us department of commerce economics and statistics administration census bureau form ps 54193 02 06 2007 economic classification omb no 0607 0934 approval expires 12 31 2008 penalty for failure to report uscensusbureau continue on page 2 54193016 due date february mail your completed 1201 east 10th street jeffersonville in 47134 0001 need help or have questions about filling out this visit www gov econhelp write the address above include 11 digit file number cfn printed mailing please correct any errors response is required by law title 13 united states code requires businesses other organizations that receive questionnaire answer return same confidential it may be seen only persons sworn uphold confidentiality information used statistical purposes further copies retained respondents files are immune from legal process use blue black ballpoint pen do not pencil felt tip place an x
