ACS Methods Panel Test

American Community Survey Methods Panel Tests

ACS MP Mail Materials Test Attachments A-G_061918

ACS Methods Panel Test

OMB: 0607-0936

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0607-0936 can be found here:

Document [pdf]

Download: pdf | pdf

Attachment A
Description of Experimental Treatments
Mailing and
Contents
Initial Mailing
Outgoing
Envelope

Current
Production

Treatment 1
(Modified
Production)

Treatment 2
(Emphasized
Mandatory)

Treatment 3
(De-emphasized
Mandatory with
Modified
Questionnaire)

Your Response is
Required by Law

Your Response is
Required by Law
Open
Immediately
NO

FAQ Brochure

YES

Open
Immediately
NO

Letter Design

Current design
No Callout Box

Updated design
Callout Box

Letter Wording

Current wording

Current wording;
Cybersecurity
removed from
front, FAQ
Information
added to back

No message

Reminder
Letter
Outside of
Mailer
Letter

Questionnaire
Package
Outgoing
Envelope

Treatment 4
(Softer/
Eliminated
Mandatory)
Your Response
is Required by
Law

Treatment 5
(De-emphasized
Mandatory
with Current
Questionnaire
Your Response is
Required by Law

Treatment 6
(Production with
Tri-fold
Pressure Seal
Letters)

Treatment 7
(Production,
Sorted Separately)

Your Response is
Required by Law

Open Immediately

YES

Updated design
Callout Box

Updated design Callout
Box

Updated design
Callout Box

Current design No
Callout Box

Emphasized
mandatory, FAQ
information
added to back

Mandatory
wording similar
to Treatment 1,
FAQ information
added to back

Mandatory wording
similar to Treatment
1, FAQ information
added to back

Current wording

No message

Current wording

Updated design,
mandatory
wording slightly
softer than
Treatment 1

Updated design,
mandatory wording
slightly softer than
Treatment 1

Current wording

Bi-fold printing

Updated design,
mandatory
wording slightly
softer than
Treatment 1

Current wording

Bi-fold Printing

Updated design,
emphasized
mandatory

Tri-fold printing

Bi-fold printing

Your Response is
Required by Law

Open
Immediately

Your Response
is Required by
Law

Your Response is
Required by Law

Open Immediately

Questionnaire

Current design

Design Changes;
Bold Mandatory
Heading

Design Changes

Current design

FAQ Brochure

YES

Letter

Current wording

Cybersecurity
removed from
front, FAQ
Information
added to back

Updated design,
emphasized
mandatory
wording, FAQ
Information
added to back

Updated design,
mandatory
similar to
Treatment 1, FAQ
Information
added to back

Updated design, NO
Mandatory, FAQ
Information added
to back

Updated design,
mandatory similar to
Treatment 1, FAQ
Information added to
back

Current wording

Instruction
Card
Reminder
Postcard

YES

Address Side
Wording

U.S. Census Bureau

Your Response is
Required by Law
Current wording

Current wording

Updated design,
bold mandatory,
bold interviewer
contact note

Updated design,
unbold
mandatory,
unbold
interviewer
contact note

Updated design, no
mandatory, unbold
interviewer contact
note

Updated design,
unbold mandatory,
unbold interviewer
contact note

Current wording

Outside of
Mailer

No message

‘Final Notice
Respond Now’

No message

Wording

Current wording

Updated
wording, added
callout box

Updated design,
bold mandatory

Updated design,
unbold
mandatory

Updated design, NO
mandatory wording

Updated design,
unbold mandatory

Current wording

Tri-fold printing

Bi-fold printing

Final Reminder

Bi-fold printing

Note: The areas highlighted in yellow in this table indicate how the treatment differs from current production.

Attachment B
Treatment 1 (Modified Production)
I.
II.
III.
IV.
V.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 1: Initial Mailing
Envelope:

ACS-46 IM(2013)(12-2012)

Instruction Card:

ACS-34IM (08_08_2013)

Letter:

ACS-13 (LX)MMTC

Multilingual Brochure:

ACS-9 (2017)(11-2017)

Treatment 1: Initial Mailing Envelope
U.S. DEPARTMENT OF COMMERCE

Economics and Statistics Administration
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
ACS-46IM(2013) (12-2012)

The American Community
Survey

YOUR RESPONSE IS
REQUIRED BY LAW

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Treatment 1: Initial Mailing Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Go to https://respond.census.gov/acs to complete the American Community Survey online.

(Vea el otro lado
para español.)

IMPORTANT: You will need information from the address label on this card to log in. If you need help or have
questions about the American Community Survey, call the toll-free number 1-800-354-7271.
ACS-34IM (08_08_2013).indd 1

8/7/2013 2:55:00 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Vaya a https://respond.census.gov/acs para completar la Encuesta sobre la Comunidad Estadounidense por
Internet en español.

ATENCIÓN: Necesitará información que aparece en la etiqueta en el otro lado de esta tarjeta para iniciar la
sesión. Si usted necesita ayuda para llenar la encuesta o tiene preguntas acerca de la Encuesta sobre la
Comunidad Estadounidense, llame sin cargo al 1-877-833-5625.

See other side for English.
ACS-34 IM (08/08/2013)

ACS-34IM (08_08_2013).indd 2

8/7/2013 2:55:00 PM

Treatment 1: Initial Mailing Letter
ACS-13(LX)MMTC
(2018)
(4-2018)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau ...
Your household has been randomly selected to complete a very important national survey,
the American Community Survey. The U.S. Census Bureau conducts this survey to give our
country an up-to-date picture of how we live—our education, employment, housing, and more.
Using the enclosed instructions, please complete the survey online as soon as possible at:
https://respond.census.gov/acs
The Census Bureau is using the internet to collect this information in an effort to conserve
natural resources, save taxpayers’ money, and process your data more efficiently. If you are
unable to complete the survey online, there is no need to contact us. We will send you a
paper questionnaire in a few weeks.
This survey collects critical information used to meet the needs of communities across the
United States. For example, results from this survey are used to decide where new schools,
hospitals, and fire stations are needed. This information also helps communities plan for the
kinds of emergency situations that might affect you and your neighbors, such as floods and
other natural disasters.
The Census Bureau chose your address, not you personally, as part of a randomly selected
sample. You are required by U.S. law to respond to this survey.
If you need help completing the survey, please call our toll-free number (1–800–354–7271).
Thank you.

Enclosures

census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and 193.
Federal law protects your privacy and keeps your answers confidential (Title 13, United States
Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information will
be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in other
Census Bureau surveys that are voluntary.

Treatment 1: Initial Mailing Multilingual Brochure
Important
Information From the
U.S. Census Bureau

La Oficina del Censo de los Estados
Unidos está realizando la Encuesta
sobre la Comunidad Estadounidense
En unos días, recibirá por correo un
cuestionario de la Encuesta sobre la
Comunidad Estadounidense. Como usted
esta viviendo en los Estados Unidos, la ley
exige que usted responda a esta encuesta.
Si tiene preguntas sobre el cuestionario,
llámenos al 1-877-833-5625 para hablar
con uno de nuestros empleados que habla
español. La llamada es gratis. El empleado
podrá contestar sus preguntas o usted
podrá completar la encuesta por teléfono.

Yes. The U.S. Census Bureau is
required by law to keep your
information confidential. The Census
Bureau is not permitted to publicly
release your responses in a way that
could identify you. Per the Federal
Cybersecurity Enhancement Act of
2015, your data are protected from
cybersecurity risks through screening
of the systems that transmit your data.

Sí. La Oficina del Censo de los
EE.UU. está obligada por ley a mantener
confidencial su información. A la Oficina
del Censo no se le permite divulgar sus
respuestas de manera que este hogar
pudiera ser identificado. En conformidad
con la Ley para el Fortalecimiento de la
Seguridad Cibernética Federal del 2015,
sus datos están protegidos contra los
riesgos de seguridad cibernética mediante
los controles aplicados a los sistemas que
trasmiten su información.

Issued September 2017
ACS-9 (2017)

是的。 根据法律规定，美国人口普查
局将对您的信息保密。人口普查局不得
以可识别您的身份的方式公开发布您的
回复。依据2015年联邦增强网络安全法
案，通过监察传输您资料的系统，来确
保您个人资料受到保护，避免网络安全
风险。

Có. Cục Thống Kê Dân Số Hoa Kỳ được pháp
luật yêu cầu bảo mật thông tin của quý vị. Cục
Thống kê không được phép công bố công khai
các phản hồi của quý vị theo cách có thể nhận
diện quý vị. Theo Luật Tăng Cường An Ninh
Mạng của Liên Bang 2015, số liệu của quí vị sẽ
được bảo vệ để tránh khỏi các nguy cơ về an
ninh mạng qua cách kiểm duyệt các hệ thống
chuyển số liệu của quí vị.

Да. По закону Бюро переписи
населения США обязано соблюдать
конфиденциальность ваших данных. Ему
запрещено публично разглашать Ваши
ответы таким образом, чтобы по ним
можно было установить Вашу личность.
Защиту Ваших данных от кибер-рисков
регулирует федеральный закон «О
повышении кибербезопасности» от 2015
года, в соответствии с которым регулярно
проводится проверка систем передачи
данных.

