Island Areas Censuses - Group Quarters

FORM

D-ARCP-GE-AS (4-11-2019)

OMB No. 0607-1006: Approval Expires 11/30/2021

This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.

1. IDENTIFICATION

GROUP QUARTERS ADDRESS REGISTER
2020 Census of American Samoa

County
BCU
Book

of

2. ASSIGNMENT INFORMATION
Name – Please Print

Employee ID
Number

Telephone Number

Date
Assigned

Completed

Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.

Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator

3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Group Quarters
Listed

Date
Number

4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
People
Enumerated

Date
Number

Remarks

DC

5. OFFICE USE ONLY
Name of Reviewer

American Samoa

Date

Initials

The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.

CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Group Quarters.
There are no duplicate addresses listed in the Address Listing Page for Group Quarters.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Group Quarters.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.

SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.

FORM D-ARCP-GE-AS (4-11-2019)

FORM

D-ARCP-GE-GU (4-12-2019)

OMB No. 0607-1006: Approval Expires 11/30/2021

This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.

1. IDENTIFICATION

GROUP QUARTERS ADDRESS REGISTER
2020 Census of Guam

County
BCU
Book

of

2. ASSIGNMENT INFORMATION
Name – Please Print

Employee ID
Number

Telephone Number

Date
Assigned

Completed

Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.

Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator

3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Group Quarters
Listed

Date
Number

4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
People
Enumerated

Date
Number

Remarks

DC

5. OFFICE USE ONLY
Name of Reviewer
Guam

Date

Initials

The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.

CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Group Quarters.
There are no duplicate addresses listed in the Address Listing Page for Group Quarters.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Group Quarters.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.

SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.

FORM D-ARCP-GE-GU (4-12-2019)

FORM

D-ARCP-GE-MI (4-12-2019)

OMB No. 0607-1006: Approval Expires 11/30/2021

This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.

1. IDENTIFICATION

GROUP QUARTERS ADDRESS REGISTER
2020 Census of the Commonwealth of the Northern Mariana Islands

County
BCU
Book

of

2. ASSIGNMENT INFORMATION
Name – Please Print

Employee ID
Number

Telephone Number

Date
Assigned

Completed

Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.

Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator

3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Group Quarters
Listed

Date
Number

4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
People
Enumerated

Date
Number

Remarks

DC

5. OFFICE USE ONLY
Name of Reviewer
Commonwealth of the
Northern Mariana Islands

Date

Initials

The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.

CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Group Quarters.
There are no duplicate addresses listed in the Address Listing Page for Group Quarters.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Group Quarters.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.

SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.

FORM D-ARCP-GE-MI (4-12-2019)

FORM

D-ARCP-GE-VI (4-12-2019)

OMB No. 0607-1006: Approval Expires 11/30/2021

This listing contains confidential information, including Title 13 and Personally Identifiable Information (PII), the release of which is protected by the
Privacy Act of 1974.

1. IDENTIFICATION

GROUP QUARTERS ADDRESS REGISTER
2020 Census of the U.S. Virgin Islands

County
BCU
Book

of

2. ASSIGNMENT INFORMATION
Name – Please Print

Employee ID
Number

Telephone Number

Date
Assigned

Completed

Certification Statement – I certify that the information is
true to the best of my knowledge and the work completed
according to Census Bureau procedures.
The Crew Leader and all Enumerators must sign this
certification statement.

Crew Leader
Enumerator
Reassigned Enumerator
Reassigned Enumerator

3. ENUMERATOR DAILY PROGRESS RECORD (LISTING)
Group Quarters
Listed

Date
Number

4. ENUMERATOR DAILY PROGRESS RECORD (ENUMERATION)
People
Enumerated

Date
Number

Remarks

DC

5. OFFICE USE ONLY
Name of Reviewer

U.S. Virgin Islands

Date

Initials

The contents of this Address Register are confidential by law (Title 13, U.S.
Code). It may be seen only by sworn persons with a need to know and used
solely for statistical purposes.

