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Cr = sat OO use ca ec cr erate re hen occas . Were there any: 1al people staying here on April 1, 2020 ‘that you did not inelude in Question 17 Mack x all that apply. Chore, related or unrelated, such as newbom babes, ‘gandenidren.o Tosterchieros + Count all people, in most ofthe time, +1110 one lve! this address most of the time, go or call the number on page 8. oO 11. Retatves, suchas adut chiro, cousins, or inlaws 1) Nonrelatves, uch ae roommates or Wen babyiters oO 2 include People staying here temporary ple without a permanent 1) No actions people 3. ts this house, apartment, or mobile home — Mark * ONE box. 15) Owned by you or someone inthis househala with a mortgage tr loan? Induse home eau lane staying here on Apr 1, 2020, count that person. ‘The Census Bureau also conducts counts in institutions and ‘other places, so: ‘Oued by you or someone in this household fre and clear tee ongage’ or oan)? + Do not count anyone living away from here, either at colege oF in the Armed Forces. + Do not count anyone in a nursing home, jail, prison, detention facility, etc, on Apri 1, 2020. + Leave these people off your questionnaire, even if they will rotum to live here afler they leave college, the nursing home, the military. jal, ete, Otherwiee, they may be counted twice. 1 pemea? (Occupied without payment of rt? |. What Is your telephone number? We wil only contact you if needed for official Census Bureau business. Telephone Number = How many people were living or staying in this house, ‘apartment, or mobile home on April 1, 20207 Number of people 5. Please provide information for each person living here. It ‘there Is someone living here who residence, start by listing him or her as Person 1. If the ‘owner or the person who pays the rent does not live here, start by listing any adult living here as Person 1 ‘What is Person 1's name? Print name below. Fst Name Last Name) What is Person 1's sex? Mark X ONE box wale What is Person 1's age and what is Person 1's date of birth? For babias less than 1 year old, do not wnite the age in ‘months. White 0as the age Month Day ‘Age on Ap 1, 2000 Year of bith we [TILT I NSZ NOTE: Please answer BOTH Question origin and Question 9 about race. F origins are not 1 No, ne ot Hane, o can Ar Chicano o o Yes another Hepa, Latna, or Spanish orin— Poi. or ‘example, Salvadoran, Dominican, Colombian, Guatemalan, Spaniard Ecuadoran, ete Taha conn Pannen ‘the rent or owns this 9. What is Person 1's race? Mark X one or mare boxes AND print origin. a white - Print fr example. German, lich, English alan, Lebanese, Eayptan, eta Back ot Atiean Am, ~ Pit. for example, Aican American, sJamalean, Hatlan, Nigenan, Etopian, Semall ete. 5° = ‘rnpal tbe), for exam Scere Hone a onmy g (WH oe M8 Vietnamese (Native Hawainn © Korean 1 Samoan Indian Japanese) Chamotro C Other Asan — © otnar Pact ltander — Brit for example Pousti? Cambetan, bimong te Print ler axa, Marsnaiese, ete. Some other race = Print race or eign 5r * If more people were counted in Question 1 on the front page, continue with Person 2 on the next page. -Printname ot Person 2 FirstName ™ Last Name) - Does this person usually live or stay somewhere else? Mark x all that apply. Yost a parr or Yes tora may assgrment (Ye, a sptonal or os. forajeporbusness 7) Yes, inal or pcon es. na nursing home 1 Yes: or acter reason |. How is this person related to Person 1? Mark X ONE box. Opposte-sexhusbandivtelsouse [| Father ormether COppoete-ex unmared partner Grandes Same-tox hutbandiiteepouse Parent Same-sox unmared parr Somimaw or daughter ian Bogie son or daugrer ther lave ~ =~ = Month Day -Adopes son or daughter Stopsono saughlor oOooo0ogo000g Brother or sister * ny or babies to month Wh ae mre NOTE: Please answer BOTH Question 6 about Hispanic ‘origin and Question 7 about race. For this census, Hispanic ‘origins are not races. Year bin Is this porson of Hispanic, Latino, or Spanish origin? (No, nat of Hipanie,Latine, o Spanish eign Yes, Mexlean, Mesean Am, Chicano Yes, Puerto ican Yes, Cuban oooo ‘Yes, another Higpani, Latino, or Spanish agin = Pin for ‘example, Salvadoran, Dominican, Celombian, Guatemala, Spaniard Ecuadorian, ot 37 7. Whats this person's race? ‘Mark / one or more boxes AND print origin. (1) wite— Prin, for example, German, lish, Engh, aan Lebanese, Egyptian, ete. yp Black or Atcan Am. - Print fr example, ican American, slamaiean, altar, Nigeran, Etnopian, § male AmoscanInan of Alaska Nalve = Print name of nvlled or nepal ibe), for example, Navajo Nation, Blackfeet Tribe Itayan. Arte. Naive Vilage of Barrow IngpatTraenal Government, Nome Eskimo Community, ey Chinese 1 Native Hawaian Filipino [1 samean o aoe Some cer race = Print ace or origin. - 1 ehamone oooo [1 other Pace ttander — Brant for example, To mn Marhaliese, ete ~ If more people were counted in Question 1 on the front page, continue with Person 3 on the next page. 1. printname ot Person 3 Feat Name u Last Name(s) 2. Does this person usually ve or stay somewhere else? Mark all tat apply. 0 we Yes tr etege Yagi a parent or © Westra mitayassinment Ye at staan Yes. torajob or bushess Yin ata praon Yes, in nursing ome Yes tr acter reason 3. How is this person related to Person 17 Mark X ONE box. 1 oppostesextusbandtespouse [-) Faherormeber Toppa sex nmaned paver). Grant Same-sex hustandviesouse (1 Paentinten C1 Sameer nmariedpatner (C1 Sondra or dauahernsaw 1D. Bllogison or daughir 1 oer ratve doped so or saugher 1 Roommate ot howe