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09-21-99 Regular Meeting of La Porte Complete Count Committee
• • MEETING NOTICE CENSUS 2000 COMPLETE COUNT COMMITTEE MEETING DATE: SEPTEMBER 21, 1999 TIME: 6:00 P.M. PLACE: CITY HALL COUNCIL CHAMBERS 604 WEST FAIRMONT PARKWAY LA PORTE, TEXAS 77571 RSVP: CITY SECRETARY'S OFFICE - 281-471-5020 EXT. 233 SANDWICHES, CHIPS, COOKIES AND SOFT DRINKS WILL BE PROVIDED. • City of La Porte Census 2000 Complete Count Committee Meeting Minutes of September 21, 1999 Members Present: Tim O'Connor, Tom Rafferty, Wayne Spears, Joeena Davis, Vicky Abshire, Lorraine Jeffery, Debbie Kurz and Kathy Alberts. Members Absent: Beth Rickert, Tom Rawls, Colleen Hicks, Ada Bowen, Jeanne Zemanek, Susan Parastar, Steve Jacks, Mazlin Fenn, Linda Barley, Randy Gilchrist, James Snider. Others Present: Gwen Goodwin, Census Bureau Representative. City Staff Present: City Secretary Martha Gillett, Assistant City Secretary Janis Goulder and Planner Masood Malik. I. Call to Order. The meeting was called to order at 6:05 P.M. by Masood Malik. II. Elect a Chairperson and aVice-Chairperson ~1~1 ~'c r ~ ~>> A motion was made by Tim O'Con~tto appoint Jeannie Zemanek and Father Tom Rafferty as Co-Chairman of the Census Count Committee. Seconded by Joeena Davis. The motion carried unanimously. Ayes: 8 Nays: None III. Consider approving minutes of Special Called Meeting on August 25, 1999 Motion was made by Joeena Davis to approve the minutes as presented. Seconded by Tim O'Connor. The motion carried unanimously. Ayes: 8 Nays: None IV. Discuss Activities for Sub-Committees V. Develop A Plan of Action for Subcommittees The following committee actions and plans were discussed: Government -This committee will work closely with the Media Committee. It was suggested that a mail out be worked on jointly between the two groups. City staff will assist as needed. Page 2 The committee requested Ms. Goodwin to bring information to the next meeting that outlines the hard to reach areas. Media -Lorraine Jeffery volunteered to work on the Media Committee. The group noted that all flyers would need to be in Spanish and English. Ms. Goodwin shared some examples from the Census Bureau. Joeena Davis volunteered to work on the Media and Business Committees. Tim O'Connor advised the committee he would draft a letter to be sent to potential people who can work with the committee. Religious -This committee will be working with the Ministerial Alliance to seek their assistance in educating the community on the importance of completing a Census Form. Education -Martha Gillett reported that Beth Rickert will serve as chairperson of the Education Committee. She will be working with the principals and teachers to distribute information to students. In addition, they will notify School Board Members and provide them with information about the Census 2000. Gwen Goodwin provided the committee with posters and advised them she could reserve as many as needed. In addition, she will be providing the committee members with stickers and t-shirts. The next meeting date was set for October 19, 1999 in the City Council Chambers at 6:00 P.M. VI. Adjourn There being no further business, the meeting adjourned at 7:00 P.M. Respectfully submitte Martha A. Gillett City Secretary Approved on October 19, 1999. CJ • COMPLETE COUNT COMMITTEE {CCC} Colleen Hicks La Porte -Bayshore Chamber P. O. Box 996 La Porte, Texas 77572 281-471-1123 Lorraine Jeffery La Porte Library 526 San Jacinto La Porte, Texas 77571 281-471-4022 lieffery(a~stic.lib.tx.us Jeanne Zemanek Fairmont Park Home Owners Association 3102 Valley Brook La Porte, Texas 77571 281-471-1426 Linda Barley Neighborhood Center, Inc. 911 S. 8~'.Street La Porte, Texas 77571 281-471-1824 Day 281-471-2977 Fax lindabarley~a hotmail.com Susan Parastar Hams County Community Youth Services/LPISD &Neighborhood Centers Board Chair 301 E. Fairmont Parkway La Porte, Texas 77571 281-604-4731 arastar ash.net Father Tom Rafferty St. Mary's Catholic Church 816 Park Avenue La Porte, Texas 77571 tomr(a~brokersys. com Beth Rickert La Porte Independent School District 301 East Fairmont Parkway La Porte, Texas 77571 281-604-7007 bethrickert a~att_net Randy Gilchrist First Baptist Church 310 S. Broadway La Porte, Texas 77571 281-471-0338 laportefbc a~aol:com Steve Jacks Steve Jacks Insurance Agency Deer Park Masonic Lodge 1200 Highway 146 S. #152 La Porte, Texas 77571 281-471-0481 Marlin Fenn First United Methodist Church P. O. Box 1185 La Porte, Texas 77571 281-478-4673 Herman H. Berges (RESIGNED FROM COMMITTEE) P. 0. Box 215 La Porte, Texas 77572 281-471-0344 hhberger(a,myweb.net Kathy Alberts 8735 Collingdale La Porte, Texas 77571 281-930-0926 su~~ez~a,swbell.net Tim O'Conner 9806 Brookview La Porte, Texas 77571 (281) 470-0560 toconnor a~ci.mocity.tx.us Ada Bowen 1613 Willowview La Porte, Texas 77571 (281) 471-7244 • • Reverend Tom Rawls 11702 North P. Street La Porte, Texas 77571 (281) 471-4106 Debra Kurz 3118 Eastwick La Porte, Texas 77571 (281) 479-1470 smsdeb _,ibm.net Vicky Abshire 3811 Barracuda La Porte, Texas 77571 (281) 867-0775 (IT) (281) 842-1503 (La Porte WK) Pager (713) 727-0973 Dr. Wayne Spears 3109 Old Hickory La Porte, Texas 77571 (281) 471-7421 James Snider 9801 Brookview La Porte, Texas 77571 (281) 470-1491 Hm. (281) 476-2933 Wk. Joeena Davis 3118 Oaken Ln. La Porte, Texas 77571 (281) 471-3539 ioeena. b. davis(n,usa. dupont. com u S:\AdminShare\Martha\COMPLETE COUNT COMMITTEE.doc .} LAPORTE, TEXAS CENSUS 2000 ,~ - , ~, COMPLETE COUNT COMMITTEE ` MEDIA SUB-COMMITTEE REPORT for OCTOBER 1999 ~ ~~.~ ~ ~~ Committee, Members: Tim O'Connor, Lorraine Jeffery, Joeena Davis, Mark Snider and Mnrthn Gillett. ~ ~ f ~k~t****ytst~t~~tyt~t*~k~k*********~t~t~t*******~t***~c*****~t*******yF~k*******~k*~k**~k~kytyt~k ~ iE ;~~;;, ,,~;. _,;.: PRE-CENSUS DAY "ACTION STEPS" .~~~ [] Press Conference - We do not think it necessary to facilitate a Press ~ ~_;`~=A. Conference for the LaPorte Community. This decision is based on the fact that the Census- 2000 is a nationwide campaign, and we can not expect the television ~ ~~~ and print media to cover such nn event specifically for LaPorte. We will prepare ~~~ a -"media package" for the Bayshore Sun Newspaper, which. will involve providing them with articles for publication from January through April of 2000. ` 'F `~ F' ~~,~. [] Local Mailing List - We will compile a mailing list, with contact person, for all ~~°" area.churches, business and industry, homeowners associations, schools, ;u municipalities, youth sports associations and civic clubs and organizations. This `'-~~~ "list"::.will be mailed all news releases generated by our committee, in hope that ; :~ ; they will include them in all newsletters, bulletins and flyers they generate for distribution to their membership. I believe that the Chamber of Commerce has ~~ k R compiled a significant number of these contacts. I would hope that City stuff ~~, ~.,~ could generate the mailing labels, and provide the envelopes and pay for the x rr y: postage that this project will demand. ~ ~ ,, A _. a,• .. ~ ,.~~ apt. .: . ~;. [] Potential Promotional Vehicles- LaPorte Cable Channel, Water/Sewer Bills, r ~ ... Employee Ne , wsletters, School District Newsletters Chamber Publications and `! ~~~ Newsletters, Municipal ~ School District,Bulletin Boa f ~ ~ ~ f ~ ~~ rds, Local "Storefronts", ,, ~ ~ ;:' ` R. Youth Sports Associations and San Jacinto College. ~ . _ . ~:~.~ ~ [] Promotional Materials - We need Gwen Goodwin to procure the necessary numbers of promotionalposters and flyers for the local efforts. ,We will have era ._ ..., .. n - ~~ ,. , _ ~Y~J. ~ ~ ~ . "_ ..