네. 미국 인구조사국은 법에 따라 귀하의
정보를 비밀로 유지해야 할 의무가 있습니다.
미국 인구조사국은 귀하가 응답한 정보를
귀하의 신상을 알 수 있는 형태로 일반에 공개할
수 없으며, 2015년 연방 사이버보안강화법에
따라, 귀하의 데이터는 데이터 전송
시스템의 철저한 검사를 통해 사이버 보안의
위험으로부터 보호됩니다.

Attachment B
Treatment 1 (Modified Production)
VI.
VII.
VIII.
IX.
X.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 2: First Reminder Mailing
Letter:

ACS-20 (L)(2018)(2-2018)

Treatment 1: First Reminder Letter
ACS20(L)(2018) (22018)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau

Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

A message from the Director, U.S. Census Bureau ...
A few days ago, you should have received instructions for completing the American
Community Survey online. Local communities depend on information from this survey to
decide where schools, highways, hospitals, and other important services are needed. If you
have not already responded, please do so now.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
If we do not receive your response online, we will mail a paper questionnaire to your address.
Your response to this survey is required by law. Your response is critically important to your
local community and your country. Responding promptly will prevent your receiving additional
reminder mailings, phone calls, or personal visits from Census Bureau interviewers.
If you need help completing the survey or have questions, please call 1–800–354–7271.
Thank you in advance for your prompt response.

Security Security Security Security Security

census.gov

U.S. DEPARTMENT OF
COMMERCE

Economics and Statistics Administration

U.S. CENSUS BUREAU
1201 E 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-20(L)(2018) (2-2018)

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment B
Treatment 1 (Modified Production)
XI.
XII.
XIII.
XIV.
XV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 3: Questionnaire Package Mailing
Envelope:

ACS-46 (2012)(5-2011)

Letter:

ACS-14 (LX)MMTC

Survey Form:

ACS-1 (2017) - First two pages

Return Envelope:

6385-47 (2014)(10-2013)

Treatment 1: Questionnaire Package Envelope

U.S. DEPARTMENT OF COMMERCE

Economics and Statistics Administration
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
ACS-46(2012) (5-2011)

The American Community
Survey Form Enclosed

YOUR RESPONSE IS
REQUIRED BY LAW

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Treatment 1: Questionnaire Package Letter
ACS-14(LX)MMTC
(2018)
(4-2018)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau...
About two weeks ago, the U.S. Census Bureau sent instructions for completing the American
Community Survey to your address. We asked you to help us with this very important survey by
completing it online. But we have not received your response yet.
If you have already completed the survey, thank you very much. If you have not, please complete
the survey soon using ONE of the following two options.
Option 1: Go to https://respond.census.gov/acs to complete the survey online.
Option 2: Fill out and mail back the enclosed questionnaire.
This survey is so important that a Census Bureau representative may attempt to contact you by
telephone or personal visit if we do not receive your response.
The information collected in this survey will help decide where new schools, hospitals, and fire
stations are needed. The information also is used to develop programs to reduce traffic
congestion, provide job training, and plan for the health care needs of the elderly.
The Census Bureau chose your address, not you personally, as part of a randomly selected
sample. You are required by U.S. law to respond to this survey. The U.S. 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.
If you need help completing the survey, please call our toll-free number (1–800–354–7271).
Thank you.

Enclosures

census.gov

Treatment 1: Questionnaire Package Questionnaire
13197017
U.S. DEPARTMENT OF COMMERCE

Economics and Statistics Administration
U.S. CENSUS BUREAU

THE

American Community Survey

Start Here
Respond online today at:
https://respond.census.gov/acs
OR
Complete this form and mail it
back as soon as possible.
This form asks for information about the
people who are living or staying at the
address on the mailing label and about the
house, apartment, or mobile home located
at the address on the mailing label.

➜Please print today’s date.
Month

Day

Year

➜Please print the name and telephone number of the person who is
filling out this form. We will only contact you if needed for official
Census Bureau business.
Last Name

First Name

Area Code + Number

If you need help or have questions
about completing this form, please call
1-800-354-7271. The telephone call is free.
Telephone Device for the Deaf (TDD):
Call 1–800–582–8330. The telephone call is free.
¿NECESITA AYUDA? Si usted habla español y
necesita ayuda para completar su cuestionario,
llame sin cargo alguno al 1-877-833-5625.
Usted también puede completar su entrevista
por teléfono con un entrevistador que habla
español. O puede responder por Internet en:
https://respond.census.gov/acs
For more information about the American
Community Survey, visit our web site at:
http://www.census.gov/acs

—

➜How many people are living or staying at this address?

• INCLUDE everyone who is living or staying here for more than 2 months.
• INCLUDE yourself if you are living here for more than 2 months.
• INCLUDE anyone else 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 or someone in the
Armed Forces on deployment.
Number of people

➜Fill out pages 2, 3, and 4 for everyone, including yourself, who is
living or staying at this address for more than 2 months. Then
complete the rest of the form.

ACS-1(2017)

FORM
(03-14-2016)

§.4g2¤
ACS-1(2017), Page 1, Base (Black)

ACS-1(2017), Page 1, Green Pantone 354 (18, 100%)

OMB No. 0607-0810
OMB No. 0607-0936

13197025

Person 1

Person 2
1 What is Person 2’s name?
Last Name (Please print)

(Person 1 is the person living or staying here in whose name this house
or apartment is owned, being bought, or rented. If there is no such
person, start with the name of any adult living or staying here.)

First Name

2 How is this person related to Person 1? Mark (X) ONE box.

1 What is Person 1’s name?
Last Name (Please print)

First Name

How is this person related to Person 1?
X

Person 1

Female

Month

Day

Housemate or roommate

Brother or sister

Unmarried partner

Father or mother

Foster child

Grandchild

Other nonrelative

Female

Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.

Year of birth

Age (in years)

Month

Day

Year of birth

➜NOTE: Please answer BOTH Question 5 about Hispanic origin and

Question 6 about race. For this survey, Hispanic origins are not races.

5 Is Person 2 of Hispanic, Latino, or Spanish origin?

Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican Am., Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard,
and so on. C

6 What is Person 2’s race? Mark (X) one or more boxes.

What is Person 1’s race? Mark (X) one or more boxes.
White

White

Black or African Am.

American Indian or Alaska Native — Print name of enrolled or principal tribe. C

Asian Indian

Japanese

Native Hawaiian

Asian Indian

Japanese

Native Hawaiian

Chinese

Korean

Guamanian or Chamorro

Chinese

Korean

Guamanian or Chamorro

Filipino

Vietnamese

Samoan

Filipino

Vietnamese

Samoan

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Other Asian – Print race,
for example, Hmong,
Laotian, Thai, Pakistani,
Cambodian, and so on. C

Some other race – Print race. C

Roomer or boarder

Stepson or stepdaughter

4 What is Person 2’s age and what is Person 2’s date of birth?

Question 6 about race. For this survey, Hispanic origins are not races.

Adopted son or daughter

Male

➜NOTE: Please answer BOTH Question 5 about Hispanic origin and
5

Other relative

3 What is Person 2’s sex? Mark (X) ONE box.

What is Person 1’s age and what is Person 1’s date of birth?
Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Son-in-law or daughter-in-law

Biological son or daughter

Parent-in-law

What is Person 1’s sex? Mark (X) ONE box.
Male

Husband or wife

Some other race – Print race. C

§.4g:¤
ACS-1(2017), Page 2, Base (Black)

ACS-1(2017), Page 2, Green Pantone 354 (18, 100%)

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Treatment 1: Questionnaire Package Return Envelope

AN EQUAL OPPORTUNITY EMPLOYER

OFFICIAL BUSINESS
Penalty for Private Use $300

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

6385-47(2014) (10-2013)

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 16081

WASHINGTON DC

POSTAGE WILL BE PAID BY THE U.S. CENSUS BUREAU

DIRECTOR
US CENSUS BUREAU PO
BOX 5240
J E F F E R S O N V I L L E IN 4 7 1 9 9 - 5 2 4 0

FFATTFADDDTAADTFADDFAFTDFFAADFFFAFDTFDTAFATFDFATADTTFDFDTFFFFATTF

Attachment B
Treatment 1 (Modified Production)
XVI.
XVII.
XVIII.
XIX.
XX.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 4: Second Reminder Mailing
Postcard:

ACS-29 (2017)(6-2017)

Treatment 1: Second Reminder Postcard
U.S. DEPARTMENT OF COMMERCE
Economic and Statistics
Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132-0001

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

ACS-29(2017) (6-2017)

U.S. DEPARTMENT OF COMMERCE
Economic and Statistics
Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132-0001
ACS-29(2017) (6-2017)

OFFICIAL BUSINESS
Penalty for Private Use $300

U.S. DEPARTMENT OF COMMERCE
Economic and Statistics
Administration
U.S. Census Bureau

1201 E 10th Street
Jeffersonville IN 47132-0001
ACS-29(2017) (6-2017)

OFFICIAL BUSINESS
Penalty for Private Use $300

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

1201 E 10th Street
Jeffersonville IN 47132-0001
ACS-29(2017) (6-2017)

OFFICIAL BUSINESS
Penalty for Private Use $300

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

ACS-29(2017) (6-2017)

UNITED STATES DEPARTMENT OF COMMERCE

ACS-29(2017) (6-2017)

Economics and Statistics Administration

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

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau . . .

