Decennial Census Temporary, Intermittent Applicant Information Collection (Applicant)

Job Application Information and
Supplemental Voluntary
Applicant Information
Decennial Census Temporary, Intermittent Applicant Information
Collection
4/30/2025

Account Creation

2

3

If the applicant hovers over the information icon, then the
below message appears:

Enter your name as it appears on your federal,
state, or foreign legal identification
documentation.

If the applicant attempts to create a password that does not meet the
requirements, then the following error message appears: Passwords must
contain at least fifteen (15) non-blank characters. Characters must meet at least
three (3) of the following four (4) categories: English upper-case characters (A-Z);
English lower-case characters (a-z); Base 10 digits (0-9); Non-Alphanumeric (ex. !,
$, #).

Once the applicant clicks the Create Account button and successfully creates
their account, the following pop-up appears:

4

If the applicant attempts to sign in with an incorrect Email
Address and/or Password, then the following error message
appears: Your login attempt has failed. Make sure the
username and password are correct.
If the applicant attempts to sign in with the Email Address
field blank, then the following error message appears: Enter
a value in the User Name field.
If the applicant attempts to sign in with the Password field
blank, then the following error message appears: Enter a
value in the Password field.

If the applicant clicks the Create Account link, then the
applicant is taken to the Account Creation screen.

5

Job Application Information

6

If the applicant clicks on the Privacy Act and Burden Statement link, then the
Privacy Act Burden Statement information pop-up on the following slide appears.
If the applicant chooses not to acknowledge the Electronic Disclosure
statement, then the Opt Out Alert pop-up on the following slide
appears.

7

If the applicant clicks the Privacy Act and Burden Statement link
on the Electronic Disclosure screen, then the following Privacy
Act Burden Statement information pop-up will appear:
Solicitation of your personal information is authorized by Title 13 U.S.C., Chapter 1, Subchapter II, Section 23(a) and 23(c); Title 5 U.S.C., Part II, Chapter 13; Title 5 U.S.C., Part III, Subpart B, Chapter 33, Subchapter 1, Section 1 and 20; and
Executive Orders
9397,
10566. information is authorized by Title 13 U.S.C., Chapter 1, Subchapter II, Section 23(a) and ©; Title 5 U.S.C., Part II, Chapter 13; Title 5 U.S.C., Part III, Subpart B,
Solicitation
of your
personal
Chapter 33, Subchapter 1, Section 1 and 20; and Executive Orders 9397, 10566.

The purpose of collecting this information is primarily to determine your qualifications for employment and may also be used to identify you to other sources asked to comment on your
qualifications, e.g. educational institutions, former employers, and enforcement agencies, or to a court during legal proceedings. Personal information collected includes your Social
Security Number (SSN), name, address, date of birth, telephone number, etc.
Disclosure of the information provided to us may be shared with other Census Bureau staff for the work-related purposes identified in this statement as permitted under the Privacy Act of
1974 (5 U.S.C. Section 552a). Disclosure of this information is also subject to the published routine uses as identified in the Privacy Act System of Record Notice OPM/GOVT-5, Recruiting,
Examining, and Placement Records, OPM/GOVT–7-Applicant Race, Sex, National Origin, and Disability Status Records and COMMERCE/DEPT-25 Access Control and Identity Management
System.
Furnishing this information is voluntary, but failure to provide any part or all of the data requested will result in you receiving no further consideration for employment.
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden, to [email protected]; use "Paperwork Reduction Project 0607-XXXX" as the subject.
The eight digit OMB number confirms our authority to collect this information.

If the applicant chooses not to acknowledge the Electronic Disclosure
statement, then the following Opt Out Alert pop-up appears:

8

9

Fields are pre-populated with the applicant’s Account Creation entries.

If the applicant clicks the here link, then the applicant will be taken to account
management, allowing the applicant to make updates to their information.

If the applicant enters an invalid SSN, then the following error message
appears: You entered an invalid number. Please re-enter.
If the applicant enters an SSN that is already in use with another account,
then the following error message appears: Social Security number currently in
use. Please contact 833-893-2026 for assistance.
If the applicant hovers over the information icon,
then the below message appears:

If the applicant enters a different number in the Confirm SSN field, then the
following error message appears: The Social Security numbers entered do not
match. Please re-enter.

10

If the applicant enters a PO Box in the Street Address textbox, then the following error
message appears: Please enter PO Box in the upcoming Mailing Address section of this
application.

If the applicant attempts to enter more than 165 characters in the Street Address textbox,
then the following error message appears: Street Address cannot exceed 165 characters.

If the applicant enters numbers in the City textbox, then the following error message
appears: You entered an invalid City. Please re-enter.

11

If the applicant selects the Select if same as Home Address checkbox, then the
fields auto populate with the applicant’s Home Address entries and the fields are
greyed out.

If the applicant attempts to enter more than 165 characters in the
Mailing Address textbox, then the following error message appears:
Mailing Address cannot exceed 165 characters.

If the applicant enters numbers in the City textbox, then the following
error message appears: You entered an invalid City. Please re-enter.

12

If the applicant enters a different date in the Confirm Date of Birth fields, then the following error
message appears: The dates entered do not match. Please re-enter.
If the applicant enters the current year for the Date of Birth year, then the following error
message appears: You entered an invalid DOB. Please re-enter.
If the applicant is under 18, then the following information message appears: Based on your entry
you are under 18 years of age. You currently don’t qualify; however, if you turn 18 prior to the end of
hiring, then your application could be considered.

If the applicant selects “No”, then the In what
country were you born? drop-down menu appears.

