2016 Census Test - Self and Enumerator Response

This document provides the specifications for the English, self-administered version of the Internet instrument for the 2016 Census Test. The instrument will function with a dashboard that is reached after a case is authenticated. The dashboard will direct respondents to complete the necessary sections of the instrument.

Translations and wording for Telephone Questionnaire Assistance will be provided in separate documents. Help text for each screen will also be provided in a separate document.

Input Variables

Variable	Possible Values	Default Value (non-ID cases)
INTERNET_AFRAM	1 = Black or African Am. (Control) 2 = Black or African American	1
INTERNET_RELATIONSHIP	1 = Full list of relationship categories (control) 2 = Remove “roomer or boarder” 3 = Remove “roomer or boarder” and “housemate or roommate”	1
INTERNET_ROSTER	1 = Rules and pop count question 2 = Pop count question with rules in the help text 3 = The “others” question with rules in the help text	3
INTERNET_UNDERCOUNT	0 = No undercount question 1 = 2015 design of two separate questions 2 = One question	1
INTERNET_OVERCOUNT	0 = No overcount question 1 = Person based overcount question	1

Standard Fills

<ADDRESS>	Partial address from RESIDENCE screen if available. Else, partial reference address from input file (street address and apt/bldg number)
<REFDATE>	April 1, 2016
<FULL ADDRESS>	Full address from the input file
<OMB STATEMENT>	The U.S. Census Bureau estimates that, for the average household, this survey 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 0607-####, U.S. Census Bureau, DCMD-3H174, 4600 Silver Hill Road, Washington, DC 20233. You may e-mail comments to [email protected]; use “Paperwork Project 0607-####” as the subject. You are not required to respond to this collection of information if it does not display a valid approval number from the Office of Management and Budget (OMB). The eight-digit OMB number is 0607-####.
<WARNING MESSAGE>	WARNING You have accessed a UNITED STATES GOVERNMENT computer. Use of this computer without authorization or for purposes for which authorization has not been extended is a violation of Federal law and can be punished with fines or imprisonment (PUBLIC LAW 99-474). System usage may be monitored, recorded, and subject to audit. Any information you enter into this system may be used by the Census Bureau for statistical purposes, including but not limited to improving the efficiency of our data collection programs. For information regarding the use of this system, and how your privacy is protected, visit our online privacy webpage at http://www.census.gov/privacy/privacy_policy/. Use of this system indicates consent to the collection, monitoring, recording, and use of information provided inside this system.

Instructions

The instructions, provided from a link on the Dashboard, should include the following:

#1	Who Should Complete the Survey: This survey should be completed by the person who owns or rents the living quarters, or any other person who is at least 15 years of age with knowledge of the household.
#2	Navigation: Use only the “Next” or “Previous” buttons on the bottom of each screen. Do NOT use the Forward or Back buttons on your browser. MOBILE: Use only the forward or back arrows…
#3	Changing Responses: For questions where you must choose a single response from a list, clicking another response will change your answer to that response. If it is a “check all that apply” question, you may click on a selected check box to unselect the box and remove it as one of your answers.
#4	Session Time Limits and Login/Logout: For your security, you will be logged out after 15 minutes of inactivity. If you need to leave the survey for more than 15 minutes, please click “Save and Log Out” so you may return to the survey at a later time. All of your information will be saved. You will need to enter your PIN to resume the survey. Your PIN will be provided to you during the survey.
#5	Help with Survey Questions: If you need assistance on a specific survey question, use the “Help” link that appears with that question.
#6	Submitting your Survey: Once your survey is submitted, you will not be able to access your information or change any of your responses. After you submit your survey and are shown the confirmation page you may close the web browser.

FAQs

Frequently Asked Questions (FAQs), provided from a link on the Dashboard, should include the following:

#1	Q. What is the 2016 Census Test? The 2016 Census Test is a survey that the U.S. Census Bureau is conducting in preparation for the 2020 Census. The goal of this survey is to develop new methods that will make the next census easier, more convenient, and less costly for taxpayers.
#2	Q. Do I have to complete this survey? This survey is mandatory, but will only take about 10 minutes to complete. We are conducting this survey under the authority of Title 13 United States Code Section 193. This survey has been approved by the Office of Management and Budget (OMB). For this survey, the OMB approval number is 0607-XXXX.
#3	Q. Why was I selected for this survey? The U.S. Census Bureau chose your address, not you personally, as part of a randomly selected sample. Your address was selected to represent a cross section of households in your community.
#4	Q. Who should complete the survey? This survey should be completed by the person who owns or rents the living quarters or any other person who is at least 15 years of age with knowledge of the household.
#5	Q. How do I change my answers? For questions where you must choose a single response from a list, clicking another response will change your answer to that response. If it is a “check all that apply” question, you may click on a selected check box to unselect the box and remove it as one of your answers.
#6	Q. How long will it take to complete this survey? The U.S. Census Bureau estimates that, for the average household, this survey 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 0607-XXXX, U.S. Census Bureau, DMD-3H174, 4600 Silver Hill Road, Washington, DC 20233. You may e-mail comments to [email protected]; use “Paperwork Project 0607-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. The OMB approval number for this survey is 0607-XXXX.
#7	Q. What types of questions will I be asked? In this survey, you will be asked if the housing unit is rented or owned and for the names of everyone living in the household. For each person living in the household, you will be asked for the name, relationship to householder, sex, age/date of birth, race or origin and whether or not the person sometimes lives or stays somewhere else.
#8	Q. Do you share my data with other agencies such as Immigration and Customs Enforcement, the Federal Bureau of Investigations, the Internal Revenue Service, courts, or the police? No, individual responses are not shared with anyone, including these government agencies or private organizations. It is against the law to disclose or publish any private information (names, telephone numbers, etc.) that identifies an individual or business. We use your information to produce statistics. The personal information you provide here cannot be used against you by any government agency or court.
#9	Q. How does the Census Bureau protect my survey data? Federal law protects your information, and we have developed policies and statistical safeguards to help us follow the law and further ensure the confidentiality of your information. Federal Law: Title 13 of the United States Code protects the confidentiality of all your information. Violating this law is a crime with severe penalties. Privacy Principles: Our Privacy Principles are guidelines that cover all of our activities. These principles encompass both our responsibilities to protect your information and your rights as a respondent. They apply to the information we collect and the statistics we publish. Statistical Safeguards: Statistical methods ensure that the statistics we release do not identify individuals or businesses. These methods include extensive review and analysis of all our data products, as well as disclosure avoidance methodologies such as data suppression and modification. Your information is confidential and we will never identify you individually. For more information, visit the Census Bureau’s Data Protection and Privacy Policy webpage (http://www.census.gov/privacy/).
#10	Q. Is it safe to complete this survey online? Yes, for more information, please refer to the FAQ question link, "How does the Census Bureau protect my survey data?" for guidelines on Federal Law, Privacy Principles, and Statistical Safeguards. Additionally, the following policies apply to personally identifiable information provided in an online survey. More information on this topic can be found on the Data Protection and Privacy Policy webpage (http://www.census.gov/privacy/). For each online survey, we are required to provide an explanation to respondents about the confidentiality of the data and the laws that protect those data (e.g., Title 13, United States Code Section 9 (a)). All web data submissions are encrypted in order to protect your privacy, even in the remote chance that your survey responses are intercepted.
#11	Q. Will the results be published? The Census Bureau plans to make results of this study available to the general public. Results will be presented in aggregate form and no personally identifiable information will be published. Information quality is an integral part of the pre-dissemination review of the information disseminated by the Census Bureau (fully described in the Census Bureau’s Information Quality Guidelines at http://www.census.gov/quality/guidelines/index.html). Information quality is also integral to the information collection conducted by the Census Bureau and is incorporated into the clearance process by the Paperwork Reduction Act.

Logout Verification

If a respondent selects Logout at any time, the following should be displayed for respondents who were provided a PIN:

Are you sure you want to log out?

If you leave now, you will need your PIN or to have answered a verification question in order to log in again.

If you do not want to leave the survey, click [Return to survey].

If you want to log out, click [Save and Log Out].

If a respondent selects Logout at any time, the following should be displayed for respondents who were not provided a PIN:

Are you sure you want to log out?

If you leave now, you will not be able to log in again.

If you do not want to leave the survey, click [Return to survey].

If you want to log out, click [Save and Log Out].

Timeouts

The instrument will time out if a respondent is inactive for 15 minutes. After 13 minutes of inactivity, display a warning: “Your session is about to expire. Press Ok to keep working or you will be logged out.”

Flow Charts

Overall

Login

Shape1

TQA Login

Verify Address

Roster/Home

NonID Address

Demographics

Shape2

Dashboard

There will be a dynamic Dashboard that the respondent will return to throughout the survey. It will display different content depending on what survey questions have previously been answered.

For a case that has accessed the survey with an ID, it will first display a “Verify Address” button that will go to the Verify Address path.

For a NonID case, it will display an “Address” button that will go to the NonID address collection path.

Once an address is verified or collected, there will be a “Who lives here?” button that will go to the Roster path.

Once a Roster is collected, each roster name will be displayed. Each name will a “Start” button that will start the Demographics section for that person. There will also be a “Delete” option. If the questions for that person have been completed, there will be an “Edit” button instead of a start button. If the demographics have been started, but not completed, for that person, there will be a “Continue” button. There will also be an option to add additional people below the list of names.

Once data has been collected for each name, there will be a “Submit” button.

Welcome Screens

Screen Name	WELCOME
Field Names
Data Needed
Universe
Question Wording	Welcome to the 2016 Census Test. You will need the materials we mailed to you in order to start. All the information that you provide will remain confidential. Begin the 2016 Census Test <OMB STATEMENT> <WARNING MESSAGE>
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching	Goto LOGIN
Help Text link
Special Instructions	Center all text. Display the OMB Burden Statement and the Government Computer access warning message at the bottom of the screen in a smaller font.

Screen Name	NONID WELCOME
Field Names
Data Needed
Universe
Question Wording	Welcome to the 2016 Census Test. All the information that you provide will remain confidential. Begin the 2016 Census Test <OMB STATEMENT> <WARNING MESSAGE>
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching	Goto NONID LOGIN
Help Text link
Special Instructions	Center all text. Display the OMB Burden Statement and the Government Computer access warning message at the bottom of the screen in a smaller font.

Login Screens

Screen Name	LOGIN
Field Names	censusid: NUM 14
Data Needed
Universe	Cases from ID URL page or VERIFY== (blank or invalid)
Question Wording	Please Log In Please enter the 14-digit User ID found below the barcode on the materials we mailed to you. User ID: _____ - _____ - ____ [Login Button] If you do not have a User ID, click here.
Question Wording Fills
Response Options	User ID: _____-_____-____ (3 numeric text boxes, 2 with 5 digits and 1 with 4 digits, separated by a hyphen. Include auto-tabbing between fields.)
Response Options Fills	N/A
Edits/Errors	If no ID is entered or VERIFY=blank, display: “Login failed. Please try again.” If an invalid ID is entered or VERIFY=invalid, display: “Invalid User ID. Please try again.” If user exceeds the allowable number of login attempts, display: “Your account has been temporarily locked. You will be able to access the survey in 15 minutes.” When there is an edit/error message, the box should be bolded and highlighted in yellow.
Branching	If valid, previously used User ID, and complete, goto COMPLETED. If valid, previously used User ID, goto LOGIN2. If valid, not previously used User ID, goto CONFIRM. If blank, goto NON-ID LOGIN.
Help Text link
Special Instructions	Center “Please Log In” towards the top of the page. Display an image of the mailing label on the left side of the page indicating where the User ID is located. Display the question wording on the right side of the page. On mobile screens, display the mailing label image below the User ID, Login button, and no user ID text. If the user exceeds the 15 minute inactivity limit anywhere in the survey, display this screen with the error message: “Your session has been inactive for 15 minutes. Please log in to complete the survey.” At bottom of page, display <OMB STATEMENT>.

Screen Name	CONFIRM
Field Names	confirm_yes: NUM 1 (0=not selected and 1=selected) confirm_no: NUM 1 (0=not selected and 1=selected)
Data Needed	<FULL ADDRESS>
Universe	LOGIN = valid ID or VERIFY ID <> LOGIN ID
Question Wording	Are you completing the 2016 Census Test for the address below? (Help) <FULL ADDRESS>
Question Wording Fills	N/A
Response Options	Radio Buttons Yes No
Response Options Fills	N/A
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If “Yes” or blank, goto VERIFY ADDRESS. If first time on screen and “No”, goto VERIFY. If second time on screen and “No”, goto NONID LOGIN
Help Text link	CONFIRM
Special Instructions	No “Previous” button on this screen.