Within the last few weeks, the U.S. Census Bureau sent you several requests to
complete the American Community Survey. Now is the time to complete the
survey if you have not already done so. Please complete the questionnaire
and return it now OR go to https://respond.census.gov/acs to respond online.

Your response to this survey is required by U.S. law. If you do not
respond, a Census Bureau interviewer may contact you to complete the survey.
Local and national leaders use the information from this survey for planning schools,
hospitals, roads, and other community needs.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

ACS-29(2017) (6-2017)

UNITED STATES DEPARTMENT OF COMMERCE

ACS-29(2017) (6-2017)

Economics and Statistics Administration

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

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau . . .

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

Attachment B
Treatment 1 (Modified Production)
XXI.
XXII.
XXIII.
XXIV.
XXV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 5: Final Reminder Mailing
Letter:

ACS-23(LX) MMTC

Treatment 1: Final Reminder Letter
ACS23(L)(2018) (22018)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau

Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

A message from the Director, U.S. Census Bureau ...
Within the last few weeks, the U.S. Census Bureau mailed an American Community Survey
questionnaire package to your address. You are required by U.S. law to respond to
this survey. The U.S. Census Bureau is required by law to keep your information
confidential. The Census Bureau is not permitted to publicly release your responses in a way
that could identify you. Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data. If
you have already responded, thank you. If you have not, please complete the questionnaire
and send it now, or complete the survey online.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
Your response is critically important to your local community and to your
country. If you do not respond, a Census Bureau interviewer may contact you by personal
visit to complete the survey.
If you would like to complete the survey by telephone or need assistance, please call our
toll-free number (1–800–354–7271).
Thank you.

Security Security Security Security Security

census.gov

U.S. DEPARTMENT OF
COMMERCE

Economics and Statistics Administration

U.S. CENSUS BUREAU
1201 E 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-23(L)(2018) (2-2018)

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment C
Treatment 2 (Emphasized Mandatory)
I.
II.
III.
IV.
V.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 1: Initial Mailing
Envelope:

ACS-46 IM (X)MMT

Instruction Card:

ACS-34IM (08_08_2013)

Letter:

ACS-13 (LX)MMT

Multilingual Brochure:

ACS-9 (2017)(11-2017)

Treatment 2: Initial Package Envelope

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46IM(X)MMT (3-2018)

OPEN IMMEDIATELY

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 2: Initial Package Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Go to https://respond.census.gov/acs to complete the American Community Survey online.

(Vea el otro lado
para español.)

8/7/2013 2:55:00 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Vaya a https://respond.census.gov/acs para completar la Encuesta sobre la Comunidad Estadounidense por
Internet en español.

ATENCIÓN: Necesitará información que aparece en la etiqueta en el otro lado de esta tarjeta para iniciar la sesión.
Si usted necesita ayuda para llenar la encuesta o tiene preguntas acerca de la Encuesta sobre la Comunidad
Estadounidense, llame sin cargo al 1-877-833-5625.

See other side for English.
ACS-34 IM (08/08/2013)

ACS-34IM (08_08_2013).indd 2

8/7/2013 2:55:00 PM

Treatment 2: Initial Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
Your address has been randomly selected by the U.S. Census Bureau to participate in the
American Community Survey. The Census Bureau conducts this survey each year to give our
country an up-to-date picture of how we live – including our education, housing, and jobs.
Communities across the country rely on information from this survey to decide where important
services are needed, including:
•
•
•

Improving roads and reducing traffic
Building schools
Planning for the health care needs of the elderly

Respond now at https://respond.census.gov/acs
Your response is required by U.S. law.
Because your household has been asked to participate on behalf of your community, it is vital
that you complete this survey to help meet critical needs in your area.
If you are unable to complete the survey online, we will send you a paper questionnaire in a
few weeks. The Census Bureau is using the internet to collect this information to conserve natural
resources, save taxpayers' money, and process data more efficiently.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you in advance for your prompt response.

Enclosures

American Community Survey data help determine the annual distribution of
more than $675

ACS-13(LX)MMT (4-2018)

billion in federal funds to communities nationwide.
census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 2: Initial Package Multilingual Brochure
Important
Information From the
U.S. Census Bureau

Issued September 2017
ACS-9 (2017)

Attachment C
Treatment 2 (Emphasized Mandatory)
VI.
VII.
VIII.
IX.
X.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 2: First Reminder Mailing
Letter:

ACS-20 (LX)MMT

Treatment 2: First Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
A few days ago, you should have received instructions for completing the American Community
Survey online. Local communities depend on information from this survey to decide where schools,
highways, hospitals, and other important services are needed. If you have not already responded,
please do so now.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
If we do not receive your response online, we will mail a paper questionnaire to your address.

Your response to this survey is required by law.
Your response is critically important to your local community and your country. Responding
promptly will prevent you from receiving additional reminder mailings, phone calls, or personal visits
from Census Bureau interviewers.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you in advance for your prompt response.

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-20(LX)MMT (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment C
Treatment 2 (Emphasized Mandatory)
XI.
XII.
XIII.
XIV.
XV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 3: Questionnaire Package Mailing
Envelope:

ACS-46(X)MMT

Letter:

ACS-14(LX)MMT

Survey Form:

ACS-1(X)MMT2 - First two pages

Return Envelope:

6385-47 (2014)(10-2013)

Treatment 2: Questionnaire Package Envelope

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46(X)MMT (3-2018)

OPEN IMMEDIATELY
U.S. CENSUS FORM ENCLOSED

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 2: Questionnaire Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
The U.S. Census Bureau recently sent you a request to complete the American Community Survey
online. If you have not already responded to this important survey, please do so now.
Complete the survey using ONLY ONE of the following options:

• Respond online at https://respond.census.gov/acs
• If you are unable to respond online, please fill out and
mail back the enclosed questionnaire.
You are required by U.S. law to respond to this survey.
The Census Bureau has randomly selected your address to receive this survey as part of a nationally
representative sample. Because you will be providing important information on behalf of your
community, it is vital that you complete this survey to help meet critical needs in your area – including
determining where to locate new schools, hospitals, and fire stations.
If you do not respond promptly, a Census Bureau interviewer may contact you to complete the survey.
The Census Bureau is required by law to keep your information confidential.
The Census Bureau is not permitted to publicly release your responses in a way that could identify
you or your household.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you for your prompt response.

Enclosures

ACS-14(LX)MMT (4-2018)

census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 2: Questionnaire Package Questionnaire

13017017

U.S. DEPARTMENT OF COMMERCE

The American Community Survey

Economics and Statistics Administration
U.S. CENSUS BUREAU

Start Here
We wrote to you earlier with a request to respond
online. We are sending this paper questionnaire to
all households that have not yet responded
because we realize not everyone can or wants to
respond over the internet.
You have two ways to respond:

➜

Please print the name and telephone number of the person who is
filling out this form. We will only contact you if needed for official
Census Bureau business.
Last Name

Respond online today at:
https://respond.census.gov/acs
OR
Complete this form and mail it
back as soon as possible.

First Name

Area Code + Number

—

Your response is required by law.
The American Community Survey is conducted by the
U.S. Census Bureau. This survey is one of only a few
surveys for which all recipients are required by law to
respond. The U.S. Census Bureau is required by law
to protect your information.

➜

If you need help or have questions
about completing this survey, please
call toll-free 1-800-354-7271.

How many people are living or staying at this address?
• INCLUDE everyone who is living or staying here for more than 2 months.
• INCLUDE yourself if you are living here for more than 2 months.
• INCLUDE anyone else 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 or someone in the
Armed Forces on deployment.
Number of people

Telephone Device for the Deaf (TDD):
Call toll free 1-800-582-8330.
¿Necesita ayuda? Llame sin cargo alguno al 1-877-833-5625.
For more information about the American Community
Survey, visit our website at: http://www.census.gov/acs

➜

Fill out pages 2, 3, and 4 for everyone, including yourself, who is
living or staying at this address for more than 2 months. Then
complete the rest of the form.

FORM

ACS-1(X)MMT2
(04-18-2018)

§."g2¤

OMB No. 0607-0810
OMB No. 0607-0936

13018015

Person 1

Person 2
1 What is Person 2’s name?

(Person 1 is the person living or staying here in whose name this house or
apartment is owned, being bought, or rented. If there is no such person, start
with the name of any adult living or staying here.)

➜

Last Name (Please print)

First Name

Please print today’s date.
Month

Day

2 How is this person related to Person 1? Mark (X) ONE box.

Year

What is Person 1’s name?
Last Name (Please print)

First Name

How is this person related to Person 1?
X

Person 1

Female

Month

Day

Year of birth

Question 6 about race. For this survey, Hispanic origins are not races.

Housemate or roommate

Brother or sister

Unmarried partner

Father or mother

Foster child

Grandchild

Other nonrelative

Female

4 What is Person 2’s age and what is Person 2’s date of birth?

Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Month

Day

Year of birth

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and

Question 6 about race. For this survey, Hispanic origins are not races.

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican Am., Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard,
and so on. C

6 What is Person 2’s race? Mark (X) one or more boxes.

What is Person 1’s race? Mark (X) one or more boxes.
White

White

Black or African Am.