>~ -~~the exact numbersupon completion of :the .local mailing list compilation. ~, ; 1~1r - ~.t ~e iF~ /f _ ~ `J a -. tc 't ~.'` ~-.ypp', ~` '~~"~ . ~ ~~ ~ ~ W 1 ' L' ~ 1~ ~'j ~ ~'.,~! "~; M i L W~ Sit A 11.'~fT/~"L 3L t,, Y t f 1 f S j~ Yfi~ r Y ~~ 1 - - 'k ` ~ s r `~' ~ ~ t3'Tv+ '""'~`~t~i a ~~ "t4sd+ `` ~.o `tpyg ~ 1 ~ ~, ~iS c ~~ " ~ ' H: ~ 'S, e 4 Sµ ~ f,~ .~}* T ~~~'~ x`~l~' r ~;~ T3Q ~'~ '` *4 ~ },i V„`l , r A {{~~ ..~..,..-.. _.-~.__._.. ..~ _._.. .. ..u.. ... ....u _. ._... ..__ - .Yl. .. .. i ~ ~ -~ ~~~ ,,,~ fl ,,,~ N page two ~I' I 'i'! ,, [] Development of n Speakers Bureau - .We aspire to create n bureau that; will ,~i ~;~j have the depth to allow for presentations to civic groups and other interested r ~? organization. We feel that there is a need for both English and Spanish ' presenters. I envision using the Student Government students to facilitate some ~ ~~, h of these presentations. Maybe Beth could assist? ~ ~ "~t_.. r `~~~ t1 ~~~~ [] Committee Assistance - We perceive our committee as a "tool" for every wo ~~~.: , other Census 2000 Committee &Sub-Committee. It is imperative that they copy ' ~';';'"y;; ~, ~~:.x us with a listing of their activities so that we can assist in the promotion of ~~~.~ those efforts. y~' ,+'y - The Media Sub-Committee will be conducting a lengthy planning meeting in - . =-r t~ ,.~~ November. We would like to use the classroom at the Recreation and Fitness ~""~ Center, if possible. The purpose of the meeting will be to formulate the action ~;~`~~ steps identified in the "getting started" section of the attachment. `st,~t~~ ,,,r~ NOTES: '~~~ ~~ ~~ ~~~ x•vr S i~i~ .. ~, ~, ~~`'~~~ ~~ r ~' ids f(~~ ~_ ~ ~i ~~yy ~~ .! I~i4~i ~~{. .,iq~, ~~ _ ~ ;' ,> pro- ,.% C,Y *xS';q 1 ... ~+ } - -~_>.; - - t' ,~ ~i ~ ~ M t~~ ... - tin:;. .L,. ^" 'i-a ;i ..- .'~~•~ c, Y n'~; ~c NYS'?~k~ 5. 1. ~. nt~ ~~ a; ~n ;l ~ d'~ `{ a - 1.,.i~. Suggested Activities~or the Media Sub-committee - P'RE=CENSUS .DAY SNOW through MARCH2000 suggested rrne ACTION STEPS Range ^ Arrange a press conference announcing the formation of the Complete Count Committee (CCC). Highlight the background, accomplishments, and role of the chairperson. '' ^ Ask the chairperson of the other sub-committees to compile an ongoing list of Census activities generated by groups in their area of focus. ^ Create a series of messages about the Census tailored to address your community Getting and its major concerns. Use them to create press releases. StaCtet~ ^ Produce Census messages and promotional materials tailored to your community. ~ ~ Ask the local newspapers and trade magazines to insert your materials into their publications.. i.e., a flyer. ^ List five things your community could stand to gain by participating in the Census. List five things the community may lose without an accurate count ^ Create five or more Census articles (drop-in articles) that can be easily submitted to newspapers and used with little or no editing. ^ Create a flyer emphasizing the CONFIDENTIALITY of Census information. ^ Identify community members who are fluent in each of the languages spoken in your community. Ask them to translate flyers, press releases, and other articles into that language.. ,~N ~i~~~' ^ ~- Ask local media to do a series of stories on Census operations, such as, hiring, -~g$ - -. address listing; block canvassing, completing and returning questionnaires, and - activities generated by the CCCsuh-committees. t~ll"~UgI4 ^ L Create a calendar of Census events and circulate it to local media. - ^ L Hold periodic press conferences for your highest elected official and other known ~- F~BRLiARY community leaders and members to talk about the importance of the Census. ^ ~ D l d di 2000 eve op, an stribute public service announcements (PSAs) tailored to your . community using popular local personalities as messengers. ^ Q Arrange for appearances on radio and television talk shows to discuss Census , .: - RaI51I1g subjects such as CONFIDENTIALITY of the individual's responses to the Census ~' nd th b n fi f C n d a e e e ts o e sus ata to the community. If you wish, ask for a local Awareness. _ census Bureau representative to accompany you. ^ Q A k l l " ~ _ s oca radio stations to air regular Census"Profile America .messages available ~: . - _, - on CD from the U.S. Bureau of the Census, Public Information Ofl3ce, , 301-457-1808.... - - ^ ~-'r'~ Prepare messages, that can be-used on computerized displays at sports events, on °° 'office buildings; and for~use by businesses. , . ^ 4Y~ 'Ask college offlcials'to have Marketing,'Advertising, Journalism,Television, and Radio students to develop Census promotional material tailored to your community. in exchange for class credit. . f r x~^ 3 3F`.. J 4 .~~ 1~ . 4 ~ y,~ -. ?. i ` . ~ s~ # x ~ r ~F ~ iu Jt ~ ~, - r S i ,~,.~, 1~,, ~ :~2 ~ a, `.t~;c~,~! u't+~s`'~':.~~"~~ ,~ ~`~:, "Y.; ° r.E~ 0: ~ x j ~;~~~~~t y,~..~s.,~~.r ; ~°- ~ d,: T.t F. Y~% .n.~ ~_ ;. ~.~~~ ~~,~~ ~P ~ ~t ~ ~:. t ,. „ ~~< '3~!; '~ ~ 4ga ~~ a ~ R~g~ '~ -MARCH O ~ Hold a press conference announc~.he delivery of the questionnaires to the nation's households. Include all stakeholders, educators, students, parents, socia 1 999: service providers, health care providers, Headstart leaders, senior citizen advoca - „ and other agencies-that depend on federal funding. ~~ O ~ ' °'Contact college newspapers and radio stations and ask them to print and broads COQC1tdOWn Census stories and messages. ~ ~' t0 _ ~ ~- Ask highest elected official to send a letter to all residents urging them to comple - their Census questionnaires accurately and return them. promptly. {- Census Day ~ I` Ask radio stations to earmark certain times of [he day as Census time, and give a short motivational talk to residents encouraging them to participate in the Censu O L+~ Keep the media abreast of all Census activities generated by the CCC sub- committees. }, ; CENSUS DAY 2000 - APRtL 1_,..::2000• APR[L ° ~' .2000 • - o ~ oL The time oL has come to act... Hold a Census Day rally in a prominent location featuring the highest elected , i ~~ official, local personalities, entertainment, and prizes. '~^Qe~-S ! ~r Continue to ask radio stations to earmark certain times of the day as Census time," reminding residents to complete and return Census questionnaires immediately.'%~ Circulate a schedule of Census activities generated by other sub-committees and e organizations in the community. Distribute balloons imprinted with "Census 2000 ACT TODAY"'. Ask residents to~~' , display them in their yards, on their balconies, in their windows and doors as a ~~'}' show of support for and participation in Census 2000. ::POST -CENSUS DAY -_MAY - NOVElt1(BE~ ~~k ~.. ~-MAY - )t,ILY 2000 I~Ion- . - _, response Fot[ow up (NRFtI), ,O ~ :;Ask radio and television stations to include Census speakers on their-talk show ~~ programs. =~'' 0 L Encourage local media to re ind residents that Census 2000 is not over, and to . ', cooperate with Census workers. - . , ,~, :3 : O ~...-1'(Z. Hold press conferences to give the community an update on the progress of the . ~~ Non-response Follow up operation. , ' F~ OL~ Hold press conferences in areas that have a low mail response rate. t ~1 0 Keep the Census awareness momentum in the forefront of the minds of the med ia . s- _ ~. z. { ,;: S . :-. ~ :. , H~. ~^' d' , '1 _, r Y 1 irk ~tif:~ ~, ~•] Y. '~ ~ .. L - ~ _ 32 v .:~ ,, ~. ~ P< _ ~ ~ - ~ ~ e - ~ .r ~. r ~ r- ~ f , ~. , - , ., , ~ , , - . • _ ., : t - - - - - . , . r q yy ~ _ ~ '' ~~i tw ~°!ta v`~'~ ~? + ~' ~ t;p'~j'~ ~x? a ~' i- ~~.