2017 Census Test - Self Response

2017 Census Test

dg_5_es_20160818

2017 Census Test - Self Response

OMB: 0607-0996

Document [pdf]
Download: pdf | pdf
Draft 1 (8-18-2016)

9-1/2"
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AN EQUAL OPPORTUNITY EMPLOYER

U.S. Department of Commerce
Economics and Statistics Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132

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

YOUR RESPONSE IS
REQUIRED BY LAW

1-7/8"

OFFICIAL BUSINESS
Penalty for Private Use $300

SU RESPUESTA ES
REQUERIDA POR LEY

DG-5(E/S) (8-2016)

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4-1/8"
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3/4"

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1-5/8"
5"

3-3/4"

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5/8"

DG-5(E/S) Specifications

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Size 9 -1/2 x 4-1/8 with covered window 1-5/8 x 5

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Available in English online
Disponible en español en internet

survey.census.gov


File Typeapplication/pdf
File Titleuntitled
File Modified2016-08-18
File Created2016-08-18

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