D-1301.2 2020 PES Person Followup Reinterview Questionnaire

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

D-1301.2(PFU-RI)

FORM
(9-18-2020)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

Section A – ORIGINAL PFU INTERVIEW INFORMATION

Section B – ASSIGNMENT INFORMATION
a. QC FSA

U.S. CENSUS BUREAU

QC Field Supervisor name

FR Code

b. Reinterviewer name

POST-ENUMERATION SURVEY
PERSON FOLLOWUP REINTERVIEW FORM
2020 Census

FR Code

Section D1 – TELEPHONE REINTERVIEW OUTCOME
PLACE LABEL FOR PFU RI
SAMPLE CASE HERE

1
2

Pass - 201
Fail - 283 (PV
replacement
interview required)

3

4

Noninterview – 214
Unresolved (PV
reinterview required)
Noninterview – 218 Refusal

QC
FS

QC
OE

QC
FS

QC
OE

Case Notes
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. Access restricted to authorized PES staff.

Section C1 – TELEPHONE REINTERVIEW RESULTS
a. Original respondent’s telephone number

c. Record of telephone reinterview attempts
If invalid phone number or no answer, record result
in item c and complete Section D1, as necessary.

1
2

Attempt a telephone reinterview.
No telephone number, PV reinterview required.

b. Interview
(1) Hello, I am (your name) from the U.S. Census Bureau. I’m doing a quality check to
verify that a census interviewer was there recently. The survey is authorized by
Title 13 of the United States Code* and your response is required by law. Our
approval number from the Office of Management and Budget is XXXX-XXXX. All
the information you provide will remain confidential. The interview will take
approximately 2 minutes.

(2) May I speak to

?

2

Respondent available – Go to 3 below.
Respondent unavailable – Attempt to arrange a callback time and record result in item c.

3

Refused – Thank you. Record result in item c and complete Section D1.

1

(3) Were you contacted on or about M M D D 2 0 2 1
by an interviewer asking questions about where people may have lived in
2020?

3

Yes – Thank you. Record result in item c and complete Section D1.
No . . . . ⎫ Thank you. I will be visiting your household in the near
⎬ future to conduct an interview. Record result in item c and
Don’t know ⎭ complete Section D1.

4

Refused – Thank you. Record result in item c and complete Section D1.

1
2

*Authorized by Title 13, Sections 141 and 193.

USCENSUSBUREAU

Date

Time

(1)

(2)

MM D D 2 0 2 1
MM D D 2 0 2 1
MM D D 2 0 2 1
MM D D 2 0 2 1
MM D D 2 0 2 1
MM D D 2 0 2 1

:
:
:
:
:
:

Call result
code
(3)

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

Notes
(4)

Call result codes for column (3)
1
Yes – Respondent was contacted by a Census Bureau interviewer. Mark (X) "Pass" in Section D1.
2
3
4
5
6
7
8
9

No – Respondent was not contacted by a Census Bureau interviewer. Mark (X) "Fail" in Section D1. Case requires a Personal Visit for
replacement interview only.
Don’t know if respondent was contacted by a Census Bureau interviewer. Mark (X) "Fail" in Section D1. Case requires a Personal
Visit for replacement interview only.
Refused – Mark (X) "Noninterview-Refusal" in Section D1.
Callback appointment made. Specify date and time of callback in item c, column (4) "Notes."
Invalid phone number. Mark (X) "Noninterview-Unresolved" in Section D1. Case requires a Personal Visit for reinterview.
No answer or respondent not available and no callback time arranged. Make up to 6 attempts at various times of day to contact respondent.
Noninterview Final Attempt: Respondent never reached by telephone after 6 attempts. Mark (X) "Noninterview-Unresolved" in
Section D1. Case requires a Personal Visit for reinterview.
Other. Specify in item c, column (4) "Notes." Mark (X) "Noninterview-Unresolved" in Section D1. Case requires a Personal Visit for
reinterview.

NOTICE

If found, please either call 1–301–763–3301 collect to arrange for pickup or mail to: Census Coverage Measurement,
U.S. Census Bureau, 4600 Silver Hill Rd, Washington, DC 20233 – 5700.