--:~~ I, „ ~.. .: i. x~` ,y~C~a ';,i'~''~J ~. R,,f~`f4`fi w. ` ~ ti,' P . '^ r' , v s ~ s , i . , •; j ~ ~ , F ~ h r AIIC U ST ~ j,; ~ ~ Encourage the media to continue rem~.g residents to cooperate with Census i~~" ,NOVEMBER workers. ^L~ Hold press conferences in areas where Census workers are interviewing residents :~~ .: ,s ' :~s • 2000 ° t~ Send press releases reporting on the progress of the Census operation. '~~+ O t>f'-2. Keep the Census awareness momentum in the forefront of the minds of the media. ' O l~ Send a press release to announce the conclusion of the Census 2000 operation, 'g?~.,$ POSL recognizing the efforts of the members of the Complete Count Committee. '1 ~Elnumeration • ° ~ Celebrate the success of your work and recognize the efforts of the committee SiIICVe}/ members. D "Thank YOU!" , ,' i (PE$) D "Thank YOU! QUat[ty O "Thank YOU!" " " Ch k rv p We could not have done it without YOU! ec Su ey ~w • ~ ~ ~ ~;.:: ~,,: r ~ @ o~~r~, Census 2000 The census is as important to our nation as highways and telephone lines. Every question is required by law to manage or evaluate federal programs or is needed to meet federal case law requirements. Federal and state funds supporting schools, employment services, housing assistance, road construction, hospital services, program for the elderly and more are distributed based on census figures. FIVE BIG REASONS WHY YOU SHOULD FILL OUT YOUR CENSUS FORM. 1. Help your community thrive. Does your neighborhood have a lot of traffic congestion, elderly people living alone or over crowded schools? Census numbers can help you community work out public improvement strategies. 2. Get Help In Times of Need. Many 911 emergency systems are based on maps developed for the last census. Census information helps health providers predict the spread of disease through communities with children or elderly people. When floods, tornadoes or earthquakes hit, the census tells rescuers how many people will need their help. When Hurricane Andrew hit South Florida in 1991, census information aided the rescue effort by providing estimates of the number of people in each block. 3. Make Government Work for You. It's a good way to tell our leaders who we are and what we need. The numbers are used to help determine the distribution of over $100 billion in federal funds and even more in state funds. We're talking hospitals, highways, stadiums and school lunch programs. Senior citizens in one New England community successfully argued their case for a new community center before county commissioners. Thev used the census numbers to support their request. 4. Reduce Risk for American Business. Because census numbers help industry reduce financial risk and locate potential markets, businesses are able to produce the products you want. All the Basic Facts you Need to Know to Start a New Business a publication of the Massachusetts Department of Commerce, shows small businesses how to use census numbers o determine the marketability of new products. 5. Help Yourself and Your Family. Individual records are held confidential for 72 years, but you can request a certificate from past censuses that can be used as proof to establish your age, residence or relationship, information that could help you qualify for a pension, establish citizenship or obtain an inheritance. In 2072, your great-grandchildren may want to use census information to research family history. Right now, you children may be using census information to do their homework Because we've had a census every 10 years since 1790, we know how farAmerica has come. IT'S ALL CONFIDENTIAL The Law Protects Your Answers. By law, the Census Bureau cannot share your answers with the IRS, FBI, Welfare, Immigration - or any other government agency. No court of law, not even the President of the United States, can find out your answers. The same law that keeps your answers out of the hands of these agencies, prevents the Census Bureau from selling or giving away your address to people who want to send you mail. Technology Protects Your Answers. The Census Bureau protects your information with numerous security measures, including electronic barriers, scrambling devices and dedicated lines. Your answers are combined with others to produce the statistical summaries that are published No one can connect your answers with your name or address. ~ ~ LONG FORM 'LEASE DO NOT FILL OUT THI~~RM. This is not an ~icial census form. It is for informational IIIII The "Informational Copy" shows the content of the United States Census 2000 "long" form questionnaire. Each household will f receive either a short form (100-percent questions) or a long form (100-percent and sample questions). The long form questionnaire includes~the same 6 population questions and 1 housing question that are on the Census 2000 short form, plus ^~ additional population questions, - d 20 additional housing questions. On average, about 1 in ' every 6 households will receive the long form. The content of the forms resulted from reviewing the 1990 census data, consulting with federal and non-federal data users, and conducting tests. For additional information about i Census 2000, visit our website at www.census.gov or write to the Director, Bureau of the Census, Washington, DC 20233. ~~ ~ Start Here Please use a black or blue pen. O How many people were living or staying in this house, apartment, or mobile home on April 1, 2000? `_', ~`- -~ Number of people ~~~~;'J- ,~ . ,-- INCLUDE in this number. ``~=: • foster children, roomers, o~ housemates ~~~...,~ • people staying here on :~.ril"1, 2000 who have no other peren3rt~nt place to stay • people living her~m: t of the time while working, even.i~.they have another place to live DO NOT INCLUDE in this number: • college. s:'udents living away while att~nd;rg college • peoF ~~in a correctional facility, nursing home, ~_ or.-mental hospital on April 1, 2000 . • Armed Forces personnel living somewhere else •~ ~ people who live or stay at another place most -- - of the time © Please turn the page and print the names of all the people living or staying here on April 1, 2000. if you need help completing this form, call 1-80~XXX-~(aLY between 8:00 a.m. and 9:00 p.m., 7 days a week The telephone call is free. TDD -Telephone display device for the hearing•impaired. Ca111-S00-XXX-x'GYX between 8.00 a.m. and 9'00 p.m., 7 days a week fie telephone cal! is free. ~NEC1ESlTA AYUDAT Si usted necesita ayuda pars completer esie aestionario flame al 1-800-)00(-X)G~G(entre /as 8:00 a.m. y las 9:00 pm., 7 dlas a la semana. La llamada telefbnio es grains The Census Bureau estimates that, for the average household, this form will take about • 38 minutes to complete, including the time for reviewing the instructions and answers. Comments about the estimate should be directed to the Associate Director for Finance and Administration, Attn: Paperwork Reduction Project 0607-0856, Room 3104, Federal Building 3, Bureau of the Census, Washington, OC 20233. Responderrts are not required to respond to any information collection unless it displays a r~, valid approval number from the Office of Management and Budget Q Please be sure you answered question 1 on the front gage before continuing. Please print the names of all the people who you indicated in question 1 were living or staying here on April 1, 2000. F~eample -Last Name J`a'{f?N~s~U'N' First Name MI Start with the person, or one of the people living here who owns, is buying, or rents this house, apartment, or mobile home. If there is no such person, start with any adult living or staying here. Person 1 -Last Name First Name MI ~ ~ ~ ( i I Person 2 -Last Name ~,~`, i!! I I t ~ ~ v~ First Name MI i "1 \~J ~.i..ti.. Person 3 -Last Name ~"'~ ~~` (~ ~`;~, v First Name ~~,, '~~`_ MI ~,~ ~~~;~, Person 4 -last Name First Name MI Person 6 -Last Name First Name Person 7 -Last Name First Name ,,. Person 8 -Last Nam? `+., r` ;~ ., ;-r-:~ ~ . First Name ~:_t` ~\~ }r . Persarir.