Group Quarters

2018 End-to-End Census Test – Peak Operations

dh_40_gq_20170512

Group Quarters

OMB: 0607-0999

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Draft 5 (5-12-2017)

AN EQUAL OPPORTUNITY EMPLOYER
U. S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

T

Enumerator Name:

Date of Enumeration:
Total Number of ICQs for GQ:

AF

GQ Name:

of

Total Envelopes

D

Envelope

R

Total Number of ICQs in this envelope:

USE SEPARATE ENVELOPES FOR EACH GQ.
DO NOT PLACE QUESTIONNAIRES FROM DIFFERENT GQs
IN THE SAME ENVELOPE.

DH-40(GQ) (5-2017)

10" x 13" envelope with no window

DC

D

R

AF

T

Disclosure Prohibited—Title 13 U.S. Code


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File Titleuntitled
File Modified2017-05-22
File Created2017-05-12

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