CREW LEADER REVIEW CHECKLIST
Before sending to the Census Office, verify the following:
The Enumerator has made entries in a legible manner.
All appropriate fields are completed in the Address Listing Page for Group Quarters.
There are no duplicate addresses listed in the Address Listing Page for Group Quarters.
There is an entry of 0 in Pop. Count for vacant units in the Address Listing Page for Group Quarters.
The Enumerator completed the Assignment Information section.
The Quality Control check is complete.

SPECIAL NOTICE
INFORMATION CONTAINED IN THIS ADDRESS REGISTER IS CONFIDENTIAL.
ALL ENTRIES MADE IN THIS ADDRESS REGISTER MUST BE LEGIBLE,
COMPLETE, AND ACCURATE.

FORM D-ARCP-GE-VI (4-12-2019)

OMB No. 0607-1006: Approval Expires 11/30/2021

FORM D-ARLP-GE-AS (4-18-2019)

DC
Line
No.

(1)

(1)

2020 Census of American Samoa
American Samoa

Date Assigned

Group Quarters ID

(2)

(1)
(1)

ADDRESS LISTING PAGE FOR GROUP QUARTERS

County

Map Spot

(4)
BCU
(3)

(2)

(3)

(5)

Complete Street Name
OR
(11)

Apt/Unit No.

Village OR

Facility Point of Contact Name

(6)

Address
No.
(9)

(13)

(15)

(17)

Within Map
Spot ID
(7)

GQ Type
Code
(10)

Physical Location
Description
(12)

ZIP Code

Estate –
U.S. Virgin Islands Only
(16)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

Case Status Codes
A – Appointment
IC – Interview Completed
GC – Gated Community
LB – Language Barrier
NC – No Contact

NV – Left Notice of Visit
RA – Restricted Access
RE – Refusal
UN – Unsafe
OT – Other

(22) Contact Attempts
– Enumeration
(Tally)

Facility Name

(8)
(8)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(29) QC
Action

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(26) Contact
Attempts –
FFU (Tally)

(29) QC
Action

(9)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(24) Date
(25) Case Status
Enumerated
Code – FFU

Abbreviations
Apt – Apartment
BCU – Basic Collection Unit
FFU – Field Followup
GQ – Group Quarters
No. – Number

(26) Contact
Attempts –
FFU (Tally)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(18)

Telephone
Number
(19)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(14)

Title

Pop. – Population
QC – Quality Control
Y/N/DK – Yes, No, or Don’t Know

(26) Contact
Attempts –
FFU (Tally)

Remarks

(29) QC
Action

OMB No. 0607-1006: Approval Expires 11/30/2021

FORM D-ARLP-GE-GU (4-18-2019)

DC
Line
No.

(1)

(1)

2020 Census of Guam
Guam
Date Assigned

Group Quarters ID

(2)

(1)
(1)

ADDRESS LISTING PAGE FOR GROUP QUARTERS

County

Map Spot

(4)
BCU
(3)

(2)

(3)

(5)

Complete Street Name
OR
(11)

Apt/Unit No.

Village OR

Facility Point of Contact Name

(6)

Address
No.
(9)

(13)

(15)

(17)

Within Map
Spot ID
(7)

GQ Type
Code
(10)

Physical Location
Description
(12)

ZIP Code

Estate –
U.S. Virgin Islands Only
(16)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

Case Status Codes
A – Appointment
IC – Interview Completed
GC – Gated Community
LB – Language Barrier
NC – No Contact

NV – Left Notice of Visit
RA – Restricted Access
RE – Refusal
UN – Unsafe
OT – Other

(22) Contact Attempts
– Enumeration
(Tally)

Facility Name

(8)
(8)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(29) QC
Action

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(26) Contact
Attempts –
FFU (Tally)

(29) QC
Action

(9)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(24) Date
(25) Case Status
Enumerated
Code – FFU

Abbreviations
Apt – Apartment
BCU – Basic Collection Unit
FFU – Field Followup
GQ – Group Quarters
No. – Number

(26) Contact
Attempts –
FFU (Tally)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(18)

Telephone
Number
(19)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(14)

Title

Pop. – Population
QC – Quality Control
Y/N/DK – Yes, No, or Don’t Know

(26) Contact
Attempts –
FFU (Tally)

Remarks

(29) QC
Action

OMB No. 0607-1006: Approval Expires 11/30/2021

FORM D-ARLP-GE-MI (4-18-2019)

DC
Line
No.

