SC-435 Reinterview Dependent Quality Check Record

FORM

SC-435 (1-19-2023)

OMB No. 0607-0368

UNITED STATES DEPARTMENT OF COMMERCE

SCID:

AA:

Starting address line number:

Date DQC Conducted:

U.S. CENSUS BUREAU

DEPENDENT QUALITY CHECK RECORD
Special Census
Check the address for these errors
Consecuve
addresses on
the ground

HU, GQ, or TL missing from
SC-920 and SC-921
(Enter listing line number)

(1)

(2)

Address is on SC-920 with Action Code U, N, Address is on SC-920 with Action Code V or C,
Failed Addresses
DCL, or CW but should have Acon Code V or C
but should have Acon Code U or N
Mark (X) if entry in
(Enter listing line number)
(Enter listing line number)
Column (2), (3), or (4)

(3)

(4)

Notes

(5)

(6)

1
2
3
4
5
6
7
8
9
10
11
12
If the total number of Failed Addresses is 2 or more, the AA has failed DQC
Mark (X) one:

AA Passed – Return materials

AA Failed – Recanvass AA

➨

▲

DQC OUTCOME

Total number of Failed Addresses