American Indian or Alaska Native — Print name of enrolled or principal tribe. C

Asian Indian

Japanese

Native Hawaiian

Asian Indian

Japanese

Native Hawaiian

Chinese

Korean

Guamanian or Chamorro

Chinese

Korean

Guamanian or Chamorro

Filipino

Vietnamese

Samoan

Filipino

Vietnamese

Samoan

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Other Asian – Print race,
for example, Hmong,
Laotian, Thai, Pakistani,
Cambodian, and so on. C

Some other race – Print race. C

Roomer or boarder

Stepson or stepdaughter

5 Is Person 2 of Hispanic, Latino, or Spanish origin?

Is Person 1 of Hispanic, Latino, or Spanish origin?

Adopted son or daughter

Male

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and
5

Other relative

3 What is Person 2’s sex? Mark (X) ONE box.

What is Person 1’s age and what is Person 1’s date of birth?
Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Son-in-law or daughter-in-law

Biological son or daughter

Parent-in-law

What is Person 1’s sex? Mark (X) ONE box.
Male

Husband or wife

§."q0¤

Some other race – Print race. C

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Treatment 2: Questionnaire Package Return Envelope
AN EQUAL OPPORTUNITY EMPLOYER

OFFICIAL BUSINESS
Penalty for Private Use $300

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

6385-47(2014) (10-2013)

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 16081

WASHINGTON DC

POSTAGE WILL BE PAID BY THE U.S. CENSUS BUREAU

DIRECTOR
US CENSUS BUREAU
PO BOX 5240
JEFFERSONVILLE IN 47199-5240

FFATTFADDDTAADTFADDFAFTDFFAADFFFAFDTFDTAFATFDFATADTTFDFDTFFFFATTF

Attachment C
Treatment 1
XVI.
XVII.
XVIII.
XIX.
XX.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 4: Second Reminder Mailing
Postcard:

ACS-29(LX)MMT

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT (4-2018)

YOUR RESPONSE IS
REQUIRED BY LAW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT (4-2018)

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 2: Second Reminder Postcard

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

You are required by U.S. law to respond to this survey (Title 13, U.S. Code,
Sections 141, 193, and 221).

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

You are required by U.S. law to respond to this survey (Title 13, U.S. Code,
Sections 141, 193, and 221).

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

Attachment C
Treatment 2 (Emphasized Mandatory)
XXI.
XXII.
XXIII.
XXIV.
XXV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 5: Final Reminder Mailing
Letter:

ACS-23(LX)MMT

Treatment 2: Final Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
The U.S. Census Bureau has sent you several requests to complete the American
Community Survey. If you have not already done so, now is the time to respond.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
OR complete and mail back your paper questionnaire.
Your response is required by law.
If you do not respond promptly, a Census Bureau interviewer may contact you with a
personal visit to complete the survey. If you would like to complete the survey by
telephone or need assistance, please call our toll-free number (1–800–354–7271).
Thank you.

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-23(LX)MMT (4-2018)

FINAL NOTICE
RESPOND NOW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment D
Treatment 3 (De-emphasized Mandatory with Modified Questionnaire)
I.
II.
III.
IV.
V.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 1: Initial Mailing
Envelope:

ACS-46 IM (X)MMT

Instruction Card:

ACS-34IM (08_08_2013)

Letter:

ACS-13 (LX)MMT2

Multilingual Brochure:

ACS-9 (2017)(11-2017)

Treatment 3: Initial Package Envelope

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46IM(X)MMT (3-2018)

OPEN IMMEDIATELY

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 3: Initial Package Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Go to https://respond.census.gov/acs to complete the American Community Survey online.

(Vea el otro lado
para español.)

8/7/2013 2:55:00 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Vaya a https://respond.census.gov/acs para completar la Encuesta sobre la Comunidad Estadounidense por
Internet en español.

ATENCIÓN: Necesitará información que aparece en la etiqueta en el otro lado de esta tarjeta para iniciar la sesión.
Si usted necesita ayuda para llenar la encuesta o tiene preguntas acerca de la Encuesta sobre la Comunidad
Estadounidense, llame sin cargo al 1-877-833-5625.

See other side for English.
ACS-34 IM (08/08/2013)

ACS-34IM (08_08_2013).indd 2

8/7/2013 2:55:00 PM

Treatment 3: Initial Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

Improving roads and reducing traffic
Building schools
Planning for the health care needs of the elderly

Respond now at https://respond.census.gov/acs
Because your household has been asked to participate on behalf of your community, it is vital
that you complete this survey to help meet critical needs in your area. Your response is
required by U.S. law.
If you are unable to complete the survey online, we will send you a paper questionnaire in a
few weeks. The Census Bureau is using the internet to collect this information to conserve natural
resources, save taxpayers' money, and process data more efficiently.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you in advance for your prompt response.

Enclosures

American Community Survey data help determine the annual distribution of
more than $675

ACS-13(LX)MMT2 (4-2018)

billion in federal funds to communities nationwide.
census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 3: Initial Package Multilingual Brochure
Important
Information From the
U.S. Census Bureau

Issued September 2017
ACS-9 (2017)

Attachment D
Treatment 3 (De-emphasized Mandatory with Modified Questionnaire)
VI.
VII.
VIII.
IX.
X.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 2: First Reminder Mailing
Letter:

ACS-20 (LX)MMT2

Treatment 3: First Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
A few days ago, you should have received instructions for completing the American Community
Survey online. Local communities depend on information from this survey to decide where
schools, highways, hospitals, and other important services are needed. If you have not already
responded, please do so now.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
If we do not receive your response online, we will mail a paper questionnaire to your address.
Your response is critically important to your local community and your country and is required by
law. Responding promptly will prevent you from receiving additional reminder mailings, phone
calls, or personal visits from Census Bureau interviewers.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you in advance for your prompt response.

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-20(LX)MMT2 (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment D
Treatment 3 (De-emphasized Mandatory with Modified Questionnaire)
XI.
XII.
XIII.
XIV.
XV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 3: Questionnaire Package Mailing
Envelope:

ACS-46(X)MMT

Letter:

ACS-14(LX)MMT2

Survey Form:

ACS-1(X)MMT - First two pages

Return Envelope:

6385-47 (2014)(10-2013)

Treatment 3: Questionnaire Package Envelope

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46(X)MMT (3-2018)

OPEN IMMEDIATELY
U.S. CENSUS FORM ENCLOSED

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 2: Questionnaire Package Letter

Treatment 3: Questionnaire Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

• Respond online at https://respond.census.gov/acs
• If you are unable to respond online, please fill out and
mail back the enclosed questionnaire.
Your response is important to your community.
The Census Bureau has randomly selected your address to receive this survey as part of a nationally
representative sample. You are required by U.S. law to respond to this survey. Because you will
be providing important information on behalf of your community, it is vital that you complete this
survey to help meet critical needs in your area – including determining where to locate new schools,
hospitals, and fire stations.
If you do not respond promptly, a Census Bureau interviewer may contact you to complete the survey.
The Census Bureau is required by law to keep your information confidential.
The Census Bureau is not permitted to publicly release your responses in a way that could identify
you or your household.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you for your prompt response.

Enclosures

ACS-14(LX)MMT2 (4-2018)

census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 3: Questionnaire Package Questionnaire

13017017
U.S. DEPARTMENT OF COMMERCE

The American Community Survey

Economics and Statistics Administration
U.S. CENSUS BUREAU

➜

Last Name

Respond online today at:
https://respond.census.gov/acs
OR
Complete this form and mail it
back as soon as possible.

The American Community Survey is
conducted by the U.S. Census Bureau. This
survey is one of only a few surveys for which
all recipients are required by law to respond.
The U.S. Census Bureau is required by law to
protect your information.

Please print the name and telephone number of the person who is
filling out this form. We will only contact you if needed for official
Census Bureau business.

First Name

Area Code + Number

—

➜

If you need help or have questions
about completing this survey, please
call toll-free 1-800-354-7271.

➜

Fill out pages 2, 3, and 4 for everyone, including yourself, who is
living or staying at this address for more than 2 months. Then
complete the rest of the form.

ACS-1(X)MMT

FORM
(04-18-2018)

§."g2¤

OMB No. 0607-0810
OMB No. 0607-0936

13018015

Person 1

Person 2
1 What is Person 2’s name?

(Person 1 is the person living or staying here in whose name this house or
apartment is owned, being bought, or rented. If there is no such person, start
with the name of any adult living or staying here.)

➜

Last Name (Please print)

First Name

Please print today’s date.
Month

Day

2 How is this person related to Person 1? Mark (X) ONE box.

Year

What is Person 1’s name?
Last Name (Please print)

First Name

How is this person related to Person 1?
X

Person 1

Female

Month

Day

Year of birth

Question 6 about race. For this survey, Hispanic origins are not races.

Housemate or roommate

Brother or sister

Unmarried partner

Father or mother

Foster child

Grandchild

Other nonrelative

Female

4 What is Person 2’s age and what is Person 2’s date of birth?

Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Month

Day

Year of birth

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and

Question 6 about race. For this survey, Hispanic origins are not races.

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican Am., Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard,
and so on. C

6 What is Person 2’s race? Mark (X) one or more boxes.

What is Person 1’s race? Mark (X) one or more boxes.
White

White

Black or African Am.

