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US DEPARTMENT OF COMMERCEEconomics and Statistics Administration

US CENSUS BUREAUThis is the o˜cial questionnaire for this addressIt is quick and easy to respond and your answers are protected by law

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US DEPARTMENT OF COMMERCEEconomics and Statistics Administration

US CENSUS BUREAU

and This

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US DEPARTMENT OF COMMERCEEconomics and Statistics Administration

US CENSUS BUREAUThis is the o˜cial questionnaire for this addressIt is quick and easy to respond and your answers are protected by law

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US DEPARTMENT OF COMMERCEEconomics and Statistics Administration

US CENSUS BUREAU

and This

easy is

tothe

o

respondcial

and questionnaire

your

answersfor

this

are addressprotectedIt is quick by law

OFFICIALFOR

USE ONLY

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yumlrlk wxlh

Tnfa yumlrlk wxlh l=ulao

ixKk ldfrac34hdxYfha ks ldfrac34hhla i|yd wjYH jqjfyda

muKla wms Tnj iiumlnkaO lrksuqiexcl

tlaia ckmo ixKk ldfrac34hdxYh 4

wjika ku

(last name[s]) uqa ku

(frst name)

Egravekh 2020 wfmaa 1 Egravekg

jhi wjqreyumljska

2 fjks msgqfjys jiumlmi sfnk mYak iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

lreKdlr fuys Ocircjajk tla tla mqoahd i|yd fdr=re

imhkakiexcl fuu ksflakh wha fyda fuys l=sh fjk hiuml

wfhla fuys Ocircja jkafka kiuml Tyq fyda weh 1 fjks mqoahd

jYfhka ehsia= lr wdriumlN lrkakiexcl whsslre fyda l=sh

fjk mqoahd fuys Ocircja fkdjkafka kiuml fuys Ocircja jk

acutekEu jeaumlysaacutefhl= 1 fjks mqoahd jYfhka ehsia= lr

wdriumlN lrkakiexcl

1 fjks mqoahdfa ku l=ulao

lreKdlr 1 fjks mqoahdfa ku bxSis NdYdfjka shkakiexcl

ueo ku ^uqa wl=ramp

(middle initial)

Wmka

jfrac34Ih

1 fjks mqoahdfa sxslajh l=ula otla fldgqjla muKla iltl=Kq lrkakiexcl

msszligntilde eyeKq

1 fjks mqoahdfa jhi l=ulao iy 1 fjks mqoahdfa Wmka Egravekhl=ulao

jhi jfrac34I 1 g jvd wvq ltorejka i|yd jhi udijska

fkdshkakiexcl jhi wjqreyuml 0 fi shkakiexcl

1 fjks mqoahd iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqawfhlao

ke iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqa wfhl=

fkdfotilde

Totilde fulaisldkq fulaisldkq weuszligldkq Ntildeldfkda

Totilde mqjfgda szligflda

Totilde lshqndkq

Totilde fjka iamd[a[ ska fyda iamd[a[ iiumlNjhlska hq=

wfhls mdash uacuteYd wl=szligka shkak WodyrKhlg ieajfodarfvdntildekslka fldfltdiumligravehdkq ajduddkq iamd[a[blajfodar wdsect jYfhka

tlaia ckmo ixKk ldfrac34hdxYh 5

udih

2 fjks msgqfjys ol=Kqmi sfnk mYakh iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

1 fjks mqoahdfa cdsh l=ulao

tla fldgqjl fyda jeauml Kkl il=K fhdokak iy iiumlNjh

uacuteYd wl=szligka shkak

iqyuml mdash uacuteYd wl=szligka shkak WodyrKhlg cfrac34udkqwhfrac34ka bxSis bds fnkka Bethma= wdsect jYfhka

liquest fyda wmsldkq wefuszligldkq mdash uacuteYd wl=szligka shkakWodyrKhlg wmsldkq wefuszligldkq cefuhsldkq yhsaacutekhsOcircszlighdkq bsfhdamshdkq fidaudshdkq wdsect jYfhka

wefuszligldkq bkaEgravehdkq fyda weialdkq cdsl mdash shdmEgravexNtilde

fyda mOdk fdafha ^fdajamp ku uacuteYd wl=szligka shkakWodyKhlg Navajo Nation Blackfeet Tribeudhdkq weiafgla Native Village of Barrow InupiatTraditional Government Nome Eskimo Communitywdsect jYfhka