Screen Name	VERIFY
Field Names	verifyid: NUM 14
Data Needed	List of valid User IDs
Universe	CONFIRM=no
Question Wording	Please enter your 14-digit User ID again so that we can verify that you need to complete this survey.
Question Wording Fills	N/A
Response Options	User ID: _____-_____-____ (3 numeric text boxes, 2 with 5 digits and 1 with 4 digits, separated by a hyphen. Include auto-tabbing between fields.)
Response Options Fills	N/A
Edits/Errors	N/A
Branching	If VERIFY is blank, goto LOGIN If VERIFY is invalid, goto LOGIN If VERIFY = LOGIN, goto NONID LOGIN If VERIFY <> LOGIN, goto CONFIRM.
Help Text link	N/A
Special Instructions	No “Previous” button on this screen.

Screen Name	NONID LOGIN
Field Names	Non-id_email: CHAR 50 Non-id_email2: CHAR 50
Data Needed	N/A
Universe	Cases from Non ID Welcome page. LOGIN = “Click here” if no ID link selected. VERIFY = LOGIN CONFIRM = “No” twice
Question Wording	Please enter your email address so that we may log you into the survey.
Question Wording Fills	N/A
Response Options	50 character email text boxes: Email Address: ____________________________ Confirm Email Address: ___________________________ Check box: “No email address available.” Check the box below to enter the survey,” CAPTCHA Below response options, display OMB Burden statement. <OMB STATEMENT>
Response Options Fills	N/A
Edits/Errors	If email field is completely empty and no email box is not selected, display: “Please enter a valid email address. It must be in the format: [email protected].” Also, the write-in box should be bolded and highlighted in yellow. Email fields must contain “@” and “.” in the field. If either (or both) is missing, display: “Please enter a valid email address. It must be in the format: [email protected].” If CAPTCHA is invalid, display error message:“Incorrect response. Please try again.” If the ‘No email address’ checkbox is clicked, display in green error box or white pop up like help “If you leave the survey before finishing it and have not provided an email address, your responses will be not be saved for you to return and finish.”
Branching	If valid, new email, goto PIN. If valid, previously used email and survey has been completed, goto COMPLETED. Else if valid, previously used email, goto LOGIN2. If no email address box selected, goto DASHBOARD (NonID Address collection).
Help Text link	NONIDLOGIN
Special Instructions	No “Previous” button on this screen. At bottom of page, display <OMB STATEMENT>. The confirmation check, to make sure both addresses are entered the same, should not be case-sensitive. Create an ID for spawned NONID cases.

Screen Name	LOGIN2
Field Names	N/A
Data Needed	User IDs from input file Email addresses that respondents have provided. PINs and verification questions/responses for User IDs and email addresses.
Universe	LOGIN = Previously used, but not complete, ID NONID LOGIN=previously used, but not complete, email.
Question Wording	(If from LOGIN, display) Please Log In Please enter the 14-digit User ID found below the barcode on the materials we mailed to you. User ID: _____ - _____ - ____ Enter the 4-digit PIN we gave you the last time you entered the survey. PIN: ____ If you do not know your PIN, click here. [Login Button] (If from NONID LOGIN, display) Please enter the PIN associated with this email address. Email Address: [email protected] Enter your 4-digit PIN: If you do not know your PIN, click here. [Login Button]
Question Wording Fills
Response Options	PIN: ____ (4 digit PIN)
Response Options Fills	N/A
Edits/Errors	If no PIN entered (on first or second attempt): Display error message “Failed login. Please try again.” Also, the write-in box should be bolded and highlighted in yellow. If no PIN entered (on first or second attempt): Display error message “Failed login. Please try again.” Also, the write-in box should be bolded and highlighted in yellow.
Branching	Correct PIN, goto Dashboard. Third time incorrect PIN entered, goto SECURITY. “Click here” selected and verification available, goto SECURITY. “Click here” selected and verification not available, goto ASSISTANCE.
Help Text link
Special Instructions	For ID cases, pre-fill the User ID with the information provided in LOGIN. For NON ID cases, display the email address provided in NONID LOGIN.

Screen Name	SECURITY
Field Names	N/A
Data Needed	User IDs from input file Email addresses that respondents have provided. Verification questions/responses for User IDs and email addresses.
Universe	LOGIN2 = invalid PIN. LOGIN2 = “Click here” and verification question available.
Question Wording	Please provide the answer to the following verification question to return to your survey. If correct response provided, display: Your new PIN is:_____ Please log in using your new PIN to access your account.
Question Wording Fills
Response Options	Response:_____________________ Click here if you do not know your verification question response.
Response Options Fills	N/A
Edits/Errors	On first or second blank entry, display: “Please provide an answer to the verification question.” Also, all of the name boxes should be bolded and highlighted in yellow. On first or second incorrect entry, display: “Incorrect response. Please try again or call 1-###-###-#### for assistance.”
Branching	If correct response entered, display new PIN and goto LOGIN2. If third attempt and wrong response and ID case, goto LOGIN and display “session locked message.” If third attempt and wrong response and NONID case, goto NONID LOGIN and display “session locked” message. If “Click here” is selected, goto ASSISTANCE.
Help Text link	N/A
Special Instructions	No “Previous” button.

Screen Name	ASSISTANCE
Field Names	N/A
Data Needed	User IDs from input file Email addresses that respondents have provided. Verification questions/responses for User IDs and email addresses.
Universe	LOGIN2 = “Click here” and verification question not available. SECURITY “Click here” selected
Question Wording	If no security question selected, display first: No security question selected. For assistance, please call 1-###-###-#### Return to Login
Question Wording Fills	N/A
Response Options	N/A
Response Options Fills	N/A
Edits/Errors	On first or second blank entry, display: “Please provide an answer to the verification question.” Also, all of the name boxes should be bolded and highlighted in yellow. On first or second incorrect entry, display: “Incorrect response. Please try again or call 1-###-###-#### for assistance.”
Branching	If ID case, goto LOGIN. If NONID case, goto NONID LOGIN
Help Text link	N/A
Special Instructions	No “Previous” button.

TQA Login Screens

Screen Name	TQA ADMIN LOGIN
Field Names
Data Needed	List of TQA ADMIN user names and passwords
Universe	TQA URL cases
Question Wording	TQA/CATI Login User Name: ________ Password: _______
Question Wording Fills
Response Options	User Name: ________ (8 digit alphanumeric) Password: _______ (15-digit alphanumeric)
Response Options Fills	N/A
Edits/Errors	Incorrect login entered: Display error message “Failed login. Please try again.”
Branching	Goto TQA LOGIN
Help Text link
Special Instructions

Screen Name	TQA LOGIN
Field Names	censusid: NUM 14
Data Needed
Universe
Question Wording	This interview may be recorded for quality assurance purposes. Do I have your permission to record this interview? Please give me your 14-digit User ID. This ID can be found below the barcode on the materials we mailed you. Interviewer Instructions, in faded text: Use the example below to help the respondent locate their User ID Keep in mind that not all respondents will have a User ID. If the respondent does not have or is unable to provide a User ID, use the “click here” link under the LOGIN button. User ID: _____ - _____ - ____ [Login Button] If you do not have a User ID, click here.
Question Wording Fills
Response Options	User ID: _____-_____-____ (3 numeric text boxes, 2 with 5 digits and 1 with 4 digits, separated by a hyphen. Include auto-tabbing between fields.)
Response Options Fills	N/A
Edits/Errors	If invalid ID entered, display: Unable to find respondent with ID xxxxx-xxxxx-xxxx
Branching	If valid, previously used User ID, and complete, goto COMPLETED. If validUser ID, goto TQA CONFIRM. If blank, goto TQA NONID LOGIN.
Help Text link
Special Instructions

Screen Name	TQA CONFIRM
Field Names	confirm_yes: NUM 1 (0=not selected and 1=selected) confirm_no: NUM 1 (0=not selected and 1=selected)
Data Needed	<FULL ADDRESS>
Universe	TQA LOGIN = valid ID
Question Wording	Are you completing the 2016 Census Test for <FULLADDRESS>? (Help) <FULL ADDRESS>
Question Wording Fills	N/A
Response Options	Radio Buttons Yes No
Response Options Fills	N/A
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If second time at CONFIRM and “No,” goto DASHBOARD (to start as if no email) If new ID and “Yes” or blank, goto TQA QUESTIONS If previously used ID and “Yes,” goto DASHBOARD (to start where left off) If “No”, goto TQA NONID LOGIN
Help Text link	CONFIRM
Special Instructions	No “Previous” button on this screen. If TQA CONFIRM = “No,” create a new ID.

Screen Name	TQA NONID LOGIN
Field Names	Non-id_email: CHAR 50 Non-id_email2: CHAR 50
Data Needed	N/A
Universe	Cases from Non ID Welcome page. LOGIN = “Click here” if no ID link selected. VERIFY = LOGIN CONFIRM = “No” twice
Question Wording	What is your email address?
Question Wording Fills	N/A
Response Options	50 character email text boxes: Email Address: ____________________________ Confirm Email Address: ___________________________ Check box: “No email address available.”
Response Options Fills	N/A
Edits/Errors	If email field is completely empty and no email box is not selected, display: “Please enter a valid email address. It must be in the format: [email protected].” Also, the write-in box should be bolded and highlighted in yellow. Email fields must contain “@” and “.” in the field. If either (or both) is missing, display: “Please enter a valid email address. It must be in the format: [email protected].” If CAPTCHA is invalid, display error message:“Incorrect response. Please try again.” If the ‘No email address’ checkbox is clicked, display in green error box or white pop up like help “If you leave the survey before finishing it and have not provided an email address, your responses will be not be saved for you to return and finish.”
Branching	If valid, previously used email and survey has been completed, goto COMPLETED. Else if valid, previously used email, goto TQA CONFIRM. If valid, new email, goto TQA QUESTIONS If no email address box selected, goto DASHBOARD.
Help Text link	NONIDLOGIN
Special Instructions	No “Previous” button on this screen. At bottom of page, display <OMB STATEMENT>. The confirmation check, to make sure both addresses are entered the same, should not be case-sensitive. Create an ID for spawned NONID cases.

Screen Name	TQA QUESTIONS
Field Names	N/A
Data Needed	Randomly generated PIN Full list of verification questions
Universe	CONFIRM = “Yes” NONID LOGIN = valid email
Question Wording	This survey will take approximately 10 minutes. To maintain the confidentiality of your data, you will need to answer a verification question to return to the survey in case you leave the survey before submitting your data. Please select a verification question for your PIN. Read all verification questions to the respondent.
Question Wording Fills	N/A
Response Options	One drop down box with pre-filled verification question options What color was your first car? What is the name of your first pet? In what city were you born? What is your paternal grandfather’s first name? One 50-character text box that is not case sensitive labeled “Response”. Response:_____________________
Response Options Fills	N/A
Edits/Errors	N/A
Branching	Goto DASHBOARD.
Help Text link	N/A
Special Instructions	No “Previous” button.

Verify Address

Screen Name	VERIFY ADDRESS
Field Names	address_yes: NUM1 (0=not selected and 1=selected) address_no: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe
Question Wording	On <REFDATE>, <FILL1> living or staying at <ADDRESS>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will you be” If current date is on or after REFDATE, then <FILL1> = “were you”
Response Options	Radio Buttons Yes No
Response Options Fills	N/A
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.”
Branching	If “Yes,” goto PIN If “No” or blank, goto ANYONE
Help Text link	VERIFY ADDRESS
Special Instructions	No “Previous” button on this screen. (Cannot go back to PIN screen.)

Screen Name	ANYONE
Field Names	anyone_yes: NUM1 (0=not selected and 1=selected) anyone_no: NUM1 (0=not selected and 1=selected) anyone_dk: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe	VERIFY ADDRESS=no
Question Wording	<FILL1> at <ADDRESS> on <REFDATE>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “Will anyone be living” If current date is on or after REFDATE, then <FILL1> = “Did anyone live”
Response Options	Radio Buttons Yes No Don’t know
Response Options Fills	N/A
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.”
Branching	If “No,” goto VACANCY Else, goto NONID LOGIN
Help Text link	ANYONE
Special Instructions

Screen Name	VACANCY
Field Names	for_rent: NUM1 (0=not selected and 1=selected) rented_not_occupied: NUM1 (0=not selected and 1=selected) for_sale: NUM1 (0=not selected and 1=selected) sold: NUM1 (0=not selected and 1=selected) seasonal: NUM1 (0=not selected and 1=selected) migrant: NUM1 (0=not selected and 1=selected) other_vacant: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe
Question Wording	What is the primary reason why no one <FILL1> living or staying at <ADDRESS> on <REFDATE>? The unit <FILL2> – (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” <FILL2> = “will be” If current date is on or after REFDATE, then <FILL1> = “was” <FILL2> = “was”
Response Options	Radio Buttons For rent Rented, not occupied For sale only Sold, not occupied For seasonal, recreational, or occasional use For migrant workers Other
Response Options Fills	N/A
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.”
Branching	Goto NONID LOGIN
Help Text link	VACANCY
Special Instructions

Screen Name	PIN
Field Names	N/A
Data Needed	Randomly generated PIN Full list of verification questions
Universe	VERIFY ADDRESS = “Yes” NONID LOGIN = valid email
Question Wording	To maintain the confidentiality of your data, you will need this PIN to return to the survey in case you leave the survey before submitting your data. This survey will take approximately 10 minutes. You will be automatically logged off if your computer is idle for 15 minutes. Please make note of the 4-digit PIN below. PIN: ____ Please select a verification question for your PIN. If you forget your PIN, you will be asked to provide this response to enter the survey.
Question Wording Fills	N/A
Response Options	One drop down box with pre-filled verification question options What color was your first car? What is the name of your first pet? In what city were you born? What is your paternal grandfather’s first name? One 50-character text box that is not case sensitive labeled “Response”. Response:_____________________
Response Options Fills	N/A
Edits/Errors	N/A
Branching	Goto DASHBOARD.
Help Text link	N/A
Special Instructions	No “Previous” button.

