra> de<REFERENCE PERSON>. ¿Es eso correcto?

Question name	CHANGE RELATIONSHIP
Question wording for in person housing unit respondent	Looking at the screen, <you are/roster person is> <reference person>’s _______. Show screen to respondent or read if necessary
Response options	(Radio buttons) Opposite-sex husband/wife/spouse Opposite-sex unmarried partner Same-sex husband/wife/spouse Same-sex unmarried partner Biological son or daughter Adopted son or daughter Stepson or stepdaughter Brother or sister Father or mother Grandchild Parent-in-law Son-in-law or daughter-in-law Other relative Roomer or boarder Housemate or roommate Foster child Other nonrelative
Spanish question wording for in person housing unit respondent	Mirando a la pantalla, <usted/roster person> es el(la) _______de <reference person>. Show screen to respondent or read if necessary
Spanish response options	(Radio buttons) Esposo/esposa/cónyuge del sexo opuesto Pareja no casada del sexo opuesto Esposo/esposa/cónyuge del mismo sexo Pareja no casada del mismo sexo Hijo(a) biológico(a) Hijo(a) adoptivo(a) Hijastro(a) Hermano(a) Padre o madre Nieto(a) Suegro(a) Yerno o nuera Otro pariente Inquilino(a) o pupilo(a) Compañero(a) de casa o de cuarto Hijo(a) de crianza (foster) Otra persona que no es pariente

Question name	RACE
Question wording for in person housing unit respondent	I’m going to read you a list of categories. You may choose one or more. <Is ROSTER NAME/Are you> White; Hispanic, Latino, or Spanish; Black or African American; Asian; American Indian or Alaska Native; Native Hawaiian or Other Pacific Islander; or Some other race or origin?
Response options	(Check boxes) White Hispanic, Latino, or Spanish Black or African American Asian American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Some other race or origin
Spanish question wording for in person housing unit respondent	Le voy a leer una lista de categorías. Puede elegir una o más categorias. ¿Es <NAME/usted> blanco(a); hispano(a), latino(a), o español(a); negro(a) o afroamericano(a); asiático(a); indio(a) americano(a) o nativo(a) de Alaska; nativo(a) de Hawaii u otra de las islas del Pacífico; o de alguna otra raza u origen?
Spanish response options	(Check boxes) Blanco/a Hispano/a, latino/a o español/a Negro/a o africano/a americano/a Asiático/a Indígena americano/a o nativo/a de Alaska Nativo/a de Hawaii o de otra de las islas del Pacífico Alguna otra raza u origen