American Indian or Alaska Native — Print name of enrolled or principal tribe. C

Asian Indian

Japanese

Native Hawaiian

Asian Indian

Japanese

Native Hawaiian

Chinese

Korean

Guamanian or Chamorro

Chinese

Korean

Guamanian or Chamorro

Filipino

Vietnamese

Samoan

Filipino

Vietnamese

Samoan

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Other Asian – Print race,
for example, Hmong,
Laotian, Thai, Pakistani,
Cambodian, and so on. C

Some other race – Print race. C

Roomer or boarder

Stepson or stepdaughter

5 Is Person 2 of Hispanic, Latino, or Spanish origin?

Is Person 1 of Hispanic, Latino, or Spanish origin?

Adopted son or daughter

Male

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and
5

Other relative

3 What is Person 2’s sex? Mark (X) ONE box.

What is Person 1’s age and what is Person 1’s date of birth?
Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Son-in-law or daughter-in-law

Biological son or daughter

Parent-in-law

What is Person 1’s sex? Mark (X) ONE box.
Male

Husband or wife

§."q0¤

Some other race – Print race. C

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Treatment 3: Questionnaire Package Return Envelope
AN EQUAL OPPORTUNITY EMPLOYER

OFFICIAL BUSINESS
Penalty for Private Use $300

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

6385-47(2014) (10-2013)

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 16081

WASHINGTON DC

POSTAGE WILL BE PAID BY THE U.S. CENSUS BUREAU

DIRECTOR
US CENSUS BUREAU
PO BOX 5240
JEFFERSONVILLE IN 47199-5240

FFATTFADDDTAADTFADDFAFTDFFAADFFFAFDTFDTAFATFDFATADTTFDFDTFFFFATTF

Attachment D
Treatment 3 (De-emphasized Mandatory with Modified Questionnaire)
XVI.
XVII.
XVIII.
XIX.
XX.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 4: Second Reminder Mailing
Postcard:

ACS-29(LX)MMT2

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT2 (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT2 (4-2018)

Treatment 3: Second Reminder Postcard

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

Your response to this survey is required by U.S. law (Title 13, U.S. Code,
Sections 141, 193, and 221).

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

Your response to this survey is required by U.S. law (Title 13, U.S. Code,
Sections 141, 193, and 221).

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

Attachment D
Treatment 3 (De-emphasized Mandatory with Modified Questionnaire)
XXI.
XXII.
XXIII.
XXIV.
XXV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 5: Final Reminder Mailing
Letter:

ACS-23(LX)MMT2

Treatment 3: Final Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-23(LX)MMT2 (4-2018)

FINAL NOTICE
RESPOND NOW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment E
Treatment 4 (Softer/Eliminated Mandatory)
I.
II.
III.
IV.
V.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 1: Initial Mailing
Envelope:

ACS-46 IM (X)MMT3

Instruction Card:

ACS-34IM (08_08_2013)

Letter:

ACS-13 (LX)MMT2

Multilingual Brochure:

ACS-9 (2017)(11-2017)

Treatment 4: Initial Package Envelope

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46IM(X)MMT3 (3-2018)

YOUR RESPONSE IS
REQUIRED BY LAW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Treatment 4: Initial Package Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Go to https://respond.census.gov/acs to complete the American Community Survey online.

(Vea el otro lado
para español.)

8/7/2013 2:55:00 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Vaya a https://respond.census.gov/acs para completar la Encuesta sobre la Comunidad Estadounidense por
Internet en español.

ATENCIÓN: Necesitará información que aparece en la etiqueta en el otro lado de esta tarjeta para iniciar la sesión.
Si usted necesita ayuda para llenar la encuesta o tiene preguntas acerca de la Encuesta sobre la Comunidad
Estadounidense, llame sin cargo al 1-877-833-5625.

See other side for English.
ACS-34 IM (08/08/2013)

ACS-34IM (08_08_2013).indd 2

8/7/2013 2:55:00 PM

Treatment 4: Initial Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

Improving roads and reducing traffic
Building schools
Planning for the health care needs of the elderly

Enclosures

American Community Survey data help determine the annual distribution of
more than $675

ACS-13(LX)MMT2 (4-2018)

billion in federal funds to communities nationwide.
census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 4: Initial Package Multilingual Brochure
Important
Information From the
U.S. Census Bureau

Issued September 2017
ACS-9 (2017)

Attachment E
Treatment 4 (Softer/Eliminated Mandatory)
VI.
VII.
VIII.
IX.
X.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 2: First Reminder Mailing
Letter:

ACS-20 (LX)MMT2

Treatment 4: First Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
A few days ago, you should have received instructions for completing the American Community
Survey online. Local communities depend on information from this survey to decide where
schools, highways, hospitals, and other important services are needed. If you have not already
responded, please do so now.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
If we do not receive your response online, we will mail a paper questionnaire to your address.
Your response is critically important to your local community and your country and is required by
law. Responding promptly will prevent you from receiving additional reminder mailings, phone
calls, or personal visits from Census Bureau interviewers.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you in advance for your prompt response.

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-20(LX)MMT2 (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment E
Treatment 4 (Softer/Eliminated Mandatory)
XI.
XII.
XIII.
XIV.
XV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 3: Questionnaire Package Mailing
Envelope:

ACS-46(X)MMT3

Letter:

ACS-14(LX)MMT3

Survey Form:

ACS-1(X)MMT - First two pages

Return Envelope:

6385-47 (2014)(10-2013)

Treatment 4: Questionnaire Package Envelope

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46(X)MMT3 (3-2018)

U.S. CENSUS FORM ENCLOSED

YOUR RESPONSE IS
REQUIRED BY LAW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Treatment 3: Questionnaire Package Letter

Treatment 4: Questionnaire Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

• Respond online at https://respond.census.gov/acs
• If you are unable to respond online, please fill out and
mail back the enclosed questionnaire.
Your response is important to your community.
The Census Bureau has randomly selected your address to receive this survey as part of a nationally
representative sample. Because you will be providing important information on behalf of your
community, it is vital that you complete this survey to help meet critical needs in your area – including
determining where to locate new schools, hospitals, and fire stations.
If you do not respond promptly, a Census Bureau interviewer may contact you to complete the survey.
The Census Bureau is required by law to keep your information confidential.
The Census Bureau is not permitted to publicly release your responses in a way that could identify
you or your household.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you for your prompt response.

Enclosures

ACS-14(LX)MMT3 (4-2018)

census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 4: Questionnaire Package Questionnaire

13017017
U.S. DEPARTMENT OF COMMERCE

The American Community Survey

Economics and Statistics Administration
U.S. CENSUS BUREAU

➜

Last Name

Respond online today at:
https://respond.census.gov/acs
OR
Complete this form and mail it
back as soon as possible.

Please print the name and telephone number of the person who is
filling out this form. We will only contact you if needed for official
Census Bureau business.

First Name

Area Code + Number

—

➜

If you need help or have questions
about completing this survey, please
call toll-free 1-800-354-7271.

➜

Fill out pages 2, 3, and 4 for everyone, including yourself, who is
living or staying at this address for more than 2 months. Then
complete the rest of the form.

ACS-1(X)MMT

FORM
(04-18-2018)

§."g2¤

OMB No. 0607-0810
OMB No. 0607-0936

13018015

Person 1

Person 2
1 What is Person 2’s name?

(Person 1 is the person living or staying here in whose name this house or
apartment is owned, being bought, or rented. If there is no such person, start
with the name of any adult living or staying here.)

➜

Last Name (Please print)

First Name

Please print today’s date.
Month

Day

2 How is this person related to Person 1? Mark (X) ONE box.

Year

What is Person 1’s name?
Last Name (Please print)

First Name

How is this person related to Person 1?
X

Person 1

Female

Month

Day

Year of birth

Question 6 about race. For this survey, Hispanic origins are not races.

Housemate or roommate

Brother or sister

Unmarried partner

Father or mother

Foster child

Grandchild

Other nonrelative

Female

4 What is Person 2’s age and what is Person 2’s date of birth?

Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Month

Day

Year of birth

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and

Question 6 about race. For this survey, Hispanic origins are not races.

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican Am., Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard,
and so on. C

6 What is Person 2’s race? Mark (X) one or more boxes.

What is Person 1’s race? Mark (X) one or more boxes.
White

White

Black or African Am.

American Indian or Alaska Native — Print name of enrolled or principal tribe. C

Asian Indian

Japanese

Native Hawaiian

Asian Indian

Japanese

Native Hawaiian

Chinese

Korean

Guamanian or Chamorro

Chinese

Korean

Guamanian or Chamorro

Filipino

Vietnamese

Samoan

Filipino

Vietnamese

Samoan

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Other Asian – Print race,
for example, Hmong,
Laotian, Thai, Pakistani,
Cambodian, and so on. C

Some other race – Print race. C

Roomer or boarder

Stepson or stepdaughter

5 Is Person 2 of Hispanic, Latino, or Spanish origin?

Is Person 1 of Hispanic, Latino, or Spanish origin?