NonID Address

Screen Name	RESIDENCE
Field Names	Address Type Fields ADDR_TYPE: NUM (1) (1=Street, 2=Rural Route, 3=PO Box) Respondent-Provided Street Address Fields RT_ADDR_NUMBER: varchar2 (20) RT_STREET_NAME: varchar2 (100) RT_UNIT_INFO: varchar2 (52) Respondent-Provided General Address Fields for Street Addresses RT_SA_CITY: varchar2 (16) RT_SA_STATE: varchar2 (2) RT_SA_ZIP: varchar2 (5) Respondent-Provided Rural Route Address Fields RR_DESC: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) RES_RRNUM: varchar2 (10) RES_BOXNUM: varchar2 (10) Respondent-Provided General Address Fields for Rural Route Addresses RT_RR_CITY: varchar2 (16) RT_RR_STATE: varchar2 (2) RT_RR_ZIP: varchar2 (5) ASD Concatenated Version of the Raw Rural Route Addresses (for storage and delivery to UCRM only) RT_RR_INFO: varchar2 (40) Respondent-Provided P.O. Box Address Fields RT_POBOX_INFO: varchar2 (10) Respondent-Provided General Address Fields for P.O. Box Addresses RT_PO_CITY: varchar2 (16) RT_PO_STATE: varchar2 (2) RT_PO_ZIP: varchar2 (5)
Data Needed
Universe	ID Respondents and ANYONE=(“No” or “DK”) ID Respondents, where VERIFY User ID = LOGIN User ID Non ID Responsents.
Question Wording	Where <FILL1> on <REFDATE>? (Help) Please select the type of address associated with your residence. Note: If you have a street address associated with your residence, such as one you would provide to have a package delivered to your home, then please provide it here; not your P.O. Box or Rural Route address.
Question Wording Fills	If the current date is before REFDATE, then <FILL1> = “will you be living” If the current data is on or after REFDATE, then <FILL1>= “did you live”
Response Options	Address Type: {3 radio buttons} Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box RR Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia ZIP Code: 5-character text box
Edits/Errors	If ALL address fields for Street Address, P.O. Box, and Rural Route addresses are blank when the respondent selects the “Next” button: 1. First Time: "Please provide an address.” 2. Second Time: “Please provide an address. In order to continue, you must provide a Street Address, a P.O. Box, or a Rural Route and Box. Any address you provide should also include a City and State or a ZIP Code.” 3. Third Time: End the survey and display NOCOMPLETE. If (RT_ADDR_NUMBER is nonblank and RT_STREET_NAME is blank) OR (RT_ADDR_NUMBER is blank and RT_STREET_NAME is nonblank) OR [RT_ADDR_NUMBER is blank and RT_STREET_NAME is blank and (RT_SA_CITY = nonblank OR RT_SA_STATE = nonblank OR RT_SA_ZIP=nonblank)], and the respondent selects the “Next” button: 1. First time: “Please provide both an address number and street name” 2. Second time: “Please provide both an address number and street name. In order to continue, you must provide this information. 3. Third Time: End the survey and display NOCOMPLETE. Also, the write-in box should be bolded and highlighted in yellow. If ADDR_TYPE=P.O. Box AND RT_POBOX_INFO = blank, and the respondent selects the “Next” button: 1. First time: “Please provide a P.O. Box Number.” 2. Second time: “Please provide a P.O. Box Number. In order to continue, you must provide this information.” 3. Third Time: End the survey and display NoComplete. If ADDR_TYPE=Rural Route AND (RR_DESC= blank OR RR_RRNUM = blank OR RR_BOXNUM = blank), and the respondent selects the “Next” button: 1. First time: “Please provide a Rural Route Descriptor, Rural Route Number and a Box Number.” 2. Second time: “Please provide a Rural Route Descriptor, Rural Route Number, and Box Number. In order to continue, you must provide this information.” 3. Third time: End the survey and display NOCOMPLETE. If (RT_SA_CITY = blank AND RT_SA_STATE = blank AND RT_SA_ZIP = blank/invalid AND RT_RR_CITY = blank AND RT_RR_STATE = blank AND RT_RR_ZIP = blank/invalid AND RT_PO_CITY = blank AND RT_PO_STATE = blank AND RT_PO_ZIP = blank/invalid) OR [(RT_SA_CITY = blank AND RT_SA_STATE = blank) OR RT_SA_ZIP = blank/invalid] AND [(RT_RR_CITY = blank AND RT_RR_STATE = blank) OR RT_RR_ZIP = blank/invalid] OR [(RT_PO_CITY = blank AND RT_PO_STATE = blank) OR RT_PO_ZIP = blank/invalid] And the respondent selects the ‘“Next” button: 1. First time: Please provide both a City and State or a ZIP Code. 2. Second time: If ZIP is nonblank (regardless of validity), go toRESPONDENT Else, display: “Please provide both a City and State or a ZIP Code. In order to continue, you must provide this information.” 3. Third Time: If ZIP Code is nonblank (regardless of validity), go toRESPONDENT. Else, end the survey and display NOCOMPLETE. If no ADDR_TYPE selected, and “Next” is selected First time: “In order to continue, you must select an address type” Second time, goto NOCOMPLETE. When there is an edit/error message, the box should be bolded and highlighted in yellow.
Branching	Second time “Next” is selected with no ADDR_TYPE selected, goto NOCOMPLETE. Else if, third time all address fields are blank, or “Next” is selected with an invalid address, goto NOCOMPLETE. If valid address provided and GEO Standardize is (stalled or disabled or otherwise inaccessible), goto DASHBOARD If valid address provided and GEO Standardizer is functional, goto ADDRESS STANDARDIZATION.
Help Text link	RESIDENCE
Special Instructions	For all rural route addresses, ASD must process the existing fields (RR_DESC, RES_RRNUM, and RES_BOXNUM) into one 40-character VARCHAR2 field called RT_RR_INFO. This field will combine the input from RR_DESC (RR or HC or SR or PSC or RTE), then include one single space as a delimiter, then include the input from RES_RRNUM, then include one single space as a delimiter, then add the word “Box”, then include one single space delimiter, then include the input from RES_BOXNUM. The new field RT_RR_INFO will be stored in the ASD database during address collection, then transferred with the rest of the data at the end of data collection per case. It is not intended for display to the respondent. If respondents provide an address on this screen, this address should be the fill for the “<ADDRESS>” that is referenced on the remaining screens. In other words, the address collected on RESIDENCE takes the place of the sample address provided in the input file (if one exists). If the Address Type is Street Address, display the Address Number, Street Name, and Apt/Unit only (e.g., “5007 N Maple Ave Apt. A”). If the Address Type is P.O. Box, display: “the physical address associated with P.O. Box <Box #> in <city> <state> <zip> (e.g., “the physical address associated with P.O. Box 12 in Any City, MD” or “the physical address associated with P.O. Box 12 in 99997”.) If the Address Type is Rural Route, display the Rural Route Descriptor, Rural Route Number, and Box Number (e.g., RR 15 Box 24). If the Address Type is Rural Route (ADDR_TYPE=2) or if the Address Type is P.O. Box (ADDR_TYPE=3), then GEO must automatically set rt_match_status=0 (Did Not Match to a MTdb Record, And Did Not Receive an Automated Geocode). If ADDR_TYPE = 2 (Rural Route) or 3 (P.O. Box), then GEO must set the rt_match_status flag to “0” (Did Not Match to a MTdb Record, And Did Not Receive an Automated Geocode) If ADDR_TYPE=1 (Street Address) is set and the response is valid (according to the parameters above), then the ADDR_TYPE of “1” must not be overwritten if the respondent happens to click on the P.O. Box or Rural Route radio buttons. If ADDR_TYPE=1 and the response is valid, then the respondent clicks on other radio buttons, those respective address fields (for P.O. Box and/or Rural Route) should be captured, but ADDR_TYPE=1 should not be overwritten by “2” or “3.” If ADDR_TYPE=1, and the response is valid (according to the parameters above), then all subsequent actions will be based on that value when “Next” is pressed. The selection of the radio buttons must be hard edited so that at least one radio button must be selected before the “Next” button can be executed. If one isn’t selected then see Edits/Errors above.

Screen Name	ADDRESS STANDARDIZATION
Field Names	Standardized Street Address Fields RT_STAN_ADDR_NUMBER: varchar2 (20) RT_STAN_STREET_NAME: varchar2 (100) RT_STAN_UNIT_INFO: varchar2 (40) General Address Fields for Standardized Street Addresses RT_HC_SA_CITY: varchar2 (16) RT_HC_SA_STATE: varchar2 (2) RT_HC_SA_UPZIP: varchar2 (5) RT_HC_SA_COUNTY: varchar2 (16) Geocode Block Fields for RT_MATCH_STATUS=1 Cases: RT_TAB2010BLKST: varchar2 (2) RT_TAB2010BLKCOU: varchar2 (3) RT_TAB2010BLKTRACT: varchar2 (6) RT_TAB2010BLK: varchar2 (6) Geocode Block Fields for RT_MATCH_STATUS=2 Cases: RT_TAB2010BLKST: varchar2 (2) RT_TAB2010BLKCOU: varchar2 (3) RT_TAB2010BLKTRACT: varchar2 (6) RT_TAB2010BLK: varchar2 (6) Geocode Block Fields for Automated Geocoding by GEO (RT_MATCH_STATUS=3 or 5): RT_AG_TAB2010BLKST: varchar2 (2) RT_AG_TAB2010BLKCOU: varchar2 (3) RT_AG_TAB2010BLKTRACT: varchar2 (6) RT_AG_TAB2010BLK: varchar2 (6) rt_match_status: NUM (1) 1 = Matched to a MTdb Record with an Acceptable Geocode; 2 = Matched to a MTdb record with an Unacceptable Geocode; 3 = Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode; 4 = Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode; 5= Did Not Match to a MTdb Record, And Received an Acceptable Geocode; 0 = Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode RT_MAFID: NUM (9) RT_MATCH_QUALITY: varchar2 (1) Matched Record from Real-Time: 0=Did Not Match 1=Exact Match 2=Equivocated Match RT_MATCH_PREFERRED: varchar2 (1) Matched Record from Real-Time: 0=Did not match 1=Matched to preferred location address record 2=Matched to preferred mailing address record 3=Matched to preferred location and preferred mailing record RT_MATCH_EXCLUDED: varchar2 (1) Matched Record from Real-Time: 0=Not excluded from matching 1=Illegal or missing values 2=Incomplete address 3=Duplicate CUSTID 4=Matched to ineligible MTdb record address_standardization _confirmation_previous: NUM1 (0=Previous and 1=Next) address_standardization _confirmation_next: NUM1 (0=Previous and 1=Next)
Data Needed	Standardized address from GEO parsed into the correct fields.
Universe	Respondents who entered address information on the 4.7 Residence screen, and are ADDR_TYPE=1 (Street).
Question Wording	Here is the address you submitted, using standard abbreviations and formatting: Please review your address for common errors, such as misspellings in the street name or city names, missing apartment numbers, or an incorrect ZIP Code. [Display standardized version of the address, all capitals, using data from the standardized fields] Is the address above correct?
Response Options	Yes No
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.”
Branching	Once GEO delivers the standardized street address, Centurion places the delivered data into the standardized street address and general address fields, and displays the standardized address to the respondent. There is no need to display the county field called “RT_HC_SA_COUNTY.” If the respondent selects “Yes,” and presses “Next” and the ZIP Code is inside the universe of 2016 CT ZIP Codes provided by GEO, then Centurion retains the standardized address and notifies GEO to use this version for address matching and geocoding. If the respondent selects “Yes,” and presses “Next” and the ZIP Code is outside the universe of 2016 CT ZIP Codes provided by GEO, then Centurion retains the standardized address; real-time matching and geocoding is not engaged. And if ADDR_TYPE = “Street Address,” goto DASHBOARD. Else if ADDR_TYPE = “Rural Route” or “P.O. Box,” goto RESIDENCE_PHYS If the respondent selects “No,” and presses “Next,” then Centurion takes the respondent back to RESIDENCE with the address fields pre-populated with the respondent’s original input address (for editing). THIS IS TO BE DONE ONLY ONCE. If the respondent selects “No,” and then presses “Next” a second time, then Centurion retains the standardized address and notifies GEO to use this version for address matching and geocoding. If the respondent selects neither “Yes” nor “No” and presses “Next,” then prompt the respondent with the Edit/Error message above (“Please provide an answer to the question”). If the respondent clicks on “Next” a second time, then Centurion retains the standardized address and notifies GEO to use this version for address matching and geocoding. If the respondent had selected “No” and clicked “Next” and updated the address on the RESIDENCE screen, then Centurion retains the standardized address and notifies GEO to use this version for address matching and geocoding. Branching Instructions for Matching/Geocoding: Once GEO finishes processing the standardized address, one of four match status flags will be returned to Centurion: If Centurion receives rt_match_status=1 (Matched to a Geocoded MTdb Record), then Centurion will: 1) Send the matched standardized address information to UCRM; 2) Send the RT_TAB* geocode information received back from GEO to UCRM; 3) Send the following variables to UCRM; RT_MAFID RT_MATCH_STATUS RT_MATCH_QUALITY RT_MATCH_PREFERRED RT_MATCH_EXCLUDED; 5) Send the original respondent address information (before standardization) to UCRM; and 6) Go to the DASHBOARD so the respondent may continue the questionnaire; Else if Centurion receives rt_match_status=2 (Matched to a MTdb record with an Unacceptable Geocode), then the RT_TAB* geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if Centurion receives rt_match_status=3 (Matched to a Ungeocoded MTdb Record, And Received an Acceptable Geocode), then the RT_AG_TAB* geocode information sent from GEO must be populated. Go to WEBMAP INTERFACE screen; Else if Centurion receives rt_match_status=4 (Matched to a MTdb Record, But Did Not Receive an Acceptable Geocode), then no geocode block information will be populated. Go to WEBMAP INTERFACE screen; Else if Centurion receives rt_match_status=5 (Did Not Match to a MTdb Record, And Received an Acceptable Geocode), then the RT_AG_TAB* geocode information sent from GEO must be populated. Go back to RESIDENCE screen so that the respondent can fix the address, as necessary. If the respondent address receives a RT_MATCH_STATUS of “0” or “5” and is ADDR_TYPE of “1,” then send the respondent to WEBMAP INTERFACE screen; Else if Centurion receives rt_match_status=0 (Did Not Match to a MTdb Record, And Did Not Receive an Acceptable Geocode), then no geocode block information will be populated . Go back to RESIDENCE screen so that the respondent can fix the address, as necessary. If the respondent address receives a RT_MATCH_STATUS of “0” and is ADDR_TYPE of “1,” then send the respondent to WEBMAP INTERFACE screen; or if the respondent address receives a RT_MATCH_STATUS of “5,” and is ADDR_TYPE of “1,” then send the respondent to WEBMAP INTERFACE screen (along with the RT_AG_TAB* geocode information sent from GEO).
Help Text link	ADDRESS STANDARDIZATION
Special Instructions	This can be done as a modal popup window. There is no need to display the county field called “RT_HC_SA_COUNTY.” However, ASD must populate that field when GEO returns the value for RT_HC_SA_COUNTY.

