SC-CQ HU Enumerator Continuation Questionnaire (English)

§8%?,¤

OMB No. XXXX-XXXX

Special Census
Continuation Questionnaire

U.S. DEPARTMENT OF COMMERCE
U.S. CENSUS BUREAU

Enter the 12-digit Case ID number for this household. This number is found on the SC-Q barcode label.
–

SCID

State

AA

County

Block

Tract

of

questionnaire(s)

AF

T

Questionnaire

R

CONTINUATION QUESTIONNAIRE
FOR SPECIAL CENSUS

D

–

FOR NPC
USE ONLY

QUESTIONNAIRES

FORM

SC-CQ

23043011

(08-25-2022) D6

§8%?>¤
1. What is the name of

Person

➜ NOTE: Please answer BOTH the question about Hispanic
origin and the question about race. For this census, Hispanic
origin is not a race.

?

Print name below and verify the spelling.
First Name

MI

6.

Last Name(s)

Please read the HISPANIC ORIGIN section on the Information
Sheet.
Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano

2.

Does this person usually live or stay somewhere else?
For example – Read the examples to respondent.
Mark I
K all that apply.
J
With a parent or other relative

In a jail or prison

For college

At a seasonal or
second residence

For a military assignment

For another reason

For a job or business

No

Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

7. Please read the RACE section on the Information Sheet.

In a nursing home

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or daughter-in-law

Adopted son or daughter
Stepson or stepdaughter
Brother or sister

4.

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

R

Biological son or daughter

White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

AF

Opposite-sex husband/wife/spouse

T

Please read the RELATIONSHIP section on the Information
Sheet.
How is this person related to Person 1? Mark I
K ONE box.
J

Other relative

Roommate or housemate

D

3.

What is this person’s race?
Mark I
K one or more boxes AND print origins.
J

Foster child

Other nonrelative

Is this person male or female? Mark I
K ONE box.
J
Male

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Female

5. What was this person’s age on (Special Census Day)? What is
this person’s date of birth? If you don’t know the exact age,
please estimate. For babies less than 1 year old, do not report
the age in months. Report 0 as the age.
Age on (Special Census Day)

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Print numbers in boxes.
Month
Day
Year of birth

years

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

➜ If more people were counted in Question S6 on the
SC-Q, continue with the next person on the next
page.

2

23043029

§8%?F¤
1. What is the name of

Person

➜ NOTE: Please answer BOTH the question about Hispanic
origin and the question about race. For this census, Hispanic
origin is not a race.

?

Print name below and verify the spelling.
First Name

MI

6.

Last Name(s)

Please read the HISPANIC ORIGIN section on the Information
Sheet.
Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano

2.

Does this person usually live or stay somewhere else?
For example – Read the examples to respondent.
Mark I
K all that apply.
J
With a parent or other relative

In a jail or prison

For college

At a seasonal or
second residence

For a military assignment

For another reason

For a job or business

No

Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

7. Please read the RACE section on the Information Sheet.

In a nursing home

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or daughter-in-law

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Other relative

Roommate or housemate

D

Adopted son or daughter

White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

AF

Opposite-sex husband/wife/spouse

Biological son or daughter

4.

T

Please read the RELATIONSHIP section on the Information
Sheet.
How is this person related to Person 1? Mark I
K ONE box.
J

R

3.

What is this person’s race?
Mark I
K one or more boxes AND print origins.
J

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Is this person male or female? Mark I
K ONE box.
J
Male

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Female

5. What was this person’s age on (Special Census Day)? What is
this person’s date of birth? If you don’t know the exact age,
please estimate. For babies less than 1 year old, do not report
the age in months. Report 0 as the age.
Age on (Special Census Day)

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Print numbers in boxes.
Month
Day
Year of birth

years

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

➜ If more people were counted in Question S6 on the
SC-Q, continue with the next person on the next
page.

3

23043037

§8%?N¤
1. What is the name of

Person

➜ NOTE: Please answer BOTH the question about Hispanic
origin and the question about race. For this census, Hispanic
origin is not a race.

?

Print name below and verify the spelling.
First Name

MI

6.

Last Name(s)

Please read the HISPANIC ORIGIN section on the Information
Sheet.
Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano

2.

Does this person usually live or stay somewhere else?
For example – Read the examples to respondent.
Mark I
K all that apply.
J
With a parent or other relative

In a jail or prison

For college

At a seasonal or
second residence

For a military assignment

For another reason

For a job or business

No

Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

7. Please read the RACE section on the Information Sheet.

In a nursing home

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or daughter-in-law

Adopted son or daughter
Stepson or stepdaughter
Brother or sister

4.

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

R

Biological son or daughter

White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

AF

Opposite-sex husband/wife/spouse

T

Please read the RELATIONSHIP section on the Information
Sheet.
How is this person related to Person 1? Mark I
K ONE box.
J

Other relative

Roommate or housemate

D

3.

What is this person’s race?
Mark I
K one or more boxes AND print origins.
J

Foster child

Other nonrelative

Is this person male or female? Mark I
K ONE box.
J
Male

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Female

5. What was this person’s age on (Special Census Day)? What is
this person’s date of birth? If you don’t know the exact age,
please estimate. For babies less than 1 year old, do not report
the age in months. Report 0 as the age.
Age on (Special Census Day)

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Print numbers in boxes.
Month
Day
Year of birth

years

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

➜ If more people were counted in Question S6 on the
SC-Q, continue with the next person on the next
page.

4

23043045

§8%?U¤
1. What is the name of

Person

➜ NOTE: Please answer BOTH the question about Hispanic
origin and the question about race. For this census, Hispanic
origin is not a race.

?

Print name below and verify the spelling.
First Name

MI

6.

Last Name(s)

Please read the HISPANIC ORIGIN section on the Information
Sheet.
Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano

2.