Section C2 – PERSONAL VISIT REINTERVIEW RESULTS
a. Original respondent’s address

QC
FS

c. Record of personal visit reinterview attempts
Date

Time

(1)

(2)

MM D D 2 0 2 1

:
:
:
:
:
:

MM D D 2 0 2 1
MM D D 2 0 2 1
If no answer, record result in item c and complete Section D2, as necessary.
b. Interview
(1) Hello, I am (your name) from the U.S. Census Bureau. Here is my identification.
I’m doing a quality check to verify that a census interviewer was here
recently. (Hand respondent the Information Sheet.)

MM D D 2 0 2 1
MM D D 2 0 2 1
MM D D 2 0 2 1

Personal
visit result
code
(3)

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

1

a.m. 2

p.m.

QC
OE

Notes
(4)

Personal visit result codes for column (3)
(2)

May I speak to
1
2
3

?

Respondent available – Go to 3a below.
Respondent unavailable – SKIP to 3b below.
Refused – Thank you. Record result in item c and complete Section D2.

(3a) (Speaking to original respondent)
Were you contacted on or about M M D D 2 0 2 1
by an interviewer asking questions about where people may have lived in
2020?

3

Yes (original respondent) – Thank you. Record result in item c and complete Section D2.
No (original respondent) . . . ⎫ Conduct replacement interview using the
⎬ corresponding Form D-1301. Record
Don’t know (original respondent) ⎭ result in item c and complete Section D2.

4

Refused – Thank you. Record result in item c and complete Section D2.

1
2

ORIGINAL RESPONDENT OR PROXY – Yes, respondent or other household member was contacted by a Census Bureau interviewer.
Mark (X) "Pass" in Section D2, item a and as appropriate, mark (X) either "Original respondent" or "Proxy" in Section D2, item b.
ORIGINAL RESPONDENT OR PROXY – No, respondent or other household member was not contacted by a Census Bureau interviewer.
Mark (X) "Fail" in Section D2, item a and as appropriate, mark (X) either "Original respondent" or "Proxy" in Section D2, item b. Conduct
replacement interview using the corresponding Form D-1301.

1
2

ORIGINAL RESPONDENT – Don’t know if respondent was contacted by a Census Bureau interviewer. Mark (X) "Fail" in Section D2,
item a and mark (X) "Original Respondent" in Section D2, item b. Conduct replacement interview using the corresponding Form D-1301.
PROXY – Don’t know if respondent or other household member was contacted by a Census Bureau interviewer and no contact time
arranged. Make up to 6 attempts to contact the original respondent.
Refused – Mark (X) "Noninterview-Refusal" in Section D2, item a.
Callback appointment made. Specify date and time of callback in item c, column (4) "Notes."
No one home. Make up to 6 attempts at different times of day to contact respondent.

3
4
5
6
7
8

Noninterview Final Attempt: Never found respondent or other knowledgeable household member to reinterview after 6 attempts. Mark (X)
"Noninterview-Unresolved" in Section D2, item a.

9

Other. Specify in item c, column (4) "Notes." Mark (X) "Noninterview-Unresolved" in Section D2, item a.

Section D2 – PERSONAL VISIT REINTERVIEW OUTCOME
a. Outcome code

(3b) (Speaking to another household member) Was
or someone else contacted on or about M M D D 2 0 2 1
by an interviewer asking questions about where people may have lived
in 2020?
1

Yes (proxy respondent) – Thank you.

2

No (proxy respondent) – Conduct replacement interview using
the corresponding Form D-1301.
Don’t know (proxy respondent) – Thank you Arrange time to
callback original respondent.
Refused – Thank you.

3
4

Page 2

⎫
⎬
⎭

Record result in item c
and complete Section
D2, as necessary.

1
2

Pass - 201

b. Type of respondent
3

4
Fail - 283 (PV
replacement
interview required)

Noninterview – 214 Unresolved
Noninterview – 218
QC
Refusal

FS

1

QC
OE

2

Original respondent
Proxy

QC
FS

QC
OE

Case Notes

FORM D-1301.2(PFU-RI) (9-18-2020)