Not Found Form

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OMB No. 0607-0117

In response to your application, a search has been made of the records of the census listed below,
but we were unable to find a record for the person named below.
Name
Census date

Address

If you can furnish a new or corrected address for the census year listed above, a search will be made
in this census year without an additional fee if your reply is received within 90 days. Use the area
below to provide the information. (Note: If you desire a search in a census year other than the census
year listed above, it will be necessary for you to fill out and sign a new application and return with
another fee.)
Census date

Number and street

City, town, township

County

Name of person with whom living
(head of household)

State

Relationship of person to head of household

Return this letter, or a new application, to:
U.S. Census Bureau, Personal Census Search Unit
PO Box 1545
Jeffersonville, IN 47131-0001.

DRAFT BC-649(L)

The average time it should take you to fill out the information requested on this letter (BC-649)
including the time spent reading instructions, is 6 minutes. This collection of information has been
approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number that
appears at the top of page 1 confirms this approval. If this number were not displayed, respondents
would not be required to respond. Send any comments concerning this collection by email to
<[email protected]>. Use "Paperwork Reduction Project 0607-0117" as the subject.
The U.S. Census Bureau is required by law to protect your information. The Census Bureau is not
permitted to publicly release your responses in a way that could identify you or your household. Title
13, United States Code, Section 8(a) permits release to the person whom the information pertains or
to their legal representative. Several Federal laws protect your privacy and keeps your answers
confidential (5 U.S.C. § 552a and Title 13, United States Code, Section 9).
The information provided to us may be shared with other Census Bureau staff for the work-related
purposes per the published routine uses as identified in the Privacy Act System of Records Notice
COMMERCE/Census-6, Population Census Records for 1910 and All Subsequent Decennial Censuses.
Furnishing this information is voluntary. Failure to do so may affect the Census Bureau’s ability to
provide the information requested.