Oumlk uacutehUumlkdu iajfoaYSh yjdhs

mssmSk fldszlighdkq iefudajka

wdishdkq bkaEgravehkq cmka pfudafrda

fjka wdishdkq fjka meissla

mdash uacuteYd yenmaa jeishd

wl=szligka shkak mdash uacuteYd

WodyrKhlg wl=szligka shkak mdlsiadkq WodyrKhlg ldiumlfndac fgdxfaka Sethhdkq yafudkaa wdsect udIaia wdsect

jYfhka jYfhka

fjka cdshls mdash cdsh fyda iiumlNjh uacuteYd wl=szligka shkak

tlaia ckmo ixKk ldfrac34hdxYh 6

tla tla wur mqoahd i|yd mYak iiumlmQfrac34K lrkak

my i|yka mYak fol tla tla wur mqoahdfka wikq efiacute

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

fuu mqoahd idudkHfhka fjka iadkhl Ocircja jkafka fyda kjdeka fk isagraveo

wod ishumlu fldgqj il=K fhdokakiexcl

ke

Totilde uacuteoHdh i|yd Totilde uotildemshka fyda fjka

Totilde yuqod mejreula i|yd keoEfhl= iuOtilde

Totilde lshdjla fyda Totilde iD=uh fyda fojk

jHdmdrhla i|yd ksjil

Totilde ida= ksjdihla =lt Totilde isrfhla fyda

nkaOkddrhla =lt

Totilde fjka fya=jla

fjkqfjka

fuu mqoahd 1 fjks mqoahdg ds jQfha flfiao

tla fldgqjl muKla il=K fhdokak

uacutereoaO sxfha iajdntildemqreIhd$igraveszlig|$lhd

uacutereoaO sxsl wuacutejdyl iylre

tlu sxfha iajdntildemqreIhd$igraveszlig|$lhd

iudk sxsl wuacutejdyl yjqalre

OcircjuacuteoHdaul mqd fyda yumlj

yoda mqd fyda yumlj

iqiquest mqd fyda iqiquest yumlj

ifydaorhd fyda ifydaoszligh

mshd fyda uj

uqKqnqrd$ntildeksigraveszligh

lhdfa foudmshka

nEkd fyda fas

fjka kEhka

fkajdisl ntilde=rd fyda l=gqiumlN iOtildehd

(roommate or housemate) yod jvd a orejd

kEhka fkdjk fjka

tlaia ckmo ixKk ldfrac34hdxYh 7

Tn fuu ldfrac34hh wdriumlN lsIacuteug fmr 1 Tnfa mYakdjsh ndfk tys mltuq msgqj fmrkakiexcl

2 bxSis niska hqa m mYakdjsfha Tnfa mspdrh igyka lsIacuteu i|yd fuu isxy

udfrac34fdamfoaYlfha wvx= fdr=re Nduacuted lrkakiexcl Tnfa mslts=re fuu udfrac34f damfoaYlfhys fkdshkakiexcl

3 Tn mltuq mYakh i|yd mslts=re iemhSug fmr my udfrac34fdamfoaY Nduacuted lrntildeka fuu

ksjfia uya ksjfia fyda cxu ksjfia Ocircja jk mqoahska Kka lrkakiexcl

Kka llt hqafa ljqrekao fuu ksjfiaa uya ksjfia fyda cxu ksjfia Ocircja jk mqoahska Kka lrkak(

bull fuys Ocircja jk iy jeauml ldhla

ksod isaacutek ltorejka we=iquestj ishiquestu

mqoahska Kka lrkakiexcl

bull fuu smskfha jeauml ldhla Ocircja

jk iy ksok lsisfjla fkdisagrave kiuml wkafrac34cdh uska mspdr olajkakiexcl

Ocircjaugraveug iaOacuter iadkhla fkduesj isaacutek mqoahskao ixKkhg we=lta uacuteh hq= h(

bull Ocircjaugraveug iaOgraver iadkhla fkdues

hiuml wfhl= 2020 wfmaa ui 1 fjks

Egravek fuys kejS isaacutekafka kiuml tu

mqoahdo Kka lrkakiexcl

ixKk ldfrac34hdxYh uacuteiska wdhkhkays iy wfkl=a iadkjo Kka lsIacuteu mjajhs(

bull 2020 wfmaa ui 1 fjks Egravek ida=

ksjdihl isrfhl nkaOkddrhl |jqiuml myiqliuml imhk iadkhl jeks

iadkhl Ocircjajk lsisfjl= Kka

fkdlrkakiexcl

bull Tjqka uacuteoHdh ida= ksjdih yuqodj isrfh wdEgraveh yerfdia kej fuys

Ocircjaugraveug mentildesbquoha fuu mqoahska

Tnfa mYakdjsfhka bja lrkakiexcl

tfia fkdjqjfyda Tjqka fojrla Kka

flrkq weiexcl

BltOtilde msgqfjys sfnk mYak iy Wmfoia lshjkakiexcl

Tnfa mslts=re fuu udfrac34fdamfoaYlfhys fkdshkakiexcl

tlaia ckmo ixKk ldfrac34hdxYh 3

uqamsgqfotilde sfnk mYak iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

mqoahska ixLHdj

2020 wfmaa ui 1 fjks Egravek fuu ksjfia uya ksjfia fyda cxu

ksjfia mqoahska lS fofkl= ethjaj fyda kejS isaacutefha o

2020 wfmaa ui 1 fjks Egravek Tn mYak wxl 1 g we=lta fkdllt lsishiuml wur mqoahska fuys kejS isaacutefha o

