Self Response -Internet/Telephone/Paper

Draft 1 (5-5-2017)

U.S. Department of Commerce
Economics and Statistics Administration
U.S. Census Bureau

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

1201 E 10th Street
Jeffersonville IN 47132
OFFICIAL BUSINESS
Penalty for Private Use $300
DH-6A(IN) (5-2017)

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AN EQUAL OPPORTUNITY EMPLOYER

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YOUR RESPONSE IS
REQUIRED BY LAW

Size 10-1/16 x 6-1/16" Open window 4-1/4" x 2-3/4"

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Available in English online

survey.census.gov