[The 1980 census was completed via self-enumeration; the Census Bureau mailed questionnaires to each household in March, and instructed them to complete the forms on their own and mail them to the Census on "Census Day," Tuesday, April 1, 1980. A sample of the population received a "long-form" questionnaire that asked additional questions in addition to the basic questions asked of all households. This had been the case in 1960 and 1970 as well, but in 1980 there was only one version of the long form, whereas the previous two censuses had each employed several different versions. The 1980 PUMS was drawn entirely from the long-form questionnaires.] 

[The text of the long-form questionnaire is reproduced here, beginning with a general introduction, followed by the population questions and then the housing questions. In addition to the questionnaires, which consisted of brief questions followed by a series of possible answers with corresponding FOSDIC circles (the little circles that must be filled with a Number 2 lead pencil), households received a separate section containing more detailed instructions for each question. In order to minimize cross-referencing, we have combined these below. For each item, we reproduce the question as worded on the questionnaire, followed by any additional instructions contained on the separate instruction sheet. The additional instructions appear in quotation marks.]

Please fill out this official Census Form and mail it back on Census Day, Tuesday, April 1, 1980 

A message from the Director, Bureau of the Census ...
We must, from time to time, take stock of ourselves as a people if our Nation is to meet successfully the many national and local challenges we face. This is the purpose of the 1980 census. 

The essential need for a population census was recognized almost 200 years ago when our Constitution was written. As provided by article I, the first census was conducted in 1790 and one has been taken every 10 years since then. 

The law under which the census is taken protects the confidentiality of your answers. For the next 72 years -- or until April 1, 2052 -- only sworn census workers have access to the individual records, and no one else may see them. 

Your answers, when combined with the answers from other people, will provide the statistical figures needed by public and private groups, schools, business and industry, and Federal, State, and local governments across the country. These figures will help all sectors of American society understand how our population and housing are changing. In this way, we can deal more effectively with today’s problems and work toward a better future for all of us. 

The census is a vitally important national activity. Please do your part by filling out this census form accurately and completely. If you mail it back promptly in the enclosed postage-paid envelope, it will save the expense and inconvenience of a census taker having to visit you. 

Thank you for your cooperation. 

Your answers are confidential
By law (title 13 U.S. Code), census employees are subject to fine and/or imprisonment for any disclosure of your answers. Only after 72 years does your information become available to other government agencies or the public. The same law requires that you answer the questions to the best of your knowledge. 

Para personas de habla hispana
(For Spanish-speaking persons)
SI USTED DESEA UN CUESTIONARIO DEL CENSO EN ESPAÑ OL llame a la oficina del censo. El nú mero de telé fono se encuentra en el encasillado de la direcció n. O, si prefiere, marque esta casilla ¢ y devuelva el cuestionario por correo en el sobre que se le incluye. 

How to fill out your Census Form

See the filled-out example [omitted] in the yellow instruction guide [that is, the separate instructions accompanying the questionnaire]. This guide will help with any problems you may have. If you need more help, call the Census Office. The telephone number of the local office is shown at the bottom of the address box on the front cover. 

Use a black pencil to answer the questions. Black pencil is better to use than ballpoint or other pens. Fill circles "O" completely, like this. l When you write in an answer, print or write clearly. 

Make sure that answers are provided for everyone here. See page 4 of the guide if a roomer or someone else in the household does not want to give you all the information for the form. 

Answer the questions on pages 1 through 5, and then starting with pages 6 and 7, fill a pair of pages for each person in the household. Check your answers. Then write your name, the date, and telephone number on page 20. 

Mail back this form on Tuesday, April 1, or as soon afterward as you can. Use the enclosed envelope; no stamp is needed. 

Please start by answering Question 1 below.

[The form provides a column for each individual within the household to respond separately to each question listed below.]
1. What is the name of each person who was living here on Tuesday, April 1, 1980, or who was staying or visiting here and had no other home?

List in Question 1

Last name
________________________________ 

First name Middle initial
________________________________ 

"List in question 1 ... the names of all the people who usually live here. Then turn to pages 2 and 3 where there are columns to list up to seven persons. In the first column print the name of one of the household members in whose name this home is owned or rented. If no household member owns or rents the living quarters, list in the first column any adult household member who is not a roomer, boarder, or paid employee. Print the names of the other household members, if any, in the columns which follow, using question 1 as a checklist." 