-~ Last Name `~~~. !1-.=~; i'~ \ :~ irsi Name Person 10 -Last Name first Name Person 11 -Last Name First Name Person 12 -Last Name First Name MI MI MI MI MI MI MI ~~•t~ ~x~ t~J What is this person's name? Print the name of Person 1 from page 2. last Name First Name MI What is this person's race? Mark Q one or more races to indicate what this person considers himself/herself to be. O White O Black, African Am., or Negro O American Indian or Alaska Native -Print name of enrolled or principal tribe. ~ ^ Asian Indian O Native Hawaiian O Chinese ~ ~ O Guamanian or ^ Filipino ~~ Chamorro ^ Japanese ~;~;;~ _ ~" O Samoan "~ O Korean~~ "~.:~ ~~> O Other Pacific O vetn~rres? 1-` Islander - ^ OtF~e A=ian - Print race. ~ Print race. 7 ~l What is this person's telephone number? We may ~ ti contact this person if we don't understand an answer. . Area Code + Number ,~ '~ • ~~ ~ ~` ~ ~ O Some other race -Print race. ~ What is this person's sex? Mark ©ONE box. .~ ~~;~~`~-~., ^ Male _ ~~• `~ . ~ OFemale `~• f;;~> ~ ~ What is this person's age and what isthi5 person's date of birth? Age on April 1, 2000 ~ ~ , '~ ,\ ~:.. > -~ Print numbers in boxes. `~\' ; Month Day <~e~ot birth .. ,..:~ '. NOTE: Please answer BOTH Questions 5 and 6. Is this person Spanish/Hispanic/Latino? Mark the "No" box if not Spanish/Hispanic/Latino. O No, not Spanish/Hispanic/Latino O Yes, Mexican, Mexican Am., Chicano O Yes, Puerto Rican . O Yes, Cuban O Yes, other Spanish/Hispanic/Latino -Prins group. ~ ~ IIIIIIIIIIIIII What is this person's marital status? O Now married O Widowed O Divorced O Separated O Never married a. At any time since February 1, 2000, has this person attended regular school or college? Include only nursery school or preschool, kindergarten, elementary school, and schooling which leads to a high schoo/ diploma or a college degree. O No, has not attended since February 1 --~ Skip to 9 ^ Yes, public school, public college O Yes, private school, private college (1~ Question is asked of all persons on ~ the short (100-percent) and long (sample) forms. ~~ ~ Porm o.e, e b. What grade or level was this person attending? Mark Q ONE box. ^ Nursery school, preschool ]Kindergarten l~ Grade 1 to grade 4 ^ Grade 5 to grade 8. ^ Grade 9 to grade 12 ^ College undergraduate years (freshman to senior) ^ Graduate or professional school (for example: medical, dental, or law school) What is the highest degree or level of school this person has COMPLETED? Mark Q ONE box. !f currently enrolled, mark the previous grade or highest degree received. ^ No schooling completed ^ Nursery school to 4th grade ^ Sth grade or 6th grade ^ 7th grade or 8th grade ^ 9th grade ^ 10th grade ^ 11th grade ^ 12th grade, NO DIPLOMA ^ HIGH SCHOOL GRADUATE -high school DIPLOMA,-,~:~t or the equivalent (for example: GED) ~. ^ Some college credit, but less than 1 year `~ ~ `~~ ~v==: ^ 1 or more years of college, no degree s;;, . •.~ Associate degree (for example: AA, AS) ~t.~'~; ~ .~ Bachelor's degree (for example: BA, AB• BS) ~`, {' •'-=`~ ^ Master's degree (for example: MA, ~~;%7~Eng, MEd, MSW, MBA) ~ F.' ^ Professional degree (for exampf~•:,N,r;C; LDS, DVM, LLB, JD) '~ ^ Doctorate degree (for exan;~te~,ohD, EdD) What is this person's ancesVyyor ethnic origin? (For example: Italian, Jamaican, African Am., Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian, and so on.) a. Does this person speak a language other than English at home? ^ Yes ^ No -~ Skip to 12 b. What is this language? (For example: Korean, Italian, Spanish, Vietnamese} c. How well does this person speak English? ^ Very well ^ Well ,., ^ Not well C,`, ^ Not at all `~ ~~~ ,^~ Where was this ~erso`ri` orn? ^ In the Unitt~d"Sfa>:es - Prini name of state. l` }i ~•~:" ^ Clgtsi~e~Itie United States -Print name of foreign ~cou~fry; or Puen:o Rico, Guam, etc. ,~,.., ~\,~ !:s'this person a CRIZEN of the United States? ^ Yes, born in the United States ~ Skip to 15a ^ Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas ^ Yes, born abroad of American parent or parents ^ Yes, a U.S. citizen by naturalization ^ No, not a citizen of the United States When did this person come to live in the United StatesT Print numbers in boxes. Year a. Did this person live in this house or apartment 5 years ago (on April 1, 1995)? ^ Person is under 5 years old -~ Skip to 33 ^ Yes, this house -~ Skip to 16 ^ No, outside the United States -Print name of foreign country, or Puerto Rico, Guam, etc., below; then skip to 16. ^ No, different house in the United States ~ o-s~e b. Where did this person live 5 years ago? Name of city, town, or post office Did this person live inside the limits of the city or town? ^ Yes ^ No, outside the city/town limits Name of county Name of state ZIP Code Does this person have any of the following long-lasting conditions: Yes No a. Blindness, deafness, or a severe vision or hearing impairment? ^ ^ b. A condition that substantially limits one or more basic physical activities ° ';.` such as walking, climbing stairs, "~ ' reaching, lifting, or carrying? ^'~ __,C,' `~.~~. ~~ ,~,~ . Because of a physical, mental, or emot:oaaf` -' condition lasting 6 months or more;;;daes~ this person have any difficulty in d~:iny::3ny of the following activities: '~'~~ ` : . ~` '~ ,!~ _-- Yes No , a. Learning, remembering, or`"~~;= -' .5,; concentrating? - ~ ^ ^ ~ _., ~ b. Dressing, bathing, or`~ettieig around inside the home? ^ ^ c. (Answer if this person is 16 YEARS OLD OR OVER.) Going outside the home alone to shop or visit a doctor's office? ^ ^ d. (Answer if this person is 16 YEARS OLD OR OVER.) Working at a job or business? ^ ^ Was this person under 15 years of age on April 1, 20007 ^ Yes -~ Skip to 33 ^ No ~, iiiiiiiiiuiii a. Does this person have any of his/her own grandchildren under the age of 18 living in this house or apartment? ^ Yes ^ No --~ Skip ro 20a b. Is this grandparent currently responsible for most of the basic needs of any grandchild(ren) under the age of 18 who live(s) in this house or apartment? ^ Yes ^ No ~ Skip to 20a c How long has this grandparent been responsible for the(se) grandchild(ren)? If the grandparent is financially responsible ~orrri%re than one grandchild, .answer the question for the~~rrndchild for whom the grandparent has been responsill~ ror. the longest period of time. ^ Less thae~e ~monlis ^ 6 to 11 .~nonLhs ^ 1 0(`2 years , .~ <<1 or~~~-;ears 5.years or more a. F;as this person ever served on active du in ~~trie U.S. Armed Forces, military Reserves, ory ;. National Guard? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War. ^ Yes, now on active duty ^ Yes, on alive duty in past, but not now ^ No, training for Reserves or National Guard only --~ Skip io 21 ^ No, never served in the military -~ Skip to 21 b. When did this person serve on active duty in the U.S. Armed Forces? Mark Q a box for EACH period in which this person served. ^ April 1995 or later ^ August 1990 to March 1995 (including Persian Gulf War) ^ September 1980 to July 1990 ^ May 1975 to August 1980 ^ Vietnam era (August 1964-April 1975) ^ February 1955 to July 1964 ^ Korean conflict (June 1950-January 1955) ^ World War II (September 1940-July 1947) ^ Some other time G In total, how many years of active-duty military service has this person had? ^ Less than 2 years ^ 2 years or more Form 0.616 LAST WEEK, did this person do ANY work for either pay or profit? Mark Q the "Yes" box even if the person worked only 1 hour, or helped without pay in a `amily business or farm for 15 hours or more, or was on active duty in the Armed Forces. Yes No --> Skip to 25a At what location did this person work LAST WEEK? If this person worked at more than one location, print where he or she worked most last week. a. Address (Number and street name) pf the exact address is not known, give a description of the location such as the building name or the nearest street or intersection.) b. Name of city, town,.or post office c. Is the work location inside the limits of that city or town? Yes No, outside the city/town limits ;.