Friday, December 9, 2011

The American Community Survey Questions

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We received the American Community Survey form this week, and I filled it out last night.  The letter from Robert M. Groves, director of the U.S. Census Bureau, said:

"This survey collects critical up-to-date information used to meet the needs of communities across the United States.  for example, results from this survey are used to decide where new schools, hospitals and fire stations are needed.  This information also helps communities plan for the kinds of emergency situations that might affect you and your neighbors, such as floods and other natural disasters.

"The U.S. Census Bureau chose your address, not you personally, as part of a randomly selected sample.  You are required by U.S. law to respond to this survey.  The Census Bureau is required by U.S. law to keep your answers confidential..."

The American Community Survey questions are:

Page 1:

*  Please print today's date.
*  Please print the name and telephone number of the person who is filling out this form.
*  How many people are living or staying at this address?
*  Fill out pages 2,3,and 4 for everyone, including yourself, who is living or staying at this address for more than 2 months.  Then complete the rest of the form.

Page 2 (Persons 1 and 2):

1.  What is Person 1/2's name?
2.  How is this person related to Person 1?
3.  What is Person 1/2's sex?
4.  What is Person 1/2's age and what is Person 1/2's date of birth?
5.  Is Person 1/2 of Hispanic, Latino or Spanish origin?
6.  What is Person 1/2's race?

Page 3 (Persons 3 and 4) - answer same questions as on Page 2.

Page 4 (Persons 5 to 10) - Person 5 answers same questions as on Page 2, Persons 6 to 10 provide only name, sex and age)

Pages 5 to 7 - Housing

1.  Which best describes this building?
2.  About when was this building first built?
3.  When did Person 1 (listed on page 2) move into this house, apartment or mobile home?
4.  How many acres is this house or mobile home on?
5.  [If more than one acre] In the past 12 months, what were the actual sales of all agricultural products from this property?
6.  Is there a business (such as a store or barber shop) or a medical office on this property?
7a.  How many separate rooms are in this house, apartment, or mobile home?
7b.  How many of these rooms are bedrooms?
8.  Does this house, apartment, or mobile house have -
a.  hot and cold running water?
b.  a flush toilet?
c.  a bathtub and shower?
d.  a sink with a faucet?
e.  a stove or range?
f.  a refrigerator?
g.  telephone service from which you can both make and receive calls?
9.  How many automobiles, vans and trucks of one-ton capacity or less are kept at home for use by members of this household?

10.  Which fuel is used most for heating this house, apartment, or mobile home?
11a. Last month, what was the cost of electricity for this house, apartment or mobile home?
11b.  Last month, what was the cost of gas for this house, apartment, or mobile home?
11c.  In the past 12 months, what was the cost of water and sewer for this house, apartment, or mobile home?
11d.  In the past 12 months, what was the cost of oil, coal, kerosene, wood, etc. for this house, apartment, or mobile home.
12.  In the past 12 months, did anyone in this household receive Food Stamps or a Food Stamp benefit card?

13.  Is this house, apartment, or mobile home part of a condominium?  [If yes, what is the monthly condominium fee?]
14.  Is this house, apartment, or mobile home owned with a mortgage, owned free and clear, rented, or occupied without payment?
15a.  [If rented] What is the monthly rent for this house, apartment, or mobile home?
15b. [If rented] Does the monthly rent include any meals?
16.  [If owned] About how much do you think this house and lot, apartment, or mobile home (and lot, if owned) would sell for if it were for sale?
17. [If owned] What are the annual real estate taxes on this property?
18.  [If owned]  What is the annual payment for fire, hazard and flood insurance on this property?
19a. [If owned] Do you or any member of this household have a mortgage, deed of trust, contract to purchase, or similar debt on this property?
19b. [If owned, with debt] How much is the regular monthly mortgage payment on this property?
19c. [If owned, with debt] Does the regular monthly mortgage payment include payments for real estate taxes on this property?
19d. [If owned, with debt] Does this regular monthly mortgage payment include payments for fir, hazard, or flood insurance on this property?
20a. [If owned] Do you or any member of this household have a second mortgage or a home equity loan on this property?
20b. [If owned] How much is the regular monthly payment on all second or junior mortgages and all home equity loans on this property?
21. [Mobile home only]  What are the total annual costs for personal property taxes, site rent, registration fees, and license fees on this mobile home and its site?

Pages 8 to 11 (Person 1 information):

7.  Where was this person born [state or country]
8.  Is this person a citizen of the United States?
9.  [If not born in U.S.] When did this person come to live in the United States?