Screen Name	RESIDENCE_PHYS
Field Names	Physical Description Field ADDR_DESC_LINE1: varchar2 (250)
Data Needed
Universe	RESIDENCE ADDR_TYPE=2 (Rural Route) or ADDR_TYPE=3 (P.O. Box).
Question Wording	Please describe the physical location of where you <FILL1> living on <REFDATE>. Please provide as much information as possible, including city, state and zip code. (Help) For example: a location description such as "The apartment over the gas station in Selma, CA" or "The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD 20746"; or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: "Friendship Park, Paoli, PA." Note: If you have a street address associated with your residence, such as one you would provide to have a package delivered to your home, please go to the previous screen to enter the street address.
Question Wording Fills	FILLS: If the current date is before REFDATE then FILL1 = will be If the current date is on or after REFDATE then FILL1 = were
Response Options	Physical Location: 250-character text area
Response Options Fills
Edits/Errors	For P.O. Boxes and Rural Routes, if “Physical Location” is blank, provide a single error message that says: “Please provide a physical location according to the guidelines above the text box.” However, because Physical Location is not required for a valid response, after one edit, the instrument shall allow the respondent to select the “Next” button and move to the 4.11 P.O. Box Address Standardization Confirmation screen (if a P.O. Box Address) or 4.12 Rural Route Address Standardization Confirmation screen (if a Rural Route Address).
Branching	If the respondent presses ‘Previous’ then Centurion takes the respondent back to the appropriate address type screen (ADDR_TYPE=2 or 3) so that the respondent can choose a Street Address type (ADDR_TYPE=1) . Rural Route Addresses (ADDR_TYPE=2) and P.O. Box Addresses (ADDR_TYPE=3) If “Next” is pressed and the Address Type is Rural Route (ADDR_TYPE=2) or P.O. Box (ADDR_TYPE=3) and the response is valid (according to the parameters above), and ZIP Code is outside the universe of 2016 CT ZIP Codes provided by GEO, then go to the 5.2 Respondent screen. If “Next” is pressed and the Address Type is Rural Route (ADDR_TYPE=2) or P.O. Box (ADDR_TYPE=3) and the response is valid (according to the parameters above), and ZIP Code is inside the universe of 2016 CT ZIP Codes provided by GEO, then go to the 4.15 Web Map Interface for Ungeocoded Cases screen.
Help Text link	RESIDENCE_PHYS
Special Instructions

Screen Name	WEBMAP INTERFACE
Field Names	Geocode Block Fields for Unacceptable Geocodes Captured During MTdb Matching (Not via Automated Geocoding); This is for RT_MATCH_STATUS=2 Cases: RT_TAB2010BLKST: varchar2 (2) RT_TAB2010BLKCOU: varchar2 (3) RT_TAB2010BLKTRACT: varchar2 (6) RT_TAB2010BLK: varchar2 (6) General Address Fields for Standardized Street Addresses RT_HC_SA_CITY: varchar2 (16) RT_HC_SA_STATE: varchar2 (2) RT_HC_SA_UPZIP: varchar2 (5) General Address Fields for Standardized P.O. Box Addresses RT_HC_PO_CITY: varchar2 (16) RT_HC_PO_STATE: varchar2 (2) RT_HC_PO_UPZIP: varchar2 (5) General Address Fields for Standardized Rural Route Addresses RT_HC_RR_CITY: varchar2 (16) RT_HC_RR_STATE: varchar2 (2) RT_HC_RR_UPZIP: varchar2 (5) General County Name Field for Standardized Addresses (All Types) RT_HC_SA_COUNTY: varchar2 (16) Geocode Block Fields for Automated Geocoding: RT_AG_TAB2010BLKST: varchar2 (2) RT_AG_TAB2010BLKCOU: varchar2 (3) RT_AG_TAB2010BLKTRACT: varchar2 (6) RT_AG_TAB2010BLK: varchar2 (6) Geocode Block Fields for Respondent Geocoding : RESG_TAB2010BLKST: varchar2 (2) RESG_TAB2010BLKCOU: varchar2 (3) RESG_TAB2010BLKTRACT: varchar2 (6) RESG_TAB2010BLK: varchar2 (6) Automated Geocode Respondent Confirmation Status Flag: RT_AG_RES_CONFIRM: varchar2 (1) (Y=Yes, Area Confirmed; N=No, Respondent Chose New Block Geocode; 0=Cannot Locate Area)
Data Needed	Geocode data (RT_TAB; RT_AG_ ; RESG_ *). TIGER spatial data
Universe	Address Type=1 (Street) and RT_MATCH_STATUS=0, 2, 3, 4, 5 OR Address Type=2 (Rural Route) OR Address Type=2 (P.O. Box)
Question Wording	<FILL1> Otherwise, mark the “Cannot Locate Area” checkbox at the bottom of the page, then continue to the next page. NOTE: New roads, especially those that are part of a new development, may not appear on the map. In these cases, click and highlight the area you believe contains your address, then click continue to the next page.
Question Wording Fills	<FILL1> (If Address Type=1 (street) and RT_MATCH_STATUS=2,3,5): Please review the highlighted area. If you agree that your address is located within that highlighted area, then continue to the next page. If you believe that your address is not in the highlighted area, use the map below to zoom in and find your address location at the street level. Once you have navigated to the street level, please select the area and ensure that your address is located in the highlighted block. (If Address Type=1 (street) and RT_MATCH_STATUS=0,4) or Address Type =2, 3: Please use the map below to zoom in and find your address location at the street level. Once you have navigated to the street level, please select the area and ensure that your address is located in the highlighted block.
Response Options	Checkbox • Cannot Locate Area Using the spatial tools found on the map.
Response Options Fills
Edits/Errors	If ‘Next’ is clicked without a selected block or the Cannot Locate Area checkbox is left unselected: Display message “You must click on an area on the map or the Cannot Locate Area checkbox, then continue to the next page.”
Branching	Goto DASHBOARD
Help Text link	WEBMAP
Special Instructions	The following pieces are needed to be considered a valid response: Clicking on the map and highlighting a block OR Clicking on the “Cannot Locate Area” checkbox; AND Clicking on the “Next” button. For geocoded cases, if the respondent clicks on another area, then clicks on the “Cannot Locate Area” checkbox, RT_TAB* or RT_AG* should remain filled and RESG_* should remain blank. The web map interface needs maximum space on the screen in order to fully utilize the mapping functionality. Instrument must allow a default (i.e., “Start Over”) button which resets the map to the original view (i.e., undoes any zooming and panning) that was provided to the respondent.

Roster

Screen Name	RESPONDENT
Field Names	resp_name_first: CHAR 20 resp_name_middle CHAR 20 resp_name_last CHAR 20 resp_phone_area: NUM 3 resp_phone_num1: NUM 3 resp_phone_num2: NUM 4 email1: CHAR 50 email2: CHAR 50
Data Needed	None
Universe	VERIFY ADDRESS=yes Valid address provided in NON_ID ADDRESS BLOCK
Question Wording	What is your name, phone number, and email address? We will only contact you if needed for official Census Bureau business. (Help)
Question Wording Fills	N/A
Response Options	Name First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Phone Number (separate by a hyphen with auto-tabbing) Telephone Number: two 3-digit numeric text boxes and a 4-digit numeric text box Enter email address: 50-character text box Confirm email address: 50-character text box
Response Options Fills	N/A
Edits/Errors	If there are fewer than 3 characters in the name fields combined and the next button is selected: First time: “Please provide your name. If you prefer not to provide your name, please provide a nickname or description so that you will know who each question refers to.” Name boxes should be bolded and highlighted in yellow. Second time: “Your name is required to continue the survey. If you prefer not to provide your name, please provide a nickname or description.” Name boxes should be bolded and highlighted in yellow. If the two email addresses provided do not match, leave both entries and display the following message: “Your responses do not match. Please try again.” Email fields must contain “@” and “.” in the field. If either (or both) is missing, display soft edit message: “Please enter a valid email address. It must be in the format: [email protected].”
Branching	If fewer than 3 characters in the name field and third time “next” is selected, go to NOCOMPLETE. Else if INTERNET_ROSTER =1, 2, go to POPCOUNT. Else if INTERNET_ROSTER = 3, go to OTHERS.
Help Text link	RESPONDENT
Special Instructions	There should be a non-case sensitive confirmation check to make sure both email addresses match.