Adopted son or daughter

Male

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and
5

Other relative

3 What is Person 2’s sex? Mark (X) ONE box.

What is Person 1’s age and what is Person 1’s date of birth?
Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Son-in-law or daughter-in-law

Biological son or daughter

Parent-in-law

What is Person 1’s sex? Mark (X) ONE box.
Male

Husband or wife

§."q0¤

Some other race – Print race. C

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Treatment 4: Questionnaire Package Return Envelope
AN EQUAL OPPORTUNITY EMPLOYER

OFFICIAL BUSINESS
Penalty for Private Use $300

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

6385-47(2014) (10-2013)

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 16081

WASHINGTON DC

POSTAGE WILL BE PAID BY THE U.S. CENSUS BUREAU

DIRECTOR
US CENSUS BUREAU
PO BOX 5240
JEFFERSONVILLE IN 47199-5240

FFATTFADDDTAADTFADDFAFTDFFAADFFFAFDTFDTAFATFDFATADTTFDFDTFFFFATTF

Attachment E
Treatment 4 (Softer/Eliminated Mandatory)
XVI.
XVII.
XVIII.
XIX.
XX.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 4: Second Reminder Mailing
Postcard:

ACS-29(LX)MMT3

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT3 (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT3 (4-2018)

Treatment 4: Second Reminder Postcard

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

Attachment E
Treatment 4 (Softer/Eliminated Mandatory)
XXI.
XXII.
XXIII.
XXIV.
XXV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 5: Final Reminder Mailing
Letter:

ACS-23(LX)MMT3

Treatment 4: Final Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

Respond now at https://respond.census.gov/acs
Log in using this user ID:
OR complete and mail back your paper questionnaire.
If you do not respond promptly, a Census Bureau interviewer may contact you with a
personal visit to complete the survey. If you would like to complete the survey by
telephone or need assistance, please call our toll-free number (1–800–354–7271).
Thank you.

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-23(LX)MMT3 (4-2018)

FINAL NOTICE
RESPOND NOW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment F
Treatment 5 (De-emphasized Mandatory with Current Questionnaire)
I.
II.
III.
IV.
V.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 1: Initial Mailing
Envelope:

ACS-46 IM (X)MMT

Instruction Card:

ACS-34IM (08_08_2013)

Letter:

ACS-13 (LX)MMT2

Multilingual Brochure:

ACS-9 (2017)(11-2017)

Treatment 5: Initial Package Envelope

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46IM(X)MMT (3-2018)

OPEN IMMEDIATELY

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 5: Initial Package Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Go to https://respond.census.gov/acs to complete the American Community Survey online.

(Vea el otro lado
para español.)

8/7/2013 2:55:00 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Vaya a https://respond.census.gov/acs para completar la Encuesta sobre la Comunidad Estadounidense por
Internet en español.

ATENCIÓN: Necesitará información que aparece en la etiqueta en el otro lado de esta tarjeta para iniciar la sesión.
Si usted necesita ayuda para llenar la encuesta o tiene preguntas acerca de la Encuesta sobre la Comunidad
Estadounidense, llame sin cargo al 1-877-833-5625.

See other side for English.
ACS-34 IM (08/08/2013)

ACS-34IM (08_08_2013).indd 2

8/7/2013 2:55:00 PM

Treatment 5: Initial Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

Improving roads and reducing traffic
Building schools
Planning for the health care needs of the elderly

Enclosures

American Community Survey data help determine the annual distribution of
more than $675

ACS-13(LX)MMT2 (4-2018)

billion in federal funds to communities nationwide.
census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 5: Initial Package Multilingual Brochure
Important
Information From the
U.S. Census Bureau

Issued September 2017
ACS-9 (2017)

Attachment F
Treatment 5 (De-emphasized Mandatory with Current Questionnaire)
VI.
VII.
VIII.
IX.
X.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 2: First Reminder Mailing
Letter:

ACS-20 (LX)MMT2

Treatment 5: First Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

A message from the Director of the U.S. Census Bureau:
A few days ago, you should have received instructions for completing the American Community
Survey online. Local communities depend on information from this survey to decide where
schools, highways, hospitals, and other important services are needed. If you have not already
responded, please do so now.

Respond now at https://respond.census.gov/acs
Log in using this user ID:
If we do not receive your response online, we will mail a paper questionnaire to your address.
Your response is critically important to your local community and your country and is required by
law. Responding promptly will prevent you from receiving additional reminder mailings, phone
calls, or personal visits from Census Bureau interviewers.
If you need help completing the survey or have questions, please call our toll-free number
(1–800–354–7271).
Thank you in advance for your prompt response.

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-20(LX)MMT2 (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment F
Treatment 5 (De-emphasized Mandatory with Current Questionnaire)
XI.
XII.
XIII.
XIV.
XV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 3: Questionnaire Package Mailing
Envelope:

ACS-46(X)MMT

Letter:

ACS-14(LX)MMT2

Survey Form:

ACS-1 (2017) - First two pages

Return Envelope:

6385-47 (2014)(10-2013)

Treatment 5: Questionnaire Package Envelope

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-46(X)MMT (3-2018)

OPEN IMMEDIATELY
U.S. CENSUS FORM ENCLOSED

YOUR RESPONSE IS
REQUIRED BY LAW

Treatment 4: Questionnaire Package Letter

Treatment 5: Questionnaire Package Letter

DC
U.S. Census Bureau
Washington, DC 20233

Enclosures

ACS-14(LX)MMT2 (4-2018)

census.gov

Will my response be confidential?
Yes. The U.S. Census Bureau is required by law to protect this information. The Census Bureau is
not permitted to publicly release your responses in a way that could identify you. We are
conducting this survey under the authority of Title 13, United States Code, Sections 141 and
193. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Am I required to fill out the survey?
Yes. Your response to this survey is required by law (Title 13, U.S. Code, Sections 141, 193, and
221). Title 13, as changed by Title 18, imposes a penalty for not responding. As a randomly
selected representative of your community, you are the voice of your neighbors and peers. To
create an accurate picture of your community, it is critical that you respond.
How will the Census Bureau use the information I provide?
By law, the Census Bureau can only use your responses to produce statistics. Your information
will be used in combination with information from other households to produce data for your
community. Similar data will be produced for communities across Puerto Rico and the United
States.
We may combine your answers with information that you gave to other agencies to enhance the
statistical uses of these data. This information will be given the same protections as your survey
information. Based on the information that you provide, you may be asked to participate in
other Census Bureau surveys that are voluntary.

Treatment 5: Questionnaire Package Questionnaire
13197017

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

THE

American Community Survey

Start Here
Respond online today at:
https://respond.census.gov/acs
OR
Complete this form and mail it
back as soon as possible.

➜

Please print today’s date.
Month

➜

Day

Year

Please print the name and telephone number of the person who is
filling out this form. We will only contact you if needed for official
Census Bureau business.
Last Name

This form asks for information about the
people who are living or staying at the
address on the mailing label and about the
house, apartment, or mobile home located
at the address on the mailing label.

First Name

Area Code + Number

—

➜

Fill out pages 2, 3, and 4 for everyone, including yourself, who is
living or staying at this address for more than 2 months. Then
complete the rest of the form.

¿NECESITA AYUDA? Si usted habla español y
necesita ayuda para completar su cuestionario,
llame sin cargo alguno al 1-877-833-5625.
Usted también puede completar su entrevista
por teléfono con un entrevistador que habla
español. O puede responder por Internet en:
https://respond.census.gov/acs
For more information about the American
Community Survey, visit our web site at:
http://www.census.gov/acs

ACS-1(2017)

FORM
(03-14-2016)

§.4g2¤
ACS-1(2017), Page 1, Base (Black)

ACS-1(2017), Page 1, Green Pantone 354 (18, 100%)

OMB No. 0607-0810
OMB No. 0607-0936

13197025

Person 1

Person 2
1 What is Person 2’s name?

Last Name (Please print)

First Name

2 How is this person related to Person 1? Mark (X) ONE box.

What is Person 1’s name?
Last Name (Please print)

First Name

How is this person related to Person 1?
X

Person 1

Female

Month

Day

Housemate or roommate

Brother or sister

Unmarried partner

Father or mother

Foster child

Grandchild

Other nonrelative

Female

Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.

Year of birth

Age (in years)

Month

Day

Year of birth

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and

Question 6 about race. For this survey, Hispanic origins are not races.

5 Is Person 2 of Hispanic, Latino, or Spanish origin?

Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican Am., Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard,
and so on. C

6 What is Person 2’s race? Mark (X) one or more boxes.

What is Person 1’s race? Mark (X) one or more boxes.
White

White

Black or African Am.

American Indian or Alaska Native — Print name of enrolled or principal tribe. C

Asian Indian

Japanese

Native Hawaiian

Asian Indian

Japanese

Native Hawaiian

Chinese

Korean

Guamanian or Chamorro

Chinese

Korean

Guamanian or Chamorro

Filipino

Vietnamese

Samoan

Filipino

Vietnamese

Samoan

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Other Asian – Print race,
for example, Hmong,
Laotian, Thai, Pakistani,
Cambodian, and so on. C

Some other race – Print race. C

Roomer or boarder

Stepson or stepdaughter

4 What is Person 2’s age and what is Person 2’s date of birth?

Question 6 about race. For this survey, Hispanic origins are not races.