~: ~~` i,ti~, d. Name of county ~ '~ ,;~~ -, `,r~~ `(~ ._ „ a. Name of U.S. state or forei n coun ` ~`~~~ ' l 9 try,. •,z`~.:.., ;.~- '~ . f. Z1P Code ,? `. ~% ~`~~.~ \~ ~. a. How did this person usuaiiy~get to work LAST WEEK? If this person usually used more than one method of transportation during the trip, mark Q the box of the one used for most of the distance. ~ Car, truck, or van ~ Bus or trolley bus ~ Streetcar or trolley car Subway or elevated (] Railroad Ferryboat ~ Taxicab Q Motorcycle 0 Bicycle ~ Walked Worked at home -~ Skip to 27 ~ Other method If "Car, truck, or van" is marked in 23a, go to 23b. Otherwise, skip to 24a. b. How many people, including this person, usually rode to work in the car, truck, or van LAST WEEK? ~ Drove alone 2 people 3 people 4 people ~ 5 or 6 people 0 7 or. more people a. What time did thispefson usually leave home to go to work LAS;t:-t,~Ri? i ~ '~ y\\~~ ~~`~^~a~n. 0 p.m. b. How many minutes did it usually take this person to het fiom home to work LAST WEEK? .~ Minutes 4 '~? .~ answer questions 25-26 for persons who did not +~ork for pay or profit last week. Others skip to 27. a. LAST WEEK, was this person on layoff from a job? Q Yes ~ Skip to 25c No b. LAST WEEK, was this person TEMPORARILY absent from a job or business? ~ Yes, on vacation, temporary illness, labor dispute, etc. -~ Skip to 26 Q No -~ Skip to 25d c. Has this person been informed that he or she will be recalled to work within the next 6 months OR been given a date to return to work? Q Yes -~ Skip to 25e Q No d. Has this person been looking for work during the last 4 weeks? Yes No -~ Skip to 26 e. LAST WEEK, could this person have started a job if offered one, or returned to work it retailed? Yes, could have gone to work No, because of own temporary illness 0 No, because of all other reasons rn school, etc.) When d'id this person last work, even for a few days? 1995 to 2000 1994 or earlier, or never worked -~ Skip to 31 it a'` f= :r~Y t Nnr ~~`~ ~M ~ ~. 3 ~ , { ;~ `;~~ ~, s+i < r `.t. .rte; w dam, yk ~ ; a+ ~ : r.. _.Xi 1' t 'q+ spa _.. ', ~. ,- Industry or Employer -Describe clearly this person's chief job activity or business last week. If this person had more than one job, describe the one at which this person worked the most hours. If this person had no job or business last week, give the information for his/her last job or business since 1995. a. For whom did this person work? !f now on active duty in the Armed Forces, mark Q this box --~ ^ and print the branch of the Armed Forces. Name of company, business, or other employer b. What kind of business or industry was this? Describe the activity at location where employed. (for example: hospital, newspaper publishing, mail order house, auto repair shop, bank) :~,. =,_. ~~ -:-~ ~~:~ ``- `~ `, ,\,~ c. Is this mainly - Mark Q ONE box. ,,~`'~ ~~ ~ ~` ;~~•' ^ Manufacturing? ~,,, ,.; ^ Wholesale trade? '~ '~~ '~-~} ^ Retail trade? ~,%~ ~;; r` ^ Other (agriculture, constrc:ct~irir:; service, government, etc.)? ., ~ ~,~ ~~ %, Occupation a. What kind of woilt-viras,this person doing? (for example: registernurse, personnel manager, supervisor of order department, auto mechanic, accountant) b. What were this person's most important actiivities or duties? (For example: patient care, directing hiring policies, supervising order Jerks, repairing automobiles, reconciling financial records) m, umiiiuiui Was this person - Mark Q ONE box. ^ Employee of a PRIVATE-FOR-PROFIT company or business or of an individual, for wages, salary, or commissions ^ Employee of a PRIVATE NOT-FOR-PROFIT, tax-exempt, or charitable organization ^ Local GOVERNMENT employee (city, county, etc) ^ State GOVERNMENT employee ^ Federal GOVERNMENT employee ^ SELF-EMPLOYED in own NOT INCORPORATED business, professional practice, or farm ^ SELF-EMPLOYED in own INCORPORATED business, professional practice, or farm ^ Working WITHOUT PAY in family business or farm a. LAST YEAit;.1999, did this person work at a job or business at any time? ^ No ~ `Skip ro 31 :. b. How many weeks did this person work in 1999? ~'~ C'ount paid vacation, paid sick leave, and military service. `-~ ~ ~~'Jeeks c. During the weeks WORKED in 1999, how many hours did this person usually work each WEEK? Usual hours worked each WEEK INCOME IN 1999 - Mark Q the "Yes" box for each income source received during 1999 and enter the total amount received during 1999 to a maximum of $999,999. Mark Q the 'No' box if the income source was not received. If net income was a loss, enter the amount and mark Q the "Loss' box next to the dollar amount. for income received jointly, report if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark Q the "No" box for the other person. If exact amount is not known, please give best estimate. a. Wages, salary, commissions, bonuses, or tips from all jobs -Report amount before deductions for taxes, bonds, dues, or other items. ^ Yes Annual amount -Dollars ^ No a ~:~t} b. Self-employment income from own nonfarm businesses or farm businesses, inducting proprietorships and partnerships -Report NET income after business expenses. ^ Yes Annual amount - DoNars ' `''~ ^ Loss ^ No Form D-61B HOUSING QUESTIONS c. Interest, dividends, net rental income, royalty income, or income from estates and trusts -Report even small amounts credited to an account. Yes Annual amount -Dollars ;,,- -'~ O Loss O No d. Social Security or Railroad Retirement O Yes Annual amount -Dollars O No .'C e. Supplemental Security Income (551) O Yes Annual amount -Dollars O No i'C f. Any public assistance or welfare payments from the state or local welfare office O Yes Annual amount -Dollars /' :~~ O No <' ` ~~ g. Retirement, survivor, or disability pensions, ~~ ~, ~o NOT include Social Security. ~~~~ ~~ J Yes Annual amount -Dollars ~ .`\\ ~ ,~, \, `~. :~,\ , h. Any other sources of inco~ne_,tacarved regularly such as Veterans' (VA) pay~e,~ts unemployment compensation, child support^a~ alimony - Do NOT include lump-sum payments suc~i as money from an inheritance or sale of a home. O Yes Annual amount - Dollars O No .v~i' What was this person's total income in 1999? Add entries in questions 31 a-31 h; subtract any losses. /f net income was a loss, enter the amount and mark Q the "Loss" box next to the dollar amount. Annual amount -Dollars O None OR ? •~~ O Loss ( ~' Question is asked of all households on - the short (100-percent) and long !~ (sample) forms. Now, please answer questions 33-53 about your household. Is this house, apartment, or mobile home - O Owned by you or someone in this household with a mortgage or loan? O Owned by you or someone in this household free and clear (without a mortgage or loan)? O Rented for cash rent? O Occupied without payment of cash rent? Which best describes this building? Include all apartments, flats, etc., even if vacant. O A mobile home O Aone-family hol~se~c etched from any other house O A one-familyhQ~ ~~attached to one or more houses O A building ~i~\ith~':~ apartments O A build'i~g vv~f#F3 or 4 apartments O A buildir'g~vith 5 to 9 apartments O A` building with 10 to 19 apartments '\ O(r~~u?"dmg with 20 to 49 apartments • "building with 50 or more apartments ~.,.