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pdf(Recipient Name)
(Name of State Coalition Organization)
(Address Line 1)
(City) (State) (ZIP)
A Message from the Director, U.S. Census Bureau
Dear (Recipient):
In 2020, the U.S. Census Bureau will count residents across our Nation to enumerate the U.S.
population. The decennial census provides the information each community needs to obtain
funding for health assistance, services for older adults, employment services, schools, and more.
The Census Bureau plans to enumerate persons residing in pre-identified domestic violence
shelters during the Group Quarters Operation. This operation will take place at a pre-arranged
time from April 1, 2020, through April 30, 2020. Enclosed is an overview of our plans to
enumerate domestic violence shelters. Specialized operations such as this are designed to
provide everyone an opportunity to be included in the census without creating undue stress.
People enumerated at shelter locations will be included in your area’s overall population counts,
therefore safeguarding information collected on people living in domestic violence shelters.
To ensure that we enumerate all known shelters in your area, we request your assistance in
providing us a listing of the “domestic violence shelters” for your state. We will require the
name of the shelter, a city-style address that includes address number; street name; city, state,
county, parish, or borough name; and ZIP Code. Enclosed are the procedures for constructing a
list of shelters. We will use the listing of shelters to determine the addresses we need to visit to
conduct the enumeration. These addresses will not be included in any subsequent operations.
All information that the Census Bureau receives is confidential and protected by federal law,
Title 13, United States Code. Please provide your information no later than June 21, 2019, in the
enclosed prepaid envelope so that we can include your information in our census enumeration
operations.
If you have questions regarding this request, please contact Ms. Dora Durante at (301) 763-9371
or Ms. Alysia Blake (301) 763-0300. Thank you for your cooperation.
Enclosures:
Return Envelope with Prepaid Postage
Enumeration Plans for Domestic Violence Shelters for the 2020 Census
Procedures for Submitting Address Information for Domestic Violence Shelters to the
U.S. Census Bureau
Domestic Violence Shelter Participation Response Form
Domestic Violence Shelter Information Form
Domestic Violence Shelter Submittal Form
Procedures for Submitting Address Information for
Domestic Violence Shelters to the U.S. Census Bureau
1. Your State Coalition Against Domestic Violence may submit address information for
domestic violence shelters to the Census Bureau. These addresses will not appear on any
Census Bureau products distributed to the public.
2. Your submission may be on paper or use any computer-readable format. If your
submissions are on paper, please enter the information on the enclosed “Domestic
Violence Shelter Submittal” form. If you are submitting a computer-readable file, burn
the file onto a CD or DVD. Please submit a name and an address for the domestic
violence shelter. Only submit city-style addresses.
Please include the following information:
a. Address Number
b. Street or Road Name
c. Name of Group Quarters (in this case, the domestic violence shelter)
d. Apartment/Unit Number (if applicable)
e. ZIP Code
f. Fill out and include the “Domestic Violence Shelter Information Form”
3. Please place the domestic violence shelters list and the “Domestic Violence Shelter
Information” form in the prepaid return envelope. Label both sides of the inner envelope
with this disclosure notice:
“THIS PACKAGE CONTAINS SENSITIVE GROUP QUARTERS ADDRESS INFORMATION.”
Please call Dora Durante at 301-763-9371 or Alysia Blake 301-763-0300 if you need
assistance. Thank you.
Please include this form with your domestic violence shelter submission.
Please call Dora Durante at 301-763-9371 or Alysia Blake at 301-763-0300 if you need assistance.
Domestic Violence Shelter Information Form
State Coalition Name:
Contact Name:
Contact Phone Number:
Email Address:
Number of Shelters Submitted:
Date:
ENUMERATION PLANS FOR DOMESTIC VIOLENCE SHELTERS FOR
THE 2020 CENSUS
OBJECTIVES OF THE ENUMERATION OF DOMESTIC VIOLENCE SHELTERS
The three primary objectives are: (a) to maintain strict confidentiality of the addresses of the
shelters and to reduce their contact with U.S. Census Bureau employees; (b) to ensure all
residents in the shelters are included in the 2020 Census; and (c) to ensure people enumerated at
shelter locations will be included in your area’s population counts.
OPTIONS FOR ENUMERATION
There are two types of enumeration methods a DVS facility may use. The unit of collection for
the enumeration is an Individual Census Questionnaire (ICQ). In addition to demographics, this
form also has a question asking for the full address of the place where a person lives or stays
most of the time. Any respondents who feel uncomfortable giving their usual residence is NOT
required to provide this information. Also, respondents may choose to use a number rather than
their names to further protect their personal identity. The enumeration methods are detailed
below:
1. Facility Self-Enumeration: Facility Self Enumeration allows the designated staff to
enumerate each person in the facility on Census Day, April 1, 2020. A census worker
will swear in and train the designated staff as well as provide all the materials needed
to conduct the enumerations. To conduct the enumerations, the designated staff will
prepare the enumeration forms, distribute and collect forms, review the completed
materials and obtain any missing data. The census worker will return to pick up the
completed materials.
2. In-Person Interview: A Census Bureau worker will conduct an in-person interview
with each person who was living or staying at this facility on Census Day, April 1,
2020.
SUPPORT FOR PARTICIPATION
The National Network to End Domestic Violence will notify their members about the plans for the
2020 Census. They will encourage shelters to participate by sharing U.S. Census Bureau
information with survivors, who then can decide how much to individually share directly with the
Census Bureau, since local domestic violence programs are prohibited by federal laws from
disclosing personally identifying information of the victims they serve.