Adopted son or daughter

Male

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and
5

Other relative

3 What is Person 2’s sex? Mark (X) ONE box.

What is Person 1’s age and what is Person 1’s date of birth?
Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Son-in-law or daughter-in-law

Biological son or daughter

Parent-in-law

What is Person 1’s sex? Mark (X) ONE box.
Male

Husband or wife

Some other race – Print race. C

§.4g:¤
ACS-1(2017), Page 2, Base (Black)

ACS-1(2017), Page 2, Green Pantone 354 (18, 100%)

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Treatment 5: Questionnaire Package Return Envelope
AN EQUAL OPPORTUNITY EMPLOYER

OFFICIAL BUSINESS
Penalty for Private Use $300

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

6385-47(2014) (10-2013)

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 16081

WASHINGTON DC

POSTAGE WILL BE PAID BY THE U.S. CENSUS BUREAU

DIRECTOR
US CENSUS BUREAU
PO BOX 5240
JEFFERSONVILLE IN 47199-5240

FFATTFADDDTAADTFADDFAFTDFFAADFFFAFDTFDTAFATFDFATADTTFDFDTFFFFATTF

Attachment F
Treatment 5 (De-emphasized Mandatory with Current Questionnaire)
XVI.
XVII.
XVIII.
XIX.
XX.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 4: Second Reminder Mailing
Postcard:

ACS-29(LX)MMT2

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT2 (4-2018)

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES
PAID
U.S. Census Bureau
Permit No. G-58

U.S. Department of Commerce

Economics and Statistics Administration

U.S. Census Bureau

National Processing Center

1201 E. 10th St.
Jeffersonville, IN 47132-0001

OFFICIAL BUSINESS
Penalty for Private Use $300

ACS-29(X)MMT2 (4-2018)

Treatment 5: Second Reminder Postcard

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

Your response to this survey is required by U.S. law (Title 13, U.S. Code,
Sections 141, 193, and 221).

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

The U.S. Census Bureau has sent you repeated requests to complete the
American Community Survey. If you have not already responded, it is
imperative that you complete this survey now.

Complete and mail back your paper questionnaire now.
Or respond at https://respond.census.gov/acs

Your response to this survey is required by U.S. law (Title 13, U.S. Code,
Sections 141, 193, and 221).

If you do not respond now, a Census Bureau interviewer may contact you to
complete the survey.

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

Attachment F
Treatment 5 (De-emphasized Mandatory with Current Questionnaire)
XXI.
XXII.
XXIII.
XXIV.
XXV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 5: Final Reminder Mailing
Letter:

ACS-23(LX)MMT2

Treatment 5: Final Reminder Letter

DC
U.S. Census Bureau
Washington, DC 20233

Security Security Security Security Security

census.gov

DC
U.S. Department of Commerce
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
1201 E. 10th St.
Jeffersonville, IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
AN EQUAL OPPORTUNITY EMPLOYER
ACS-23(LX)MMT2 (4-2018)

FINAL NOTICE
RESPOND NOW

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment G
Production ACS, Treatment 6, and Treatment 7
Materials
I.
II.
III.
IV.
V.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 1: Initial Mailing
Envelope:

ACS-46 IM(2013)(12-2012)

Instruction Card:

ACS-34IM (08_08_2013)

Letter:

ACS-13 (L)(2017)(6-2017)

FAQ Brochure:

ACS-10SM (2017)(8-2017)

Multilingual Brochure:

ACS-9 (2017)(11-2017)

Production ACS Materials: Initial Package Envelope

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
ACS-46IM(2013) (12-2012)

The American Community Survey

YOUR RESPONSE IS
REQUIRED BY LAW

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Production ACS Materials: Initial Package Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Go to https://respond.census.gov/acs to complete the American Community Survey online.

(Vea el otro lado
para español.)

8/7/2013 2:55:00 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Vaya a https://respond.census.gov/acs para completar la Encuesta sobre la Comunidad Estadounidense por
Internet en español.

ATENCIÓN: Necesitará información que aparece en la etiqueta en el otro lado de esta tarjeta para iniciar la sesión.
Si usted necesita ayuda para llenar la encuesta o tiene preguntas acerca de la Encuesta sobre la Comunidad
Estadounidense, llame sin cargo al 1-877-833-5625.

See other side for English.
ACS-34 IM (08/08/2013)

ACS-34IM (08_08_2013).indd 2

8/7/2013 2:55:00 PM

Production ACS Materials: Initial Package Letter

ACS-13(L)(2017)
(6-2017)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau ...
Your household has been randomly selected to complete a very important national survey,
the American Community Survey. The U.S. Census Bureau conducts this survey to give our
country an up-to-date picture of how we live—our education, employment, housing, and more.
Using the enclosed instructions, please complete the survey online as soon as possible at:
https://respond.census.gov/acs
The Census Bureau is using the Internet to collect this information in an effort to conserve
natural resources, save taxpayers’ money, and process your data more efficiently. If you are
unable to complete the survey online, there is no need to contact us. We will send you a
paper questionnaire in a few weeks.
This survey collects critical information used to meet the needs of communities across the
United States. For example, results from this survey are used to decide where new schools,
hospitals, and fire stations are needed. This information also helps communities plan for the
kinds of emergency situations that might affect you and your neighbors, such as floods and
other natural disasters.
The Census Bureau chose your address, not you personally, as part of a randomly selected
sample. You are required by U.S. law to respond to this survey. The U.S. Census Bureau is
required by law to keep your information confidential. The Census Bureau is not permitted to
publicly release your responses in a way that could identify you. Per the Federal Cybersecurity
Enhancement Act of 2015, your data are protected from cybersecurity risks through screening
of the systems that transmit your data. The enclosed brochures answer frequently asked
questions about the survey.
If you need help completing the survey, please call our toll-free number (1–800–354–7271).
Thank you.

Enclosures

census.gov

Production ACS Materials: Initial Package FAQ
census.gov/acs
1-800-354-7271

Frequently Asked
Questions

AMERICAN
COMMUNITY
SURVEY

American
Community
Survey
Si necesita ayuda para completar su cuestionario,
llame sin cargo alguno al: 1-877-833-5625.

Issued April 2018
ACS-10SM(2018)

U.S. Department of Commerce
Economics and Statistics Administration
U.S. CENSUS BUREAU

census.gov

ACS-10SM_April(2018).indd 1

4/11/2018 8:57:07 AM

Frequently Asked Questions
What is the American Community Survey?
The American Community Survey collects information
about population and housing characteristics for the
nation, states, cities, counties, metropolitan areas, and
communities on a continuous basis. Based on the
American Community Survey, the U.S. Census Bureau can
provide up-to-date data about our rapidly changing
country more often than once every 10 years when the
census is conducted.

Do I have to answer the questions on the
American Community Survey?
Yes. Your response to this survey is required by law
(Title 13, U.S. Code, Sections 141,193, and 221). Title 13,
as changed by Title 18, imposes a penalty for not
responding. We estimate this survey will take about 40
minutes to complete.

Will the Census Bureau keep my
information confidential?
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. Per the Federal Cybersecurity Enhancement
Act of 2015, your data are protected from cybersecurity
risks through screening of the systems that transmit
your data.

How will the Census Bureau use the
information that I provide?
How do I benefit by answering the
American Community Survey?
Communities need data about the well-being of children,
families, and the older population to provide services to
them. By responding to the American Community Survey
questionnaire, you are helping your community to
establish goals, identify problems and solutions, and
measure the performance of programs.
The data also are used to decide where to locate new
highways, schools, hospitals, and community centers; to
show a large corporation that a town has the workforce
the company needs; and in many other ways.

ACS-10SM_April(2018).indd 2

By law, the Census Bureau can only use your responses
to produce statistics. Your information will be used in
combination with information from other households to
produce data for your community. Similar data will be
produced for communities across Puerto Rico and the
United States.

Where can I find more information about
the American Community Survey or get
assistance?
You may visit our Web site at census.gov/acs or call
1-800-354-7271, if you need assistance or more
information.

We may combine your answers with information that
you gave to other agencies to enhance the statistical
uses of these data. This information will be given the
same protections as your survey information. Based on
the information that you provide, you may be asked to
participate in other Census Bureau surveys that are
voluntary.

4/11/2018 8:57:09 AM

Production ACS Materials: Initial Package Multilingual Brochure
Important
Information From the
U.S. Census Bureau

Issued September 2017
ACS-9 (2017)

Attachment G
Production ACS, Treatment 6, and Treatment 7
VI.
Materials
VII.
VIII.
IX.
X.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 2: First Reminder Mailing
Letter:

ACS-20 (L)(2018)(2-2018)

Production ACS Materials: First Reminder Letter
ACS-20(L)(2018)
(2-2018)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

Security Security Security Security Security

census.gov

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
1201 E 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
ACS-20(L)(2018) (2-2018)

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Attachment G
Production ACS, Treatment 6, and Treatment 7 Materials
XI.
XII.
XIII.
XIV.
XV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 3: Questionnaire Package Mailing
Envelope:

ACS-46 (2012)(5-2011)

Instruction Card:

ACS-34RM (11-15-2016)

Letter:

ACS-14 (L)(2017)(6-2017)

Survey Form:

ACS-1 (2017) - First two pages

FAQ:

ACS-10SM(2017)(8-2017)

Return Envelope:

6385-47 (2014)(10-2013)

Production ACS Materials: Questionnaire Package Envelope

The American Community Survey
Form Enclosed

YOUR RESPONSE IS
REQUIRED BY LAW

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

Production ACS Materials: Questionnaire Package Instruction Card

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Hay dos maneras para completar la Encuesta sobre la Comunidad
Estadounidense:
Opción 1 – Vaya a https://respond.census.gov/acs para completar la encuesta por
Internet en español. ATENCIÓN: Necesitará información que aparece en la etiqueta
del cuestionario adjunto para iniciar la sesión.