Does this person usually live or stay somewhere else?
For example – Read the examples to respondent.
Mark I
K all that apply.
J
With a parent or other relative

In a jail or prison

For college

At a seasonal or
second residence

For a military assignment

For another reason

For a job or business

No

Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

7. Please read the RACE section on the Information Sheet.

In a nursing home

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or daughter-in-law

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Other relative

Roommate or housemate

D

Adopted son or daughter

White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

AF

Opposite-sex husband/wife/spouse

Biological son or daughter

4.

T

Please read the RELATIONSHIP section on the Information
Sheet.
How is this person related to Person 1? Mark I
K ONE box.
J

R

3.

What is this person’s race?
Mark I
K one or more boxes AND print origins.
J

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Is this person male or female? Mark I
K ONE box.
J
Male

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Female

5. What was this person’s age on (Special Census Day)? What is
this person’s date of birth? If you don’t know the exact age,
please estimate. For babies less than 1 year old, do not report
the age in months. Report 0 as the age.
Age on (Special Census Day)

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Print numbers in boxes.
Month
Day
Year of birth

years

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

➜ If more people were counted in Question S6 on the
SC-Q, continue with the next person on the next
page.

5

23043052

§8%?]¤
1. What is the name of

Person

➜ NOTE: Please answer BOTH the question about Hispanic
origin and the question about race. For this census, Hispanic
origin is not a race.

?

Print name below and verify the spelling.
First Name

MI

6.

Last Name(s)

Please read the HISPANIC ORIGIN section on the Information
Sheet.
Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano

2.

Does this person usually live or stay somewhere else?
For example – Read the examples to respondent.
Mark I
K all that apply.
J
With a parent or other relative

In a jail or prison

For college

At a seasonal or
second residence

For a military assignment

For another reason

For a job or business

No

Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

7. Please read the RACE section on the Information Sheet.

In a nursing home

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or daughter-in-law

Adopted son or daughter
Stepson or stepdaughter
Brother or sister

4.

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

R

Biological son or daughter

White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

AF

Opposite-sex husband/wife/spouse

T

Please read the RELATIONSHIP section on the Information
Sheet.
How is this person related to Person 1? Mark I
K ONE box.
J

Other relative

Roommate or housemate

D

3.

What is this person’s race?
Mark I
K one or more boxes AND print origins.
J

Foster child

Other nonrelative

Is this person male or female? Mark I
K ONE box.
J
Male

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Female

5. What was this person’s age on (Special Census Day)? What is
this person’s date of birth? If you don’t know the exact age,
please estimate. For babies less than 1 year old, do not report
the age in months. Report 0 as the age.
Age on (Special Census Day)

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Print numbers in boxes.
Month
Day
Year of birth

years

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

➜ If more people were counted in Question S6 on the
SC-Q, continue with the next person on the next
page.

6

23043060

§8%?o¤
1. What is the name of

Person

➜ NOTE: Please answer BOTH the question about Hispanic
origin and the question about race. For this census, Hispanic
origin is not a race.

?

Print name below and verify the spelling.
First Name

MI

6.

Last Name(s)

Please read the HISPANIC ORIGIN section on the Information
Sheet.
Is this person of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano

2.

Does this person usually live or stay somewhere else?
For example – Read the examples to respondent.
Mark I
K all that apply.
J
With a parent or other relative

In a jail or prison

For college

At a seasonal or
second residence

For a military assignment

For another reason

For a job or business

No

Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin – Print, for
example, Salvadoran, Dominican, Colombian, Guatemalan,
Spaniard, Ecuadorian, etc. C

7. Please read the RACE section on the Information Sheet.

In a nursing home

Father or mother

Opposite-sex unmarried partner

Grandchild

Same-sex husband/wife/spouse

Parent-in-law

Same-sex unmarried partner

Son-in-law or daughter-in-law

Black or African Am. – Print, for example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. C

American Indian or Alaska Native – Print name of enrolled or
principal tribe(s), for example, Navajo Nation, Blackfeet Tribe,
Mayan, Aztec, Native Village of Barrow Inupiat Traditional
Government, Nome Eskimo Community, etc. C

Other relative

Roommate or housemate

D

Adopted son or daughter

White – Print, for example, German, Irish, English, Italian,
Lebanese, Egyptian, etc. C

AF

Opposite-sex husband/wife/spouse

Biological son or daughter

4.

T

Please read the RELATIONSHIP section on the Information
Sheet.
How is this person related to Person 1? Mark I
K ONE box.
J

R

3.

What is this person’s race?
Mark I
K one or more boxes AND print origins.
J

Stepson or stepdaughter

Foster child

Brother or sister

Other nonrelative

Is this person male or female? Mark I
K ONE box.
J
Male

Chinese

Vietnamese

Native Hawaiian

Filipino

Korean

Samoan

Asian Indian

Japanese

Chamorro

Female

5. What was this person’s age on (Special Census Day)? What is
this person’s date of birth? If you don’t know the exact age,
please estimate. For babies less than 1 year old, do not report
the age in months. Report 0 as the age.
Age on (Special Census Day)

Other Asian –
Print, for example,
Pakistani, Cambodian,
Hmong, etc. C

Print numbers in boxes.
Month
Day
Year of birth

years

Other Pacific Islander –
Print, for example,
Tongan, Fijian,
Marshallese, etc. C

Some other race – Print race or origin. C

➜ If needed, continue with the next person on another
Continuation Questionnaire (SC-CQ) and update the
number of continuation questionnaires on page 8 of
the SC-Q and page 1 of the SC-CQ questionnaires.

7

23043078

AF

T

§8%?w¤

D

R

This page intentionally left blank.

8

23043086

OMB No. XXXX-XXXX