~ v ~~ ~a0at, RV, van, etc. About when was this building first built? O 1999 or 2000 O 1995 to 1998 O 1990 to 1994 O 1980 to 1989 O 1970 to 1979 O 1960 to 1969 O 1950 to 1959 O 1940 to 1949 O 1939 or earlier When did this person move into this house, apartment, or mobile home? O 1999 or 2000 O 1995 to 1998 O 1990 to 1994 O 1980 to 1989 O 1970 to 1979 O 1969 or earlier How many rooms do you have in this house, apartment, or mobile home? Do NOT count bathrooms, porches, balconies, foyers, halls, or half-rooms. O 1 room O 6 rooms O z rooms ~ O 7 rooms O 3 rooms O 8 rooms O 4 rooms O 9 or more rooms O 5 rooms Form p.618 How many bedrooms do you have; that is, how many bedrooms would you list if this house, apartment, or mobile home were on the market for sale or rent? No bedroom ~ 1 bedroom 0 2 bedrooms 3 bedrooms 0 4 bedrooms ~] 5 or more bedrooms • Do you have COMPLETE plumbing facilities in this house, apartment, or mobile home; that is, 1) hot and cold piped water, 2) a flush toilet, and 3) a bathtub or shower? ~ Yes, have all three facilities No Do you have COMPLETE kitchen facilities in this house, apartment, or mobile home; that is, 1) a sink with piped water, 2) a range or stove, and 3) a refrigerator? ~ Yes, have all three facilities 0 No Is there telephone service available in this house,;" .. apartment, or mobile home from which you cad:.{,, ', both make and receive calls? `~`~ t\ Yes ~ - ~' `:fi`~~ i No -~ , `~~ Which FUEL is used MOST for heatirths house, apartment, or mobile home? %~ ~:~; j;, ~ ~~.~. }1 ~ Gas: from underground pi~es;seruitig the neighborhood ~• `:~ ~,: Gas: bottled, tank, ot'~-,` .,~ ~., ~ Electricity ~, Fuel oil, kerosene, etc. `~ 0 Coal or coke Wood Solar energy Otherfuel ~ No fuel used How many automobiles, vans, and trucks of one-ton capacity or less are kept at home for use by members of your household? 0 None 1 2 3 4 5 6 or more IIIIIIIIIIIIII Answer ONLY if this is aONE-FAMILY HOUSE OR MOBILE HOME -All others skip to 45. a. Is there a business (such as a store or barber shop) or a medical office on this property? Yes No b. How many aces is this house or mobile home on? 0 Less than 1 acre -~ Skip to 45 Q 1 to 9.9 acres Q 10 or more acres c In 1999, what were Lhe actual sales of all agricultural products. from this property? ~;_ t Q None ;~\~:; ~ $2,500 to $4,999 $1 to $999 :-~.'•~;•., ~ $5,000 to $9,999 Q $1,000 ta$2,459 ~ ~ $10,000 or more ., t~" What are the-annual costs of utilities and fuels for this house, apartment, or mobile home? !f you have lived tiera.i~ss than 1 year, estimate the annual cost. ,; ~.. ., a., Electricity ..~; ,: .~ -annual cost -Dollars . _ ., OR ~ Included in rent or in condominium fee No charge or electricity not used b. Gas Annual cost -Dollars .. OR Q Included in rent or in condominium fee ~ No charge or gas not used c Water and sewer Annual cost -Dollars ~ i} OR Included in rent or in condominium fee 0 No charge d. Oil, coal, kerosene, wood, etc. Annual cost -Dollars S ~~ OR ~ Included in rent or in condominium fee ~ No charge or these fuels not used Form G619 • Answer ONLY if you PAY RENT for this house, apartment, or mobile home -All others skip to 47. a. What is the monthly rent? Aonthly amount -Dollars ,r ,J . Jai b. Does the monthly rent include any meals? Yes No Answer questions 47a-53 if you or someone in this household owns or is buying this house, apartment, or mobile home; otherwise, skip to questions for Person 2. a. Do you have a mortgage, deed of trust, contract to purchase, or similar debt on THIS property? Yes, mortgage, deed of trust, or similar debt Yes, contrail to purchase No -3 Skip to 48a b. How much is your regular monthly mortgage payment on THIS property? Include payment only on first mortgage or contras to purchase. Monthly amount -Dollars OR Gtl ~~~~'~ ~~.. ~J No regular payment required -~ Skip to 48a C~''~ . Does your regular monthly mortgage payment~•; .nclude payments for real estate taxes o~'l;til'~ property? ,~ :~. '~.~ .: ~i~`,~ Yes, taxes included in mortgage payment; ~ No, taxes paid separately or taxes'ri~t_r;~uired •. ~; ~._~; d. Does your regular monthly rrior±gage payment include payments for fire,.ha~rd; or flood insurance on THIS property?~~ ~:> v Yes, insurance included in mortgage payment Q No, insurance paid separately or no insurance a. Do you have a second mortgage or a home equity loan on THIS property? Mark ©all boxes that apply. ~ Yes, a second mortgage Yes, a home equity loan (] No -~ Skip to 49 b. How much is your regular monthly payment on all second or junior mortgages and all home equity loans on THIS property? Monthly amount -Dollars 5 .QQ OR No regular payment required What were the real estate taxes on THIS property last year? Yearly amount -Dollars ,~~ OR None What was the annual payment for fire, hazard, and flood insurance on THIS property? Annual amount -Dollars a , i~U OR ~~ Q None ,~;~ ~ ~~ ..,\, What is the value ~f this property; that is, how much~d-a yc~.~ink this house and lot, apartment+,`or mobile home and lot would sell for if it were :or sale? ~;~Les~.s~t~i $10,000 ~ $90,000 to $99,999 ~~~;~? ~0a to $14, 999 ~ $100,000 to $124 999 :~;~'?5,000 to $19,999 ~~ $20,000 to $24,999 $25,000 to $29,999 $30,000 to $34,999 $35,000 to $39,999 $40,000 to $49,999 $50,000 to $59,999 (] $60,000 to $69,999 Q $70,000 to $79,999 $80,000 to $89,999 $125,000 to $149,999 $150,000 to $174,999 $175,000 to $199,999 $200,000 to $249,999 0 $250,000 to $299,999 $300,000 to $399,999 ^ $400,000 to $499,999 0 $500,000 to $749,999 $750,000 to $999,999 0 $1,000,000 or more Answer ONLY if this is a CONDOMINIUM - What is the monthly condominium feel Monthly amount -Dollars .,)~ Answer ONLY if this is a MOBILE HOME - a. Do you have an installment loan or contract on THIS mobile home? Yes No b. What was the total cost for installment loan payments, personal property taxes, site rent, registration fees, and license fees on THIS mobile home and its site last year? Exclude real estate taxes. Yearly amount -Dollars s ~ .ao Are there more people living here? If yes, continue with Person 2. . . --+ -~--- What is this person's name? Print the name of Person 2 from page 2. Last Name First Name MI ;,`4 ll~ How is this person related to Person 1? Mark ©ONE box. %~~~; 0 Husband/wife ~ ~ `"~ 0 Natural-born son/daughter ;., . ,~, ,;. Adopted son/daughter ~ Stepson/stepdaughter ~~;-. --~ , .,,> ~ Brother/sister ~`:.~'` ~ Father/mother ,-~ , '': ~ Grandchild ~~~ i:~. ` ~. 