Question name	DETAILED ORIGIN
Response options	Programmer’s Note: For the specified person on the roster, if “White” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> White. What is that specific origin? Read if necessary: For example, German, Irish, English, Italian, Lebanese, Egyptian, and so on. [100-character text box] Programmer’s Note: For the specified person on the roster, if “Hispanic, Latino, or Spanish” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> Hispanic, Latino, or Spanish. What is that specific origin? Read if necessary: For example, Mexican or Mexican American, Puerto Rican, Cuban, Dominican, Salvadoran, Colombian, and so on. [100-character text box] Programmer’s Note: For the specified person on the roster, if “Black or African American” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> Black or African American. What is that specific origin? Read if necessary: For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian, and so on. [100-character text box] Programmer’s Note: For the specified person on the roster, if “Asian” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> Asian. What is that specific origin? Read if necessary: For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, and so on. [100-character text box] Programmer’s Note: For the specified person on the roster, if “American Indian or Alaskan Native” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> American Indian or Alaska Native. What is <ROSTER NAME’s/your> enrolled or principal tribe? Read if necessary: For example, Navajo Nation, Blackfeet Tribe, Muscogee (Creek) Nation, Mayan, Doyon, Native Village of Barrow Inupiat Traditional Government, and so on. [100-character text box] Programmer’s Note: For the specified person on the roster, if “Native Hawaiian or Other Pacific Islander” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> Native Hawaiian or Other Pacific Islander. What is that specific origin? Read if necessary: For example, Native Hawaiian, Samoan, Guamanian or Chamorro, Tongan, Fijian, Marshallese, and so on. [100-character text box] Programmer’s Note: For the specified person on the roster, if “Some other race or origin” is selected on RACE screen, display the following: You said <ROSTER NAME is/you are> some other race or origin. What is that specific race or origin? [100-character text box]
Spanish response options	Programmer’s Note: If respondent reports as White display this question with text box on the screen: Usted dijo que <ROSTER NAME/usted> es blanco/a. ¿Cuál es su origen específico? Read if necessary: Por ejemplo, alemán, irlandés, inglés, italiano, libanés, egipcio, etc. [100] Programmer’s Note: If respondent reports as Hispanic, Latino, or Spanish Display this question with text box on the screen: Usted dijo que <ROSTER NAME/usted> es hispano, latino o español. ¿Cuál es su origen específico? Read if necessary: Por ejemplo, mexicano o mexicano americano, puertorriqueño, cubano, dominicano, salvadoreño, colombiano, etc. ¿??No [100}????? Programmer’s Note: If respondent reports as Black or African American Display this question with text box on the screen: Usted dijo que <ROSTER NAME/usted> es negro o africano/a americano/a ¿Cuál es su origen específico? Read if necessary: Por ejemplo, africano americano, jamaiquino, haitiano, nigeriano, etíope, somalí, etc. [100] Programmer’s Note: If respondent reports as Asian Display this question with text box on the screen: Usted dijo que <ROSTER NAME/usted> es asiático. ¿Cuál es su origen específico? Read if necessary: Por ejemplo, chino, filipino, indio asiático, vietnamita, koreano, japonés, etc. Programmer’s Note: If respondent reports as American Indian or Alaska Native Display this question with text box on the screen: Usted dijo que <ROSTER NAME/usted> es indígena americano/a o nativo/a de Alaska. ¿Cuál es la tribu en la que <ROSTER NAME/usted> está inscrito o la tribu principal? Read if necessary: Por ejemplo, Navajo Nation, Blackfeet Tribe, Muscogee (Creek) Nation, Maya, Doyon, Native Village of Barrow Inupiat Traditional Government, etc. Programmer’s Note: If respondent reports as Native Hawaiian or Other Pacific Islander Display this question with text box on the screen: Usted dijo que <ROSTER NAME/usted> es nativo/a de Hawaii o de otra de las islas del Pacífico. ¿Cuál es su origen específico? Read if necessary: Por ejemplo, nativo de Hawaii, samoano, guameño o Chamorro, , tongano, fiyiano, de las islas Marshall, etc. Programmer’s Note: If respondent reports as Some other race or origin Display this question with text box on the screen: Usted dijo que <ROSTER NAME is/you are> es de alguna otra raza u origen. ¿Cuál es esa raza u origen específico?

Overcount Screens

The overcount screens are used to determine if there are additional addresses at which people could be counted. For example, group quarters (jails, colleges, military bases, etc.) use their own records to provide a count of the people who live there. If these people are also counted at their homes, they could be counted twice.

The seven location types are broken into a series of seven screens to determine more detailed information regarding which specific locations each person had also lived (SEASONAL through ANOTHER REASON). The delete screens are topic based. For example, SEASONAL asks: “Does anyone sometimes live or stay at another home, like a seasonal or second residence” and, if yes, provides the list of roster names as answer choices. After asking the seven delete questions, the survey again becomes person-based. For each roster person that was identified as have an additional address, the respondent is asked where that person lived most of the time (MOST) and where that person lived on the reference date (WHERE). Once the MOST, and WHERE cycle is completed for that person, the respondent is asked the MOST question for the following person and the cycle continues.

