American Community Survey

• About the American Community Survey
  • How the ACS works
  • Why were you selected?
  • Why should you participate?
    • ACS helps communities (video)
  • How to respond to the survey or get help
    • Respond Online
    • Respond Online Video
    • Respond by Mail
    • Respond by Phone
    • In-person Interview
    • FAQs
  • For people living in group housing
  • Questions on the form and why we ask
    • Income
    • Place of work/Journey to work
    • Explore the Form
    • Explore the Form (text only)
  • 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. 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
English [PDF 337B] Spanish [PDF 375KB]	2013 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 222KB] Spanish [PDF 226KB]	2013 American Community Survey instructions The booklet provides instructions on how to complete the form. Available in English and Spanish.
English [PDF 303KB] Spanish [PDF 215KB]	2013 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 199KB] Spanish [PDF 222KB]	2013 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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