Attachment E - Reinterview Questionnaire COFA 2018

Attachment E: Reinterview Questionnaire

OMB No. 0607-XXXX: Approval Expires xx/xx/xxxx

SUPERVISORY REVIEW – Must be completed if R5 is marked "falsification suspected"
R6. What is your assessment of this case?
1

FORM COFA-RI (2018)

U.S. DEPARTMENT OF COMMERCE

Reinterview Questionnaire

Falsification suspected
– Stop all work assigned to interviewer
– Proceed with a formal investigation and complete a COFA Reinterview Data Falsification
Investigation Form (COFA RI 3)

2

Falsification not suspected – Discrepancies due to respondent error
– Explain in Notes

3

Falsification not suspected – Discrepancies due to interviewer error
– Explain in Notes.
– Proceed with formal retraining to correct incorrect procedure

Island

Block

ID No.

Map Spot No.

Street or road name, Rural route and box,
or PO box No.

Apartment No.

Tract

G

Economics and Statistics Administration
U.S. CENSUS BUREAU

House No.

2018
SURVEY OF COMPACT OF
FREE ASSOCIATION (COFA)
MIGRANTS

Location description

Village

4

COFA (HU) Status

COFA Completion Date

Falsification not suspected – Discrepancies due to reinterviewer error
– Explain in Notes
– Proceed with formal retraining to correct incorrect procedures

01
02

Month

Day

03
04

Telephone Number

NOTES

05
06

-

ZIP Code

COFA FR Code

COFA Vacant

Occupied
Occupied–Continuation
Vacant – Regular
Vacant – Usual
home elsewhere
Demolished/Burned out
Cannot locate

07
08
09

10

Duplicate
Nonresidential
Other (open to
elements,
condemned,
under
construction)
Refused

1
2

COFA POP

For rent
For sale only

5

Rented or sold,
not occupied
For seasonal, recreational,
or occasional use
For migrant workers

6

Other vacant

3

4

01–97 = Total
persons
00=Vacant
98=Delete
99=POP
unknown

RECORD OF REINTERVIEW CONTACT
Day

Month

Type

Time

Personal
Telephone
Personal
Telephone
OUTCOME CODES:

Outcome

Type

Month

:

a.m.

Personal

p.m.

Telephone

:

a.m.

Personal

p.m.

Telephone

NV = Left notice of visit

NC = No contact

RE = Refusal

Day

CI = Conducted interview

Time

Outcome

:

a.m.

:

a.m.

p.m.

p.m.

OT = Other

CERTIFICATION
RIer Code

RI Assignment Date

Month

I certify that the entries I have made on this reinterview questionnaire are
true and correct to the best of my knowledge.

RI Completion Date

Month

Day

Day

INTRODUCTION
RS1. Hello, my name is (Your name) and I’m an official working with the U.S. Census Bureau on the 2018 Survey
of Compact of Free Association (COFA) Migrants. (If personal visit, show ID card) Is this (read unit address)?
1
2

Yes
No

Continue to S2.
Ask: Can you tell me where to find (read address) ? Thank respondent and END Reinterview.

RS2. May I speak to
1
2

Yes
No

?

Find a knowledgeable person. Put name here.

RS3. I am checking the accuracy of our interviewer’s work. I’d like to ask you a few questions to verify that the
information we obtained for this household is correct. It should only take a few minutes of your time.

Continue to appropriate verification section.

4

FORM H-COFA(2018)RIS (1-2018)

USCENSUSBUREAU

VERIFICATION OF COFA NONINTERVIEW (COFA (HU) Status 03 – 10)
N1. Did a Census Bureau interviewer contact (you/original respondent’s name from S2) to collect information about
(read unit address)?
1
2
3

I5. Refer to COFA roster. ASK: Where was (person name) born? On the following line, list the person number (and form
identification [e.g., 2 of 3] if appropriate) of all household members who have a different place of birth given by the
respondent during reinterview than given during the COFA interview. Include ONLY if the household member was listed on
the roster (item 1 of the COFA interview) and had a place of birth given in item 5 of the COFA interview.

