dd6ain_Draft 1_

Draft 1 (8-29-2014)

U.S. Department of Commerce
Economics and Statistics Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47199-1111
OFFICIAL BUSINESS
Penalty for Private Use $300
DD-6A(IN) (9-2014)

AN EQUAL OPPORTUNITY EMPLOYER

YOUR RESPONSE
IS REQUIRED BY LAW

Size 10-1/16 x 6-1/16" Covered window 4-3/4" x 2-3/4"

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. CENSUS BUREAU
PERMIT NO. G-58