Starting March 12, 2020, households across America were able to respond to the 2020 Census online, over the phone, or by mail using a paper questionnaire. Here is a sample of the bilingual English and Spanish language paper questionnaire that was used during the 2020 Census. It excludes some features that were made available on that date, such as the URL for online response and the contact information for phone response. This is a sample only and cannot be used to mail in actual responses.

Find links to all 2020 Census language guides in 59 languages and accessible versions in Large Print and American Sign Language.

1. How many people were living or staying in this house, apartment, or mobile home on April 1, 2020?
   
   Why we ask this question: This helps us count the entire U.S. population and ensures that we count people where they live most of the time as of Census Day (April 1, 2020).
2. Were there any additional people staying here on April 1, 2020, that you did not include in Question 1?
   Mark all that apply.

   _ Children, related or unrelated, such as newborn babies, grandchildren, or foster children
   _ Relatives, such as adult children, cousins, or in-laws
   _ Nonrelatives, such as roommates or live-in babysitters
   _ People staying here temporarily
   _ No additional people.
   
   Why we ask this question: The goal of the 2020 Census is to count everyone just once and in the right place. We want to ensure that everyone in your home who should be counted is counted—including newborns, roommates, and those who may be staying with you temporarily.

3. Is this house, apartment, or mobile home — Mark ONE box.

   _ Owned by you or someone in this household with a mortgage or loan? Include home equity loans.
   _ Owned by you or someone in this household free and clear (without a mortgage or loan)?
   _ Rented?
   _ Occupied without payment of rent?
   
   Why we ask this question: This helps us produce statistics about homeownership and renting. The rates of homeownership serve as one indicator of the nation's economy. They also help with administering housing programs, planning, and decision-making.

4. What is your telephone number?
   We will only contact you if needed for official Census Bureau business.
   
   Why we ask this question: The Census Bureau asks for your phone number in case there are any questions about your census form. We will only contact you for official census business, if needed.
5. Please provide information for each person living here. If there is someone living here who pays the rent or owns this 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?
   
   Why we ask this question: The Census Bureau asks a series of questions about each member of your household. This allows us to establish one central figure as a starting point.
6. What is Person 1's sex? Mark ONE box.
   
   _ Male
   _ Female
   
   Why we ask this question: This allows us to create statistics about males and females, which can be used in planning and funding government programs. This data can also be used to enforce laws, regulations, and policies against discrimination.
7. What is Person 1's age and what is Person 1's date of birth?
   For babies less than 1 year old, do not write the age in months. Write 0 as the age.
   
   Why we ask this question: The U.S. Census Bureau creates statistics to better understand the size and characteristics of different age groups. Agencies use this data to plan and fund government programs that support specific age groups, including children and older adults.
   
   NOTE: Please answer BOTH Question 8 about Hispanic origin and Question 9 about race. For this census, Hispanic origins are not races.
8. Is Person 1 of Hispanic, Latino, or Spanish origin?
   

   _ No, not of Hispanic, Latino, or Spanish origin
   _ Yes, Mexican, Mexican Am., Chicano
   _ Yes, Puerto Rican
   _ Yes, Cuban
   _ Yes, another Hispanic, Latino, or Spanish origin – Print, for example, Salvadoran, Dominican, Colombian, Guatemalan, Spaniard, Ecuadorian, etc. _______________
   
   Why we ask this question: These responses help create statistics about this ethnic group. This helps federal agencies monitor compliance with anti-discrimination provisions, such as those in the Voting Rights Act and the Civil Rights Act.

9. What is Person 1's race?
   Mark one or more boxes AND print origins.
   

   _ White – Print, for example, German, Irish, English, Italian, Lebanese, Egyptian, etc. ____________
   

   _ Black or African American – Print, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. ____________________
   _ American Indian or Alaska Native – Print name of enrolled or principal tribe(s), for example Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. __________________
   _ Chinese
   _ Filipino
   _ Asian Indian
   _ Vietnamese
   _ Korean
   _ Japanese
   _ Other Asian – Print, for example, Pakistani, Cambodian, Hmong, etc. ____________
   _ Native Hawaiian
   _ Samoan
   _ Chamorro
   _ Other Pacific Islander – Print, for example, Tongan, Fijian, Marshallese, etc. _______
   _ Some other race – Print race or origin. ______

   Why we ask this question: This allows us to create statistics about race and to analyze other statistics within racial groups. This data helps federal agencies monitor compliance with anti-discrimination provisions, such as those in the Voting Rights Act and the Civil Rights Act.

