American Community Survey

• About the American Community Survey
  • Why were you selected?
  • Why should you participate?
    • ACS helps communities (video)
  • How to respond or get help with your form
  • For people living in group housing
  • Questions on the form and why we ask
    • Income
    • Place of work/Journey to work
    • Explore the form
  • How we protect your privacy
    • Census Oath of Non-Disclosure
  • Is the American Community Survey legitimate?
  • Sample forms and instructions
• American Community Survey and 2010 Census
• About the Puerto Rico Community Survey
  • Sample forms and instructions
• Operations and Administration of the ACS
  • ACS Program Review
    • FAQs
  • 2011 American Community Survey Improvements

Resources for

• American Indian and Alaska Native Population
• Media
• Congress

Sample forms and instructions

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

If you have misplaced the form that you received in the mail, please call 1-800-354-7271.

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

Downloadable Document	Description
English [PDF 353B] Spanish [PDF 402KB]	2012 American 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 English and Spanish.
English [PDF 246KB] Spanish [PDF 252KB]	2012 American Community Survey instructions The booklet provides instructions on how to complete the form. Available in English and Spanish.
English [PDF 228KB] Spanish [PDF 286KB]	2012 American Community Survey Group Quarters form This American Community Survey form is for people living in group housing facilities such as dorms, nursing homes, barracks, and correctional facilities. Available in English and Spanish.
English [PDF 188KB] Spanish [PDF 207KB]	2012 American Community Survey Group Quarters instructions The booklet provides instructions on how to complete the group quarters form. Available in English and Spanish.

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

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