If the applicant selects “Yes”, then the following warning message appears: You have
indicated you are a U.S. citizen or national. If you are NOT, then please update your
answer.
If the applicant selects “No”, then the following error message appears: You must be
a citizen of the United States to be hired for a census job.

13

If the applicant clicks the Selective Service System (sss.gov) link,
then the applicant will be taken to https://www.sss.gov/verify.
If the applicant selects “Yes”, then the Please enter
your Selective Service Number textbox appears.

If the applicant attempts to enter more than 350 characters in the explanation textbox,
then the following error message appears: Explanation cannot exceed 350 characters.

If the applicant selects “No” that they have not registered with SSS and does not provide
an explanation or upload documentation, then the following error message appears: You
must provide an explanation or upload supporting documentation before continuing.

14

15

If the applicant clicks the Standard Form 15 (SF-15) link, then the
applicant will be taken to https://www.opm.gov/forms/pdf_fill/sf15.pdf.

Select Document Type list options below:
•
•
•
•
•
•
•
•
•
•

DD-214 Certification of Release or Discharge from Active Duty
SF-15 Application for 10-point Veteran Preference
Certification of Discharge or Release
Official Statement/Letter of Disability
DD Form 1300, Report of Casualty
Retirement or separation orders
Reserve Corps Transfer Documents
Official Statement from Military Personnel Record Center
Certified Death Certificate
Certified Copy of Court Decree of Annulment

If the applicant selects a Veterans’ Preference category and does not upload
documentation, then the following error message appears: You must upload supporting
documentation at the time of application or remove your claim of preference. You may
16
submit your application and update your response later.

If the applicant selects “Yes” that they are currently employed
by a federal government agency, then the Please select your
agency and enter your title and hire date fields appear.

If the applicant selects that they have received VSIP/Buyout,
then the Indicate VSIP/Buyout Year and Agency fields appear.

If the applicant selects “Yes” that they are a retiree
receiving a federal annuity, then the Indicate the
agency, your Civil Service Annuitant (CSA) number,
and upload your Annuitant Statement fields appear.

17

18

If the applicant hovers over the information icon,
then the below message appears:

19

Total hours per week list options below:
•
•
•
•

Any Hours
40 Hours
20-39 Hours
1-19 Hours

20

If the applicant hovers over the information
icon, then the below message appears:

21

If the applicant does not check the checkboxes, then
the following error appears: Applicants must
acknowledge both statements above in order to submit
their application.
When the applicant checks BOTH checkboxes, then the
Signature textbox populates with the applicant’s name.
When the applicant checks BOTH checkboxes, then the Date
and Time textboxes populates with the current date and time.

22

Supplemental Voluntary Applicant Information

23

If the applicant clicks the Paperwork Reduction Act Statement
link, then the Paperwork Reduction Act Statement
information pop-up on the following slide appears.
If the applicant clicks the Privacy Act Statement
link, then the Privacy Act Statement information
pop-up on the following slide appears.

24

If the applicant clicks the Privacy Act Statement link
on the Your Privacy is Protected screen, the following
Privacy Act Statement information pop-up appears:

If the applicant clicks the Paperwork Reduction Act Statement link
on the Your Privacy is Protected screen, the following Paperwork
Reduction Act Statement information pop-up appears:

25

If the applicant selects “Yes”, the Enter
your referral code textbox appears.

If the applicant hovers over the information icon, then
the below message appears:

26

Recruiting Source categories below in bold and annotated with *.
Specific Recruiting Source sub-categories below, bulleted beneath associated Recruiting Source.
* Referred by a Person or Through Social Media
• Social Media Ad/Post
• Word-of-mouth/Family/Co-Worker/Other Person
• Census Employee/Recruiter
* Electronic Employment Source or Service (App/Internet/Online)
• Online Job Board/Online Employment Resource
• Search Engine/Searched Online
* In-Person Employment Source or Service
• Employment Office/Job Service Center
• Job Fair/Career Fair/Employment Fair
* Entertainment or Media Source
• Online News Source
• Mobile App Advertisement – Ads in games, videos, or other apps
• Print Newspaper/Magazine/Shopper or Other Print (Ad/Article)
• Radio/Audio Streaming Service/Podcast (Ad/News/Other)
• TV/Video Streaming Service (Ad/News/Other)
* Organization/Public Official/Government (Include Electronic Messages/Postings from These Sources)
• Faith-Based/Religious Organization or Official
• Educational Organization or Library or Official – School/College/University/Library/Other Educational Organization
• Government Organization or Official-Federal/State/Tribal/Local Government Organization
• Business Organization – Small Business/Sole Proprietorship, Corporations, LLCs, Partnerships
• Community-Based Organization or Official – Non-Government Organization (often non-profit)
* Transportation/Outdoor/Out-of-Home Advertisement
• Public Transportation/Mass Transit/Subway/Bus/Taxi/Airport/Rideshare or Similar Advertisement
• Other Public Location – Mall/Gas or Charging Station/Movie Theatre/Other
• Billboard/Electronic Billboard
* Census Bureau Promotions or Events
• Census Mailing/Postcard Sent to your Home
• Flyer/Card/Lawn Sign/Brochure or Similar
• Event Booth/Representative at Event – Conference/Festival/Market/Expo/Fair/Show/Parade/Sporting Event or Similar
• Other Communications from Census Bureau – Email/Phone/Text/Other

27

28

If the applicant checks the Other Disability or Serious Health Condition
checkbox, then the applicant will be taken to the Other Disability or
Serious Health Conditions (Optional) screen on the following slide.

29

If the applicant checked the Other Disability or Serious Health Condition checkbox on the
Disability/Serious Health Conditions screen, then the applicant will be taken to this screen.

List continued below:

30

31