Screen Name	POPCOUNT
Field Names	popcount: NUM2
Data Needed	<ADDRESS> <REFDATE>
Universe	RESPONDENT and INTERNET_ROSTER=1,2
Question Wording	If INTERNET_ROSTER=1: Count the people who live at <ADDRESS> using our guidelines. We need to count people where they usually live and sleep For people with more than one place to live, we need to count them at the place where they sleep most of the time Do NOT include these people: College students who live away from <ADDRESS> most of the year Armed forces personnel who live away People who, on <REFDATE>, <FILL1> in a nursing home, mental hospital, jail, prison, detention center, etc. DO include these people: Babies and children living at <ADDRESS>, including foster children Roommates Boarders People staying at <ADDRESS> on <REFDATE> who have no permanent place to live On <REFDATE>, how many people <FILL2> living or staying at <ADDRESS>, including yourself? (Help) If INTERNET_ROSTER=2: On < REFDATE >, how many people <FILL3> living or staying at <ADDRESS>, including yourself?
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” <FILL2> = “will be” <FILL3> = “will be” If current date is on or after REFDATE, then <FILL1> = “were” <FILL2> = “were” <FILL3> = “were”
Response Options	One 2-digit numerical text box.
Response Options Fills	N/A
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.” Soft edit if 0 is entered: “Please include yourself when reporting the number of people.” Soft edit if any non-numeric characters are entered: “Please enter a number between 1 and 49.”
Branching	If POPCOUNT=1 and INTERNET_UNDERCOUNT=0, goto HOME. If POPCOUNT=1 and INTERNET_UNDERCOUNT=1, goto ADD_PPL. If POPCOUNT=1 and INTERNET_UNDERCOUNT=2, goto UC2. Else, goto PEOPLE.
Help Text link	POPCOUNT
Special Instructions

Screen Name	OTHERS
Field Names	others_yes: NUM1 (0=not selected and 1=selected) others_no: NUM1 (0=not selected and 1=selected)
Data Needed	<ADDRESS> <REFDATE>
Universe	RESPONDENT and INTERNET_ROSTER=3
Question Wording	On <REFDATE>, <FILL1> anyone else besides you living or staying at <ADDRESS>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will there be” If current date is on or after REFDATE, then <FILL1> = “was there”
Response Options	Radio Buttons Yes No
Response Options Fills	N/A
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.”
Branching	If “yes” or (blank and INTERNET_UNDERCOUNT=0), goto PEOPLE. If (“no”) and INTERNET_UNDERCOUNT=0, goto HOME. If (“no” or blank) and INTERNET_UNDERCOUNT=1, goto ADD_PPL. If (“no” or blank) and INTERNET_UNDERCOUNT=2, goto UC2.
Help Text link	PEOPLE
Special Instructions

Screen Name	PEOPLE
Field Names	ppl_name_first: CHAR 20 ppl_name_middle: CHAR 20 ppl_name_last: CHAR 20
Data Needed	<ADDRESS> <REFDATE> Name from RESPONDENT If INTERNET_ROSTER =1,2 need POPCOUNT response
Universe	POPCOUNT<>1 OTHERS=yes, blank
Question Wording	What is the name of each person who <FILL1> living or staying at <ADDRESS> on <REFDATE>? (Help) Enter names until you have listed everyone who <FILL2> living or staying there, then continue to the next page. The names listed so far are: <RESPONDENT NAME>
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be” <FILL2> = “will be” If current date is on or after REFDATE, then <FILL1> = “was” <FILL2> = “was”
Response Options	Name First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Click here to add more people
Response Options Fills	N/A
Edits/Errors	If all fields are blank and “next” is selected: First time: “Please provide an answer to the question. Listing names helps to make sure that everyone in your household is included and no one is listed twice. If you prefer not to provide names, please provide nicknames or descriptions so that you will know who each question refers to.” Name boxes should be bolded and highlighted in yellow Second time: A list of household members is required to continue the survey. If you prefer not to provide names, please provide nicknames or descriptions so that you will know who each question refers to. Name boxes should be bolded and highlighted in yellow . If INTERNET_ROSTER=1,2 and POPCOUNT <> number of names provided and POPCOUNT (1-49), display a soft edit: Earlier, you said that the number of people living or staying at <ADDRESS> <FILL1> <POPCOUNT>, but you have listed a name for <PERSONCOUNT> <FILL2>. Please review the people you have listed.
Edits/Errors Fills	If current date is before REFDATE, then <FILL1> = “will be” If current date is on or after REFDATE, then <FILL1> = “was” If PERSONCOUNT=1 <FILL2>=“person” If PERSONCOUNT=(2-49) <FILL2>=“people”
Branching	If all fields are blank and “next” is selected for a third time, goto NOCOMPLETE. Else if there are 49 people on the roster, including the respondent, goto HOME. Else if there are at least 3 characters for any name and INTERNET_UNDERCOUNT=0, goto HOME. Else if there are at least 3 characters for any name and INTERNET_UNDERCOUNT=1, goto ADD_PPL. Else if there are at least 3 characters for any name and INTERNET_UNDERCOUNT=2, goto UC2.
Help Text link	PEOPLE
Special Instructions	Set PERSONCOUNT = total number of names on the roster, including respondent. Display the name from RESPONDENT above the response boxes. Display fields for 6 names at a time. Add 6 more fields if “Click here to add more people” is selected.

Undercount Screens

Screen Name	ADD_PPL
Field Names	add_ppl_yes: NUM1 (0=not selected and 1=selected) add_ppl_no: NUM1 (0=not selected and 1=selected) add_ppl_name_first: CHAR 20 add_ppl_name_middle: CHAR 20 add_ppl_name_last: CHAR 20
Data Needed	<ADDRESS> <REFDATE> ROSTER (all names from PEOPLE and RESPONDENT)
Universe	PERSONCOUNT<49 and INTERNET_UNDERCOUNT=1
Question Wording	We do not want to miss any people who might <FILL1> at <ADDRESS> around <REFDATE>. <FILL2> any additional people who you did not already list? For example: Babies? Foster children? Any other relatives? Roommates or people not related to you? The names listed so far are: <NAMES FROM RESPONDENT AND PEOPLE>
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “be staying” <FILL2> = “Will there be” If current date is on or after REFDATE, then <FILL1> = “have stayed” <FILL2> = “Were there”
Response Options	Radio Buttons Yes No IF YES, display: Enter Name: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Click here to add more people
Response Options Fills	N/A
Edits/Errors	If missing a yes/no response: “Please answer “Yes” or “No.” If the answer is “Yes,” please provide the name of that person.
Branching	If <PERSONCOUNT>=49, goto HOME. Else, goto ADD_NOPERM.
Help Text link	ADD_PPL
Special Instructions	The name boxes should only appear when “Yes” is selected. If the respondent clicks “No” (removing a “Yes” entry), the name boxes should disappear. When “Yes” is selected, one set of name boxes should appear. One additional set of name boxes should appear when “Click here to add more people” is selected. Increment <PERSONCOUNT> for each name added on ADD_PPL. If <PERSONCOUNT>=49, remove the “Click here to add more people” link. If the name field is left blank, there is no edit message.

Screen Name	ADD_NOPERM
Field Names	add_noperm_yes: NUM1 (0=not selected and 1=selected) add_noperm_no: NUM1 (0=not selected and 1=selected) add_noperm_name_first: CHAR 20 add_noperm_name_middle: CHAR 20 add_noperm_name_last: CHAR 20
Data Needed	<ADDRESS> <REFDATE> ROSTER (all names from PEOPLE, RESPONDENT, and ADD_PPL)
Universe	PERSONCOUNT<49 and INTERNET_UNDERCOUNT=1
Question Wording	<FILL1> anyone else staying at <ADDRESS> on <REFDATE> who <FILL2> no permanent place to live? The names listed so far are: <NAMES FROM RESPONDENT, PEOPLE, AND ADD_PPL>
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “Will there be” <FILL2> = “has” If current date is on or after REFDATE, then <FILL1> = “Were there” <FILL2> = “had”
Response Options	Radio Buttons Yes No IF YES, display: Enter Name: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Click here to add more people
Response Options Fills	N/A
Edits/Errors	If missing a yes/no response: “Please answer “Yes” or “No.” If the answer is “Yes,” please provide the name of that person.
Branching	Goto HOME.
Help Text link	ADD_NOPERM
Special Instructions	The name boxes should only appear when “Yes” is selected. If the respondent clicks “No” (removing a “Yes” entry), the name boxes should disappear. When “Yes” is selected, one set of name boxes should appear. One additional set of name boxes should appear when “Click here to add more people” is selected. Increment <PERSONCOUNT> for each name added on ADD_NOPERM. If <PERSONCOUNT>=49, remove the “Click here to add more people” link. If the name field is left blank, there is no edit message.

Screen Name	UC2
Field Names	add_uc2_yes: NUM1 (0=not selected and 1=selected) add_uc2_no: NUM1 (0=not selected and 1=selected) add_uc2_name_first: CHAR 20 add_uc2_name_middle: CHAR 20 add_uc2_name_last: CHAR 20
Data Needed	<ADDRESS> <REFDATE> ROSTER (all names from PEOPLE and RESPONDENT)
Universe	PERSONCOUNT<49 and INTERNET_UNDERCOUNT=2
Question Wording	We do not want to miss any people who might <FILL1> at <ADDRESS> around <REFDATE>. <FILL2> any additional people who you did not already list? For example: Babies? Foster children? Any other relatives? Roommates or people not related to you? People who have no permanent place to live? The names listed so far are: <NAMES FROM RESPONDENT AND PEOPLE>
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “be staying” <FILL2> = “Will there be” If current date is on or after REFDATE, then <FILL1> = “have stayed” <FILL2> = “Were there”
Response Options	Radio Buttons Yes No IF YES, display: Enter Name: First Name: 20-character text box Middle Name: 20-character text box Last Name: 20-character text box Click here to add more people
Response Options Fills	N/A
Edits/Errors	If missing a yes/no response: “Please answer “Yes” or “No.” If the answer is “Yes,” please provide the name of that person.
Branching	Goto HOME
Help Text link	UC2
Special Instructions	The name boxes should only appear when “Yes” is selected. If the respondent clicks “No” (removing a “Yes” entry), the name boxes should disappear. When “Yes” is selected, one set of name boxes should appear. One additional set of name boxes should appear when “Click here to add more people” is selected. Increment <PERSONCOUNT> for each name added on UC2. If <PERSONCOUNT>=49, remove the “Click here to add more people” link. If the name field is left blank, there is no edit message.

Tenure

Screen Name	HOME
Field Names	tenure_wmor: NUM1 (0=not selected and 1=selected) tenur_nomor: NUM1 (0=not selected and 1=selected) tenure_rent: NUM1 (0=not selected and 1=selected) tenure_nopymt: NUM1 (0=not selected and 1=selected)
Data Needed
Universe	All eligible households
Question Wording	On <REFDATE>, <FILL1> the house, apartment, or mobile home at <ADDRESS> <FILL2>– (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will” <FILL2> = “be” If current date is on or after REFDATE, then <FILL1> = “was” <FILL2> = blank
Response Options	Radio Buttons Owned by you or someone in this household with a mortgage or loan? Include home equity loans. Owned by you or someone in this household free and clear (without a mortgage or loan)? Rented? Occupied without payment of rent?
Response Options Fills	N/A
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If Roster size = 1, goto DASHBOARD Else if “Occupied without payment of rent” or blank, goto DASHBOARD. Else goto OWNER.
Help Text link	HOME
Special Instructions	If “Occupied without payment of rent” set <REF NAME> = Person 1.

Screen Name	OWNER
Field Names	For each person selected: NUM1 (0=not selected and 1=selected) Owner_None: NUM1 (0=not selected and 1=selected)
Data Needed	Roster names
Universe	Roster size >1 AND HOME = “Owned by you or someone in this household with a mortgage or loan” or “Owned by you or someone in this household free and clear” or “Rented”
Question Wording	Of the people who <FILL1> at <ADDRESS>, who <FILL2>the house, apartment, or mobile home on <REFDATE>? (Help)
Question Wording Fills	If current date is before REFDATE, then <FILL1> = “will be living” If HOME=Rented, <FILL2> = “will rent” Else, <FILL2> = “will own” If current date is on or after REFDATE, then <FILL1> = “lived” If HOME=Rented, <FILL2> = “rented” Else, <FILL2> = “owned”
Response Options	Check boxes where each name from the roster is assigned to a check box. Also, include a box for “None of the above”.
Response Options Fills	N/A
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	Goto DASHBOARD
Help Text link	OWNER
Special Instructions	This question is used to select the reference person for the remainder of the survey: If one person is selected, that person is the reference person. If multiple people are selected, the first person listed - of those selected people - becomes the reference person. If "None of the above" is selected, the reference person is the first person on the list. If the respondent selects "None of the above" and any number of names, the reference person is the first (or only) person listed, that was selected. If the respondent does not provide a selection (nonresponse), the reference person is the first person on the list.

Demographics

Screen Name	RELATIONSHIP
Field Names	rel1_oppspouse: NUM1 (0=not selected and 1=selected) rel1_opppartner: NUM1 (0=not selected and 1=selected) rel1_samespouse: NUM1 (0=not selected and 1=selected) rel1_samepartner: NUM1 (0=not selected and 1=selected) rel1_biosondau: NUM1 (0=not selected and 1=selected) rel1_adopted: NUM1 (0=not selected and 1=selected) rel1_stepsondau: NUM1 (0=not selected and 1=selected) rel1_brosis: NUM1 (0=not selected and 1=selected) rel1_dadmom: NUM1 (0=not selected and 1=selected) rel1_grandch: NUM1 (0=not selected and 1=selected) rel1_pinlaw: NUM1 (0=not selected and 1=selected) rel1_sdinlaw: NUM1 (0=not selected and 1=selected) rel1_othrel: NUM1 (0=not selected and 1=selected) rel1_roomer: NUM1 (0=not selected and 1=selected) rel1_housemate: NUM1 (0=not selected and 1=selected) rel1_foster: NUM1 (0=not selected and 1=selected) rel1_othrnonrel: NUM1 (0=not selected and 1=selected)
Data Needed	REFERENCE PERSON NAME# INTERNET_RELATION flag
Universe	PERSONCOUNT=(1-49) who aren’t the reference person
Question Wording	Next, we need to record each person’s relationship to <REF NAME>. <NAME#> is <REF NAME>’s ... (Help)
Response Options	If INTERNET_RELATIONSHIP=1, display 17 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 If INTERNET_RELATIONSHIP=2, display 16 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 Housemate/roommate Foster child Other nonrelative If INTERNET_RELATIONSHIP=3, display 15 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 Foster child Other nonrelative
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.”
Branching	Goto SEX
Help Text link	RELATIONSHIP
Special Instructions	This screen is not displayed for single-person households. This screen is not displayed for the reference person.