The following information is collected for each additional person identified in Question 1 on the front page until information is collected for ALL persons in the household.

1. Print name of Person 2
   
   Why we ask this question: The 2020 Census asks information about each member of your household. This question identifies the next person to refer to in the ensuing questions. This process repeats for each person in your household..
2. Does this person usually live or stay somewhere else?
   Mark all that apply.
   _ No
   _ Yes, for college
   _ Yes, for a military assignment
   _ Yes, for a job or business
   _ Yes, in a nursing home
   _ Yes, with a parent or other relative
   _ Yes, at a seasonal or second residence
   _ Yes, in a jail or prison
   _ Yes, for another reason
   
   Why we ask this question: This question helps ensure that the Census Bureau is counting everyone once, only once, and in the right place.
3. How is this person related to Person 1?
   Mark ONE box.
   _ Opposite-sex husband/wife/spouse
   _ Opposite-sex unmarried partner
   _ Same-sex husband/wife/spouse
   _ Same-sex unmarried partner
   _ Biological son or daughter
   _ Adopted son or daughter
   _ Stepson or stepdaughter
   _ Brother or sister
   _ Father or mother
   _ Grandchild
   _ Parent-in-law
   _ Son-in-law or daughter-in-law
   _ Other relative
   _ Roommate or housemate
   _ Foster child
   _ Other nonrelative
   
   Why we ask this question: This allows the Census Bureau to develop data about families, households, and other groups. Relationship data is used in planning and funding government programs that support families, including people raising children alone.
4. What is this person's sex? Mark ONE box.
   
   _ Male
   _ Female
   
   Why we ask this question: This allows us to create statistics about males and females, which can be used in planning and funding government programs. This data can also be used to enforce laws, regulations, and policies against discrimination.
5. What is this person's age and what is this person's date of birth?
   For babies less than 1 year old, do not write the age in months. Write 0 as the age.
   
   Why we ask this question: The U.S. Census Bureau creates statistics to better understand the size and characteristics of different age groups. Agencies use this data to plan and fund government programs that support specific age groups, including children and older adults.
   
   NOTE: Please answer BOTH Question 6 about Hispanic origin and Question 7 about race. For this census, Hispanic origins are not races.
6. Is this person of Hispanic, Latino, or Spanish origin?
   

   _ No, not of Hispanic, Latino, or Spanish origin
   _ Yes, Mexican, Mexican Am., Chicano
   _ Yes, Puerto Rican
   _ Yes, Cuban
   _ Yes, another Hispanic, Latino, or Spanish origin – Print, for example, Salvadoran, Dominican, Colombian, Guatemalan, Spaniard, Ecuadorian, etc. _______________
   
   Why we ask this question: These responses help create statistics about this ethnic group. This helps federal agencies monitor compliance with anti-discrimination provisions, such as those in the Voting Rights Act and the Civil Rights Act.

7. What is this person's race?
   Mark one or more boxes AND print origins.
   

   _ White – Print, for example, German, Irish, English, Italian, Lebanese, Egyptian, etc. ____________
   

   _ Black or African American – Print, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. ____________________
   _ American Indian or Alaska Native – Print name of enrolled or principal tribe(s), for example Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. __________________
   _ Chinese
   _ Filipino
   _ Asian Indian
   _ Vietnamese
   _ Korean
   _ Japanese
   _ Other Asian – Print, for example, Pakistani, Cambodian, Hmong, etc. ____________
   _ Native Hawaiian
   _ Samoan
   _ Chamorro
   _ Other Pacific Islander – Print, for example, Tongan, Fijian, Marshallese, etc. _______
   _ Some other race – Print race or origin. ______

   Why we ask this question: This allows us to create statistics about race and to analyze other statistics within racial groups. This data helps federal agencies monitor compliance with anti-discrimination provisions, such as those in the Voting Rights Act and the Civil Rights Act.