Sample forms and instructions
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]
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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]
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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]
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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.
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English [PDF 188KB] Spanish [PDF 207KB]
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2012 American Community Survey Group Quarters instructions
The booklet provides instructions on how to complete the group quarters form. Available in English and Spanish.
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For previous year's questionnaires, visit our Questionnaire Archive in the Methodology section.
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