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Unformatted text preview: http:lew.ojp.usdaj.govlbjslpuhlpdfa‘ncvfi0-1.de -Windows Internet Explorer —___—... $115} "' IE, http:,l',l'www.ojp.usdo].govll'bjsl'publ'pdfil'ncvs194.pdf j*'¢=IX:|:. giggle E Y Ingeard'IH-fil' LL) $’ ISI' '9‘ \Q fl ' fl Bucki'narks’r as; 013$ ' <[I‘l_].flII.nthi|i ' fl Dfl.. Inal' men.Carter-‘5L5W&W| ... :BT‘Yé .wE EDIE! s:- I '5' IIOIIEE — WeaIe ommmg _ - Section 6. Secnon 9 of the Iswrequres LE III:- I-eep el niun'rrnon abautvou and Inur l'cusshcl-Il EITB'II'f' confidential We may use Hie rIforrrIahon arty Iorataliau'cfi purple-sea. Also. "file ‘2. Sect'un 5732 Urind States Code. umhufim the Bursa“ ui Janos Statistics. Depulmanrof Justice. ballet; inlen'mrion using ‘IItli sum. Tile-£1 Seem 3.7395 arti SE5. UriEd States Code. aim natures LE 3 I3 all Irtnrrnamn ahcutmu andyour household filncfld confidential. accudngtclha Pawn-9d: LISEDI'IMI'JIIM. mperacns are reqLired nreep-ondma Minion of informeiun unless such collection dis-plays a valid OMB nurrta-ar lflflfii II'I'EII'UIEU- “Milli Fm CONTROL “In Control number Psu ISegmenL’SLIffn Ih's awe-r Lndel It's aLnIIcmy-dTilta 13, United States Code. .910-2034) ISnmpla lienati lHH N0.|'3p|n01f desiunation'suffixlaifiu I Ilndicansr FOFIH NC 715- 1 “GUS-1 BASIC SCREEN QUESTIONNAIRE m IITEII‘I‘IEIII- “MRI! Fm WITIOL mu- cent. OMB No. 1121-9111: US. DEPARTMENT OF COMMERCE Em'fl'ntsam mam,- mmmn U.S. CENSUS EIUFIEI‘IU Approval Expires 7131:2906 ACTING FS COLLECTING .lfa'ENT F'JFI TH E EIUFIEAU "JF JUSTICE STATIS‘I1r35 U.S. DEF’AFITMENT CIF JUSTICE NATIONAL CRIME VICTIMIZATIOH SURVEY ITHS FILED AT START OF III'I'E‘II'UIE‘H 123. Household Income in: Item 29} 'I. Field representative identification 21 4 I _ ”mm" $5503 ‘5 _ ”"132" “499 H — 35305—39949 2 $5.999 — 7.499 T IT.5L‘C'- H.999 l2 4CI.9[I|J— 49.999 Code | Name _ _ _ _ _ I 3 1599 — 9.999 a 91].,[0— 24.999 la EILDDII— H.911 4 19.999 — 12.4912I 9 25020—29999 l4 T5990 and over Unit status 5 _ 12-.500—14.§LQQ 19 _ SD.-m— 34.:90 J Unit In sample the preuous enumeration pe nod —Fli' 3 12b. CollegelUni'uersity (a: item ab} 1 J Unit In sample first time this perm-d — SKIP to -t 21 s I Yes 2 III No 3. Household status - lafaiktiist tux thatamlies 12c. Public Housing {filter}: 35-, 20.3 I :I Same household Interviewed the previous enumeration 215 K — Itern blank I [I Yes [public 3 [I No (not public 2 :I He placement hou as hold am as the pranou s enume ration huu sing] housm g] 3 :I NGHIWIEWIBW ll“? PWWS enumeration 12d. “inane! ln"erilit:ati<:|n a! Public Housing (in: Item Sufi I :I Other — Speclfil 229 I Item blank --" 13 0 Unknown Zuni: ,' start 1.- USE: f'-'1E|"-'1IIZZ :‘I E Mil lit F'I:II-'-I~3I'F'I:Iint ... .-" I'IIZE|:I :II'II'|.-'-.| .... . .3];- . us-jn. .. E E“ "< .--'I 1:11 F'f'-'1 ...
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