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American Community Survey

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Sample forms and instructions

These American Community Survey forms are only samples. Most people can reply to the survey online. Learn more about responding 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
2014 America Community Survey form

English [PDF 406KB]
Spanish [PDF 378KB]

2014 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.

2013 America Community Survey instruction

English [PDF 233KB]
Spanish [PDF 271KB]

2014 American Community Survey instructions

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

2013 American Community Survey Group Quarters form

English [PDF 296KB]
Spanish [PDF 261KB]

2014 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.

2013 American Community Survey Group Quarters instructions

English [PDF 200KB]
Spanish [PDF 217KB]

2014 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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  • 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, 2014
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