wodlt ishumlu fldgqj il=Kq lrkak

ltuqka kEhka fyda kEhka fkdjk wuml Wmka ltorejka uqKqnqre ntildesbquoigraveszlighka fyda yod jvda ltuqka jeks

kEoEhska jeaumlysaacute ltuqka dshd fyda uacutejdyl kEhka jeks

kEoE fkdjk fkajdisl ntilde=rka fyda fkajdislj ltorejka nd

kakka jeks

fuys djldslj kejS isaacutek mqoahska

wur mqoahska ke

fuu ksji uya ksji fyda cxu ksji mdash

tla fldgqjl muKla il=Kq lrkak

Wlila fyda Khla iuOtilde Tng fyda fuys fjfik hiuml wfhl=g

ysntildeo ksjdi iufldgia Kh we=lta lrkakrsquo

ksoyiaj iy ksrjqaj Tng fyda fuys fjfik hiuml wfhl=g

ysntildeo ^Wlila fyda Khla fkduesjamp

l=shg kq enQfotildeo

l=sh fkdfjd jdih lrhso

yumlrlk wxlh

Tnfa yumlrlk wxlh l=ulao

ixKk ldfrac34hdxYfha ks ldfrac34hhla i|yd wjYH jqjfyda

muKla wms Tnj iiumlnkaO lrksuqiexcl

tlaia ckmo ixKk ldfrac34hdxYh 4

wjika ku

(last name[s]) uqa ku

(frst name)

Egravekh 2020 wfmaa 1 Egravekg

jhi wjqreyumljska

2 fjks msgqfjys jiumlmi sfnk mYak iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

lreKdlr fuys Ocircjajk tla tla mqoahd i|yd fdr=re

imhkakiexcl fuu ksflakh wha fyda fuys l=sh fjk hiuml

wfhla fuys Ocircja jkafka kiuml Tyq fyda weh 1 fjks mqoahd

jYfhka ehsia= lr wdriumlN lrkakiexcl whsslre fyda l=sh

fjk mqoahd fuys Ocircja fkdjkafka kiuml fuys Ocircja jk

acutekEu jeaumlysaacutefhl= 1 fjks mqoahd jYfhka ehsia= lr

wdriumlN lrkakiexcl

1 fjks mqoahdfa ku l=ulao

lreKdlr 1 fjks mqoahdfa ku bxSis NdYdfjka shkakiexcl

ueo ku ^uqa wl=ramp

(middle initial)

Wmka

jfrac34Ih

1 fjks mqoahdfa sxslajh l=ula otla fldgqjla muKla iltl=Kq lrkakiexcl

msszligntilde eyeKq

1 fjks mqoahdfa jhi l=ulao iy 1 fjks mqoahdfa Wmka Egravekhl=ulao

jhi jfrac34I 1 g jvd wvq ltorejka i|yd jhi udijska

fkdshkakiexcl jhi wjqreyuml 0 fi shkakiexcl

1 fjks mqoahd iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqawfhlao

ke iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqa wfhl=

fkdfotilde

Totilde fulaisldkq fulaisldkq weuszligldkq Ntildeldfkda

Totilde mqjfgda szligflda

Totilde lshqndkq

Totilde fjka iamd[a[ ska fyda iamd[a[ iiumlNjhlska hq=

wfhls mdash uacuteYd wl=szligka shkak WodyrKhlg ieajfodarfvdntildekslka fldfltdiumligravehdkq ajduddkq iamd[a[blajfodar wdsect jYfhka

tlaia ckmo ixKk ldfrac34hdxYh 5

udih

2 fjks msgqfjys ol=Kqmi sfnk mYakh iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