Opción 2 – Llene y devuelva por correo el cuestionario adjunto en el sobre de envío incluido.
Por favor, escoja SOLAMENTE una manera de responder. Si usted necesita ayuda para llenar la
encuesta o tiene preguntas acerca de la Encuesta sobre la Comunidad Estadounidense, llame sin
cargo al 1-877-833-5625.
See other side for English.
ACS-34RM (11/15/2016)

ACS-34 RM (11_15_2016)_11_2016.indd 1

11/16/2016 2:48:06 PM

American Community Survey
U.S. Department of Commerce | Economics and Statistics Administration

Two Ways to Complete the American Community Survey:
Option 1 – Go to https://respond.census.gov/acs to complete the survey online.
IMPORTANT: You will need information from the address label on the enclosed
questionnaire to log in.
Option 2 – Fill out the enclosed questionnaire and mail it back in the postage-paid envelope.

Please choose ONLY one way to respond. If you need help or have questions about the
American Community Survey, call the toll-free number 1–800–354–7271.
Vea el otro lado para español.
ACS-34RM (11/15/2016)

ACS-34 RM (11_15_2016)_11_2016.indd 2

11/16/2016 2:48:06 PM

Production ACS Materials: Questionnaire Package Letter
ACS-14(L)(2017)
(6-2017)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau...
About two weeks ago, the U.S. Census Bureau sent instructions for completing the American
Community Survey to your address. We asked you to help us with this very important survey by
completing it online. But we have not received your response yet.
If you have already completed the survey, thank you very much. If you have not, please complete
the survey soon using ONE of the following two options.
Option 1: Go to https://respond.census.gov/acs to complete the survey online.
Option 2: Fill out and mail back the enclosed questionnaire.
This survey is so important that a Census Bureau representative may attempt to contact you by
telephone or personal visit if we do not receive your response.
The information collected in this survey will help decide where new schools, hospitals, and fire
stations are needed. The information also is used to develop programs to reduce traffic
congestion, provide job training, and plan for the health care needs of the elderly.
The Census Bureau chose your address, not you personally, as part of a randomly selected
sample. You are required by U.S. law to respond to this survey. The U.S. Census Bureau is
required by law to keep your information confidential. The Census Bureau is not permitted to
publicly release your responses in a way that could identify you. Per the Federal Cybersecurity
Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of
the systems that transmit your data. The enclosed brochure answers frequently asked questions
about the survey.
If you need help completing the survey, please call our toll–free number (1–800–354–7271).
Thank you.

Enclosures

census.gov

Production ACS Materials: Questionnaire Package Questionnaire
13197017

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

THE

American Community Survey

Start Here
Respond online today at:
https://respond.census.gov/acs
OR
Complete this form and mail it
back as soon as possible.

➜

Please print today’s date.
Month

➜

Day

Year

Please print the name and telephone number of the person who is
filling out this form. We will only contact you if needed for official
Census Bureau business.
Last Name

First Name

Area Code + Number

—

➜

Fill out pages 2, 3, and 4 for everyone, including yourself, who is
living or staying at this address for more than 2 months. Then
complete the rest of the form.

ACS-1(2017)

FORM
(03-14-2016)

§.4g2¤
ACS-1(2017), Page 1, Base (Black)

ACS-1(2017), Page 1, Green Pantone 354 (18, 100%)

OMB No. 0607-0810
OMB No. 0607-0936

13197025

Person 1

Person 2
1 What is Person 2’s name?

Last Name (Please print)

First Name

2 How is this person related to Person 1? Mark (X) ONE box.

What is Person 1’s name?
Last Name (Please print)

First Name

How is this person related to Person 1?
X

Person 1

Female

Month

Day

Housemate or roommate

Brother or sister

Unmarried partner

Father or mother

Foster child

Grandchild

Other nonrelative

Female

Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.

Year of birth

Age (in years)

Month

Day

Year of birth

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and

Question 6 about race. For this survey, Hispanic origins are not races.

5 Is Person 2 of Hispanic, Latino, or Spanish origin?

Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican Am., Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard,
and so on. C

6 What is Person 2’s race? Mark (X) one or more boxes.

What is Person 1’s race? Mark (X) one or more boxes.
White

White

Black or African Am.

American Indian or Alaska Native — Print name of enrolled or principal tribe. C

Asian Indian

Japanese

Native Hawaiian

Asian Indian

Japanese

Native Hawaiian

Chinese

Korean

Guamanian or Chamorro

Chinese

Korean

Guamanian or Chamorro

Filipino

Vietnamese

Samoan

Filipino

Vietnamese

Samoan

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Other Asian – Print race,
for example, Hmong,
Laotian, Thai, Pakistani,
Cambodian, and so on. C

Some other race – Print race. C

Roomer or boarder

Stepson or stepdaughter

4 What is Person 2’s age and what is Person 2’s date of birth?

Question 6 about race. For this survey, Hispanic origins are not races.

Adopted son or daughter

Male

➜ NOTE: Please answer BOTH Question 5 about Hispanic origin and
5

Other relative

3 What is Person 2’s sex? Mark (X) ONE box.

What is Person 1’s age and what is Person 1’s date of birth?
Please report babies as age 0 when the child is less than 1 year old.
Print numbers in boxes.
Age (in years)

Son-in-law or daughter-in-law

Biological son or daughter

Parent-in-law

What is Person 1’s sex? Mark (X) ONE box.
Male

Husband or wife

Some other race – Print race. C

§.4g:¤
ACS-1(2017), Page 2, Base (Black)

ACS-1(2017), Page 2, Green Pantone 354 (18, 100%)

Other Pacific Islander –
Print race, for example,
Fijian, Tongan, and
so on. C

Production ACS Materials: Questionnaire Package FAQ
census.gov/acs
1-800-354-7271

Frequently Asked
Questions

AMERICAN
COMMUNITY
SURVEY

American
Community
Survey
Si necesita ayuda para completar su cuestionario,
llame sin cargo alguno al: 1-877-833-5625.

Issued April 2018
ACS-10SM(2018)

U.S. Department of Commerce
Economics and Statistics Administration
U.S. CENSUS BUREAU

census.gov

ACS-10SM_April(2018).indd 1

4/11/2018 8:57:07 AM

ACS-10SM_April(2018).indd 2

4/11/2018 8:57:09 AM

Production ACS Materials: Questionnaire Package Return Envelope
AN EQUAL OPPORTUNITY EMPLOYER

OFFICIAL BUSINESS
Penalty for Private Use $300

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

6385-47(2014) (10-2013)

BUSINESS REPLY MAIL
FIRST-CLASS MAIL

PERMIT NO. 16081

WASHINGTON DC

POSTAGE WILL BE PAID BY THE U.S. CENSUS BUREAU

DIRECTOR
US CENSUS BUREAU
PO BOX 5240
JEFFERSONVILLE IN 47199-5240

FFATTFADDDTAADTFADDFAFTDFFAADFFFAFDTFDTAFATFDFATADTTFDFDTFFFFATTF

Attachment G
Production ACS, Treatment 6, and Treatment 7 Materials
XVI.
XVII.
XVIII.
XIX.
XX.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 4: Second Reminder Mailing
Postcard:

ACS-29 (2017)(6-2017)

Production ACS Materials: Second Reminder Postcard
U.S. DEPARTMENT OF COMMERCE
Economic and Statistics Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132-0001

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. DEPARTMENT OF COMMERCE
Economic and Statistics Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132-0001

ACS-29(2017) (6-2017)

OFFICIAL BUSINESS
Penalty for Private Use $300

U.S. DEPARTMENT OF COMMERCE
Economic and Statistics Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132-0001

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

U.S. DEPARTMENT OF COMMERCE
Economic and Statistics Administration
U.S. Census Bureau
1201 E 10th Street
Jeffersonville IN 47132-0001

ACS-29(2017) (6-2017)

OFFICIAL BUSINESS
Penalty for Private Use $300

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

ACS-29(2017) (6-2017)

UNITED STATES DEPARTMENT OF COMMERCE

ACS-29(2017) (6-2017)

Economics and Statistics Administration

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

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau . . .

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

ACS-29(2017) (6-2017)

UNITED STATES DEPARTMENT OF COMMERCE

ACS-29(2017) (6-2017)

Economics and Statistics Administration

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

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

A message from the Director, U.S. Census Bureau . . .

If you need help completing the survey or have questions, please call our
toll-free number (1–800–354–7271).

Thank you.

Attachment G
Production ACS, Treatment 6, and Treatment 7 Materials
XXI.
XXII.
XXIII.
XXIV.
XXV.

Mailing 1: Initial Mailing
Mailing 2: First Reminder
Mailing 3: Questionnaire Package
Mailing 4: Second Reminder
Mailing 5: Final Reminder

Mailing 5: Final Reminder Mailing
Letter:

ACS-23(L) (2018)(2-2018)

Production ACS Materials: Final Reminder Letter
ACS-23(L)(2018)
(2-2018)

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

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

Security Security Security Security Security

census.gov

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
1201 E 10th Street
Jeffersonville IN 47132-0001
OFFICIAL BUSINESS
Penalty for Private Use $300
ACS-23(L)(2018) (2-2018)

AN EQUAL OPPORTUNITY EMPLOYER

PRESORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
U.S. Census Bureau
Permit No. G-58

File Type	application/pdf
File Modified	0000-00-00
File Created	0000-00-00