SC-117 Transitory Location Control Record

FORM

SC-117 (1-19-2023)

OMB No. 0607-0368

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

TRANSITORY LOCATION CONTROL RECORD
Special Census
THIS LISTING CONTAINS INFORMATION, THE RELEASE OF WHICH IS PROHIBITED BY TITLE 13, U.S.C.

I.

A.

B.

C.

D.

Case ID:

TL Type Code:

J. AA:

C

C

K.

Tract:

M.

Map Spot:

N.

Location description: C

O.

List additional Blocks in TL in same AA:

P.

Assigned to:

Q.

Date assigned:

L.

C

Block:

C

C

SCID/GU name:

TL name:

City:

F.

Zip Code:

C

C

Street address:

E.

C

C

C
C
(Print Field Representative’s name)

C

G. State: C

C

R.

C

Date returned:

C

/
H.

County:

C

SECTION A: – TRANSITORY LOCATION FACILITY CONTACT INFORMATION
Confirm, update or collect the TL Contact information. (Complete Items 1 to 3)
Question 1, SC-688

Question 2, SC-688

1. Contact name:

2. Contact title:
Cell

3. Telephone number(s), including
area code and extension:

(

)

Home/Other

–

(

Ext.

–

)

SECTION A1: – TRANSITORY LOCATION ADVANCE CONTACT INFORMATION
Question 4, SC-688

Question 3, SC-688

6. Will you be open between (Special Census Dates)?

4. TL name:

1

YES

3

Don’t know

(Only MINOR spelling corrections are allowed)

5. Street name:

Continued on next page

2

NO (Mark (X) Closed on Special
Census Day in Section A2)

SECTION A1: – TRANSITORY LOCATION ADVANCE CONTACT INFORMATION – Continued
Question 5, SC-688

7. TL Type Code:
1

10-Campground

3

30-Marina

5

50-Racetrack

2

20-RV Park

4

40-Hotel/Motel(Mark Rooms in item 8)

6

60-Circus/Carnival/Fair

7

90-Other, Describe:

C

Question 6 and 9b, SC-688

8. Type of spaces or units: (Mark (X) all that apply).
1

Sites

RV Pads

2

Slips

3

Rooms

4

5

Units

6

Other, Describe:

Question 7 and 9a, SC-688

9. Maximum Number of Spaces or Units at Location:
Question 8, and 9c, SC-688

10. Average Number of Occupied Units:
For Housing Units, enter # of people
Question 9b, SC-688

11. Are there any people who live or stay at this hotel/motel on an extended basis?
1

YES

NO (End the interview)

2

Question 10, SC-688

12. What is the best day and time to conduct the Special Census at this location?
Date: (Mo, D, Yr)

/

Time
1

:

/

13. Appointment scheduled:

1

YES

2

am
pm

NO

2

Question 11, SC-688

14. Are there any specific instructions that Special Census staff need to know to count the people at this location?
1

YES: Mark (X) all that apply or describe)

4

Other - Describe:

2

Gated community

3

Locked entrance

5

NO

Question 12, SC-688

15. Are there any people at this location who do not speak or understand English?
1

YES - Write the language(s) spoken

❶

2

NO

❷
❸

Question 13, SC-688

16. TL site maps:

1

YES 2

NO

Question 14, SC-688

17. TL Contact responsible for additional location(s):
1

YES - Complete an SC-225, INFO-COMM, and notify your supervisor. 2

NO

SECTION A2: – TLAC STATUS
18.

Page 2

1

Complete - ETL Appointment Scheduled (include appointments for Housing Units) OR

2

Out of Enumeration Area

3

Duplicate: Survivor ID #

4

Dangerous Address

5

Housing Unit, No Appointment

7

Closed on Special Census Day

8

Demolished/Burned out

6

Group Quarter

9

Uninhabitable (Open to the Elements/Condemned/Under Construction)

10

Closed/Not Operating/Vacant

11

Refusal

13

Cannot Locate

14

Other

Continued on next page

12

Nonresidential

FORM SC-117 (1-19-2023)

SECTION B: – ENUMERATION AT TRANSITORY LOCATIONS INFORMATION
Month/Day/Year

Print Field Representative’s Name

19. Assigned to:

20. Date assigned:

/

/

Month/Day/Year

21. Date Enumeration completed:

/

/
Certification

Field Representative – I certify that the entries made on this form are true and correct to the best of my knowledge.
Month/Day/Year

22. Field Representative signature:

23. Date signed:

/

/

Section B1 – ETL Summary
24.

A) Total Number of Units:

E) Total Number of First No Contacts (NC1):

B) Total Number of Occupied Units:

F) Total Number of Second No Contacts (NC2):

C) Total Number of Permanent Structures:
(Mobile Homes/Housing Units)

G) Total Number of Completed EQs:
H) TL POPULATION COUNT:

D) Total Number of Refusals:

SECTION B2: – ETL STATUS
25.

1

Complete or Zero POP Reason: Mark (X) only one

8

Refusal

9

Uninhabitable (Open to the Elements/
Condemned/Under Construction)

2

Out of Enumeration Area

3

Duplicate: Survivor ID#

4

Dangerous Address

5

Demolished/Burned Out

6

Vacant

7

Group Quarter

10

Nonresidential

11

Cannot Locate

12

Occupied as of Special Census Day but no one
is there as of Enumeration Date

NOTES

FORM SC-117 (1-19-2023)

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