How to Complete the Form

First Question

How many people were living or staying in this house, apartment, or mobile home on April 1, 2010?

Explanation:

  • Write the number of people living in the home
  • Include everyone regardless of immigration status

Second Question

Were there any additional people staying here April 1, 2010 that you did not include in Question 1?

 

Options:

  • Children, such as newborn babies or foster children
  • Relatives, such as adult children, cousins, or in-laws
  • Nonrelatives, such as roommates or live-in baby sitters
  • People staying here temporarily
  • No additional people

Third Question

Is this house, apartment, or mobile home-

Options:

  • Owned by you or someone in this household with a mortgage or loan? Include home equity loans.
  • Owned by you or someone in this household free and clear (without a mortgage or loan)?
  • Rented?
  • Occupied without payment of rent?

Fourth Question

What is your telephone number?

Explanation:

  • It is possible that the office of the Census may call you if they do not understand an answer.
  • Area Code and Number: for example (123) 456-7890

Fifth Question

What is Person 1's name?

Provide information for each person living here.  Start with a person living here who owns or rents this house, apartment or mobile home.

If the owner or renter lives somewhere else, start with any adult living here.

Explanation:

  • Identify the Head of the Household
  • Write their Last Name, First Name, and Middle Initial
  • The information is confidential

Sixth Question

What is Person's 1 sex?

Options:

  • Male
  • Female

Seventh Question

What is Person 1's age and what is Person 1's date of birth?

  • Report babies as age 0 when the child is less than 1 year old.
  • Write the age of Person 1 on April 1, 2010
  • Write the numbers of the date of birth on the boxes in this order, for example:

Month

Day

Year

01 (January)

01

2010

 

Eighth Question

Is Person 1 of Hispanic, Latino, or Spanish origin?

  • Everyone must answer the Hispanic origin question.
  • It refers to nationality, lineage or country where your parents or ancestors were born.
  • For the purposes of this Census, Hispanic origin is not a race.
  • People of Hispanic origin may be of any race and can choose one or more race categories
  • People of Hispanic origin are asked to indicate the specific group they belong to or write it in.

Options:

  • No, not of Hispanic, Latino, or Spanish origin
  • Yes, Mexican, Mexican American, Chicano
  • Yes, Puerto Rican
  • Yes, Cuban
  • Yes, another Hispanic, Latino, or Spanish origin - Write in the origin in the box provided, for example, Argentinean, Colombian, Dominican, etc.

See the Frequently Asked Questions on Completing the Form for more information on the race and ethnicity questions.

Ninth Question

What is Person 1's race?
(Mark one or more boxes)

If you do not identify with any of the specified race groups, you may mark the "Some other race" category and write in your race.

Explanation:

Question: What is your race?

  • Race refers to groups subdivided based on a series of characteristics that are inherited through genetics.
  • You are asked to indicate the specific group to which you belong to- you are allowed to choose more than one option.
  • You will be able to write in your race if it is not listed as an option.

See the Frequently Asked Questions on Completing the Form for more information on the race and ethnicity questions.

Tenth Question

Does Person 1 sometimes live or stay somewhere else?

Explanation:

  • If this is your only place of residence mark NO
  • If you sometimes live or stay somewhere else mark YES and indicate all the places that apply

Additional Persons

Explanation:

If there is more than one person living there on April 1, 2010, you will have to answer 7 additional questions per person

Provided the following information on all additional persons that live here:

  • Name
  • Familial relationships to person 1
  • Sex
  • Age
  • Race
  • Ethnicity
  • Additional place of residence

If you need further assistance, please call (877) EL-CENSO