UNITED [stop laughing!] STATES CENSUS 2020
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How many people without a permanent place to stay are in your household? _______
How many (if any) with a permanent place to stay? _________
How many total living in this house, apartment, mobile home, tent, dugout, or packing crate? (If more than 10, use form U.S.C.28-34b, Undocumented Immigrants) ________
PERSON 1
Name _____________________________
What is this person's sex? M [ ] F [ ] G [ ] L [ ] B [ ] T [ ]
What is this person's origin?
[ ] Mexican, Mexican Am., Chicano
[ ] Puerto Rican
[ ] Cuban
[ ] Dominican, Colombian, Nicaraguan, Salvadorean, etc.
[ ] African
[ ] Middle Eastern
[ ] Imperialist American
What is this person's race?
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Haitian
[ ] Hmong
[ ] Laotian
[ ] Pakistani
[ ] Afghani
[ ] Iraqi
[ ] Cambodian
[ ] Somali
[ ] Kenyan
[ ] Nigerian
[ ] African (specify)
[ ] Other
Does Person 1 sometimes live somewhere else?
[ ] No [ ] Yes — Mark X all that apply.
[ ] Jail
[ ] Al Qaeda training camp or United Kingdom
[ ] Al Qaeda underground cell or United Kingdom
[ ] Border tunnel
[ ] Mental rehabilitation facility (sometimes referred to as "madhouse")
[ ] All of the above
Please complete this questionnaire for all other members of the household.
Congratulations! You have helped your tribe get all the entitlements it can get!
How many people without a permanent place to stay are in your household? _______
How many (if any) with a permanent place to stay? _________
How many total living in this house, apartment, mobile home, tent, dugout, or packing crate? (If more than 10, use form U.S.C.28-34b, Undocumented Immigrants) ________
PERSON 1
Name _____________________________
What is this person's sex? M [ ] F [ ] G [ ] L [ ] B [ ] T [ ]
What is this person's origin?
[ ] Mexican, Mexican Am., Chicano
[ ] Puerto Rican
[ ] Cuban
[ ] Dominican, Colombian, Nicaraguan, Salvadorean, etc.
[ ] African
[ ] Middle Eastern
[ ] Imperialist American
What is this person's race?
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Haitian
[ ] Hmong
[ ] Laotian
[ ] Pakistani
[ ] Afghani
[ ] Iraqi
[ ] Cambodian
[ ] Somali
[ ] Kenyan
[ ] Nigerian
[ ] African (specify)
[ ] Other
Does Person 1 sometimes live somewhere else?
[ ] No [ ] Yes — Mark X all that apply.
[ ] Jail
[ ] Al Qaeda training camp or United Kingdom
[ ] Al Qaeda underground cell or United Kingdom
[ ] Border tunnel
[ ] Mental rehabilitation facility (sometimes referred to as "madhouse")
[ ] All of the above
Please complete this questionnaire for all other members of the household.
Congratulations! You have helped your tribe get all the entitlements it can get!
1 comment:
[ ] Al Qaeda training camp or United Kingdom
[ ] Al Qaeda underground cell or United Kingdom
Brilliant.
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