Self Response -Internet/Telephone/Paper

Draft 11 (5-12-2017)

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

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

March 19, 2018
Dear Resident:
Your address has been randomly selected by the U.S. Census Bureau to participate in the
2018 Census Test. The Census Bureau conducts this important 10-minute survey to help make the
2020 Census easier, more convenient, and less costly.
Results from the 2020 Census will be used to:
• Allocate resources for schools, health services, and new business development.
• Prepare your community to meet transportation and emergency readiness needs.
• Help ensure the political representation of your community.

T

Please
• respond by April 1 using ONE of the following options:

R
AF

Option 1:
Go to survey.census.gov to complete the survey online.
You will need your 12-digit User ID, which is printed below the barcode on the
front of the enclosed questionnaire.
Option 2:
Complete and mail back the enclosed questionnaire in the postage-paid envelope
provided.
Respond online to help us conserve natural resources, save taxpayer money, and process data more
efficiently.

D

The census is so important that your response is required by law, and your answers are kept completely
confidential. If you do not respond, we will need to send a Census Bureau interviewer to your home to
collect your answers in person. If you need help completing the survey, please call 1–844–330–2020
toll-free.
Thank you in advance for your prompt response.
Sincerely,

John H. Thompson
Director
Enclosure

Mensaje importante: Para completar la Prueba del Censo del 2018, por favor, visite
survey.census.gov o llámenos gratis al 1–844–468–2020.
census.gov
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Base prints black 100%
Overlay prints pantone cyan #6 (10%)

FREQUENTLY ASKED QUESTIONS
How do I respond?
Go online at survey.census.gov to complete the 2018 Census Test online. You will need the 12-digit
User ID found below the barcode on the address lablel.
Are my answers confidential and private?
Yes. The Census Bureau is required by law to protect your information. The Census Bureau is not permitted
to publicly release your responses in a way that could identify you or your household. Per the Federal
Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening
of the systems that transmit your data. Per Title 5, U.S. Code, Section 552a, your responses are protected
and may only be disclosed as identified in the Privacy Act System of Records Notice COMMERCE/
CENSUS-5, Decennial Census Program.

For more information about how we protect your information, please visit our website at census.gov and click
on “Data Protection and Privacy Policy” at the bottom of the home page.
Am I required to fill out this survey?

What is the 2018 Census Test?

T

Yes. We are conducting this survey under the authority of Title 13, U.S. Code, Sections 141, 193, and
221. This collection of information has been approved by the Office of Management and Budget (OMB).
You are not required to respond to this survey if it does not display a valid OMB approval number. The
eight-digit OMB approval number is xxxx-xxxx.

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AF

The Census Bureau is researching modern and cost-efficient methods for the population to exercise its civic
obligation to be counted in the 2020 Census. By completing this survey, you help prepare for a more
accurate count of all populations in the 2020 Census.
How will the Census Bureau use the information I provide?

This survey will ask questions about the people living at this address, including each person's name, age and date of
birth, sex, race and ethnicity, and relationship to a householder. By law, the Census Bureau can only use your responses
to produce statistics. Disclosure of the information provided is permitted under the Privacy Act of 1974 (Title 5, U.S.
Code, Section 552a) and may be shared among Census Bureau staff for work-related purposes. This information may
also be disclosed for the published routine uses identified in the Privacy Act System of Records Notice COMMERCE/
CENSUS-5, Decennial Census Program.

D

How long will this survey take?

The Census Bureau estimates that completing the questionnaire will take 10 minutes on average.
Send comments regarding this burden estimate or any other aspect of this burden to: Paperwork Reduction
Project xxxx-xxxx, U.S. Census Bureau, DCMD-2H174, 4600 Silver Hill Road, Washington, DC 20233. You
may email comments to <[email protected]>; use "Paperwork Reduction Project
xxxx-xxxx" as the subject.

DH-16(L2) (5-2017)