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Census Info rmation Sheet — CONFIDENTIAL <br />Please complete the attached survey and return it with your annexation application. It is not necessary to <br />include the names of all individuals. Addresses and number of people living at each address is essential and sex <br />and age information is helpful. If you have any questions, please contact the Planning Department at 541 -682- <br />5377. <br />City of Eugene Address: J �y I roc l D 0,1 ?—'e) <br />HOUSING TYPE TENURE <br />Single Unit Structure (K) Owner - Occupied <br />Multiple Unit Structure ( ) Renter - Occupied ( ) <br />Trailer or Mobile Home ( ) Vacant <br />Seasonal ( ) <br />RESIDENTS <br />Respondent <br />2. <br />Last Name <br />First Name <br />Sex Age <br />3. <br />4. <br />61 <br />6. <br />7. <br />8. <br />9. <br />10. <br />Portland State University School of Urban and Public Affairs <br />Center for Populat Research and Census (503) 725 -3922 <br />