Screen Name	SEX
Field Names	sex_male: NUM1 (0=not selected and 1=selected) sex_female: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-49)
Question Wording	What is <NAME#>’s sex? (Help)
Response Options	Radio Buttons Male Female
Edits/Errors	Soft edit for no response: “Please provide an answer to the question.” Rel/sex Edit: If RELATIONSHIP = (“Opposite-sex husband/wife/spouse” or “Opposite-sex unmarried partner”) AND [(SEX=”Male” AND SEX of Reference Person = “Male”) OR (SEX=”Female” AND SEX of Reference Person = “Female”)] OR If RELATIONSHIP= (“Same-sex husband/wife/spouse” or “Same-sex unmarried partner”) AND [(SEX=”Male” AND SEX of Reference Person = “Female”) OR (SEX=”Female” AND SEX of Reference Person = “Male”)] Display “Please confirm that your answers are correct. <NAME#> is recorded as <REFPER>’s <RELATIONSHIP>. Is that correct?” Yes – (If yes, display next question) No – (If no, goto RELATIONSHIP to allow edit) Display “<REFPER> is recorded as <REFPER SEX>. Is that correct? Yes – (If yes, display next question) No – (If no, goto SEX of Reference person to allow edit) Display “I recorded that <NAME#> is <SEX>. Is that correct? Yes – (If yes, goto DOB) No – (If no, goto SEX of current person to allow edit) If RELATIONSHIP= (“Same-sex husband/wife/spouse” or “Same-sex unmarried partner”) AND SEX
Branching	Goto DOB
Help Text link	SEX
Special Instructions

Screen Name	DOB
Field Names	dob_month: NUM 2 dob_day: NUM 2 dob_year: NUM 4 age: CHAR 3 calc_age: CHAR 3
Data Needed	NAME#
Universe	PERSONCOUNT=(1-49)
Question Wording	What is <NAME#>’s date of birth? (Help) Verify or enter correct age as of <REFDATE>. For babies less than 1 year old, do not enter the age in months. Enter 0 as the age.
Response Options	Month drop down box containing only the name of the month (i.e., January, February, etc.) in chronological order. Day drop down box containing: 01-31 as the default if no month is selected 01-30 if month = April, June, September, or November 01-31 if month = January, March, May, July, August, October, December 01-29 if month = February Year drop down box: Starts with <current year> and goes to <current year – 126>. Age: One 3-character alphanumeric text box.
Edits/Errors	The following errors are only served after the first input. If errors are made again, no edits are given. If only DAY is missing and Month ≠ <REFDATE MONTH> No error is displayed. Red Edit Messages If DOB (or Confirm DOB) is later than <REFDATE>. Display the message “Please check the date of birth. This date is after <REFDATE>.” If DOB (or Confirm DOB) is out of the range 18900402 – 20160401 Display the message “Please check the date of birth. This date is out of range.” If DOB(or Confirm DOB) is invalid Check if the date is a “valid” date. If it is not a “valid” date, display the message “Please check the date of birth. There is no such date.” Note: A date is “valid” if the day is between 01 and 31 for the months of January, March, May, July, August, October, and December; or between 01 and 30 for the months of April, June, September, and November; or between 01 and 29 for February when the year is divisible by 4 except 1900 (i.e., 2016, 2012, 2008, 2004, 2000, 1996, 1992, 1988, 1984, 1980, etc.); or between 01 and 28 for February when the year is not divisible by 4 (or if the year is 1900). If age is outside of the 0-125 range Display: “Please enter an age between 0 and 125. If you do not know the exact age, provide an estimate.” If age auto-calculates to <0 (for DOB>4/1/2016) or >125 (for DOB<4/2/1890) Display: blank (no age) in the age box along with this error message stacked under the out of range DOB error message: “Please enter an age between 0 and 125. If you do not know the exact age, provide an estimate.” Green Edit Messages If DOB (or Confirm DOB) is totally blank or Month and/or Year are missing or month of birth is reference date month (<REFMONTH>) while day is missing AND age is blank: Display: “Please provide a complete date of birth. If you do not know it, provide what you know. Then enter or confirm age as of <REFDATE>. Estimated ages are acceptable.” Missing data fields for DOB and age should be highlighted in yellow. If DOB (or ConfirmDOB) is totally blank or Month and/or Year are missing or month of birth is reference date month (<REFMONTH>) while day is missing AND age is provided in range(0-125) “Please provide a complete date of birth. If you do not know it, provide what you know. Then enter or confirm age as of <REFDATE>.” Missing data fields for DOB should be highlighted in yellow. If age is blank while complete in range (18900402-20160401) date of birth (or ConfirmDOB) is provided “Please enter an age as of <REFDATE>. If you do not know the exact age, provide an estimate.” Age box should be highlighted in yellow. If a non-numeric character is entered in AGE: "Please provide age in completed years as of < REFDATE >. Do not round up. Do not enter age in months. For babies less than 1 year old enter 0 as the age."
Branching	Goto RACE.
Help Text link	DOB
Special Instructions	In the Day of Birth drop down for February, the range for February days depends upon whether the year is a leap year. 1-28 when February and year is 1900 or not divisible by 4. 1-29 when February and year is divisible by 4 and not 1900. Currently, the instrument will remove "29" if a respondent selects "February" and a non-leap year. For example, if I chose Feb 29 for the month and day on the instrument. If I then choose a non-leap year for the year, the 29 becomes "DAY" (i.e., blank). After a date of birth has been entered, determine whether age can be calculated. If so, calculate the age and pre-fill it in the age answer space. Allow the respondent to change the number. Calculate the Age if: 1. there is a Month and Year of birth, and the Year is between {current year – 126} and current year, and the Month is not reference day month (<REFMONTH >); or 2. there is a Month and Year of birth, and the Year is between {current year – 126} and current year, and the Month is reference day month (<REFMONTH >), and there is a valid entry for Day. Note that the final output on the URdbS is numeric only. While we do want the Internet instrument to allow alphanumeric entries, any entries with alpha or symbol characters will be deleted from the final response data.

Screen Name	RACE
Field Names	race_white_cb: NUM1 (0=not selected and 1=selected) race_hisp_cb: NUM1 (0=not selected and 1=selected) race_black_cb: NUM1 (0=not selected and 1=selected) race_asian_cb: NUM1 (0=not selected and 1=selected) race_aian_cb: NUM1 (0=not selected and 1=selected) race_mena_cb: NUM1 (0=not selected and 1=selected) race_nhopi_cb: NUM1 (0=not selected and 1=selected) race_sor_cb: NUM1 (0=not selected and 1=selected)
Data Needed	NAME#
Universe	PERSONCOUNT=(1-49)
Question Wording	Which categories describe <NAME#>? (Help) Select all boxes that apply. Note, you may report more than one group.
Response Options	Checkbox Responses White For example, German, Irish, English, Italian, Polish, French, etc. Hispanic, Latino, or Spanish For example, Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc. Black or <FILL1> For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. Asian For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. American Indian or Alaska Native For example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. Middle Eastern or North African For example, Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, etc. Native Hawaiian or Other Pacific Islander For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc. Some other race, ethnicity, or origin
Response Options Fills	<FILL1> If INTERNET_ AFRAM=1, Display: African Am. If INTERNET_AFRAM=2, Display: African American
Edits/Errors	If blank, display in red with the “x” icon: “Please provide a response.”
Branching	If RACE = “White” goto WHITE Else if RACE = “Hispanic” goto HISPANIC Else if RACE = “Black” goto BLACK Else if RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	WHITE
Field Names	race2_german: NUM1 (0=not selected and 1=selected) race2_irish: NUM1 (0=not selected and 1=selected) race2_english: NUM1 (0=not selected and 1=selected) race2_italian: NUM1 (0=not selected and 1=selected) race2_polish: NUM1 (0=not selected and 1=selected) race2_french: NUM1 (0=not selected and 1=selected) race2_white_oth: NUM1 (0=not selected and 1=selected) race2_white _desc: CHAR 200
Data Needed	NAME#
Universe	RACE = “White” RACE
Question Wording	For person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific WHITE categories? Select all boxes that apply and/or enter details in the space below. Note, you may report more than one group. (Help)
Response Options	Radio Buttons German Irish English Italian Polish French Enter, for example, Scottish, Norwegian, Dutch, etc. {display 200-character textbox}
Edits/Errors	If nothing is checked or written into a box, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “Hispanic” goto HISPANIC Else if RACE = “Black” goto BLACK Else if RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	HISPANIC
Field Names	race2_mexican: NUM1 (0=not selected and 1=selected) race2_pr: NUM1 (0=not selected and 1=selected) race2_cuban: NUM1 (0=not selected and 1=selected) race2_salvadoran: NUM1 (0=not selected and 1=selected) race2_dominican: NUM1 (0=not selected and 1=selected) race2_colombian: NUM1 (0=not selected and 1=selected) race2_hisp_oth: NUM1 (0=not selected and 1=selected) race2_hisp_desc: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “Hispanic, Latino, or Spanish”
Question Wording	If Person 1 RACE <> White, for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific HISPANIC, LATINO, OR SPANISH categories? Select all boxes that apply and/or enter details in the space below. Note, you may report more than one group. (Help)
Response Options	Radio Buttons Mexican or Mexican American Puerto Rican Cuban Salvadoran Dominican Colombian Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. {display 200-character textbox}
Edits/Errors	If nothing is checked or written into a box, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “Black” goto BLACK Else if RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	BLACK
Field Names	race2_afram: NUM1 (0=not selected and 1=selected) race2_ jamaican: NUM1 (0=not selected and 1=selected) race2_ haitian: NUM1 (0=not selected and 1=selected) race2_nigerian: NUM1 (0=not selected and 1=selected) race2_ethiopian: NUM1 (0=not selected and 1=selected) race2_somali: NUM1 (0=not selected and 1=selected) race2_black_oth: NUM1 (0=not selected and 1=selected) race2_black_desc: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “Black or African American”
Question Wording	If Person 1 RACE <> (White, Hispanic), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific BLACK OR <FILL1> categories? Select all boxes that apply and/or enter details in the space below. Note, you may report more than one group. (Help)
Question Wording Fills	<FILL1> If INTERNET_RACE_AFRAM=1, Display: AFRICAN AM. If INTERNET_RACE_AFRAM=2, Display: AFRICAN AMERICAN
Response Options	Radio Buttons African American Jamaican Haitian Nigerian Ethiopian Somali Enter, for example, Ghanaian, South African, Barbadian, etc. {display 200-character textbox}
Edits/Errors	If nothing is checked or written into a box, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “Asian” goto ASIAN Else if RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	ASIAN
Field Names	race2_chinese: NUM1 (0=not selected and 1=selected) race2_filipino: NUM1 (0=not selected and 1=selected) race2_asianindian: NUM1 (0=not selected and 1=selected) race2_vietnamese: NUM1 (0=not selected and 1=selected) race2_korean: NUM1 (0=not selected and 1=selected) race2_japanese: NUM1 (0=not selected and 1=selected) race2_asian_oth: NUM1 (0=not selected and 1=selected) race2_asian_desc: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “Asian”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific ASIAN categories? Select all boxes that apply and/or enter details in the space below. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Radio Buttons Chinese Filipino Asian Indian Vietnamese Korean Japanese Enter, for example, Pakistani, Cambodian, Hmong, etc. {display 200-character textbox}
Edits/Errors	If nothing is checked or written into a box, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “American Indian or Alaska Native” goto AIAN Else if RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	AIAN
Field Names	race2_aian_aindian_wi: CHAR 200 race2_aian_alaska_wi: CHAR 200 race2_aian_csaind_wi: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “American Indian or Alaska Native”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific AMERICAN INDIAN OR ALASKA NATIVE categories? Enter details in the space below. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	AMERICAN INDIAN Enter, for example, Navajo Nation, Blackfeet Tribe, Muscogee (Creek) Nation, etc. {display 200-character textbox} ALASKA NATIVE Enter, for example, Native Village of Barrow Inupiat Traditional Government, Nome -Eskimo Community, Orutsararmuit Native Village, etc. {display 200-character textbox} CENTRAL OR SOUTH AMERICAN INDIAN Enter, for example, Mayan, Aztec, Taino, etc. {Display 200-character text box}
Edits/Errors	If all text boxes are blank, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “Middle Eastern or North African” goto MENA Else if RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	MENA
Field Names	race2_lebanese: NUM1 (0=not selected and 1=selected) race2_iranian: NUM1 (0=not selected and 1=selected) race2_egyptian: NUM1 (0=not selected and 1=selected) race2_syrian: NUM1 (0=not selected and 1=selected) race2_moroccan: NUM1 (0=not selected and 1=selected) race2_algerian: NUM1 (0=not selected and 1=selected) race2_mena_oth: NUM1 (0=not selected and 1=selected) race2_mena_desc: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “Middle Eastern or North African”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian, American Indian), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific MIDDLE EASTERN OR NORTH AFRICAN categories? Select all boxes that apply and/or enter details in the space below. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Radio Buttons Lebanese Iranian Egyptian Syrian Moroccan Algerian Enter, for example, Israeli, Iraqi, Tunisian, etc. {display 200-character textbox}
Edits/Errors	If nothing is checked or written into a box, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “Native Hawaiian or Other Pacific Islander” goto NHOPI Else if RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	NHOPI
Field Names	race2_hawaiian: NUM1 (0=not selected and 1=selected) race2_samoan: NUM1 (0=not selected and 1=selected) race2_chamorro: NUM1 (0=not selected and 1=selected) race2_tongan: NUM1 (0=not selected and 1=selected) race2_fijian: NUM1 (0=not selected and 1=selected) race2_marshallese: NUM1 (0=not selected and 1=selected) race2_nhopi_oth: NUM1 (0=not selected and 1=selected) race2_nhopi_desc: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “Middle Eastern or North African”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian, American Indian, Middle Eastern), for person 1 only: “Next, we will collect detailed information for each category selected.” What are <NAME#’s> specific NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER categories? Select all boxes that apply and/or enter details in the space below. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	Radio Buttons Native Hawaiian Samoan Chamorro Tongan Fijian Marshallese Enter, for example, Palauan, Tahitian, Chuukese, etc. {display 200-character textbox}
Edits/Errors	If nothing is checked or written into a box, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If RACE = “Some other race, ethnicity, or origin” goto SOR Else if RACE is blank and INTERNET_OVERCOUNT=1, goto OC Else if RACE is blank and INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	SOR
Field Names	race2_other_desc: CHAR 200
Data Needed	NAME# RACE
Universe	RACE = “Some other race, ethnicity, or origin”
Question Wording	If Person 1 RACE <> (White, Hispanic, Black, Asian, American Indian, Middle Eastern, Native Hawaiian), for person 1 only: “Next, we will collect detailed information for each category selected.” Enter other details about <NAME#>’s race, ethnicity, or origin. Note, you may report more than one group. (Help)
Question Wording Fills
Response Options	{display 200-character textbox}
Edits/Errors	If text box is blank, display in green with an “i” icon: “Please provide a response. If this person does not have an answer, continue to the next page.” Also, the box should be bolded and highlighted in yellow.
Branching	If INTERNET_OVERCOUNT=1, goto OC Else if INTERNET_OVERCOUNT=0, goto DASHBOARD
Help Text link	RACE
Special Instructions

