BC-649(L) "Not Found"

DC

ATTACHMENT C
FORM BC-649(L)
(9-30-2004)

OMB No. 0607-0117:

•

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
Jeffersonville, IN 47132-0001

Re:

In response to your application, a search has been made of the records of the census listed below,
but we were unable to find the name of:
Name

Address

Census date

If you can furnish a new or corrected address for the census year listed above, a search will be made
in this census year without an additional fee if your reply is received within 90 days. Use the area
below to provide the information.

Census date

Number and street

City, town, township

County and State

Name of person with whom living (head of household)

Relationship of head of household

If you desire a search in a census year other than the census year listed above, it will be necessary for you
to fill out and sign a new application and return it to the U.S. Census Bureau, Personal Census Search
Unit, PO Box 1545, Jeffersonville, IN 47131-0001, with another fee.

USCENSUSBUREAU
Helping You Make Informed Decisions

www.census.gov

The average time it should take you to fill out the BC-649, "Not Found Form," including the time spent reading instructions
is 6 minutes.
If you have any questions regarding this estimate or any other aspect of this form, send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Paperwork
Project 0607-0117, U.S. Census Bureau, 4700 Silver Hill Road, Stop 1500, Washington, D.C. 20233-1500. You may e-mail
comments to "[email protected]; use "Paperwork Project 0607-0117" 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. This 8-digit number appears in the top left corner on the front of this form.

FORM BC-649(L) (9-30-2004)