2. How is this person related to the person in column 1 [i.e., to the householder]?
Fill one circle. If "Other relative" of person in column 1, give exact relationship, such as mother-in-law, niece, grandson, etc.
If relative of person in column 1:

3. Sex.
Fill one circle.

4. Is this person --
Fill one circle.

5. Age, and month and year of birth
         a. Age at last birthday
         Print age at last birthday.
         __________ 

        b. Month of birth
        Print month and fill one circle.

"Enter age at last birthday in the space provided (enter "0" for babies less than one year old). Also enter month and year of birth, and fill the appropriate circles. For an illustration of how to complete question 5, see the example on pages 4 and 5 [not shown here]. If age or month or year of birth is not known, give your best estimate." 

6. Marital Status
         Fill one circle.

7. Is this person of Spanish/Hispanic origin or descent?
         Fill one circle.

8. Since February 1, 1980, has this person attended regular school or college at any time?
        Fill one circle. Count nursery school, kindergarten, elementary school, and schooling which
        leads to a high school diploma or college degree.

9. What is the highest grade (or year) of regular school this person has ever attended?
         Fill one circle. If now attending school, mark grade person is in. If high school was
         finished by equivalency test (GED), mark "12."

"If the person skipped or repeated grades, mark the highest grade ever attended regardless of how long it took to get there. Persons who did not attend any college but who completed high school by finishing the 12th grade or by passing an equivalency test, such as the General Educational Development (GED) examination. should fill the circle for the 12th grade." 

10. Did this person finish the highest grade (or year) attended?
           Fill once circle.

11. In what State or foreign country was this person born?
Print the State where this person's mother was living when this person was born. Do not give the location of the hospital unless the mother's home and the hospital were in the same State.
______________________________________________________
Name of State or foreign country; or Puerto Rico, Guam, etc. "For persons born in the United States:
Print the name of the State in which this person's mother was living when this person was born. For persons born in a hospital, do not give the State in which the hospital was located unless the hospital and the mother's home were in the same State or the location of the mother's home is not known. For example, if a person was born in a hospital in Washington D.C., but the mother's home was in Virginia at the time of the person's birth, enter "Virginia." 

"For persons born outside the United States:
Print the full name of the foreign country or Puerto Rico, Guam, etc., where the person was born. Use international boundaries as now recognized by the United States. Specify whether Northern Ireland or Ireland (Eire); East or West Germany; England, Scotland or Wales (not Great Britain or United Kingdom). Specify the particular island in the Caribbean, not, for example West Indies." 

12. If this person was born in a foreign country --

"This question is only for persons born in a foreign country. Fill the Yes, a naturalized citizen circle only if the person has completed the naturalization process and is now a citizen. If the person has entered the U.S. more than once, fill the circle for the year he or she came to stay permanently." a. Is this person a naturalized citizen of the United States?

b. What is this language?
__________________________________________
(For example -- Chinese, Italian, Spanish, etc.)

"Print the non-English language spoken at home. If this person speaks two or more non-English languages at home and cannot determine which is spoken most often, report the first language the person learned to speak." 

c. How well does this person speak English?

14. What is this person's ancestry? If uncertain about how to report ancestry, see instruction guide.
______________________________________________________________________________
(For example: Afro-Amer., English, French, German, Honduran, Hungarian, Irish, Italian, Jamaican,
Korean, Lebanese, Mexican, Nigerian, Polish, Ukrainian, Venezuelan, etc.)

"Print the ancestry group with which the person identifies. Ancestry (or origin or descent ) may be viewed as the nationality group, the lineage, or the country in which the person or the person's parents or ancestors were born before their arrival in the United States. Persons who are of more than one origin and who cannot identify with a single group should print their multiple ancestry (for example, German - Irish). Be specific; for example, if ancestry is "Indian," specify whether American Indian, Asian Indian, or West Indian. Distinguish Cape Verdean from Portuguese, and French Canadian from Canadian. A religious group should not be reported as a person's ancestry." 

15a. Did this person live in this house five years ago (April 1, 1975)?
If in college or Armed Force in April 1975, report place of residence there.

b. Where did this person live five years ago (April 1, 1975)?

16. When was this person born?

b. Attending college?

c. Working at a job or business?

18a. Is this person a veteran of active-duty military service in the Armed Forces of the United States?
      If service was in National Guard or Reserves only, see instruction guide.

b. Was active-duty military service during --
         Fill a circle for each period in which this person served.

