dd17l3_p1_20150120_Cropped

Draft 2 (1-15-2015)
OMB No. xxxx-xxxx: Approval Expires xx/xx/xxxx

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

Important Note: This survey is
required by law. You are receiving
this notice because we did not
receive your response by
April 8, 2015.

April 13, 2015

Dear Resident:
A few weeks ago, the U.S. Census Bureau sent instructions for completing
the 2015 Census Test. We asked you to help us with this very important
survey by completing it online. But we have not received your response yet.
If you have already completed the survey, thank you.
If you have not responded, complete the survey using ONE of the following
options:
Option 1

Go to
https://survey.census.gov/censustest/ucount
to complete the survey online.

Option 2

Complete and mail back the enclosed form in the
postage-paid envelope provided.

Respond today and you can avoid a personal visit from a Census Bureau
interviewer. If you would like to complete the survey by telephone, or need
assistance, please call our toll-free number 1–866–226–2836.
You are required by U.S. law to respond to this survey. Your answers will only
be used for statistical purposes, and no other purpose. The back of this letter
contains more information about protecting your data.
Sincerely,

John H. Thompson
Director
Enclosure
Mensaje importante: Para completar la Prueba del Censo del 2015, por
favor, visite https://survey.census.gov/censustest/ucount o llame sin
cargo al 1–888–262–5931.
census.gov
DD-17(L)(3) (1-2015)

Base copy prints black ink
Overlay prints Pantone Cyan #6 - 10% and 20%

Your Answers Are Confidential
The Census Bureau is required by U.S. law to keep your
answers confidential. This means that the Census Bureau
cannot give out information that identifies you or your
household. The Census Bureau chose your address, not you
personally, as part of a randomly selected sample.
We are conducting this survey under the authority of Title 13,
United States Code, Sections 141 and 193. Federal law
protects your privacy and keeps your answers confidential
(Title 13, United States Code, Sections 9 and 214).
For more information about this survey, visit
http://www.census.gov/2015censustests.
For more information about how we protect your information,
please visit our website at www.census.gov and click on “Data
Protection & Privacy Policy.”

The U.S. Census Bureau estimates that, for the average household, this form 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, U.S. Census Bureau,
DMD-3H174, 4600 Silver Hill Road, Washington, DC 20233. You may e-mail
comments to ; use "Paperwork Project xxxx-xxxx" 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.

DD-17(L)(3) (1-2015)

Base copy prints black ink
Overlay prints Pantone Cyan #6 - 10%