Thank you for your interest in the 2010 Census.
Taking ten minutes to complete the form is important.
The Census must count every person
living in the United States on April 1, 2010.
Your participation ensures that your community
receives its fair share of political representation
and federal funds for the next 10 years.
This video will show you just how easy it is
to fill in and mail back the form.
Remember, all of your answers are completely confidential
and your identity is protected.
The best person to complete the form
is the owner or renter
of this house, apartment, or mobile home.
If the owner or renter lives somewhere else,
any adult living here can complete the form.
To begin, unfold the form
and have a blue or black pen ready
to answer all the questions for each person in your household.
Let's begin with Question 1.
You will find Question 1
in the large box that reads "Start here"
at the top of the page.
Before you answer Question 1,
count the people living in your house, apartment, or mobile home
using these guidelines:
Count all people, including babies,
who live and sleep here most of the time.
But do not count anyone living away at college
or in the Armed Forces, or in a nursing home, jail,
and so on, on April 1, 2010.
However, if someone who has no permanent place to stay
is staying here on April 1, 2010,
count that person.
Now you are ready to answer Question 1.
How many people were living or staying
in this house, apartment, or mobile home on April 1, 2010?
For example, if your count is three, write zero three.
Moving down to Question 2.
Were there any additional people staying here April 1, 2010
that you did not include in Question 1?
If you forgot to count children, relatives, nonrelatives,
or other people staying here temporarily,
please mark all boxes that apply.
Or, mark the box "No additional people"
if you counted everyone in Question 1.
Question 3 asks: Is this house, apartment, or mobile home
- Owned by you or someone in this household
with a mortgage or loan?
Please include home equity loans.
- Owned by you or someone in this household free and clear?
For example, without a mortgage or loan.
- Rented by you or someone in this household?
- Occupied without payment of rent?
Mark the one box that fits your situation.
Question 4 asks for your telephone number
in case we need to call you if we don't understand an answer.
Please include your area code.
Questions 5 through 10 provide information
about the person who owns or rents
this house, apartment or mobile home.
If they live somewhere else,
start with any adult living here.
This person will be referred to as Person 1.
Let's continue with Question 5.
Print Person 1's last name, with one letter in each box.
If you need more space, you may write beyond the last box.
Then print Person 1's first name.
If Person 1 has a middle initial,
please print the letter in this box.
Question 6 asks for Person 1's sex.
Please mark one box, "Male" or "Female."
Question 7 asks for Person 1's age on April 1, 2010
and for Person 1's date of birth.
Please include both Person 1's age and date of birth
and print numbers in all of the boxes.
Questions 8 and 9 ask about Hispanic origin and race.
Please answer both questions,
as Hispanic origin is not a race for this census.
Question 8 asks: Is Person 1 of Hispanic, Latino,
or Spanish origin?
Answer "No", if Person 1 is not of Hispanic, Latino,
or Spanish origin.
Otherwise, mark the box that best describes
Person 1's origin,
whether it is Mexican, Puerto Rican, Cuban,
or another origin.
If you mark another Hispanic, Latino, or Spanish origin,
please print Person 1's specific origin.
Question 9 asks for Person 1's race.
Here, you may mark one or more boxes
to best identify Person 1.
If you mark American Indian or Alaska Native,
please print the name of Person 1's enrolled or principal tribe.
Also, if you mark Other Asian or Other Pacific Islander,
you may print Person 1's specific race.
If you mark the box for some other race,
please print Person 1's race.
Remember, if you need more space,
you may write beyond the last box.
Question 10 is the last question for Person 1.
This question helps to ensure that Person 1
is counted in the right place.
If Person 1 sometimes lives or stays somewhere else,
mark "Yes" and then mark all the boxes that apply.
Otherwise, mark "No."
Congratulations!
You have completed the questions for Person 1.
If more people were counted in Question 1,
complete the answers to just seven easy questions
for each additional person
by opening the form and continuing on the next page.
Here, you will find space to answer questions
for Persons 2 through 6.
Six of the questions are the same as the last six questions
you answered for Person 1:
name, sex, age and date of birth,
Hispanic origin, race,
and if the person sometimes lives or stays somewhere else.
The only additional question is about relationship:
"How is the person for whom you are answering the questions
"related to Person 1?"
Mark only ONE box.
If there are more than six people in this household,
use this section of the form
to complete the information for Persons 7 through 12.
If there are more than 12 people in this household,
we may call for information about these additional people.
If you need further help completing this form,
call 1-866-872-6868
between 8:00 a.m. and 9:00 p.m.,
seven days a week.
The call is free.
Once you have completed the form
for all persons living or staying here,
fold the form and put it in the postage-paid envelope.
Please make sure the bar code above your address
appears in the window.
Seal the envelope and mail it back.
Thank you for completing your official 2010 Census form
and helping your community get what it needs
for the next 10 years.