19. Does this person have a physical, mental, or other health condition which has lasted for 6 or more
months and which. . .
                                                                                                                 Yes     No
 a. Limits the kind or amount of work this person can do at a job?       O        O 

b. Prevents this person from working at a job?                                       O        O 

c. Limits or prevents this person from using public transportation?    O         O 

"The term "health condition" refers to any physical or mental problem which has lasted for 6 or more months. A serious problem with seeing, hearing, or speech should be considered a health condition. Pregnancy or a temporary health problem such as a broken bone that is expected to heal normally should not be considered a health condition." 

20. If this person is a female --
           How many babies has she ever had, not counting stillbirths?
           Do not count her stepchildren or children she has adopted.

21. If this person has ever been married --
           a. Has this person been married more than once?

          c. If married more than once --
          Did the first marriage end because of the death of the husband (or wife)?

Count as work:

"Give the actual number of hours worked at all jobs last week, even if that was more or fewer hours than usually worked." 

23. At what location did this person work last week?
           If this person worked at more than one location, print where he or she worked most last week.
           If one location cannot be specified, see instruction guide.

"If the person worked at several locations, but reported to the same location each day to begin work, print where he or she reported. If the person did not report to the same location each day to begin work, print the words "various locations" for 23a, and give as much information as possible in the remainder of 23 to identify the area in which he or she worked most last week. If the person's employer operates in more than one location (such as a grocery store chain or public school system), give the exact address of the location or branch where the person worked. If the person worked in a foreign country or Puerto Rico, Guam, etc., print the name of the country in 23e and leave the other parts of 23 blank." 

a. Address (Number and street)
________________________________________
If street address is not known, enter the building name, shopping center, or other physical location description.

b. Name of city, town, village, borough, etc.
______________________________________________________________ 

c. Is this place of work inside the incorporated (legal) limits of that city, town, village, borough, etc.?

24a. Last week, how long did it usually take this person to get from home to work (one way)?
        __________ Minutes 

"Travel time is from door to door. Include time taken waiting for public transportation, picking up passengers in carpools, etc." 

b. How did this person usually get to work last week?
          If this person used more than one method, give the one usually used for most of the distance.

c. When going to work last week, did this person usually --

d. How many people, including this person, usually rode to work in the car, truck, or van last week?

25. Was this person temporarily absent or on layoff from a job or business last week?

26a. Has this person been looking for work during the last 4 weeks?

b. Could this person have taken a job last week?

27. When did this person last work, even for a few days?

28-30. Current or most recent job activity
            Describe clearly this person's chief job activity or business last week.
            If this person had more than one job, describe the one at which this person worked the most hours.
           If this person had no job or business last week, give information for last job or business since 1975.

28. Industry
          a. For whom did this person work?
           If now on active duty in the Armed Forces, print "AF" and skip to question 31.
           ________________________________________________________
           (Name of company, business, organization, or other employer)

"If the person worked for a company, business, or government agency, print the name of the company, not the name of the person's supervisor. If the person worked for an individual or a business that has no company name, print the name of the individual worked for. If the person worked in his or her own business, print ‘self-employed’." 

            b. What kind of business or industry was this?
            Describe the activity at location where employed.
            ________________________________________________________
          (For example: Hospital, newspaper publishing, mail order house, auto engine
           manufacturing, breakfast cereal manufacturing)

"Print two or more words to tell what the business, industry, or individual employer named in 28a does. If there is more than one activity, describe only the major activity at the place where the person works. Enter what is made, what is sold, or that service is given. Some examples of what is needed to make an answer acceptable are shown on the census form and here.

29. Occupation
a. What kind of work was this person doing?
______________________________________________________________________
(For example: Registered nurse, personnel manager, supervisor of order department, gasoline engine assembler, grinder operator)

"Print two or more words to describe the kind of work the person does. If the person is a trainee, apprentice, or helper, include that in the description. Some examples of what is needed to make an answer acceptable are shown on the census form and here.

"Print the most important things that the person does on the job. Some examples are shown on the census form." 

30. Was this person -- (Fill one circle)

31a. Last year (1979), did this person work, even for a few days, at a paid job or in a business or farm?

b. How many weeks did this person work in 1979?
    Count paid vacation, paid sick leave, and military service.
     __________________ Weeks 

"Count every week in which the person did any work at all, even for an hour." 

c. During the weeks worked in 1979, how many hours did this person usually work each week?
    __________________ Hours 

"If the hours worked each week varied considerably, give the best estimate of the hours usually worked most weeks." 

d. Of the weeks not worked in 1979 (if any), how many weeks was this person looking for work or on layoff from a job?
    __________________ Weeks 

"Count every week in which the person did not work at all, but spent any time looking for work or on layoff from a job. Looking for work means trying to get a job or start a business or professional practice; layoff includes either temporary or indefinite layoff." 

