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1990 Questionnaire



Page 5


Answer questions H21 TO H26, ltthis ls a one-family house, a condominium, or a mobile home that someone In this household OWNS OR lS BUYlNG; otherwise, go to page 6.

HZ1. What were the real estate taxes on THIS property last year?


Yearly amount — Dollars


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H22. What was the annual payment for fire, hazard, and flood lnsurance on THIS property?


Yearly amount — Dollars


O None


O No regular payment required

Answer ONLY lt this ls a CONDOMlNIUM H25. What U the monthly condominium fee?

H23a. Do you have a mortgage, deed of trust, contract to purchase, or similar debt on THIS property?

O Yes, mortgage, deed of trust, J

or similar debt (Go to HZ3b

O Yes, contract to purchase
O No Skip to H24a

b. How much ls your regular monthly mortgage
payment on THIS property? lnclude payment only
on first mortgage or contract to purchase.


Monthly amount — Dollars
O No regular payment required — Skip to H24a

c. Does your regular monthly mortgage payment
Include payments for real estate taxes on THIS

O Yes, taxes included in payment

O No, taxes paid separately or taxes not required

d. Does your regular monthly mortgage payment lnclude payments for fire, hazard, or flood insurance on THIS property?

O Yes, lnsurance lncluded in payment

O No, insurance paid separately or no insurance

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Census 2000 used two questionnaires-a long-form samPle of households throughout the United States and

(sample) and a short-form (100 percent) questionnaire. territories, contained 29 inquiries in addition to the 8

The short-form questionnaire consisted of 7 questions questions asked on the short-form questionnaire. These

that could be answered by up to 6 persons within a house- additional quesitons, as in the past, collected information

hold (see questions 1-6 and 33 on long-form questionnaire on the population, housing, economic, and social charac

reproduced here). Space was provided to identify 6 addi- teristics of the Nation's households,
tional members of the household. The U.S. Census Bureau
would collect data on persons 7-1 2 by telephone inter-

Measuring America 97

2000 Questionnaire



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The "Informational Copy" shows
the content of the United States
Census 2000 "long" form
questionnaire. Each household will
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
26 additional population questions,
and 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
Census 2000, visit our website at or write to the
Director, Bureau of the Census,
Washington, DC 20233.


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If you need help completing this form, call 1S00-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.

iNECESITA AYUDA? Si usted necesita ayuda para completar este cuestionario llame al

l-800-XXX-XXXX entre las 8:00 a.m. y las 9:00 p.m., 7 dias a la semana. La llamada

telefdnica es gratis. J

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, DC 20233.

Respondents are not required to respond to any information collection unless it displays a valid approval number from the Office of Management and Budget.

OMB No. 0607-0856: Approval Expires 12/31/2000

Measuring America

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