0 Parent-in-law :-,:-,:a :~ Son-in-law/~'arlghter-in-law ~=~: •:. Other relative =Print exact relationship. ;` , ,,-., „~ If NOT RELATED to Person 1: 0 Roomer, boarder Housemate, roommate ~ Unmarried partner ~ Foster child Other nonrelative .. ~ Question is asked of Persons 2~ on the short (100-percent) and i long (sample) forms. f ~ ~ m=, iiiiiiiiuiui ;For Person 2, repeat ;questions 3-32 of ;Person 1. fwm D61B For Persons 3-6. repeat questions 1-32 of Person 2. NOTE -The content for Question 2 varies between Person 7 and Persons 2-6. Thank you for completing your official U.S. Census form. If there are more than six people at this address, the Census Bureau may contact you for the same information about these people. ~„~,a SHORT FORM . ~~~ASF DO NOT FILL OUT THIS ~3M. This is not an oft,cial census form. It is for informar~onal IIIII Start Here Please use a . black or blue pen. 1. How many people were living or staying in this house, apartment, or mobile home on April 1, 20007 4. What is Person 1's telephone number? We may call this person if we don't understand an answer. Area Code + Number Number of people INCLUDE in this number: • foster children, roomers, or housemates • people staying here on April 1, 2000 who have no other permanent place to stay • people living here most of the time while working, even if they have another place to live DO NOT INCLUDE in this number: • college students living away while attending college • people in a correctional facility, nursing home, or mental hospital on April 1, 2000 • Armed Forces personnel living somewhere else • people who live or stay at another place most of the time 2. Is this house, apartment, or mobile home - Mark ©ONE box. ^ Owned by you or someone in this household with a _-? mortgage or loant ~ ,%` ^ Owned by you or someone in this household free and'~'~' clear (without a mortgage or loan)? ~' '• ~ - ~~~ ^ Rented for cash rent? ~ ~~'~"'" v ^ Occupied without payment of cash rend ,~ `~~ ~~=~- ,> ~, .. . ~\;~% 3. Please answer the following questions for each person living in this house, apartment, or mobile home. Start with the name of one of the people living here who owns, is buying, or rents this house, apartment, or mobile home. If there is no such person, start with any adult living or staying here. We will refer to this person as Person 1. What is this person's name? Print name below. Last Name Frst Name MI 5. What is Person 1's sexl Mark ©ONE box. ^ Male ^ Female .; ~ ~. 6. What is Person 1's age and vs~at is'Person 1's date of birth? Age an April 1, 2000 f "~ ~\ ; ,-= `'~` ;`~, Print numbers in tio~es,; ;, Month Day, `~ ,,;;;:Ysar of birth `~ ~ ; t . `` (~~ ~ ~~:~` ~ NEkTI=:^;~Tease answer BOTH Questions 7 and 8. `\ 7. "~,i's;Pe~rson 1 Spanish/Hispanic/Latino? Mark ©the "No" ;,,. ''!~ox`tf not Spanish/Hispanic/Latino. ~~-'•.\^ No, not Spanish/Hispanic/Latino ^ Yes, Puerto Rican ^ Yes, Mexican, Mexican Am., Chicano ^ Yes, Cuban ^ Yes, other Spanish/Hispanic/Latino -Print group. ~ 8. What is Person 1's race? Mark ©one or more races to indicate what this person considers himself/herself to be. ^ White ^ Black, African Am., or Negro ^ American fndian or Alaska Native -Print name of enrolled or principal tribe. ~ ^ Asian Indian ^ Japanese ^ Native Hawaiian ^ Chinese ^ Korean ^ Guamanian or Chamorro ^ Flipino ^ Vietnamese ^ Samoan ^ OtherAsian - Prini race. ~ ^ Other Pacific Islander - Prini race. ~ i ^ Some other race - Print race. ~ i' OMB No. 0607-0966: Approval Expires 12I31r1o00 ~ ~ ff more people live here, continue with Person 2. ='` ~r . 7 . '•~hat is Person 2's name? Print name below. M~ Name ~-~ ~ tl First Name MI 2. How is this person related to Person 17 Mark ©ONE box ^ Husband/wife If NOT RELATED to Person 1: ^ Natural-bom soNdaughter ^ Roomer, boarder ^ Adopted son/daughter ^ Housemate, roommate ^ Stepson/stepdaughter ^ Unmarried partner ^ Brother/sister ^ Foster child ^ Father/mother ^ Other nonrelative ^ Grandchild ^ Parent-in-law ^Soh-in-law/daughter-in-law ^ Other relative -Print exact relationship. ~ 3. What is this person's sex? Mark ©ONE box. ^ Male ^ Female 4. What is this person's age and what is this person's date of birth? Print numbers in boxes. Age on April t, 2000- Month Day Year of birth 5. 6. ('E: Please answer BOTH Questions 5 and 6. Is this person Spanish/Hispanic/Latino? Mark ©the `' "No"box if not Spanish/Hispanic/Latino. ~; ;'~:~ ~ ~~ ^ No, not Spanish/Hispanic/Latino ^ Yes, Puerto Rican ~~; ;,. - Yes, Mexican, Mexican Am., Chicano ^ Yes, Cuban ~ ^`, ~;; /'` .~'•, it ^ Yes, other Spanish/Hispanic/Latino- Printgroup. ~ `,!^;,~,`;:- ,,, ~ ; `ti`y ~.> ~, ,~ What is this person's race? Mark ©one or more races to indicate what this person considers himself/herself to be. O white ^ Black, African Am., or Negro ^ American Indian or Alaska Native - Print name of enrolled or principal tribe. ~ ^ Asian Indian ^ Japanese ^ Native Hawaiian ^ Chinese ^ Korean ^ Guamanian or Chamorro ^ Filipino ^ Vietnamese ^ Samoan ^ Other Asian -Print race. ~ ^ Other Pacific Islander - Print race. ~ ^ Some otherrace - Print rata. ~ '~ ni more people live here, continue with Person 3. '; -~ 1. What is Person 3's name? Print name below. ~ 3 Last Name --3s° First Name MI 2. How is this person related to Person 17 Mark ©ONE box. ^ Husband/wife If NOT RELATED to Person 1: ^ Nature!-bom son/daughter ^ Roomer, boarder ^ Adopted son/daughter ^ Housemate, roommate ^ Stepson/stepdaughter ^ B h / i ^ Unmarried partner rot er ster s ^ Foster child ^ Father/mother ^ Other nonrelative ^ Grandchild ^ Parentin-law ti ^ Son-in-aw/daughter-in-law !-`'`~`~ ~~ :; ,~ ^ Other relative -Print `~~'%~ exact relationship. -~ %''" ~' ' i`` ~~~ '' 3. What is this persons Sex~,'~lark ©ONE box. ^ Male O Female-` 4. What is this peison•'s age and what is this person's date of birth? ~~ ~~.~' Print numbers in boxes. Age on Aprif~?. 2t,00~ Month Day Year of birth -~.\..; ~ ~-~ ~L' } ti~,~ v ~~. N(y~TE: Please answer BOTH Questions 5 and 6. >~~ 5:~Is this person Spanish/Hispanic/Latino? Mark ©the "No"box if not Spanish/Hispanic/Latino. ^ No, not Spanish/Hispanic/Latino ^ Yes, Puerto Rican ^ Yes, Mexican, Mexican Am., Chicano ^ Yes, Cuban ^ Yes, other Spanish/Hispanic/Latino -Print group. ~ 6. What is this person's race? Mark ©one or more races to indicate what this person considers himself/herself to be. ^ White ^ Black, African Am., or Negro ^ American Indian or Alaska Native - Prininame of enrolled orprinapal vibe. ~ ^ Asian Indian ^ Japanese ^ Chinese ^ Korean ^ Filipino ^ Vietnamese ^ Other Asian - Print race. ~ ^ Native Hawaiian ^ Guamanian or Chamorro ^ Samoan ^ Other Pacific Islander - Print rata. ~ ^ Some other race - Print race. ~ If more people live here, continue with Person 4. ..~ :e ,~ Nha+ is Person 4's name7 Print name below. ~ s 4 first Name MI how is this person related to Person 77 Mark ©ONE box. ] Husband/wife If NOT RELATED to Person t: ] Natural-born son/daughter ^ Roomer, boarder ] Adopted son/daughter ^ Housemate, roommate ] Stepson/stepdaughter ^ Unmarried partner ] Brother/sister ^ Foster child ] Father/mother ^ Other nonrelative ] Grandchild ] Parent-in-law ] Son-in-law/daughter-in-law ] Other relative - Pn'nt exact relationship. ~ Yhat is this person's sex? Mark ©ONE box. ] Male ^ Female Yhat is this person's age and what is this person's date .f birthl Print numbers in boxes. >ge on April t, 2000 Month Day Year of birth ?lease answer BOTH Questions 5 and 6. this person Spanish/Hispanic/Latino? Mark ©the '`" 'No"box if not Spanish/Hispanic/Latino. - ` ; ~: ~~^) w' ] No, not Spanish/Hispanic/Latino ^ Yes, Puerto Rican ;•., ~~ :.; `~ ^ Yes, Cuban _. •,~ ]Yes, Mexican, Mexican Am., Chicano '~ ~-~' ~"' ,~, •,, ] Yes, other Spanish/Hispanic/Latino -Print group. ~ ~\ ~, •,~ • =~'~ ---_ , -~ ~~~ Vhat is this person's racer Mark ©one or more races to idicate what this person considers himself/herself to be. ] White ] Black, African Am., or Negro ] American Indian or Alaska Native -Print name of enrolled or principal lobe. ~ ] Asian Indian ^ Japanese ^ Native Hawaiian ] Chinese ^ Korean ^ Guamanian or Chamorro ] Filipino ^ vetnamese ^ Samoan ] Other Asian -Print race. ~ ^ Other Pacific Islander - Pant race. ~ ] Some other race - Print race. ~ n~...e people live here, continue with Person 5. • ~. 1. What is Person 5's name7 Print name below. ~~~~' last Name IL_ First Name MI 2. How is this person related to Person 11 Mark ©ONE box. ^ HusbandMrife If NOT RELATED to Person 1: ^ Natural-bom son/daughter ^ Roomer, boarder ^ Adopted son/daughter ^ Housemate, roommate ^ Stepson/stepdaughter ^ Unmarried partner ^ Brother/sister ^ Foster child ^ Father/mother ^ Other nonrelative ^ Grandchild ~ t ^ Parent~n-law _ ^ Son-in-law/daughter-in-law ,~~~ ~' .. ^ Other relative -Print ; ~ ..'