(1)

(1)

2020 Census of the Commonwealth of the Northern Mariana Islands

Commonwealth of the
Northern Mariana Islands

Date Assigned

Group Quarters ID

(2)

(1)
(1)

ADDRESS LISTING PAGE FOR GROUP QUARTERS

County

Map Spot

(4)
BCU
(3)

(2)

(3)

(5)

Complete Street Name
OR
(11)

Apt/Unit No.

Village OR

Facility Point of Contact Name

(6)

Address
No.
(9)

(13)

(15)

(17)

Within Map
Spot ID
(7)

GQ Type
Code
(10)

Physical Location
Description
(12)

ZIP Code

Estate –
U.S. Virgin Islands Only
(16)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Stutus Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Stutus Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Stutus Code
– Enumeration

Case Status Codes
A – Appointment
IC – Interview Completed
GC – Gated Community
LB – Language Barrier
NC – No Contact

NV – Left Notice of Visit
RA – Restricted Access
RE – Refusal
UN – Unsafe
OT – Other

(22) Contact Attempts
– Enumeration
(Tally)

Facility Name

(8)
(8)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(29) QC
Action

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(26) Contact
Attempts –
FFU (Tally)

(29) QC
Action

(9)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(24) Date
(25) Case Status
Enumerated
Code – FFU

Abbreviations
Apt – Apartment
BCU – Basic Collection Unit
FFU – Field Followup
GQ – Group Quarters
No. – Number

(26) Contact
Attempts –
FFU (Tally)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(18)

Telephone
Number
(19)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(14)

Title

Pop. – Population
QC – Quality Control
Y/N/DK – Yes, No, or Don’t Know

(26) Contact
Attempts –
FFU (Tally)

Remarks

(29) QC
Action

OMB No. 0607-1006: Approval Expires 11/30/2021

FORM D-ARLP-GE-VI (4-18-2019)

DC
Line
No.

(1)

(1)

2020 Census of the U.S. Virgin Islands
U.S. Virgin Islands

Date Assigned

Group Quarters ID

(2)

(1)
(1)

ADDRESS LISTING PAGE FOR GROUP QUARTERS

County

Map Spot

(4)
BCU
(3)

(2)

(3)

(5)

Complete Street Name
OR
(11)

Apt/Unit No.

Village OR

Facility Point of Contact Name

(6)

Address
No.
(9)

(13)

(15)

(17)

Within Map
Spot ID
(7)

GQ Type
Code
(10)

Physical Location
Description
(12)

ZIP Code

Estate –
U.S. Virgin Islands Only
(16)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

(22) Contact Attempts
– Enumeration
(Tally)

(2)

(3)

(4)

(6)

(5)

(7)

(20) Facility Open between
3/2/2020 and
4/15/2020? (Y/N)

(21) Case Status Code
– Enumeration

Case Status Codes
A – Appointment
IC – Interview Completed
GC – Gated Community
LB – Language Barrier
NC – No Contact

NV – Left Notice of Visit
RA – Restricted Access
RE – Refusal
UN – Unsafe
OT – Other

(22) Contact Attempts
– Enumeration
(Tally)

Facility Name

(8)
(8)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(23) Mailable?
(Y/N/DK)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(29) QC
Action

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(26) Contact
Attempts –
FFU (Tally)

(29) QC
Action

(9)

(11)

(13)

(15)

(17)

(10)

(12)

(14)

(16)

(18)

(19)

(27) Pop. Count
(Expected)

(28) Pop. Count
(Final)

(30) JIC1

(31) JIC2

(24) Date
(25) Case Status
Enumerated
Code – FFU

Abbreviations
Apt – Apartment
BCU – Basic Collection Unit
FFU – Field Followup
GQ – Group Quarters
No. – Number

(26) Contact
Attempts –
FFU (Tally)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(18)

Telephone
Number
(19)

(9)

(24) Date
(25) Case Status
Enumerated
Code – FFU

(8)

(14)

Title

Pop. – Population
QC – Quality Control
Y/N/DK – Yes, No, or Don’t Know

(26) Contact
Attempts –
FFU (Tally)

Remarks

(29) QC
Action