1 fjks mqoahdfa cdsh l=ulao

tla fldgqjl fyda jeauml Kkl il=K fhdokak iy iiumlNjh

uacuteYd wl=szligka shkak

iqyuml mdash uacuteYd wl=szligka shkak WodyrKhlg cfrac34udkqwhfrac34ka bxSis bds fnkka Bethma= wdsect jYfhka

liquest fyda wmsldkq wefuszligldkq mdash uacuteYd wl=szligka shkakWodyrKhlg wmsldkq wefuszligldkq cefuhsldkq yhsaacutekhsOcircszlighdkq bsfhdamshdkq fidaudshdkq wdsect jYfhka

wefuszligldkq bkaEgravehdkq fyda weialdkq cdsl mdash shdmEgravexNtilde

fyda mOdk fdafha ^fdajamp ku uacuteYd wl=szligka shkakWodyKhlg Navajo Nation Blackfeet Tribeudhdkq weiafgla Native Village of Barrow InupiatTraditional Government Nome Eskimo Communitywdsect jYfhka

Oumlk uacutehUumlkdu iajfoaYSh yjdhs

mssmSk fldszlighdkq iefudajka

wdishdkq bkaEgravehkq cmka pfudafrda

fjka wdishdkq fjka meissla

mdash uacuteYd yenmaa jeishd

wl=szligka shkak mdash uacuteYd

WodyrKhlg wl=szligka shkak mdlsiadkq WodyrKhlg ldiumlfndac fgdxfaka Sethhdkq yafudkaa wdsect udIaia wdsect

jYfhka jYfhka

fjka cdshls mdash cdsh fyda iiumlNjh uacuteYd wl=szligka shkak

tlaia ckmo ixKk ldfrac34hdxYh 6

tla tla wur mqoahd i|yd mYak iiumlmQfrac34K lrkak

my i|yka mYak fol tla tla wur mqoahdfka wikq efiacute

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

fuu mqoahd idudkHfhka fjka iadkhl Ocircja jkafka fyda kjdeka fk isagraveo

wod ishumlu fldgqj il=K fhdokakiexcl

ke

Totilde uacuteoHdh i|yd Totilde uotildemshka fyda fjka

Totilde yuqod mejreula i|yd keoEfhl= iuOtilde

Totilde lshdjla fyda Totilde iD=uh fyda fojk

jHdmdrhla i|yd ksjil

Totilde ida= ksjdihla =lt Totilde isrfhla fyda

nkaOkddrhla =lt

Totilde fjka fya=jla

fjkqfjka

fuu mqoahd 1 fjks mqoahdg ds jQfha flfiao

tla fldgqjl muKla il=K fhdokak

uacutereoaO sxfha iajdntildemqreIhd$igraveszlig|$lhd

uacutereoaO sxsl wuacutejdyl iylre

tlu sxfha iajdntildemqreIhd$igraveszlig|$lhd

iudk sxsl wuacutejdyl yjqalre

OcircjuacuteoHdaul mqd fyda yumlj

yoda mqd fyda yumlj

iqiquest mqd fyda iqiquest yumlj

ifydaorhd fyda ifydaoszligh

mshd fyda uj

uqKqnqrd$ntildeksigraveszligh

lhdfa foudmshka

nEkd fyda fas

fjka kEhka

fkajdisl ntilde=rd fyda l=gqiumlN iOtildehd

(roommate or housemate) yod jvd a orejd

kEhka fkdjk fjka

tlaia ckmo ixKk ldfrac34hdxYh 7

uqamsgqfotilde sfnk mYak iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

mqoahska ixLHdj

2020 wfmaa ui 1 fjks Egravek fuu ksjfia uya ksjfia fyda cxu

ksjfia mqoahska lS fofkl= ethjaj fyda kejS isaacutefha o

2020 wfmaa ui 1 fjks Egravek Tn mYak wxl 1 g we=lta fkdllt lsishiuml wur mqoahska fuys kejS isaacutefha o

wodlt ishumlu fldgqj il=Kq lrkak

ltuqka kEhka fyda kEhka fkdjk wuml Wmka ltorejka uqKqnqre ntildesbquoigraveszlighka fyda yod jvda ltuqka jeks

kEoEhska jeaumlysaacute ltuqka dshd fyda uacutejdyl kEhka jeks

kEoE fkdjk fkajdisl ntilde=rka fyda fkajdislj ltorejka nd

kakka jeks

fuys djldslj kejS isaacutek mqoahska

wur mqoahska ke

fuu ksji uya ksji fyda cxu ksji mdash

tla fldgqjl muKla il=Kq lrkak

Wlila fyda Khla iuOtilde Tng fyda fuys fjfik hiuml wfhl=g

ysntildeo ksjdi iufldgia Kh we=lta lrkakrsquo

ksoyiaj iy ksrjqaj Tng fyda fuys fjfik hiuml wfhl=g

ysntildeo ^Wlila fyda Khla fkduesjamp

l=shg kq enQfotildeo

l=sh fkdfjd jdih lrhso

yumlrlk wxlh

Tnfa yumlrlk wxlh l=ulao

ixKk ldfrac34hdxYfha ks ldfrac34hhla i|yd wjYH jqjfyda

muKla wms Tnj iiumlnkaO lrksuqiexcl

tlaia ckmo ixKk ldfrac34hdxYh 4

wjika ku

(last name[s]) uqa ku

(frst name)

