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CAG2019-515 - Original - U.S. Depatment of Commerce - United States Census 2020: Census Local Update of Sensus Addresses Operation (LUCA) - 08/19/2019
ENT OF CO QPQ�a� �y�9 UNITED STATES DEPARTMENT OF COMMERCE a" m Economics and Statistics Administration D-228o U.S. Census Bureau (04-01-2019) c Washington, DC 20233 0001 STATES OF P PL5335415 Kent city SEQ001-004801 Jimmie Cordova GIS Analyst Public Works- Engineering - GIS 220 4th Ave S Kent, WA 98032-5895 The U.S. Census Bureau expects to ship the 2020 Census Local Update of Census Addresses Operation (LUCA) feedback materials soon. Participants can expect to receive the Feedback Phase materials within the next two weeks. To ensure security, the Title 13 protected data are contained in encrypted, self extracting file(s). The Title 13 data includes the digital version of the Detailed Feedback Address List and the PDF small format block maps. To open these files, enter the case sensitive password shown below. The "FB Read mefirst#.txt" file included on the DVD(s) with the materials includes a list of files and instructions for opening. In addition, the Quick Start Guide also includes guidance for opening the digital materials. If the LUCA Feedback Phase materials are not received within the next two weeks'or if problems are encountered while opening any of the materials on the DVD(s), please call 1-844-344-0169, or email us at GEO.2020.LUCA@census.gov. Your Password is: United States Census census.gov 2020 ,._E;...;.�. �•-E. 711 yT._E;..;.�r,n., �'•:E;..;.�r.n., �T•.E;.,�•• 'Yr`tii,tiG%--X►�7?: -y(' + �.r� •E �••r A_ •t+•:4_ ti:"`fi:rh_ ti+ri4_ A:"�l:rA_ +. +r- +r + n 'Ti"K•-K ,7•. -yr,-'� :4 Il::'-Yit•.rA. '1, `t_ A:�'ii.rA_ 'S, i4_ 1�:�-Yi•:rA. •t,•i4_ `ie'•1'. :K.7•„ •Yr'►i•�G%%K�7•w`�•'yr-1;•yG%%K�77: 'Y�• r. i.�. •T;•y:%K•�7.'� 'Yl• :% �.•• ,% r.�. ;�..���'>:,Y' � •A� ..•� >:�:.,�.�A%`'�`,i^;.SY-i. :.:{;-:A `i'•}I;�• �:`i:�A `i-.�;i. :r?{'�-:A�;., i. :•�`t;:/L>�;.`.i-.}I;i. ._.�-':11�;.`,i�.}Y>• ":`�:'�A�;.`,i-.�;i. j';•ti'Js • �..;tS�'Ss r•'Y•..'j'•iti'4s�: ••'.j'lt1:'9•"�: ••'.. 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O.O 1 4 � � •i1 i• 1 OMB No. 0607-0994: Approval Expires 12/31/2019 FORM D-2014(6) U.S. DEPARTMENT OF COMMERCE ECONOMICS AND STATISTICS ADMINISTRATION (02/08/2018) U.S. CENSUS BUREAU Entity ID 2020 CENSUS LOCAL UPDATE OF CENSUS PL5335415 ADDRESSES OPERATION (LUCA) Government Name PACKING SLIP Kent city The U.S. Census Bureau is providing the following materials for the 2020 Census Local Update of Census Addresses Operation(LUCA). If you are missing materials, or have any questions regarding these materials, please contact us via email at GEO.2020.WCA@census.gov, or by phone at 1-844-344-0169. f D-2014(6) — Packing Slip D-2040 — Digital Quick Start Guide D-2042 — GUPS Quick Start Guide L1� Title 13 Disk - 2020WCA_<EntitylD>_DISK1 of2.exe; Address List D-2015 — WCA Block Insert LJ Non Title 13 Disk - Readmefirst6.txt - 202OWCA_<EntitylD>_DISK2of2.exe - Partnership Shapefiles - Address Count List; 202OWCA_<EntitylD>_address_countlist.csv - Digital Respondent Guide.pdf; D-2032 - GUPS Respondent Guide.pdf; D-2033 - 2020WCA_header_file.txt - WCA20_inventory.pdf; D-2011 Geographic Update Partnership Software (GUPS) Disk /�/b-2079 — No Updates or Changes in Addresses Form D-2011 — Inventory Form D-2012 — Destruction or Return Form fFed Ex return label(s) for package(s) f Two Postage-Paid Return Envelopes for D-2012 or D-2079 seq-05155 D-2015 (2/2018) Attention: During your LUCA review, you may discover census blocks missing from your LUCA products. Why? Though all of the residential addresses that are intended to be in the 2020 Census are included in your LUCA products, some census blocks may be excluded from your address products for the following reasons: I. Census blocks in military reservations: The LUCA materials do not contain residential addresses within military installations.The Department of Defense provides the enumeration numbers to the Census Bureau for those persons living on military bases. The Census Bureau does not canvass or mail to addresses on military installations. Therefore, there is no need to include these blocks as part of the LUCA review. 2. Census blocks where the Census Bureau has only residential addresses that are both undeliverable and un-locatable: Residential addresses that the Census Bureau cannot mail or hand deliver questionnaires are not included in the 2020 Census. Census blocks that contain these types of addresses are excluded from our LUCA address list. LUCA partners may add residential addresses on the Census address list in these blocks. seq-05155 �0"AX OF�.O% UNITED STATES DEPARTMENT OF COMMERCE D-2080 ode yF,m Economics and Statistics Administration t12-2017) U.S. Census Bureau i a Washington, DC 20233-0001 e �O STATES Of PL5335415 Kent city Jimmie Cordova GIS Analyst Public Works - Engineering - GIS 220 4th Ave S Kent WA 98032-5895 Your 2020 Census Local Update of Census Addresses Operation (LUCA) materials should arrive within the next two weeks. To ensure security, the U.S. Census Bureau's Title 13 data are contained in an encrypted, self- extracting file. These include the digital address list and any maps containing map spots. To open these files, you must enter the case sensitive password shown below. The Readmefirst file, included on the DVD with your Title 13 materials, includes a list of files and instructions for opening the files. If you choose to submit YOU.