New Short Form

It's safe, easy, and fast!

Beginning with the 2010 census, residents will only be required to complete the short form instead of either the short or long form. The questions will relate to name, sex, age, date of birth, race, ethnicity, relationship and housing tenure (as seen below). In the past, the long format captured detailed socioeconomic information; however, that information will now be collected annually through the American Community Survey. The frequency of collection will be randomly within the next ten years, pulling from a rotating sample of the population.

For the first time in the history of the Decennial Census, over 13 million questionnaires will be printed with both English and Spanish on the same form. In addition, the questionnaire will also be printed in 5 additional languages: Spanish, Simplified Chinese, Korean, Russian, and Vietnamese. For anyone that speaks another language or has trouble filling out a questionnaire due to a disability, there will be 59 Language Assistant Guides available and one-on-one help at Questionnaire Assistance Centers. Census Bureau workers, hired from the local community, will be on-hand to help at those locations and can nationally assist in over 100 different languages. Both sample questionnaires and Language Assistant Guides are available on the right side this page.

To view an interactive questionnaire and learn about each question, visit the Census Bureau's new 2010 Census Web site here.

Question 1: How many people were living or staying in this house, apartment, or mobile home on May 1, 2008?

Question 2: Were there any additional people staying here May 1, 2008 that you did not include in Question 1? Mark all that apply

Question 3: Is this house, apartment, or mobile home? Mark ONE box.

Question 4: What is your telephone number? We may call if we don't understand an answer.

Question 5: Please provide information for each person living here. Start with a person living here who owns or rents this house, apartment, or mobile home. If the owner or renter lives somewhere else, start with any adult living here. This will be Person 1. What is Person 1's name?

Question 6: What is Person 1's sex? Mark ONE box.
Question 7: What is Person 1's age and what is Person 1's date of birth? Please report babies as age 0 when the child is less than 1 year old.

NOTE: Please answer BOTH Question 8 about Hispanic origin and Question 9 about race. For this census, Hispanic origins are not races.

Question 8:
Is Person 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano Yes, Puerto Rican
Yes, Cuban Yes, another Hispanic, Latino, or Spanish origin - Print origin, for example, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.

Question 9: What is Person 1's race? Mark one or more boxes.

Question 10: Does Person 1 sometimes live or stay somewhere else?
If more people were counted in Question 1, continue with Person 2.


Click below for Sample Questionnaire
- English Questionnaire -
- Bilingual Questionnaire -
Cuestionario en ingles y espano

- Chinese/ 中文
- Korean/ 한국어
- Russian/ Русский
- Spanish/ Español
- Vietnamese/ Tiếng Việt

Click below for a Language Assistant Guide
- Albanian/ Shqip
- Amharic/ አማርኛ
- Arabic/ عربي
- Armenian/ Հայերեն
- Bengali/ বাংলা
- Bulgarian/ Български
- Burmese/ မြန်မာ
- Cebuano/ Cebuano
- Chamorro/ Chamorro
- Chinese (Simplified)/ 中文(简体)
- Chinese (Traditional)/ 中文(繁體)
- Chuukese/ Non Fosun Chuuk
- Croatian/ Hrvatski
- Czech/ Čeština
- Dari/ دری
- Dinka/ Thuɔŋjäŋ
- Dutch/ Nederlands
- Farsi/ فارسی
- French/ Français
- German/ Deutsch
- Greek/ ελληνικός
- Gujarati/ ગુજરાતી
- Haitian Creole/ Kreyòl Ayisyen
- Hebrew/ עברית
- Hindi/ हिन्दी
- Hmong/ Hmoob
- Hungarian/ Magyar
- Ilocano/ Ilocano
- Italian/ Italiano
- Japanese/ 日本の
- Khmer/ Cambodian
- Korean/ 한국어
- Laotian/ ພາສາລາວ
- Lithuanian/ lietuvių
- Malayalam/ മലയാളം
- Marshallese/ Kajin Marshall
- Navajo/ Diné
- Nepali/ नेपाली
- Polish/ Polski
- Portuguese/ Português
- Punjabi/ ਪੰਜਾਬੀ
- Romanian/ Română
- Russian/ Русский
- Samoan/ Gagana Samoa
- Serbian/ Cpпски
- Somali/ Soomaali
- Spanish/ Español
- Swahili/ Kiswahili
- Tagalog/ Tagalog
- Tamil/ தமிழ்
- Telugu/ తెలుగు
- Thai/ ไทย
- Tigrinya/ ትግርኛ
- Tongan/ Lea Faka-Tonga
- Turkish/ Türkçe
- Ukrainian/ Український
- Urdu/ اردو
- Vietnamese/ Tiếng Việt
- Yiddish/ אידיש

Click below for a Large Print Assistance Guide and Web Braille
- Large Print Guide
- Braille/ ⠠⠃⠗⠁⠊⠇⠇⠑