Egravekh 2020 wfmaa 1 Egravekg

jhi wjqreyumljska

2 fjks msgqfjys jiumlmi sfnk mYak iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

lreKdlr fuys Ocircjajk tla tla mqoahd i|yd fdr=re

imhkakiexcl fuu ksflakh wha fyda fuys l=sh fjk hiuml

wfhla fuys Ocircja jkafka kiuml Tyq fyda weh 1 fjks mqoahd

jYfhka ehsia= lr wdriumlN lrkakiexcl whsslre fyda l=sh

fjk mqoahd fuys Ocircja fkdjkafka kiuml fuys Ocircja jk

acutekEu jeaumlysaacutefhl= 1 fjks mqoahd jYfhka ehsia= lr

wdriumlN lrkakiexcl

1 fjks mqoahdfa ku l=ulao

lreKdlr 1 fjks mqoahdfa ku bxSis NdYdfjka shkakiexcl

ueo ku ^uqa wl=ramp

(middle initial)

Wmka

jfrac34Ih

1 fjks mqoahdfa sxslajh l=ula otla fldgqjla muKla iltl=Kq lrkakiexcl

msszligntilde eyeKq

1 fjks mqoahdfa jhi l=ulao iy 1 fjks mqoahdfa Wmka Egravekhl=ulao

jhi jfrac34I 1 g jvd wvq ltorejka i|yd jhi udijska

fkdshkakiexcl jhi wjqreyuml 0 fi shkakiexcl

1 fjks mqoahd iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqawfhlao

ke iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqa wfhl=

fkdfotilde

Totilde fulaisldkq fulaisldkq weuszligldkq Ntildeldfkda

Totilde mqjfgda szligflda

Totilde lshqndkq

Totilde fjka iamd[a[ ska fyda iamd[a[ iiumlNjhlska hq=

wfhls mdash uacuteYd wl=szligka shkak WodyrKhlg ieajfodarfvdntildekslka fldfltdiumligravehdkq ajduddkq iamd[a[blajfodar wdsect jYfhka

tlaia ckmo ixKk ldfrac34hdxYh 5

udih

2 fjks msgqfjys ol=Kqmi sfnk mYakh iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

1 fjks mqoahdfa cdsh l=ulao

tla fldgqjl fyda jeauml Kkl il=K fhdokak iy iiumlNjh

uacuteYd wl=szligka shkak

iqyuml mdash uacuteYd wl=szligka shkak WodyrKhlg cfrac34udkqwhfrac34ka bxSis bds fnkka Bethma= wdsect jYfhka

liquest fyda wmsldkq wefuszligldkq mdash uacuteYd wl=szligka shkakWodyrKhlg wmsldkq wefuszligldkq cefuhsldkq yhsaacutekhsOcircszlighdkq bsfhdamshdkq fidaudshdkq wdsect jYfhka

wefuszligldkq bkaEgravehdkq fyda weialdkq cdsl mdash shdmEgravexNtilde

fyda mOdk fdafha ^fdajamp ku uacuteYd wl=szligka shkakWodyKhlg Navajo Nation Blackfeet Tribeudhdkq weiafgla Native Village of Barrow InupiatTraditional Government Nome Eskimo Communitywdsect jYfhka

Oumlk uacutehUumlkdu iajfoaYSh yjdhs

mssmSk fldszlighdkq iefudajka

wdishdkq bkaEgravehkq cmka pfudafrda

fjka wdishdkq fjka meissla

mdash uacuteYd yenmaa jeishd

wl=szligka shkak mdash uacuteYd

WodyrKhlg wl=szligka shkak mdlsiadkq WodyrKhlg ldiumlfndac fgdxfaka Sethhdkq yafudkaa wdsect udIaia wdsect