- updated LUCA materials via the Secure Web Incoming Module (SWIM), you will need a SWIM account. If y( u currently have a SWIM account, you can use it to submit your WCA updates. If you do not have a SWIM account, use the SWIM token shown below to create an account. Refer to the chapter "Submitting Your Updated Materials" found in your 2020 Census Local Update of Census Addresses Operation (LUCA) Respondent Guide or instructions on registering for your SWIM account. If you do not receive your I-UCA_materials_within the next two-weeks, if you encounter any problems op_eninq your digital address list file, call 1-844-344-0169, or email us at <GEO.2020.WCA@ census.gov>. 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FORM D-2201 U.S. DEPARTMENT OF COMMERCE ECONOMICS AND STATISTICS ADMINISTRATION (03/26/2019) U.S.CENSUS BUREAU OMB NO.0607-0994 Approval Expires 12/31/2019 2020 CENSUS LOCAL UPDATE OF CENSUS ADDRESSES OPERATION (LUCA) FEEDBACK ADDRESS UPDATE SUMMARY REPORT Entity ID: PL5335415 Entity Name: Kent city Date: 7/30/2019 A. SUBMITTED ADDRESSES 8022 Total number of address records submitted to the Census Bureau. 7979 Total number of submitted address records processed by the Census Bureau. 43 Total number of submitted address records not processed by the Census Bureau.' B. ADDRESS RECORDS PROCESSED Participant Action(s) Accepted 3008 Number of added (A) address records submitted and added to the Census Address List. 3409 Number of corrected (C) address records submitted and corrected in the Census Address List. 163 Number of deleted (D) address records submitted and deleted from the Census Address List. 0 Number of out of jurisdiction (J) address records submitted and removed from your jurisdiction's portion of the Census Address List. 1 Number of nonresidential (N) address records submitted and removed from the residential portion of the Census Address List. 6581 Total number of submitted address records accepted by the Census Bureau as requested. Participant Action(s) Not Accepted 3 Number of added (A) address records submitted, but not added to the Census Address List. 0 Number of corrected (C) address records submitted, but not corrected in the Census Address List. 1388 Number of deleted (D) address records submitted, but not deleted from the Census Address List. 2 Number of out of jurisdiction (J) address records submitted, but not removed from your jurisdiction's portion of the Census Address List. 2 Number of nonresidential (N) address records submitted, but not removed from the residential portion of the Census Address List. 1398 Total number of submitted address records not accepted by the Census Bureau as requested. C. OTHER ADDRESS RECORDS 15 Number of address records without action taken during the LUCA Review Phase that were deleted from the Census Address List by another LUCA participant or a different census operation. This number corresponds to the number of X01 records on your Detailed Feedback Address List. ' Participant address records were not processed if they did not meet the minimum requirements. Some examples of records that were not processed include the following: addresses submitted with blank or invalid action codes, added records submitted without geospatial information, added records submitted with 9-digit numeric MAFIDs, action codes other than "A" used on records without MAFIDs, and non-city style addresses submitted without map spots or latitude and longitude coordinates. FORM D-2006(5-24-2017) OMB.No. 0607-0994:Approval Expires 1 2/3 112 0 1 9 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics AdminisimUon United States U.S.CENSUS BUREAU PL5335415 Census SELF-ASSESSMENT CHECKLIST 2020 2020 CENSUS LOCAL UPDATE OF CENSUS Government Name ADDRESSES OPERATION (LUCA) Kent city Confidentiality & PROTECTING CENSUS BUREAU TITLE 13 MATERIALS Security Circle Y Guidelines N or NA Reference 1. Do you understand that the Census Bureau's Title 13 data, including addresses and latitude/longitude coordinate data(structure points),cannot be used to create, update, 3 Y N nor modify a tribal, state, or local jurisdiction address data base? ram, 2. Will you store Title 13 materials in a secure location? 