10a.  At any time in the last 3 months, has this person attended school or college?
10b. [If yes] What grade or level was this person attending?
11.  What is the highest degree or level of school this person has completed?


13.  What is this person's ancestry or ethnic origin? 
14a.  Does this person speak a language other than English at home?
14b. [If yes] What is this language?
14c.  How well does this person speak English?
15a.  did this person live in this house or apartment 1 year ago?
15b. [If no] Where did this person live 1 year ago? [address, city, county, state, zip code]
16.  Is this person currently covered by any of the following types of health insurance or health coverage plans?

17a.  Is this person deaf or does he/she have serious difficulty hearing?
17b.  Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?
18a.  [If over 5 years old] Because of a physical, mental or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions?
18b.  Does this person have serious difficulty walking or climbing stairs?
18c.  Does this person have difficulty dressing or bathing?
19a.  [If over 15 years old] Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone such as visiting a doctor's office or shopping?

20.  What is this person's marital status?
21.  In the past 12 months did this person get married, widowed or divorced?
22.  How many times has this person been married?
23.  In what year did this person last get married?
24.  [If female, and aged 15-50] Has this person given birth to any children in the past 12 months?
25a.  Does this person have any of his/her own grandchildren under the age of 18 living in this house or apartment?
25b.  [If yes] Is this grandparent currently responsible for most of the basic needs of any grandchildren under the age of 18 who lives in this house or apartment?
25c. [If yes] How long has this grandparent been responsible for these grandchildren?

26.  Has this person ever served on active duty in the U.S. Armed forces, military Reserves, or National Guard?
27.  [If yes] When did this person serve on active duty in the U.S. Armed Forces?
28a.  [If yes] Does this person have a VA service-connected disability rating?
28b. [If yes] What is this person's service-connected disability rating?

29a.  Last week, did this person work for pay at a job or business? [If yes, skip to 30]
29b.  Last week, did this person do any work for pay, even for as little as one hour? [If no, skip to 35]
30.  At what location did this person work last week?
31.  How did this person usually get to work last week?
32. [if car, truck or van in 31] How many people, including this person, usually rode to work in the car, truck or van last week?
33. What time did this person usually leave home to go to work last week?
34.  How many minutes did it usually take this person to get from home to work last week?
35a.  Last week, was this person on layoff from a job?
35b.  [if no to 35a] Last week, was this person temporarily absent from a job or business?
35c. [if yes to 35b]  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?
36.  During the last 4 weeks, has this person been actively looking for work?
37.  [if yes to 36] Last week, could this person have started a job if offered one, or returned to work if recalled?
38.  When did this person last work, even for a few days?
39a.  [If worked in last 12 months] During the past 12 months (52 weeks), did this person work 50 or more weeks?  Count paid time off as work.
39b. [If worked in last 12 months] How many weeks did this person work, even for a few hours, including paid vacation, paid sick leave, and military service?
40. [If worked in last 12 months] During the past 12 months, in the weeks worked, how many hours did this person usually work each week?
41.  [If worked in last 5 years] Was this person a private company employee, a government employee, self-employed, working without pay?
42. [If worked in last 5 years] For whom did this person work?
43. [If worked in last 5 years] What kind of business or industry was this?
44.  [If worked in last 5 years] Is this mainly manufacturing, wholesale trade, retail trade, other?
45.  [If worked in last five years] What kind of work was this person doing?
46. [If worked in last 5 years] What were this person's most important activities or duties?

47a.  Annual wages, salary, commissions, bonuses, or tips from all jobs.
47b.  Annual Self-employment income from own nonfarm businesses or farm businesses, including proprietorships and partnerships.
47c.  Annual interest, dividends, net rental income, royalty income, or income from estates and trusts.
47d.  Annual Social Security or Railroad Retirement.
47e.  Annual Supplemental Security Income (SSI)
47f.  Any public assistance or welfare payments from the state or local welfare office.
47g.  Retirement, survivor, or disability pensions.
47h.  Any other sources of income received regularly such as VA payments, unemployment compensation, child support or alimony.

48.  What was this person's total income during the past 12 months?

Pages 12 to 15:  Personal data for Person 2.

Pages 16 to 19:  Personal data for Person 3.

Pages 20 to 23: Personal data for Person 4.

Pages 24 to 27: Personal data for Person 5.

Page 28.  Mailing Instructions.

That took me about two hours to fill out.  I had to find our utility bills and the last income tax return.

Don't we all wish that we had access to this type of information for all of our ancestral families every so often? 

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