jYfhka jYfhka

fjka cdshls mdash cdsh fyda iiumlNjh uacuteYd wl=szligka shkak

tlaia ckmo ixKk ldfrac34hdxYh 6

tla tla wur mqoahd i|yd mYak iiumlmQfrac34K lrkak

my i|yka mYak fol tla tla wur mqoahdfka wikq efiacute

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

fuu mqoahd idudkHfhka fjka iadkhl Ocircja jkafka fyda kjdeka fk isagraveo

wod ishumlu fldgqj il=K fhdokakiexcl

ke

Totilde uacuteoHdh i|yd Totilde uotildemshka fyda fjka

Totilde yuqod mejreula i|yd keoEfhl= iuOtilde

Totilde lshdjla fyda Totilde iD=uh fyda fojk

jHdmdrhla i|yd ksjil

Totilde ida= ksjdihla =lt Totilde isrfhla fyda

nkaOkddrhla =lt

Totilde fjka fya=jla

fjkqfjka

fuu mqoahd 1 fjks mqoahdg ds jQfha flfiao

tla fldgqjl muKla il=K fhdokak

uacutereoaO sxfha iajdntildemqreIhd$igraveszlig|$lhd

uacutereoaO sxsl wuacutejdyl iylre

tlu sxfha iajdntildemqreIhd$igraveszlig|$lhd

iudk sxsl wuacutejdyl yjqalre

OcircjuacuteoHdaul mqd fyda yumlj

yoda mqd fyda yumlj

iqiquest mqd fyda iqiquest yumlj

ifydaorhd fyda ifydaoszligh

mshd fyda uj

uqKqnqrd$ntildeksigraveszligh

lhdfa foudmshka

nEkd fyda fas

fjka kEhka

fkajdisl ntilde=rd fyda l=gqiumlN iOtildehd

(roommate or housemate) yod jvd a orejd

kEhka fkdjk fjka

tlaia ckmo ixKk ldfrac34hdxYh 7

wjika ku

(last name[s]) uqa ku

(frst name)

Egravekh 2020 wfmaa 1 Egravekg

jhi wjqreyumljska

2 fjks msgqfjys jiumlmi sfnk mYak iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

lreKdlr fuys Ocircjajk tla tla mqoahd i|yd fdr=re

imhkakiexcl fuu ksflakh wha fyda fuys l=sh fjk hiuml

wfhla fuys Ocircja jkafka kiuml Tyq fyda weh 1 fjks mqoahd

jYfhka ehsia= lr wdriumlN lrkakiexcl whsslre fyda l=sh

fjk mqoahd fuys Ocircja fkdjkafka kiuml fuys Ocircja jk

acutekEu jeaumlysaacutefhl= 1 fjks mqoahd jYfhka ehsia= lr

wdriumlN lrkakiexcl

1 fjks mqoahdfa ku l=ulao

lreKdlr 1 fjks mqoahdfa ku bxSis NdYdfjka shkakiexcl

ueo ku ^uqa wl=ramp

(middle initial)

Wmka

jfrac34Ih

1 fjks mqoahdfa sxslajh l=ula otla fldgqjla muKla iltl=Kq lrkakiexcl

msszligntilde eyeKq

1 fjks mqoahdfa jhi l=ulao iy 1 fjks mqoahdfa Wmka Egravekhl=ulao

jhi jfrac34I 1 g jvd wvq ltorejka i|yd jhi udijska

fkdshkakiexcl jhi wjqreyuml 0 fi shkakiexcl

1 fjks mqoahd iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqawfhlao

ke iamd[a[ ska fyda iamd[a[ iiumlNjhlska hqa wfhl=

fkdfotilde

Totilde fulaisldkq fulaisldkq weuszligldkq Ntildeldfkda

Totilde mqjfgda szligflda

Totilde lshqndkq

Totilde fjka iamd[a[ ska fyda iamd[a[ iiumlNjhlska hq=

wfhls mdash uacuteYd wl=szligka shkak WodyrKhlg ieajfodarfvdntildekslka fldfltdiumligravehdkq ajduddkq iamd[a[blajfodar wdsect jYfhka

tlaia ckmo ixKk ldfrac34hdxYh 5

udih

2 fjks msgqfjys ol=Kqmi sfnk mYakh iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

1 fjks mqoahdfa cdsh l=ulao

tla fldgqjl fyda jeauml Kkl il=K fhdokak iy iiumlNjh

uacuteYd wl=szligka shkak

iqyuml mdash uacuteYd wl=szligka shkak WodyrKhlg cfrac34udkqwhfrac34ka bxSis bds fnkka Bethma= wdsect jYfhka

liquest fyda wmsldkq wefuszligldkq mdash uacuteYd wl=szligka shkakWodyrKhlg wmsldkq wefuszligldkq cefuhsldkq yhsaacutekhsOcircszlighdkq bsfhdamshdkq fidaudshdkq wdsect jYfhka

wefuszligldkq bkaEgravehdkq fyda weialdkq cdsl mdash shdmEgravexNtilde

fyda mOdk fdafha ^fdajamp ku uacuteYd wl=szligka shkakWodyKhlg Navajo Nation Blackfeet Tribeudhdkq weiafgla Native Village of Barrow InupiatTraditional Government Nome Eskimo Communitywdsect jYfhka

Oumlk uacutehUumlkdu iajfoaYSh yjdhs

mssmSk fldszlighdkq iefudajka

wdishdkq bkaEgravehkq cmka pfudafrda

fjka wdishdkq fjka meissla

mdash uacuteYd yenmaa jeishd

wl=szligka shkak mdash uacuteYd

WodyrKhlg wl=szligka shkak mdlsiadkq WodyrKhlg ldiumlfndac fgdxfaka Sethhdkq yafudkaa wdsect udIaia wdsect

jYfhka jYfhka

fjka cdshls mdash cdsh fyda iiumlNjh uacuteYd wl=szligka shkak

tlaia ckmo ixKk ldfrac34hdxYh 6

tla tla wur mqoahd i|yd mYak iiumlmQfrac34K lrkak

my i|yka mYak fol tla tla wur mqoahdfka wikq efiacute

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

fuu mqoahd idudkHfhka fjka iadkhl Ocircja jkafka fyda kjdeka fk isagraveo

wod ishumlu fldgqj il=K fhdokakiexcl

ke

Totilde uacuteoHdh i|yd Totilde uotildemshka fyda fjka

Totilde yuqod mejreula i|yd keoEfhl= iuOtilde

Totilde lshdjla fyda Totilde iD=uh fyda fojk

jHdmdrhla i|yd ksjil

Totilde ida= ksjdihla =lt Totilde isrfhla fyda

nkaOkddrhla =lt

Totilde fjka fya=jla

fjkqfjka

fuu mqoahd 1 fjks mqoahdg ds jQfha flfiao

tla fldgqjl muKla il=K fhdokak

uacutereoaO sxfha iajdntildemqreIhd$igraveszlig|$lhd

uacutereoaO sxsl wuacutejdyl iylre

tlu sxfha iajdntildemqreIhd$igraveszlig|$lhd

iudk sxsl wuacutejdyl yjqalre

OcircjuacuteoHdaul mqd fyda yumlj

yoda mqd fyda yumlj

iqiquest mqd fyda iqiquest yumlj

ifydaorhd fyda ifydaoszligh

mshd fyda uj

uqKqnqrd$ntildeksigraveszligh

lhdfa foudmshka

nEkd fyda fas

fjka kEhka

fkajdisl ntilde=rd fyda l=gqiumlN iOtildehd

(roommate or housemate) yod jvd a orejd

kEhka fkdjk fjka

tlaia ckmo ixKk ldfrac34hdxYh 7

2 fjks msgqfjys ol=Kqmi sfnk mYakh iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

1 fjks mqoahdfa cdsh l=ulao

tla fldgqjl fyda jeauml Kkl il=K fhdokak iy iiumlNjh

uacuteYd wl=szligka shkak

iqyuml mdash uacuteYd wl=szligka shkak WodyrKhlg cfrac34udkqwhfrac34ka bxSis bds fnkka Bethma= wdsect jYfhka

liquest fyda wmsldkq wefuszligldkq mdash uacuteYd wl=szligka shkakWodyrKhlg wmsldkq wefuszligldkq cefuhsldkq yhsaacutekhsOcircszlighdkq bsfhdamshdkq fidaudshdkq wdsect jYfhka

wefuszligldkq bkaEgravehdkq fyda weialdkq cdsl mdash shdmEgravexNtilde

fyda mOdk fdafha ^fdajamp ku uacuteYd wl=szligka shkakWodyKhlg Navajo Nation Blackfeet Tribeudhdkq weiafgla Native Village of Barrow InupiatTraditional Government Nome Eskimo Communitywdsect jYfhka

Oumlk uacutehUumlkdu iajfoaYSh yjdhs

mssmSk fldszlighdkq iefudajka

wdishdkq bkaEgravehkq cmka pfudafrda

fjka wdishdkq fjka meissla

mdash uacuteYd yenmaa jeishd

wl=szligka shkak mdash uacuteYd

WodyrKhlg wl=szligka shkak mdlsiadkq WodyrKhlg ldiumlfndac fgdxfaka Sethhdkq yafudkaa wdsect udIaia wdsect

jYfhka jYfhka

fjka cdshls mdash cdsh fyda iiumlNjh uacuteYd wl=szligka shkak

tlaia ckmo ixKk ldfrac34hdxYh 6

tla tla wur mqoahd i|yd mYak iiumlmQfrac34K lrkak

my i|yka mYak fol tla tla wur mqoahdfka wikq efiacute

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

fuu mqoahd idudkHfhka fjka iadkhl Ocircja jkafka fyda kjdeka fk isagraveo

wod ishumlu fldgqj il=K fhdokakiexcl

ke

Totilde uacuteoHdh i|yd Totilde uotildemshka fyda fjka

Totilde yuqod mejreula i|yd keoEfhl= iuOtilde

Totilde lshdjla fyda Totilde iD=uh fyda fojk

jHdmdrhla i|yd ksjil

Totilde ida= ksjdihla =lt Totilde isrfhla fyda

nkaOkddrhla =lt

Totilde fjka fya=jla

fjkqfjka

fuu mqoahd 1 fjks mqoahdg ds jQfha flfiao

tla fldgqjl muKla il=K fhdokak

uacutereoaO sxfha iajdntildemqreIhd$igraveszlig|$lhd

uacutereoaO sxsl wuacutejdyl iylre

tlu sxfha iajdntildemqreIhd$igraveszlig|$lhd

iudk sxsl wuacutejdyl yjqalre

OcircjuacuteoHdaul mqd fyda yumlj

yoda mqd fyda yumlj

iqiquest mqd fyda iqiquest yumlj

ifydaorhd fyda ifydaoszligh

mshd fyda uj

uqKqnqrd$ntildeksigraveszligh

lhdfa foudmshka

nEkd fyda fas

fjka kEhka

fkajdisl ntilde=rd fyda l=gqiumlN iOtildehd

(roommate or housemate) yod jvd a orejd

kEhka fkdjk fjka

tlaia ckmo ixKk ldfrac34hdxYh 7

tla tla wur mqoahd i|yd mYak iiumlmQfrac34K lrkak

my i|yka mYak fol tla tla wur mqoahdfka wikq efiacute

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

fuu mqoahd idudkHfhka fjka iadkhl Ocircja jkafka fyda kjdeka fk isagraveo

wod ishumlu fldgqj il=K fhdokakiexcl

ke

Totilde uacuteoHdh i|yd Totilde uotildemshka fyda fjka

Totilde yuqod mejreula i|yd keoEfhl= iuOtilde

Totilde lshdjla fyda Totilde iD=uh fyda fojk

jHdmdrhla i|yd ksjil

Totilde ida= ksjdihla =lt Totilde isrfhla fyda

nkaOkddrhla =lt

Totilde fjka fya=jla

fjkqfjka

fuu mqoahd 1 fjks mqoahdg ds jQfha flfiao

tla fldgqjl muKla il=K fhdokak

uacutereoaO sxfha iajdntildemqreIhd$igraveszlig|$lhd

uacutereoaO sxsl wuacutejdyl iylre

tlu sxfha iajdntildemqreIhd$igraveszlig|$lhd

iudk sxsl wuacutejdyl yjqalre

OcircjuacuteoHdaul mqd fyda yumlj

yoda mqd fyda yumlj

iqiquest mqd fyda iqiquest yumlj

ifydaorhd fyda ifydaoszligh

mshd fyda uj

uqKqnqrd$ntildeksigraveszligh

lhdfa foudmshka

nEkd fyda fas

fjka kEhka

fkajdisl ntilde=rd fyda l=gqiumlN iOtildehd

(roommate or housemate) yod jvd a orejd

kEhka fkdjk fjka

tlaia ckmo ixKk ldfrac34hdxYh 7

Tn mqoahska 6 fofkl=g jvd Kka lflta kiuml msgq wxl8 iiumlmQfrac34K lrkak

Tnfa mslts=re fuu udfrac34fdamfoaYlh u fkdshkak

1 fjks mqoahdg ds o

Totilde ke

2020 wfmaa

1 Egravekg jhi

wjqreyumljska

udih Egravekh msszligntilde eyeKq Wmka jfrac34Ih

wjika ku

(last name[s]) uqa ku

(frst name) ueo ku ^uqa wl=ramp

(middle initial)

lreKdlr iiumlmQfrac34K lrk o bxSis niska hqa mYakdjsh Tn fj imhk o emea

dia=-fjQ shqiuml ljrfha nyd emea lrkakrsquo

2020 ixKkhiEuuacutegu myiqh

wkafrac34cdh yryd mspdr oelauacuteh yels nj Tn okafkys o

2020 ixKkh Tng wkafrac34cdh yryd

iiumlmQfrac34K llt yels kiuml mYakdjsfha uqoslashKh lr

wes URL tl fj msuacutefikak

2020 ixKkh wkafrac34cdh yryd iiumlmQfrac34K lsIacuteu i|ydugraveaumlfhda udfrac34fdamfoaYlh my fjiacute wvuacutefhka nd yelsh

2020censusgovlanguages

D-G (sin) Sinhala

tlaia ckmo ixKk ldfrac34hdxYh 8