Screen Name	OC
Field Names	oc2_no: NUM1 (0=not selected and 1=selected) oc2_rel_cb: NUM1 (0=not selected and 1=selected) oc2_college_cb: NUM1 (0=not selected and 1=selected) oc2_military_cb: NUM1 (0=not selected and 1=selected) oc2_nurse_cb: NUM1 (0=not selected and 1=selected) oc2_jail_cb: NUM1 (0=not selected and 1=selected) oc2_season_cb: NUM1 (0=not selected and 1=selected) oc2_other_cb: NUM1 (0=not selected and 1=selected) oc2_other_wi: CHAR 250
Data Needed	NAME# <ADDRESS>
Universe	PERSONCOUNT=(1-49) and INTERNET_OVERCOUNT=1
Question Wording	Does <NAME#> sometimes live or stay at an address other than <ADDRESS>? (Help) Select all that apply. If “Yes, for another reason” is selected, display: For what reason?
Question Wording Fills
Response Options	Radio button No Checkboxes Yes, with a parent, grandparent, or other person Yes, while attending college Yes, to be closer to a job (including military assignments) Yes, in a nursing home or a group home Yes, in a jail or prison Yes, at a seasonal or second residence Yes, for another reason If “Yes, for another reason” is selected: {display 250-character textbox}
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	If “Yes, with a parent, grandparent, or other person” goto FULLSTAY_REL Else if “Yes, while attending college” goto FULLSTAY_COLLEGE Else if “Yes, to be closer to a job” goto FULLSTAY_MIL Else if “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if “Yes, for another reason” goto FULLSTAY_OTHER Else if “No” goto DASHBOARD
Help Text link	OC
Special Instructions	“No” should be a radio button that deselctes if any other option is selected. Selecting “No” should not gray out the other options. All “Yes” options should be checkboxes. Display “For what reason?” and a 250 character text box write in field only if “Yes, for another reason” is selected.

Screen Name	FULLSTAY_REL
Field Names	Address Type Fields fullstay_type_REL: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_REL: CHAR 20 full_street_REL: CHAR 100 full_unit_REL: CHAR 52 full_sa_city_REL: CHAR 16 full_sa_state_REL: NUM 1 full_sa_zip_REL: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_REL: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_REL: CHAR 10 full_boxnum_REL: CHAR 10 full_rr_city_REL: CHAR 16 full_rr_state_REL: NUM 1 full_rr_zip_REL: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_REL: CHAR 10 full_po_city_REL: CHAR 16 full_po_state_REL: NUM 1 full_po_zip_REL: NUM 5 (allow leading zeroes) Physical Description Field location_desc_REL: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, with a parent, grandparent, or other person”
Question Wording	Please provide the full address of the place where <NAME#> sometimes lives or stays with a parent, grandparent, or other person. Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (“Rural Route” or “P.O. Box”) goto FULLSTAY_PHYS_REL Else if OC= “Yes, while attending college” goto FULLSTAY_COLLEGE Else if OC= “Yes, to be closer to a job” goto FULLSTAY_MIL Else if OC= “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC=“Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_REL>: “at…” If a street address is provided: full_addnum_REL full_street_REL full_unit_REL If a P.O. box is provided: “P.O. Box” full_pobox_REL If a rural route is provided: Full_RR_DESC_REL full_rrnum_REL full_boxnum_REL If only the city and state are provided: Full_sa_city_REL full_sa_state_REL Or full_rr_city_REL full_rr_state_REL Or full_po_city_REL full_po_state_REL If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_REL
Field Names	Physical Description Field location_desc_REL: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_REL Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the place where <NAME#> sometimes lives or stays with a parent, grandparent, or other person. Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	If OC= “Yes, while attending college” goto FULLSTAY_COLLEGE Else if OC= “Yes, to be closer to a job” goto FULLSTAY_MIL Else if OC= “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link
Special Instructions

Screen Name	FULLSTAY_COLLEGE
Field Names	Address Type Fields fullstay_type_COLLEGE: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_COLLEGE: CHAR 20 full_street_COLLEGE: CHAR 100 full_unit_COLLEGE: CHAR 52 full_sa_city_COLLEGE: CHAR 16 full_sa_state_COLLEGE: NUM 1 full_sa_zip_COLLEGE: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_COLLEGE: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_COLLEGE: CHAR 10 full_boxnum_COLLEGE: CHAR 10 full_rr_city_COLLEGE: CHAR 16 full_rr_state_COLLEGE: NUM 1 full_rr_zip_COLLEGE: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_COLLEGE: CHAR 10 full_po_city_COLLEGE: CHAR 16 full_po_state_COLLEGE: NUM 1 full_po_zip_COLLEGE: NUM 5 (allow leading zeroes) Physical Description Field location_desc_COLLEGE: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, while attending college”
Question Wording	Please provide the full address of the place where <NAME#> lives or stays while attending college. Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (Rural Route or P.O. Box) goto FULLSTAY_PHYS_COLLEGE Else if OC= “Yes, to be closer to a job” goto FULLSTAY_MIL Else if OC= “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_COLLEGE>: “at…” If a street address is provided: full_addnum_COLLEGE full_street_COLLEGE full_unit_COLLEGE If a P.O. box is provided: “P.O. Box” full_pobox_COLLEGE If a rural route is provided: Full_RR_DESC_COLLEGE full_rrnum_COLLEGE full_boxnum_COLLEGE If only the city and state are provided: Full_sa_city_COLLEGE full_sa_state_COLLEGE Or full_rr_city_COLLEGE full_rr_state_COLLEGE Or full_po_city_COLLEGE full_po_state_COLLEGE If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_COLLEGE
Field Names	Physical Description Field location_desc_COLLEGE: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_COLLEGE Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the place where <NAME#> lives or stays while attending college. Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	If OC= “Yes, to be closer to a job” goto FULLSTAY_MIL Else if OC= “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link
Special Instructions

Screen Name	FULLSTAY_MIL
Field Names	Address Type Fields fullstay_type_MIL: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_MIL: CHAR 20 full_street_MIL: CHAR 100 full_unit_MIL: CHAR 52 full_sa_city_MIL: CHAR 16 full_sa_state_MIL: NUM 1 full_sa_zip_MIL: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_MIL: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_MIL: CHAR 10 full_boxnum_MIL: CHAR 10 full_rr_city_MIL: CHAR 16 full_rr_state_MIL: NUM 1 full_rr_zip_MIL: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_MIL: CHAR 10 full_po_city_MIL: CHAR 16 full_po_state_MIL: NUM 1 full_po_zip_MIL: NUM 5 (allow leading zeroes) Physical Description Field location_desc_MIL: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, to be closer to a job”
Question Wording	Please provide the full address of the place where <NAME#> sometimes lives or stays to be closer to a job (including military assignment). Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (Rural Route or P.O. Box) goto FULLSTAY_PHYS_MIL Else if OC= “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_MIL>: “at…” If a street address is provided: full_addnum_MIL full_street_MIL full_unit_MIL If a P.O. box is provided: “P.O. Box” full_pobox_MIL If a rural route is provided: Full_RR_DESC_MIL full_rrnum_MIL full_boxnum_MIL If only the city and state are provided: Full_sa_city_MIL full_sa_state_MIL Or full_rr_city_MIL full_rr_state_MIL Or full_po_city_MIL full_po_state_MIL If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_MIL
Field Names	Physical Description Field location_desc_MIL: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_MIL Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the place where <NAME#> sometimes lives or stays to be closer to a job (including military assignment). Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	If OC= “Yes, in a nursing home or a group home” goto FULLSTAY_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link
Special Instructions

Screen Name	FULLSTAY_NURSE
Field Names	Address Type Fields fullstay_type_NURSE: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_NURSE: CHAR 20 full_street_NURSE: CHAR 100 full_unit_NURSE: CHAR 52 full_sa_city_NURSE: CHAR 16 full_sa_state_NURSE: NUM 1 full_sa_zip_NURSE: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_NURSE: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_NURSE: CHAR 10 full_boxnum_NURSE: CHAR 10 full_rr_city_NURSE: CHAR 16 full_rr_state_NURSE: NUM 1 full_rr_zip_NURSE: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_NURSE: CHAR 10 full_po_city_NURSE: CHAR 16 full_po_state_NURSE: NUM 1 full_po_zip_NURSE: NUM 5 (allow leading zeroes) Physical Description Field location_desc_NURSE: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, in a nursing home or a group home”
Question Wording	Please provide the full address of the nursing home or group home where <NAME#> sometimes stays. Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (Rural Route or P.O. Box) goto FULLSTAY_PHYS_NURSE Else if OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_NURSE>: “at…” If a street address is provided: full_addnum_NURSE full_street_NURSE full_unit_NURSE If a P.O. box is provided: “P.O. Box” full_pobox_NURSE If a rural route is provided: Full_RR_DESC_NURSE full_rrnum_NURSE full_boxnum_NURSE If only the city and state are provided: Full_sa_city_NURSE full_sa_state_NURSE Or full_rr_city_NURSE full_rr_state_NURSE Or full_po_city_NURSE full_po_state_NURSE If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_NURSE
Field Names	Physical Description Field location_desc_NURSE: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_NURSE Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the nursing home or group home where <NAME#> sometimes stays. Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	If OC= “Yes, in a jail or prison” goto FULLSTAY_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link
Special Instructions

