U.S. Department of Commerce

American Community Survey

Census.govAmerican Community Survey › About the Survey: About the Puerto Rico Community Survey › Sample forms and instructions
Skip top of page navigation

Sample forms and instructions

These Puerto Rico Community Survey forms are only samples. You cannot reply to the Puerto Rico Community Survey online.

If you have misplaced the form that you received in the mail, please call 1-800-717-7381.

Use a pen with blue or black ink, or a #2 pencil, to complete the form you got in the mail.

Downloadable Document Description
2012 Puerto Rico Community Survey form

English [PDF 384KB]
Spanish [PDF 402KB]

2012 Puerto Rico Community Survey form

This form asks about the people at the address on the mailing label -- and their house, apartment or mobile home. Available in Spanish and English.

2012 Puerto Rico Community Survey instructions

English [PDF 201KB]
Spanish [PDF 402KB]

2012 Puerto Rico Community Survey instructions

The booklet provides instructions on how to complete the form. Available in Spanish and English.

2012 Puerto Rico Survey Group Quarters form

English [PDF 243KB]
Spanish [PDF 286KB]

2012 Puerto Rico Survey Group Quarters form

This Puerto Rico Community Survey form is for people living in group housing facilities such as dorms, nursing homes, barracks, and correctional facilities. Available in Spanish and English.

2012 Puerto Rico Survey Group Quarters instructions

English [PDF 233KB]
Spanish [PDF 286KB]

2012 Puerto Rico Survey Group Quarters instructions

The booklet provides instructions on how to complete the group quarters form. Available in Spanish and English.

Related Topics

For previous year's questionnaires, visit our Questionnaire Archive in the Methodology section.


[PDF] or PDF denotes a file in Adobe’s Portable Document Format. To view the file, you will need the Adobe® Reader® Off Site available free from Adobe. This symbol Off Site indicates a link to a non-government web site. Our linking to these sites does not constitute an endorsement of any products, services or the information found on them. Once you link to another site you are subject to the policies of the new site.


Call UsCall Us

  • General 1-800-923-8282
  • Questionnaire 1-800-354-7271
  • ¿Ayuda? 1-877-833-5625
Source: U.S. Census Bureau | American Community Survey Office | Email ACS | Last Revised: June 27, 2012
Give us your feedback on this website!