Screen name	SEASONAL
Question wording for in person housing unit respondent	Some people live or stay in more than one place and we would like to make sure everyone is only counted once. Does anyone sometimes live or stay at another home, like a seasonal or second residence? Yes No [Note: If “Yes”, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	Algunas personas viven o se quedan en más de un lugar, y nos gustaría asegurarnos de que cada persona sea contada solamente una vez. ¿Vive o se queda alguien a veces en otra casa, como una residencia de temporada o una segunda residencia? Sí No [Note: If “Sí” and more than one person in the HH, display the following] ¿Quién? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>

Screen name	CUSTODY
Question wording for in person housing unit respondent	Does anyone sometimes live or stay somewhere else with a parent, grandparent or other person? Yes No [Note: If “Yes, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	¿Vive o se queda alguien a veces en otro lugar con el padre o la madre, el abuelo o la abuela o alguna otra persona? Sí No [Note: If “Sí” and more than one person in the HH, display the following] ¿Quién? Marque todas las que apliquen. <roster name 1> <roster name 2-n (if applicable)>

Screen name	COLLEGE HOUSING
Question wording for in person housing unit respondent	Was anyone staying away from <partial address> while living in college housing, either on or off campus? Yes No [Note: If “Yes”, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	¿Se quedaba alguien en otro lugar que no fuera <partial address> mientras vivía en una residencia universitaria, dentro o fuera del campus? Sí No [Note: If “Yes”, display the following] ¿Quién? Marque todas las que apliquen. <roster name 1> <roster name 2-n (if applicable)>

Screen name	JOB
Question wording for in person housing unit respondent	Was anyone staying away from <partial address> to be closer to a job (including military assignments)? Yes No [Note: If “Yes, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	¿Se quedaba alguien en otro lugar que no fuera <partial address> para estar más cerca del trabajo (incluyendo asignaciones militares)? Sí No [Note: If “Yes, display the following] ¿Quién? Marque todas las que apliquen. <roster name 1> <roster name 2-n (if applicable)>

Screen name	NURSING/GROUP HOME
Question wording for in person housing unit respondent	Does anyone sometimes stay in a place like a nursing home or a group home? Yes No [Note: If “Yes”, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	¿Se queda alguien a veces en un lugar como un hogar de convalecencia o un hogar de grupo? Sí No [Note: If “Yes” and more than one person in the HH, display the following] ¿Quién? Marque todas las que apliquen. <roster name 1> <roster name 2-n (if applicable)>
Screen name	JAIL/PRISON
Question wording for in person housing unit respondent	Was anyone staying in a jail or prison? Yes No [Note: If “Yes, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	¿Estuvo alguien en la cárcel o la prisión? Sí No [Note: If “Yes”, display the following] ¿Quién? Marque todas las que apliquen. <roster name 1> <roster name 2-n (if applicable)>

Screen name	ANOTHER REASON
Question wording for in person housing unit respondent	Does anyone sometimes live away from <PARTIALADDRESS> for any reason other than those just mentioned? Yes No [Note: If “Yes, display the following] Who? Check all that apply. <roster name 1> <roster name 2-n (if applicable)>
Spanish question wording for in person housing unit respondent	¿Vive alguien a veces en otro lugar que no sea <PARTIALADDRESS> por alguna otra razón además de las que se han mencionado? Sí No [Note: If “Yes, display the following] ¿Quién? Marque todas las que apliquen. <roster name 1> <roster name 2-n (if applicable)>