Screen Name	FULLSTAY_JAIL
Field Names	Address Type Fields fullstay_type_JAIL: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_JAIL: CHAR 20 full_street_JAIL: CHAR 100 full_unit_JAIL: CHAR 52 full_sa_city_JAIL: CHAR 16 full_sa_state_JAIL: NUM 1 full_sa_zip_JAIL: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_JAIL: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_JAIL: CHAR 10 full_boxnum_JAIL: CHAR 10 full_rr_city_JAIL: CHAR 16 full_rr_state_JAIL: NUM 1 full_rr_zip_JAIL: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_JAIL: CHAR 10 full_po_city_JAIL: CHAR 16 full_po_state_JAIL: NUM 1 full_po_zip_JAIL: NUM 5 (allow leading zeroes) Physical Description Field location_desc_JAIL: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, in a jail or prison”
Question Wording	Please provide the full address of the jail or prison where <NAME#> recently stayed. Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (Rural Route or P.O. Box) goto FULLSTAY_PHYS_JAIL Else if OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_JAIL>: “at…” If a street address is provided: full_addnum_JAIL full_street_JAIL full_unit_JAIL If a P.O. box is provided: “P.O. Box” full_pobox_JAIL If a rural route is provided: Full_RR_DESC_JAIL full_rrnum_JAIL full_boxnum_JAIL If only the city and state are provided: Full_sa_city_JAIL full_sa_state_JAIL Or full_rr_city_JAIL full_rr_state_JAIL Or full_po_city_JAIL full_po_state_JAIL If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_JAIL
Field Names	Physical Description Field location_desc_JAIL: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_JAIL Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the jail or prison where <NAME#> has recently stayed. Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	If OC= “Yes, at a seasonal or second residence” goto FULLSTAY_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link
Special Instructions

Screen Name	FULLSTAY_SEASON
Field Names	Address Type Fields fullstay_type_SEASON: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_SEASON: CHAR 20 full_street_SEASON: CHAR 100 full_unit_SEASON: CHAR 52 full_sa_city_SEASON: CHAR 16 full_sa_state_SEASON: NUM 1 full_sa_zip_SEASON: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_SEASON: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_SEASON: CHAR 10 full_boxnum_SEASON: CHAR 10 full_rr_city_SEASON: CHAR 16 full_rr_state_SEASON: NUM 1 full_rr_zip_SEASON: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_SEASON: CHAR 10 full_po_city_SEASON: CHAR 16 full_po_state_SEASON: NUM 1 full_po_zip_SEASON: NUM 5 (allow leading zeroes) Physical Description Field location_desc_SEASON: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, at a seasonal or second residence”
Question Wording	Please provide the full address of the seasonal or second residence where <NAME#> sometimes lives or stays. Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (Rural Route or P.O. Box) goto FULLSTAY_PHYS_SEASON Else if OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_SEASON>: “at…” If a street address is provided: full_addnum_SEASON full_street_SEASON full_unit_SEASON If a P.O. box is provided: “P.O. Box” full_pobox_SEASON If a rural route is provided: Full_RR_DESC_SEASON full_rrnum_SEASON full_boxnum_SEASON If only the city and state are provided: Full_sa_city_SEASON full_sa_state_SEASON Or full_rr_city_SEASON full_rr_state_SEASON Or full_po_city_SEASON full_po_state_SEASON If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_SEASON
Field Names	Physical Description Field location_desc_SEASON: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_SEASON Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the seasonal or second residence where <NAME#> sometimes lives or stays. Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	If OC= “Yes, for another reason” goto FULLSTAY_OTHER Else goto MOST
Help Text link
Special Instructions

Screen Name	FULLSTAY_OTHER
Field Names	Address Type Fields fullstay_type_OTHER: NUM1 (1=Street, 2=Rural Route, 3=PO Box,) Street Address Fields full_addnum_OTHER: CHAR 20 full_street_OTHER: CHAR 100 full_unit_OTHER: CHAR 52 full_sa_city_OTHER: CHAR 16 full_sa_state_OTHER: NUM 1 full_sa_zip_OTHER: NUM 5 (allow leading zeroes) Rural Route Address Fields Full_RR_DESC_OTHER: varchar2 (3) (1=RR, 2=HC, 3=SR, 4=PSC, 5=RTE) full_rrnum_OTHER: CHAR 10 full_boxnum_OTHER: CHAR 10 full_rr_city_OTHER: CHAR 16 full_rr_state_OTHER: NUM 1 full_rr_zip_OTHER: NUM 5 (allow leading zeroes) PO Box Address Fields full_pobox_OTHER: CHAR 10 full_po_city_OTHER: CHAR 16 full_po_state_OTHER: NUM 1 full_po_zip_OTHER: NUM 5 (allow leading zeroes) Physical Description Field location_desc_OTHER: CHAR 250
Data Needed	NAME# OC All addresses entered for any person on FULLSTAY_REL, FULLSTAY_COLLEGE, FULLSTAY_MIL, FULLSTAY_NURSE, FULLSTAY_JAIL, FULLSTAY_SEASON, and FULLSTAY_OTHER
Universe	OC = “Yes, for another reason”
Question Wording	Please provide the full address of the other place where <NAME#> sometimes lives. Fill in as much information as you know. (Help) Please select the type of address associated with this residence. If you do not know the address, please enter as much information as you can about the location. For example, enter the city and state, landmarks or cross streets, whether it is outside the U.S. (if applicable), and so on.
Question Wording Fills
Response Options	Radio buttons of addresses previously entered by the respondent. Address Type: 3 radio buttons Street Address Rural Route P.O. Box Address Number: 20-character text box Street Name: 100-character text box Apt/Unit: 52-character text box Rural Route Descriptor: drop down menu with the following options RR HC SR PSC RTE Rural Route #:10-character text box RR Box ID #: 10-character text box P.O. Box: 10-character text box City: 16-character text box State: drop down menu with alphabetical states and District of Columbia Zip: 5-character text box Description: 250-character text area
Edits/Errors	Soft edit for complete nonresponse (all fields, not including Location Description, are blank: “Please select an address from the list or provide an address.” Soft edit if City, State, and ZIP are blank: “Please provide both a City and State or a Zip code.”
Valid Response	The following pieces are needed to be considered a valid response: For Street Address Address Number, Street Name, City, and State; OR Address Number, Street Name, ZIP For P.O. Box P.O. Box Number and City, and State; OR P.O. Box Number and ZIP For Rural Route Rural Route Type, Rural Route Number, Box Number, City, and State; OR Rural Route Type, Rural Route Number, Box Number, and ZIP “Description” (the two 250-character text areas) is not necessary for a valid response.
Branching	If Address Type = (Rural Route or P.O. Box) goto FULLSTAY_PHYS_OTHER Else goto MOST
Help Text link	FULLSTAY
Special Instructions	If valid response, set <ADDRESS_OTHER>: “at…” If a street address is provided: full_addnum_OTHER full_street_OTHER full_unit_OTHER If a P.O. box is provided: “P.O. Box” full_pobox_OTHER If a rural route is provided: Full_RR_DESC_OTHER full_rrnum_OTHER full_boxnum_OTHER If only the city and state are provided: Full_sa_city_OTHER full_sa_state_OTHER Or full_rr_city_OTHER full_rr_state_OTHER Or full_po_city_OTHER full_po_state_OTHER If the response is anything other than the above, there is no address pre-fill.

Screen Name	FULLSTAY_PHYS_OTHER
Field Names	Physical Description Field location_desc_OTHER: CHAR 250
Data Needed	NAME# <REFDATE> OC
Universe	FULLSTAY_OTHER Address Type = (“Rural Route” or “P.O.Box”)
Question Wording	Please describe the physical location of the other place where <NAME#> sometimes lives. Please provide as much information as possible, including city, state and ZIP code. For example: a location description such as “The apartment over the gas station in Selma, CA” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue in Suitland, MD;” or a name of a park, street intersection, or shelter if you were experiencing homelessness on <REFDATE>, as well as the name of the city and state. For example: “Friendship Park, Paoli, PA.” Note: If there is a street address associated with this residence, such as one you would provide to have a package delivered, please click the “Previous” button to enter the street address on the previous screen.
Question Wording Fills
Response Options	Description: 250-character text area
Edits/Errors	If “Physical Location” is blank, provide a single soft edit that says: “Please provide a description of the physical location according to the guidelines above the text box.” Also, the missing write-in box should be bolded and highlighted in yellow.
Branching	Goto MOST
Help Text link
Special Instructions

Screen Name	MOST
Field Names	most_ref: NUM 1 (0=not selected and 1=selected) most_rel: NUM 1 (0=not selected and 1=selected) most_college: NUM 1 (0=not selected and 1=selected) most_mil: NUM 1 (0=not selected and 1=selected) most_nurse: NUM 1 (0=not selected and 1=selected) most_jail: NUM 1 (0=not selected and 1=selected) most_season: NUM 1 (0=not selected and 1=selected) most_other: NUM 1 (0=not selected and 1=selected) most_multi: NUM 1 (0=not selected and 1=selected) most_else: NUM 1 (0=not selected and 1=selected) most _dk: NUM 1 (0=not selected and 1=selected)
Data Needed	NAME# <REFDATE> OC <ADDRESS_REL> <ADDRESS_COLLEGE> <ADDRESS_MIL> <ADDRESS_NURSE> <ADDRESS_JAIL> <ADDRESS_SEASON> <ADDRESS_OTHER>
Universe	OC = any “Yes” response
Question Wording	Where does <NAME#> live or stay most of the time? (Help)
Question Wording Fills
Response Options	Radio buttons <ADDRESS> The place with a parent, grandparent, or other person <ADDRESS_REL> The college housing <ADDRESS_COLLEGE> The job (including military assignment) <ADDRESS_MIL> The nursing home or group home <ADDRESS_NURSE> The jail or prison <ADDRESS_JAIL> The seasonal or second residence <ADDRESS_SEASON> The other address <ADDRESS_OTHER> Equal time at all places Some other place Don’t know
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	Goto WHERE
Help Text link	MOST
Special Instructions	Display the response categories only for those categories selected in OC. Examples of how response categories could look: The college housing at RR 45 Box 76 The job (including military assignment) at Arlington, VA The nursing home or group home The seasonal or second residence at 123 Vacation Way

Screen Name	WHERE
Field Names	where_ref: NUM 1 (0=not selected and 1=selected) where _rel: NUM 1 (0=not selected and 1=selected) where _college: NUM 1 (0=not selected and 1=selected) where _mil: NUM 1 (0=not selected and 1=selected) where _nurse: NUM 1 (0=not selected and 1=selected) where _jail: NUM 1 (0=not selected and 1=selected) where _season: NUM 1 (0=not selected and 1=selected) where _other: NUM 1 (0=not selected and 1=selected) where _multi: NUM 1 (0=not selected and 1=selected) where _else: NUM 1 (0=not selected and 1=selected) where _dk: NUM 1 (0=not selected and 1=selected)
Data Needed	NAME# OC <ADDRESS_REL> <ADDRESS_COLLEGE> <ADDRESS_MIL> <ADDRESS_NURSE> <ADDRESS_JAIL> <ADDRESS_SEASON> <ADDRESS_OTHER>
Universe	OC = any “Yes” response
Question Wording	Where <FILL1> on <REFDATE>? (Help)
Question Wording Fills	FILL1: If the current date is before Census Day, <FILL1> = will <NAME#> be staying If the current date is on or after Census Day, <FILL1> = was <NAME#> staying
Response Options	Radio buttons <ADDRESS> The place with a parent, grandparent, or other person <ADDRESS_REL> The college housing <ADDRESS_COLLEGE> The job (including military assignment) <ADDRESS_MIL> The nursing home or group home <ADDRESS_NURSE> The jail or prison <ADDRESS_JAIL> The seasonal or second residence <ADDRESS_SEASON> The other address <ADDRESS_OTHER> Some other place Don’t know
Edits/Errors	Soft edit for nonresponse: “Please provide an answer to the question.”
Branching	Goto DASHBOARD
Help Text link	WHERE
Special Instructions	Display the response categories only for those categories selected in OC. Examples of how response categories could look: The college housing at RR 45 Box 76 The job (including military assignment) at Arlington, VA The nursing home or group home The seasonal or second residence at 123 Vacation Way

Screen Name	NOCOMPLETE
Field Names
Data Needed
Universe	Cases where no valid address provided is provided. Cases where nobody is added to the roster.
Question Wording	You do not need to complete this survey. Thank You.
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching
Help Text link
Special Instructions	Center all text.

Screen Name	COMPLETE
Field Names
Data Needed	User IDs and email addresses from completed cases.
Universe	Completed cases who log in again.
Question Wording	The 2016 Census Test has already been completed for this address. If you have any questions, please call 1-XXX-XXX-XXXX.
Question Wording Fills
Response Options
Response Options Fills	N/A
Edits/Errors
Branching
Help Text link
Special Instructions	Center all text.

Screen Name	TQA LANGUAGE
Field Names
Data Needed
Universe	Last screen after any TQA case.
Question Wording	In which language was this interview conducted?
Question Wording Fills
Response Options	Checkboxes English Spanish Chinese Korean Other Display a 50 character text box below other
Response Options Fills	N/A
Edits/Errors	N/A
Branching
Help Text link
Special Instructions	Center all text.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Gianna S Dusch
File Modified	0000-00-00
File Created	2021-01-24

2016 Census Test - Self and Enumerator Response

2016 Census Test

2016 CT Internet Spec-Primus-Baseline