ADVANCE CONTACT OF THE SHELTERS TO FINALIZE ENUMERATION PLANS
In February 2020, during the Group Quarters Advance Contact operation depending on the
population at the shelter, a male or female ACO management staff person will contact the preidentified shelters, and make an appointment to meet with the contact person. The contact person
can agree to have this meeting at the shelter or at an alternate location satisfactory to both. This
meeting will be conducted to inform the shelter manager about the upcoming enumeration
operation, address privacy and confidentiality concerns, and identify any security issues. At this
time, the ACO manager will conduct an interview to verify the name of the shelter (Group Quarters
name), address information, contact name and phone number, obtain an agreed-upon date and time
to conduct the enumeration, and an expected Census Day population count. During this meeting,
the contact person will select an option to conduct the enumeration, finalize any specific details,
and discuss any special needs the facility may require prior to the scheduled enumeration date.
CONDUCTING THE ENUMERATION
April 1, 2020, through April 30, 2020, is the time period designated to conduct the enumeration
of domestic violence shelters. If the contact person elected to self-enumerate the shelter as
described in Option 1, the ACO designee will swear in the person at the shelter designated to
conduct the enumeration and leave them the census enumeration materials (ICQs, envelopes,
notice of confidentiality, etc.). All persons who collect data for the Census Bureau are required
to take the oath of confidentiality that gives individuals special sworn status. Individuals with
special sworn status are subject to the same fines and jail sentences as an employee of the Census
Bureau if they violate their oath to protect respondents’ confidentiality. The sworn-in shelter
contact will place the completed ICQs in their envelopes. The ACO designee will pick up the
completed ICQs in their envelopes on the date agreed upon with the contact person.
If the contact person at the shelter selected to have the residents be counted by designated census
takers as described in Option 2, a ACO designee will contact the pre-identified shelter to conduct
the enumeration on the date that was specified during the February 2020 Advance Contact
operation. The ACO designee will personally interview the residents of that address and enter their
response information on the ICQ. It is important that the designated management staff is of the
same gender as those using the shelters to avoid undue emotional distress.
PROTECTING THE DATA
The Census Bureau is required by law to protect this information (Title 13, U.S. Code, Section
9). The Census Bureau is not permitted to publicly release your responses in a way that could
identify anyone. We are conducting the 2020 Census under the authority of Title 13, U.S. Code,
Sections 141, 193, 221 and 223. Per the Federal Cybersecurity Enhancement Act of 2015, data
are protected from cybersecurity risks through screening of the systems that transmit data. All
web data submissions are encrypted in order to protect your privacy.
Title 13 of the U.S. Code protects the confidentiality of all this information. Violating the
confidentiality of a respondent is a federal crime with serious penalties, including a federal
prison sentence of up to five years, a fine of up to $250,000, or both. Only authorized individuals
have access to the stored data, and the information provided to the Census Bureau may only be
used by a restricted number of authorized individuals who are sworn for life to protect the
confidentiality of individual responses.
For more information about how we protect this information, please visit our Web site at
census.gov and click on "Data Protection and Privacy Policy" at the bottom of the home page.
This page also includes information about the collection, storage, and use of these records. Click
on "System of Records Notices (SORN)" and look for Privacy Act System of Records Notice
COMMERCE/CENSUS-5, Decennial Census Program.
Domestic Violence Shelter Participation Response Form
The U.S. Census Bureau estimates that completing this response form will take 20 minutes on average. Send
comments regarding this burden estimate or any other aspect of this collection to: Paperwork Reduction Project
0607-1006, U.S. Census Bureau, DCMD-2H174, 4600 Silver Hill Road, Washington, DC 20233. You may
email comments to <[email protected]>. Use “Paperwork Reduction Project 0607-1006” as
the subject. This collection of information has been approved by the Office of Management and Budget (OMB).
The eight-digit OMB approval number 0607-1006 confirms this approval. If this number were not displayed, we
could not conduct this survey.
In preparation for the 2020 Census, the U.S. Census Bureau is inviting members from the
Territorial and Tribal Domestic Violence Coalitions to participate in the 2020 Census Group Quarters
(GQs) Update Program to update the addressing information for domestic violence shelters. The
purpose of this program is to obtain a comprehensive address listing for domestic violence
shelters to determine the addresses we need to visit to conduct the enumeration for the 2020
Census.
Please check one of the participation options and verify your contact information below. Please
return your response using the provided prepaid envelope.
Yes. We would like to participate in the Census Bureau’s GQs Update Program to
update the addressing information for domestic violence shelters for the 2020 Census.
No. We will not be participating in the Census Bureau’s GQs Update Program to update
the addressing information for domestic violence shelters for the 2020 Census.
Current State Coalition Contact Information:
[State - Coalition Against Domestic Violence]
[Address]
[City, State, ZIP Code]
Please update your contact information if it has changed from above. Also, please include your
contact name, phone number, and e-mail address below.
Updated State Coalition Contact Information:
Name:
Address:
City:
Phone:
Email:
____________________________________________________________
____________________________________________________________
_____________________ State: ________ ZIP Code: _______________
(_____) ______________ Ext. _________ Fax: (_____) _____________
____________________________________________________________
Thank you for your response.
2020 Decennial Census
Domestic Violence Shelter Submittal
Page ___________ of ___________________Pages
Name of Preparer: __________________________
(Print Name)
Date completed: ____________________________
(MM/DD/YYYY)
State Coalition Name: ____________________________________________
(Coalition Name)
Residential Address
Line
#
Group Quarters Name
(Domestic Violence Shelter Name)
Address
Number
Street or Road Name
Contact Information
Apartment/
Unit Number
City Style
Mailing ZIP
Code
1
2
3
4
5
6
Approval No. xxxx-xxxx
Expiration date: xx/xx/xxxx
U.S. Department of Commerce
U.S. Census Bureau
This listing contains confidential information, the release of which is prohibited by Title 13, United States Code
Contact Person Name
Contact Person Number
File Type | application/pdf |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |