SC-920 Address Listing Page

Attachment I
THIS REPORT CONTAINS CONFIDENTIAL INFORMATION, INCLUDING TITLE 13 AND PERSONALLY IDENTIFIABLE INFORMATION (PII), THE RELEASE OF WHICH IS PROHIBITED BY THE PRIVACY ACT OF 1974. OMB NO. 0607-0368

SC-920
(05/12)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

ADDRESS LISTING PAGE
SPECIAL CENSUS
SCID: 23999
TRACT/AA:000308 / 150001
ST/COU: 95 / 900 Any County, Illinois
Line Action SC-1 Comp.
No. Code
Date

Print Date/Time: 05/23/2012 09:46AM
Page 1 of 7

Barcode ID

Block
No.

Map
Spot

House No.

Street Name, Rural Route and Box, or
P.O. Box

(6)

(7)

(8)

Apt. No.

Location Description

(9)

(10)

(1)

(2)

(4)

(5)

1

XXXX
XXXX
XXXX

XXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXX

1000

XXXXXX XXXXXXXXXXX No LQs in this Block
XXXXXX XXXXXXXXXXX
XXXXXX XXXXXXXXXXX

XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX

2

XXXX
XXXX
XXXX

XXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXX

1001

XXXXXX XXXXXXXXXXX No LQs in this Block
XXXXXX XXXXXXXXXXX
XXXXXX XXXXXXXXXXX

XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX

3

23999-193244423-24

1012

0001

2080

N BEACH DR

4

23999-193187676-03

1012

0003

2049

N MOUNTAIN VIEW RD

5

23999-193187675-02

1012

0004

2053

N MOUNTAIN VIEW RD

6

23999-193187698-65

1012

0002

3030

W FULANO ST

7

23999-193330414-48

1013

0011

1913

N BEACH DR

8

23999-193187715-43

1013

0019

2875

W FULANO ST

Action
Codes:

Reminder:

(3)

 - No change
C - Correction
A4 - Demolished
A5 - Burned out/cannot locate/outside block
Z = Group Quarters. If entered in column 2, DO NOT INTERVIEW.
T = Transitory Location. If entered in column 2, DO NOT INTERVIEW.

A6 - Nonresidential
A7 - Empty mobile home/trailer site
A8 - Uninhabitable (open to the elements, condemned, under construction)
A9 - Duplicate

NOTES

For Office Use Only
If A5, should
If Y, List
HU be
Add Page AA
moved? Y/N
and Line #

(11)

(12)

Crew Leader Initials ____________
Office Reviewer Initials __________

THIS REPORT CONTAINS CONFIDENTIAL INFORMATION, INCLUDING TITLE 13 AND PERSONALLY IDENTIFIABLE INFORMATION (PII), THE RELEASE OF WHICH IS PROHIBITED BY THE PRIVACY ACT OF 1974. OMB NO. 0607-0368

SC-920
(05/12)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

ADDRESS LISTING PAGE
SPECIAL CENSUS
SCID: 23999
TRACT/AA:000308 / 150001
ST/COU: 95 / 900 Any County, Illinois
Line Action SC-1 Comp.
No. Code
Date
(1)

(2)

Barcode ID

Block
No.

Map
Spot

House No.

Street Name, Rural Route and Box, or
P.O. Box

Apt. No.

Location Description

(8)

(9)

(10)

(4)

(5)

(6)

(7)

9

23999-193187714-42

1013

0017

2893

W FULANO ST

10

23999-193187713-41

1013

0016

2895

W FULANO ST

11

23999-193187718-46

1013

0018

2903

W FULANO ST

12

23999-193187717-45

1013

0015

2905

W FULANO ST

13

23999-193244426-27

1013

0014

2923

W FULANO ST

14

23999-193188048-78

1014

0008

1830

N NORTH PINE DR

15

23999-193188049-79

1014

0007

1848

N NORTH PINE DR

16

23999-193188050-03

1014

0006

1872

N NORTH PINE DR

17

23999-193188051-04

1014

0005

1890

N NORTH PINE DR

Action
Codes:

Reminder:

(3)

Print Date/Time: 05/23/2012 09:46AM
Page 2 of 7

 - No change
C - Correction
A4 - Demolished
A5 - Burned out/cannot locate/outside block
Z = Group Quarters. If entered in column 2, DO NOT INTERVIEW.
T = Transitory Location. If entered in column 2, DO NOT INTERVIEW.

A6 - Nonresidential
A7 - Empty mobile home/trailer site
A8 - Uninhabitable (open to the elements, condemned, under construction)
A9 - Duplicate

NOTES

For Office Use Only
If A5, should
If Y, List
HU be
Add Page AA
moved? Y/N
and Line #

(11)

(12)

Crew Leader Initials ____________
Office Reviewer Initials __________