32. Income in 1979 --
          Fill circles and print dollar amounts.
          If net income was a loss, write "Loss" above the dollar amount.
          If exact amount is not known, give best estimate.
          For income received jointly by household members, see instruction guide.

During 1979 did this person receive any income from the following sources?
If "Yes" to any of the sources below -- How much did this person receive for the entire year?

"Fill the Yes or No circle for each part and enter the appropriate amount. If income from any source was received jointly by household members, report if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark No for the other person, unless the other person has additional income of the same type." 

a. Wages, salary, commissions, bonuses, or tips from all jobs . . .
     Report amount before deductions for taxes, bonds, dues, or other items.

b. Own nonfarm business, partnership, or professional practice . . .
     Report net income after business expenses.

c. Own farm . . .
    Report net income after operating expenses. Include earnings as a tenant farmer or sharecropper.

d. Interest, dividends, royalties, or net rental income . . .
    Report even small amounts credited to an account.

e. Social Security or Railroad Retirement . . .

f. Supplemental Security (SSI), Aid to Families with Dependent Children (AFDC), or other public
assistance or public welfare payments . . .

g. Unemployment compensation, veterans' payments, pensions, alimony or child support, or any other sources of income received regularly . . .
    Exclude lump-sum payments such as money from an inheritance or the sale of a home.

33. What was this person's total income in 1979?
      Add entries in questions 32a through g; subtract any losses.
      If total amount was a loss, write "Loss" above amount.

H1. Did you leave anyone out of Question 1 because you were not sure if the person should be listed -- for example, a new baby still in the hospital, a lodger who also has another home, or a person who stays here once in a while and has no other home?

         O Yes -- On page 20 give name of each visitor for whom there is no one at
             the home address to report the person to a census taker.
         O No 

H4. How many living quarters, occupied and vacant, are at this address?

H5. Do you enter your living quarters --

H6. Do you have complete plumbing facilities in your living quarters, that is, hot and cold piped water, a flush toilet, and a bathtub or shower?

H7. How many rooms do you have in your living quarters?
     Do not count bathrooms, porches, balconies, foyers, halls, or half-rooms.

H8. Are your living quarters --

H9. Is this apartment (house) part of a condominium?

H10. If this is a one-family house --
a. Is the house on a property of 10 or more acres?

H11. If you live in a one-family house or a condominium unit which you own or are buying --
 What is the value of this property, that is, how much do you think this property
         (house and lot or condominium unit) would sell for if it were for sale?
         Do not answer this question if this is --

H12. If you pay rent for your living quarters --
              What is the monthly rent?
               If rent is not paid by the month, see the instruction guide on how to figure a monthly rent.

"If rent is paid: Multiply rent by:
By the day 30
By the week 4
Every other week 2 

"If rent is paid: Divide rent by:
4 times a year 3
2 times a year 6
Once a year 12" 

H13. Which best describes this building?
Include all apartments, flats, etc., even if vacant.

H14a. How many stories (floors) are in this building?
Count an attic or basement as a story if it has any finished rooms for living purposes.

b. Is there a passenger elevator in this building?

b. Last year, 1979, did sales of crops, livestock, and other farm products from this place amount to --

H17. Is this building connected to a public sewer?

H18. About when was this building originally built? Mark when the building was first constructed, not when it was remodeled, added to, or converted.

H20. How are your living quarters heated?
Fill one circle for the kind of heat used most.

H21a. Which fuel is used most for house heating?

b. Which fuel is used most for water heating?

a. Electricity

H24. How many bedrooms do you have?
Count rooms used mainly for sleeping even if used also for other purposes.

H27. Do you have air conditioning?

H28. How many automobiles are kept at home for use by members of your household?

H29. How many vans or trucks of one-ton capacity or less are kept at home for use by members of your household?

Please answer H30-H32 if you live in a one-family house which you own or are buying, unless this is --

H30. What were the real estate taxes on this property last year?

H31. What is the annual premium for fire and hazard insurance on this property?

H32a. Do you have a mortgage, deed of trust, contract to purchase, or similar debt on this property?

        b. Do you have a second or junior mortgage on this property?

        c. How much is your total regular monthly payment to the lender?
            Also include payments on a contract to purchase and to lenders holding second
            or junior mortgages on this property.

        d. Does your regular monthly payment (amount entered in H32c) include payments for
            real estate taxes on this property?