Yes
No
Don’t know/Not sure

N2. Was the status of this (house/apartment/mobile home) at this address (read COFA (HU) Status)?
1
Yes
2
No
Was this (house/apartment/mobile home) (mark one response):
Occupied
21
Vacant
22
Demolished/Burned out
23
Nonresidential
24
Other (open to elements, condemned, under construction)
25
Or did you refuse the original interview?
26
27
3

VERIFICATION OF COMPLETE COFA INTERVIEW (COFA (HU) Status 01, 02) – Cont.

1
2
3

Place of birth is correct for all people on roster
Place of birth is not correct for at least some of people on roster
Place of birth is not correct for all people on roster

I6. Thank you for your cooperation. You have been very helpful.
END Reinterview, mark all boxes below that apply to the roster, and Go to Reinterview Results.
1
2

Roster count is correct
Roster had additions

3
4

Roster had deletions
Roster falsification suspected

Occupied
Vacant

Don’t know/Not sure

N3. Thank you for your cooperation. You have been very helpful.
END Reinterview and Go to Reinterview Results.

REINTERVIEW RESULTS
R1. Reinterview Status:

VERIFICATION OF COMPLETE COFA INTERVIEW (COFA (HU) Status 01, 02)
1

I1. Did a Census Bureau interviewer contact (you/original respondent’s name from S2) to collect information about
this household?
1
2
3

Yes
No
Don’t know/Not sure

I2. How many people are living or staying in this (house/apartment/mobile home) at this address?
INCLUDE everyone living or staying here for more than 2 months.
INCLUDE anyone staying here who does not have another place to stay, even if they are here for 2 months or less.
DO NOT INCLUDE anyone who is living somewhere else for more than 2 months, such as a college student living away.

2
3
4
5

Reinterview Complete
Reinterview Noninterview – Cannot contact knowledgeable respondent
Reinterview Noninterview – Unable to locate unit
– Listing Verification must be done on this block
Reinterview Noninterview – Refused reinterview
Ineligible for reinterview

R2. Was the respondent or household contacted by the interviewer?
1
2
3

Yes
No
Don’t know/Not sure

Number of people

R3. Did the interviewer record the correct number of people living or staying in the household?
I3. Check Item Determine if questions I4 and I5 will be asked.
1

Yes

2

No

If the response to RS2 is Yes (1), then ask I4 and I5.
If the response to RS2 is No (2), but this check box is marked Yes (1) or blank, then ask I4 and I5.
If the response to RS2 is No (2), and this check box is marked No (2), then go to I6 and END the Reinterview.

1
2
3

R4. Did the interviewer record the correct places of birth of the household occupants?
1

I4. Our records indicate that (read names on COFA roster) was/were living or staying at (read ADDRESS) on (read
ORIGINAL INTERVIEW DATE). Is this correct?
1
2

Yes
No

a. List the person number (and form identification [e.g., 2 of 3] if appropriate) of all people
who should not be included.

2
3

2

b. Ask: Have I missed any household member who was/were living or staying here on
(read date) – such as babies, lodgers, or anyone who was away traveling or in the
hospital? Put check marks on the following line for all new names that respondent gives.
3

2

Don’t know/Not sure

Yes
No
Don’t know/Not sure

R5. Falsification Assessment
1

3

Yes
No
Don’t know/Not sure

No falsification suspected
Falsification suspected
– Mark if "no" is checked in items R2-R4 or if you suspect falsification for other reasons
– Explain in Notes
– SUPERVISORY REVIEW is required
Unable to determine if there is falsification
– Explain in Notes
– Proceed with formal retraining to correct incorrect procedures

FORM H-COFA(2018)RIG (1-2018)

3