2008 ACS Questionnaire - English |  Spanish

Persons

1. Name
2. Relation to first person surveyed
3. Sex
4. Age, Birthday
5. Of Hispanic, Latino, or Spanish origin?
6. Race
7. Place of birth?
8. Citizen?
9. Year came to USA?
10. Attended school/college in past 3 months? Grade?
11. Highest level completed?
12. Ethnic origin?
13. Speak a language other than English?
14. Live in home 1 year ago?
15. Covered by health insurance?
16. Deaf?
17. Difficulty remembering/making decisions? Walking, claiming stairs? Dressing or bathing?
18. Because of physical, mental, emotional condition have difficulty doing errands?
19. Marital status?
20. Past year got married, widowed, divorced?
21. Number of times married?
22. Year last married?
23. If female, given birth in past year?
24. Any grandchildren under 18 in home?
25. Been on active duty in military?
26. When?
27. Have a VA service-connected disability rating?
28. Paid for work in past week?
29. Where did they work?
30. How do they get to work?
31. How many people ride to work?
32. What time do they leave for work?
33. How long to get to work?
34. Were they laid off from work last week?
35. Last 4 weeks, looking for work?
36. Last week, could have started if offered?
37. When last worked?
38. Past year, work 50 or more weeks?
39. Past year, how many hours per week?
40. Private employee? Government employee?
41. Employer?
42. Business type?
43. Category?
44. Job work type?
45. Most important duties?
46. Income earned in past year broken down
47. Total income in past year

Housing

1. Building description
2. When was it built
3. When did you move into the building
4. How many acres
5. Sales of agricultural products from property in past year
6. Is there a business on the property?
7. How many separate rooms in the building, bedrooms?
8. Does it have: hot/cold running water, flush toilet, sink with faucet, stove, refrigerator, telephone?
9. How many automobiles?
10. Most used fuel for heating?
11. Cost of electricity,gas last month? water/sewer, heating fuel in past year?
12. In past year did anyone receive food stamps?
13. Building part of a condominium?
14. Is the building owned, rented?
15. Whats the monthly rent?
16. What would it sell for now?
17. Annual real estate taxes?
18. Annual payment for fire, hazard, flood insurance?
19. Have a mortgage, deed of trust, contract to purchase, or other debt on this property? What’s the monthly payment?
20. Do you have a second mortage or home equity lone on this property?
21. Total annual costs for property taxes, rent, fees?

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