For more information on the questions and how to answer them, please visit the Census Bureau's "Questions Asked on the Form."
1. How many people were living or staying in this house, apartment, or mobile home on April 1, 2020?
2. Were there any additional people staying here on April 1, 2020, that you did not include in Question 1?
3. Is this house, apartment, or mobile home (mark ONE box) ......Owned by you or someone in this household with a mortgage or loan? Include home equity loans. Is it owned by you or someone in this household free and clear (without a mortgage or loan)? Rented? Occupied without payment of rent?
4. What is your telephone number?
5. What is Person 1's name?
6. What is Person 1's sex?
7. What is Person 1's age and what is Person 1's date of birth?
8. Is Person 1 of Hispanic, Latino, or Spanish origin?
9. What is Person 1's race? Mark one or more boxes AND print origins: White; Black or African American; American Indian or Alaska Native; Chinese; Filipino; Asian Indian; Vietnamese; Korean; Japanese; other Asian; Native Hawaiian; Samoan; Chamorro; other Pacific Islander; some other race.
10. Print name of Person 2.
11. Does this person usually live or stay somewhere else? Mark all that apply: no; yes, for college; yes, for a military assignment; yes, for a job or business; yes, in a nursing home; yes, with a parent or other relative; yes, at a seasonal or second residence; yes, in a jail or prison; yes, for another reason.
12. How is this person related to Person 1?
Mark ONE box; opposite-sex husband/wife/spouse; opposite-sex unmarried partner; same-sex husband/wife/spouse; same-sex unmarried partner; biological son or daughter; adopted son or daughter; stepson or stepdaughter; brother or sister; father or mother; grandchild; parent-in-law; son-in-law or daughter-in-law; other relative; roommate or housemate; foster child; other nonrelative.
Person 2 and any additional residents are also asked the same questions about their age, Hispanic origin, and race as Person 1.