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4132 , <br /> OMB No. 0607-0795 <br /> FORM D•1670 U.S. DEPARTMENT OF COMMERCE ENTITY ID <br /> (6-12-20W) Economics and Statistics Administratioo <br /> U.S. CENSUS BUREAU <br /> PARTICIPATION OPTION/PRODUCT PREFERENCE <br /> LOCAL UPDATE OF CENSUS ADDRESSES (LUCA) PROGRQM PL1718823 <br /> 2010 Decennial Census <br /> i. Government name- Please Prin# Telephone number <br /> L I T Y 0 � �C. C�'( U 1Z Area code Number <br /> 2 t - �{- 2 � - 2 �- '�- � <br /> Number and street name <br /> 2. Delivery I ��R� k ��D�l'Lso Iy �LA�� <br /> address" City State ZIP Code <br /> j]�Ga-r �� � 1 L � 6'�.S 2 3 <br /> The MAF/TIGER Partnership Software (MTPS) application combines the Census Bureau's Address List <br /> (option 1 and option 2), Address Count List, and shapefiie into a GIS software package. <br /> if you have 6000 or more addresses, you can receive the Address List and Address Count List in <br /> computer-readable format oniy. Computer-readabie versions of the lists are available on CD-ROM. <br /> The paper printout of the Address List contains six (6) addresses per page; the Address Count List contains <br /> 50 census blocks per page. <br /> Please mark (X) one participation option, then select a media choice for that participation option. <br /> • • • Titie 13 Full Address List Review <br /> Signed Confidentiality Agreement Form required by law. <br /> Media Choice - Mark (X) one. <br /> ❑ MTPS application - Computer-readable Address List, Address Count List, and shapefiles <br /> ❑ All computer-readable - Address List, Address Count List, and shapefiles on CD-ROM <br /> ❑ All paper-Address List, Address Count List, and paper maps-Mark (X) only vne address list sort. <br /> ❑ Census Tract#/Block#/Street Name/House#/Unit# (default sort) <br /> ❑ Street Name/House#/Unit# (alphanumeric sort) <br /> ❑Combina#ion A- Computer-readable Address List and Address Count List on CD-ROM and <br /> paper maps <br /> ❑ Combination B -Paper Address List and paper Address Count List; and shapefiles on CD-ROM <br /> Mark (X) only one address list sort. <br /> ❑ Census Tract#/Block#/Street Name/House#/Unit# (default sort} <br /> ❑ Street Name/House#/Unit# (alphanumeric sort) <br /> • - • Title 13 Local Address List Submission <br /> Signed Confidentiality Agreement Form required by law. <br /> Media Choice - Mark (X) one. <br /> ❑ MTPS application - Computer-readable Address List, Address Count List, and shapefiles <br /> � All computer-readable -Address List, Address Count List, and shapefiles on CD-ROM <br /> ❑ Combination - Computer-readable Address List and Address Count List on CD-ROM and <br /> paper maps <br /> • � • Non-Title 13 Local Address List Submission <br /> Confidentia/ity Agreement is nof required. <br /> Media Choice - Mark (X) one. <br /> ❑ MTPS application - Computer-readable Address Count List and shapefiiles <br /> ❑ All computer-readable -Address Count List and shapefiles on CD-ROM <br /> ❑ Combination - Computer-readable Address Count List on CD-ROM and paper maps <br /> "The Census Bureau will ship all materia►s via FedEx, <br /> FedEx will not deliver to PO ZIP Codes. <br /> USCENSUSBUREAU <br />