~;•, exact relationship. -;~ •~! ' 3. What is this person's~sax7 Mark ©ONE box. ^ Male ^`'fier+ale 4. What is this parson's age and what is this person's date of birth? ` - '' Print numbers in boxes. Age on ~il;ril ;; 2000 Month ~` Day Year of birth ~~. ~-:~ ;- , ~; ; ~ ~. , ~:.; `.%r 'NOTE: Please answer BOTH Questions 5 and 6. 5. Is this person Spanish/Hispanic/Latino? Mark ©the "No" box. if not Spanish/Hispanic/Latino. ^ No, not Spanish/Hispanic/Latino ^ Yes, Puerto Rican ^ Yes, Mexican, Mexican Am., Chicano ^ Yes, Cuban ^ Yes, other Spanish/Hispanic/Latino -Print group. ~ 6. What is this person's race? Mark ~ one or more races to indicate what this person considers himse/f/herself to be. ^ White ^ Black, African Am., or Negro ^ American Indian or Alaska Native -Print name of enrolled or prinrpal tribe. ~ ^ Asian Indian ^ Japanese ^ Chinese ^ Korean ^ Filipino ^ vetnamese ^ Other Asian - Print race. ~ ^ Native Hawaiian ^ Guamanian or Chamorro ^ Samoan ^ Other Pacific Islander -Print race. ~ ^ Some other race - Print race. ~ '~ If more people live here, corrtinue with Person 6. :~ ioai • • .M '« y« 1. What is Person 6's name? Print name below. Last Name =~~~• First Name MI 2. How is this person related to Person 11 Mark ©ONE box. ^ Husbandlwife If NOT RELATED to Person 1: ^ Natural-bom soNdaughter ^ Roomer, bgarder ,~ ^ Adopted son/daughter F ^ Housemate, roommate ^ Stepsonlstepdaughier ^ Unmarried partner r ^ Brother/sister ^ Foster child ? ^ Father/mother ^ Other nonrelative ^ Grandchild `'~ t ^P~rent-in-law ,~=- 1 O Sonin-lawfdaughter-in-law : i ~~ `~•~ ,~ ^ Other relative -Print { exact relationship. --~ __ 3. What is this person's sex? MarkQ~ONE box. ,, ^ Male ^ Female ~'~=%` v 4. What is this person's age:.-atrd:~wliat is this person's date i of birth? `~2rin>;numbers in boxes. ..~_ Age on April 1, 2000 ' i'd~nth Day Year of birth r , ,:__ . ~J ~-~ NOTE: Pieas~e-answer BOTH Questions 5 and 6. „ ., , /l ~>~~ ~: 5. Is this-p"arson Spanish/Hispanic/Latino? Mark ~ the "Ma"tiox` if not Spanish/Hispanic/Latino. ' ^ IYo, not Spanish/Hispanic/Latino ^ Yes, Puerto Rican i i ^ Yes, Mexican, Mexican Am., Chicano ^ Yes, Cuban ^ Yes, other Spanish/Hispanic/Latino -Print group. ~ i a i 6. What is this person's race? Mark ©one or more races to indicate what this person considers himself/herself to be. s ^ White ^ Black, Afripn Am., or Negro } ^ American Indian or Alaska Native - Print name of enrolled or principal tribe. ~ ^ Asian Indian ^ Japanese ^ Native Hawaiian ^ Chinese ^ Korean ^ Guamanian or Chamorro ^ Filipino ^ Vetnamese ^ Samoan ^ Other Asian - Print race. ~ ^ Other Pacific Islander -Pant race. ~ ^ Some other race - Pani race. ~ ~ If more people live here, list their names on the back of this page in the spaces provided. Please turn to go to last page. Form U81A '~ .. > s ff you didn't have room to list everyone who lives in this house or apartment, please list the others below. You maybe contacted by the Census Bureau for the same information about these people. Person 7 -Last Name • The Census Bureau estimates that, for the average household, this form will take about 10 minutes to complete, including the time for reviewing the instructions and answers. Comments about the estimate should be directed to the Associate Director for Finance and Administration, Attn: Paperwork Reduction Project 0607-0856, Room 3104, Federal Building 3, Bureau of the Census, Washington, DC 20233. First Name MI Respondents are not required to respond to any information collection unless it displays a valid approval number from the Office of Management ;~- and Budget. ,~ Person 8 -Last Name ,,l J First Name MI ,~ ~~iank you for ~.-. ; c~~~~eting your official ~. \J; ~~:~.11,S. Census 2000 form. Person 9 -Last Name ,, _ , r:~.~ .-,. ~. First Name ^ i("~1~. ~~ ~~.~ ', J z;. r~~ /%' J :~:~t1 S~ ,,; ~, Person 10 -Last Name ~~~...\,;,`~' .~ ~~ ~ ~i~ ~~../ i First Name ,.'~`.~~i ~ MI ;~ ~;_ ~., , , ~\~;, Person 11 -Last Name First Name MI The "Informational Copy" shows the content of the United States Census 2000 "short" form questionnaire. Each household will receive either a short form (100-percent questions) or a long form (100-percent and sample questions). The short form questionnaire contains 6 population questions and 1 housing question. On average, about 5 in every 6 households will receive the short form. The content of the forms resulted from reviewing the 1990 census data, consulting with federal and non-federal data users, and conducting tests. Person 12 -Last Name First Name MI For additional information about Census 2000, visit our website at www.census.gov or write to the Director, Bureau of the Census, Washington, DC 20233. A. JIC7 B. JIC2 G 11C3 D. JIC4 If you need help completing this form, call 1-800-XXX-XXXX between 8:00 a.m. and 9:00 p.m., 7 days a week. The telephone call is free. TDD -Telephone display device for the hearing impaired. Call 1-800 XXX-XXXX between 8:00 a.m. and 9:00 p.m., 7 days a week. The telephone call is free. LNECESITA AYUDA? Si usted necesita ayuda Para completar este cuestionario /lame al 1-800-XXX-XXXX entre /as 8:00 a.m. y las 9:00 p.m., 7 dlas a /a semana. La llamada to/efonica es gratis. ~oa~ United States Census 2000 What is the Census? The Census is a complete count of the population and housing in the entire United States, which takes place every 10 years. When is the Census? The Census will take place on April 1, 2000. How will it be done? A Census questionnaire will be sent by mail or personally delivered to each house. ***** ANSWER THE CENSUS AND HELP YOUR COMMUNITY IT'S IMPORTANT, EASY AND CONFIDENTIAL. Who should answer the Census? Everyone counts! The Co~i.slitution of the United States requires a response from each person who resides in this country, without regard to status of residency or nationality (Article 1, Section 2). What happens when the Census is not answered? Computers designed to detect errors or duplications will make known which houses do not answer. These houses will be visited to solicit the information and collect the questionnaire. Who has access to this information? • By law, the Census Bureau cannot share your answers with the IRS, FBI, Welfare, Immigration - or any other governmental agency (Title 13-U.S. Code). • Census workers are sworn to secrecy. They are subject to a $5, 000 fine and/or. prison for any privacy violation. The law protects your answers. ***** COMPLETE THE' QUESTION- NAIRE AND SEND IT BY MAIL ON APRIL 1, 2000. What is the purpose of the Census? • Census informatiai is used to create new federal, state and local legislative districts and school district boundaries. • Every year, over .8'~p0 billion in federal and state funds are awarded to localities based upon the Census results. , How does the Census Help MY community? • The Census helps planners pick the best locations for schools, roads, hospitals, clinics, libraries, day-care and senior citizen centers, playgrounds, bus routes, job training programs and much more! • Businesses use the Census to locate supermarkets and shopping centers, housing, factories, offices, movie theaters, and restaurants. • Federal funds our communities receive (based upon the Census) are used to pay for schools and lunch programs, employment services, housing assistance, highway construction, hospital services, and programs for the elderly and disabled. REVISED: 04/06/99 Complete Cou~f Commitf~ •