D-1380 Post-Enumeration Survey Initial Housing Unit Followup (I

Put BCU Bar Code here

Note: Bar code is the same layout and information as on HUFU packet sheet.

FORM D-1380 U.S. DEPARTMENT OF COMMERCE

OMB No. XXXX-XXXX Economics and Statistics Administration

Approval Expires MM/DD/YYYY U.S. CENSUS BUREAU

Post-Enumeration Survey (PES)

Initial Housing Unit Followup (IHUFU) Quality Control (QC) Form

2020 Census

Page XX of NN

INTRODUCTION – Hello. I am (your name) from the U.S. Census Bureau. Here is my identification. Recently, Census employees checked addresses in this area as part of the 2020 Decennial Census. I am here to check the quality of their work. My questions should only take a few minutes. This notice explains that your answers are confidential. (Hand the respondent a Confidentiality Notice and allow time for him or her to read it).

Section A: Identification

1. BCU No.:

2. ACO Name:

3. ACO Code:

Section B: Assignment Information

Position (a)

FSA (b)

Name (c)

FR Code (d)

Dates

Assigned (e)

Completed (f)

Month

Day

Month

Day

1. QC Field Supervisor

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2. QC Interviewer

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3. QC Interviewer

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Section C: QC Check

Followup Cases Selected for QC Check

QC Check Results

Page # (a)

PES

Census

Followup Code (h)

Case Correct (No Critical Errors)* (i)

Case Incorrect (One or More Critical Errors) (j)

PES BCU (b)

MSN (c)

WMSN (d)

Census BCU (e)

Census ID (f)

MSN (g)

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(Note: Listing of sample continues as needed, possibly causing section to scroll to second page.)

1. Total Number of Cases Selected for QC Check:

2. Acceptance Number -BCU passes if Total Incorrect is less than or equal to:

3. Total Correct

4. Total Incorrect

5. QC Check Outcome (Mark (X) one):  Pass (Outcome Code:882)  Fail – Rectify (Outcome Code: 883)

6. Notes

Section D: Rectification

1. Total Number of Followup Cases in BCU

2. Total Number of Incorrect Cases in BCU (Cases with One or More Critical Errors)

*List of Noncritical Errors:

• Spelling

• Street-type errors

• For a GQ, one of the fields for facility name or description is filled and correct, but the other is either incorrect or blank

CENSUS CONFIDENTIAL: RESTRICTED DATA FOR OFFICIAL USE ONLY. Information contained in this report is for use by the Census Bureau and is confidential by law (Title 13, U.S.C.). It may be seen only by persons sworn to protect the confidentiality of the data and may be used only for statistical purposes.