Screen name	FULL STAY
Question wording for in person housing unit respondent	Please provide the full address <flag_location1> where <person> sometimes lived or stayed around <CENSUSDAY> <flag_location2>. Fill in as much information as the respondent can provide.
Response options	Address Type: City Style P.O. Box Rural Route If City Style is selected, then display: House Number: 20-character text box Street Name: 100-Character text box Apt/Unit #: 52-character text box City: 20-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box If P.O. Box is selected: P.O. Box #: 10-character text box City: 20-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Please provide a physical address such as: An address you would give to a shipping company if you wanted a package delivered to your home, or An address you would provide if you were requesting emergency services such as a 911 call, or A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”. Location Description: 250-character text box If Rural Route is selected: Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #: 10-character text box Box ID: 10-character text box City: 20-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Please provide a physical address such as: An address you would give to a shipping company if you wanted a package delivered to your home, or An address you would provide if you were requesting emergency services such as a 911 call, or A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”. Location Description: 250-character text box
Spanish question wording for in person housing unit respondent	Por favor, dé la dirección completa <flag_location1> dónde <person> vivía o se quedaba a veces alrededor del <CENSUSDAY> <flag_location2>. Fill in as much information as the respondent can provide.
Spanish response options	Address Type: Estilo urbano Apartado postal Ruta rural If City Style is selected, then display: Número de la casa: 20-character text box Nombre de la calle: 100-Character text box Apt./Unidad #: 52-character text box Ciudad: 20-character text box Estado: drop down menu with alphabetical states and District of Columbia Código postal: 5-character text box If P.O. Box is selected: : # de apartado postal: 10-character text box Ciudad: 20-character text box Estado: drop down menu with alphabetical states and District of Columbia Código postal: 5-character text box Haga el favor de proporcionar una dirección física, tal como: Una dirección que usted le daría a una compañía de envíos si quisiera que le enviaran un paquete a su casa, o Una dirección que usted daría si estuviera solicitando servicios de emergencia como una llamada al 911, o Una descripción de la localización, tal como “El apartamento en los altos de la Oficina del Correo en la Ruta rural 5” o “La casa azul en la esquina noreste de la Calle Principal y la Quinta Avenida”. Descripción de la localización: 250-character text box If Rural Route is selected: Descriptor de Ruta Rural: drop down menu with the following options RR HC SR PSC RTE # de ruta rural: 10-character text box Identificación del buzón: 10-character text box Ciudad: 20-character text box Estado: drop down menu with alphabetical states and District of Columbia Código postal: 5-character text box Haga el favor de proporcionar una dirección física, tal como: Una dirección que usted le daría a una compañía de envíos si quisiera que le enviaran un paquete a su casa, o Una dirección que usted daría si estuviera solicitando servicios de emergencia como una llamada al 911, o Una descripción de la localización, tal como “El apartamento en los altos de la Oficina del Correo en la Ruta rural 5” o “La casa azul en la esquina noreste de la Calle Principal y la Quinta Avenida”. Descripción de la localización: 250-character text box

Screen name	MOST
Question wording for in person housing unit respondent	Where does <person> live and sleep most of the time? <Reference Partial Address> The Seasonal address The Custody address The College Housing address The Job address The Nursing/Group Home address The Jail or Prison address The Other address Equal time at all places Some other place [Restrict response options to those that apply to <person>; always show <Reference Partial Address>, Equal time at all places, and Some other place]
Spanish question wording for in person housing unit respondent	¿Dónde vive y duerme <person> la mayor parte del tiempo? <Reference Partial Address> La dirección de temporada La dirección de la persona que tiene la custodia La dirección de la vivienda universitaria La dirección del trabajo La dirección del hogar de convalecencia/hogar de grupo La dirección de la cárcel o prisión La otra dirección El mismo tiempo en todos los lugares Algún otro lugar

Screen name	WHERE
Question wording for in person housing unit respondent	Where was <person> staying on <CENSUSDAY>? <Reference Partial Address> The Seasonal address The Custody address The College Housing address The Job address The Nursing/Group Home address The Jail or Prison address The Other address Some other place [Restrict response options to those that apply to <person>; always show <Reference Partial Address>, and Some other place]
Spanish question wording for in person housing unit respondent	¿Dónde se estaba quedando <person> el <CENSUSDAY>? <Reference Partial Address> La dirección de temporada La dirección de la persona que tiene la custodia La dirección de la vivienda universitaria La dirección del trabajo La dirección del hogar de convalecencia/hogar de grupo La dirección de la cárcel o prisión La otra dirección El mismo tiempo en todos los lugares Algún otro lugar

Screen name	EMAIL
Question wording for in person housing unit respondent	“Please provide an email address where we can contact you about this household” Enter address: ______________
Spanish question wording for in person housing unit respondent	“Por favor provea una dirección de correo electrónico donde podamos comunicarnos con usted acerca de este hogar.” Enter address: ______________
Spanish question wording for telephone housing unit respondent	(Same as in person housing unit respondent)
Spanish question wording for in person proxy respondent	(Same as in person housing unit respondent)
Spanish question wording for telephone proxy respondent	(Same as in person housing unit respondent)