Other Public Use Forms

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

ENUMERATOR
JOB AID

Pacific Islands

D-1(F)PI

(2-3-2009)

USCENSUSBUREAU
DRAFT #2 (2-3-2009)

CARD A
WHO TO COUNT ON APRIL 1st
We need to count people where they live and
sleep most of the time.

Do NOT include:
• College students who live
away from this address
most of the year
• Armed Forces personnel
who live away
• People in a nursing home,
mental hospital, etc. on
April 1, 2010
• People in a jail,
prison, detention
facility,etc. on April 1,
2010

DO include:
• Babies and children living
here, including foster
children
• Roommates
• Boarders
• People staying here on
April 1, 2010 who have no
other permanent place to
live

D-1(F)PI (2-3-2009)

CARD B
RELATIONSHIP
• Husband or wife
• 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
• Roomer or boarder
• Housemate or roommate
• Unmarried partner
• Other nonrelative

D-1(F)PI (2-3-2009)

CARD C
CITIZENSHIP
Yes, a U.S. citizen
• Born in this Area
• Born in the United States, or another
U.S. territory or commonwealth
• Born elsewhere of U.S. parent or parents
• By naturalization
No, not a U.S. citizen
• Permanent resident
• Temporary resident

D-1(F)VI (2-3-2009)

CARD D
REASON FOR MIGRATION

• Employment
• Military
• Subsistence activities
• Missionary activities
• Moved with spouse or parent
• To attend school
• Medical
• Housing
• Other

D-1(F)VI (2-3-2009)

CARD E
MILITARY DEPENDENT
• Dependent of an active-duty member of the
Armed Forces
• Dependent of retired member of the Armed
Forces, or dependent of an active-duty or
retired member of full-time National Guard or
Armed Forces Reserve
• No

D-1(F)PI (2-3-2009)

CARD F
HIGHEST DEGREE OR
LEVEL OF SCHOOL
NO SCHOOLING COMPLETED
• No schooling completed
PRE-KINDERGARTEN SCHOOL THROUGH GRADE 12
• Pre-kindergarten
• Kindergarten
• Grade 1 through 11 – Specify grade
• 12th grade – NO DIPLOMA
HIGH SCHOOL GRADUATE
• Regular high school diploma
• GED or alternative credential
COLLEGE OR SOME COLLEGE
• Some college credit, but less than 1 year of college credit
• 1 or more years of college credit, no degree
• Associate’s degree (for example: AA, AS)
• Bachelor’s degree (for example: BA, BS)
AFTER BACHELOR’S DEGREE
• Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA)
• Professional degree beyond a bachelor’s degree (for example: MD,
DDS, DVM, LLB, JD)
• Doctorate degree (for example: PhD, EdD)
D-1(F)PI (2-3-2009)

CARD G
TYPE OF HEALTH INSURANCE
(Choose either "Yes" or "No" for EACH type of
health insurance or coverage plan below.)
Yes

No

a. Insurance through a current or former employer or
union (of this person or another family member) . . . . . . . . . . . . . . . . .
b. Insurance purchased directly from an insurance company
(by this person or another family member . . . . . . . . . . . . . . . . . . . . . . . .
c. Medicare, for people 65 and older, or people with
certain disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Medicaid or any kind of federal government assistance
plan for those with low incomes or a disability. . . . . . . . . . . . . . . . . . . .
e. TRICARE or other military health care . . . . . . . . . . . . . . . . . . . . . . . . . . .
f. VA (including those who have ever used or enrolled
for VA health care) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g. Local medical programs for indigents . . . . . . . . . . . . . . . . . . . . . .
h. Any other type of health insurance or health
coverage plan – Specify. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

D-1(F)PI (2-3-2009)

CARD H
MILITARY SERVICE
Yes, ever served on active duty
• Now
• During the last 12 months, but not now
• In the past, but not during the last 12 months
No, never served on active duty
• Received training for Reserves or National
Guard only
• Never served in the military

D-1(F)PI (2-3-2009)

CARD I
PERIOD OF MILITARY SERVICE
(Choose EACH period that was served.)
• September 2001 or later
• August 1990 to August 2001 (including Persian
Gulf War)
• September 1980 to July 1990
• May 1975 to August 1980
• Vietnam era (August 1964 to April 1975)
• March 1961 to July 1964
• February 1955 to February 1961
• Korean War (July 1950 to January 1955)
• January 1947 to June 1950
• World War II (December 1941 to December 1946)
• November 1941 or earlier

D-1(F)PI (2-3-2009)

CARD J
MEANS OF TRANSPORTATION TO WORK
• Car, truck, or private van/bus
• Public van/bus
• Boat
• Taxicab
• Motorcycle
• Bicycle
• Walked
• Worked at home
• Other method

D-1(F)PI (2-3-2009)

CARD K
CLASS OF WORKER
• Employee of a PRIVATE FOR-PROFIT
company or business or of an individual, for
wages, salary, or commissions
• Employee of a PRIVATE NOT-FOR-PROFIT,
tax-exempt, or charitable organization
• Local or territorial GOVERNMENT employee
(territorial/commonwealth, etc.)
• Federal GOVERNMENT employee
• SELF-EMPLOYED in own NOT INCORPORATED
business, professional practice, or farm
• SELF-EMPLOYED in own INCORPORATED
business, professional practice, or farm
• Working WITHOUT PAY in family business
or farm

D-1(F)PI (2-3-2009)

CARD L
WHICH BEST DESCRIBES THIS BUILDING
• A mobile home
• A one-family house detached from any other
house
• A one-family house attached to one or more
houses
• Two houses – Applies only in American
Samoa
• Three or more houses – Applies only in
American Samoa
• A building with 2 apartments
• A building with 3 or 4 apartments
• A building with 5 to 9 apartments
• A building with 10 to 19 apartments
• A building with 20 to 49 apartments
• A building with 50 or more apartments
• A container
• Boat, RV, van, etc.

D-1(F)PI (2-3-2009)

CARD M
HOT AND COLD PIPED WATER
Yes, hot and cold piped water
• In this unit
• In this building, not in unit
No, only cold piped water
• In this unit
• In this building,
• Outside this building
• No piped water

D-1(F)PI (2-3-2009)

CARD N
SOURCE OF WATER
• A public system only
• A public system and catchment
• A village water system only – Applies only
in American Samoa
• An individual well
• A catchment, tanks, or drums only
• Some other source (for example: a standpipe,
spring, river, creek, etc.)

D-1(F)PI (2-3-2009)

CARD O
OWNER OR RENTER
• 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

D-1(F)PI (2-3-2009)