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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
| File Type | application/pdf |
| Author | OneFormUser |
| File Modified | 2019-07-03 |
| File Created | 2019-04-24 |