4.1, 4.2 Y N 3. Will you secure Title 13 materials to prevent unauthorized staff from accessing these materials?This includes staff members other than those who signed the Confidentiality a 1 4 Y N Agreement,that have access to the offices,cabinets, or other areas where Title 13 materials are stored- 4. Will you construct electronic security profiles to allow only those who signed the Confidentiality Agreement to access the Census Bureau's Title 13 materials,if the Title 13 4.1 /Y ) N NA information is placed on a shared computer system? Required if you are selecting GUPS,the 0Y digital address list, or the Paper/PDF maps. 5. Will you ensure that your IT system restricts the read,write, delete,and execute functions applicable to the Census Bureau's Title 13 materials to only those individuals that signed 4.1 Y N NA the Confidentiality Agreement? Required if you are selecting GUPS,the digital address list,or the Paper/PDF maps. 6. Will you assign an encrypted, unique user-ID and password for each LUCA liaison, reviewer, and anyone with access to Title 13 materials? Required if you are selecting 4.1 Y N NA GUPS,the digital address list,or the Paper/PDF maps. 7. Will you keep Title 13 data separate from your other data?Title 13 data cannot be backed-up, mixed with, nor stored with other data? Required if you are selecting GUPS, 4-1 OY N � NA the digital address list,or the Pager/PDF maps. Confidentiality & Security Circle REPORTING AN INCIDENT Guidelines Y or N Reference 8.Will you report to the Census Bureau all violations of unauthorized viewing or loss of 4.3 Y N Title 13 materials within 24 hours of discovery? Confidentiality & Security Circle ON-SITE VISITS Guidelines Y or N Reference 9. Do you understand that the Census Bureau may conduct on-site visits to your office to 4.4 N inspect your security measures regarding the Census Bureau's Title materials? Confidentiality & Secule DESTRUCTION OR RETURN OF CONFIDENTIAL MATERIALS Guidelines Guidelins Y)or N Reference 10. Will you destroy(the preferred method) or return the Title 13 materials according to the 4.5, 4.6 N approved destruction or return methods outlined in the Confidentiality and Security Guidelines? LUCA Liaison Signature % I V ( � 6�J LUCA Liaison Name (Print) Date Complete this form and return it along with the completed, signed copies of the Registration Form, Confidentiality Agreement, and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN. Geography LUCA Materials 63-E, National Processing Center, 1201 East 10th St, Jeffersonville IN 47132. Rather than mailing, you may scan your completed torts, including forms with signatures, and email them to us at GE0.2020.LUCAC�census.ctov. FORM D-2003 p-10-2017j OMB No. 0607-0994; Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration U.S.CENSUS BUREAU United States Census PRODUCT PREFERENCE FORM PL53m 20 2020 CENSUS LOCAL UPDATE OF CENSUS Government ent Name ADDRESSES OPERATION (LUCA) Kent city Plea a mark (X) to select a product preference format(Choose #1 OR #2 below) 1, GUPS-The Census Bureau's Geographic Update Partnership Software (GUPS) is a self-contained Geographic Information System (GIS) tool. It includes the Census Bureau's address list, address count list by census block, and partnership shapefiles. GUPS allows you to add external geospatial data (shapefiles, geodatabases, and imagery) for comparison and update pur- poses. GUPS functions on Windows XP, Vista, and Windows 7, 8, and 10, and Apple Mac OS X with additional bridge software. OR 2. ❑ Select one address list format in Section A and one map format in Section B. A. Address List-Select Digital or Paper B. Maps - Select Digital or Paper ❑ Digital - Requires the use of a spreadsheet or ❑ Digital - Partnership shapefiles that require the use of GIS database software. We will provide the files in Excel software. Address structure points are not included in the Comma Delimited Text (.csv) format. partnership shapefiles but can be created from the Iat/long coordinates included on the digital address list. OR OR ❑ Paper-Available only to governments with 6,000 ❑ Paper/PDF-Large format paper map(s) (42" x 36") with a or fewer addresses. Each 8 1/2" x 14" page contains six DVD of small format(8-1/2" x 14") block maps in Adobe PDF (6) addresses (1,000 pages maximum). Choose one format that contain address structure coordinates showing the address sort preference below: location of residential addresses. Title 13 requirements apply. OR ❑ Census Tract#/Block#/Street Name/House#/Unit# ❑ Paper- Large format paper map(s) (42" x 36") only. This does not include a DVD of small format (8-1/2" x 14") black maps in ❑ Street Name/House#/Unit/Census Tract#/Census Adobe PDF format that contain address structure coordinates Block# (alphanumeric sort) showing the location of residential addresses. Non-Title 13. You may access the current number of addresses by Note: The shapefiles do NOT contain address points. census block the Census Bureau has on file for your If you choose a paper address list and digital jurisdiction at http://wwwr.census.gov/geo/partnerships!luca.htmf. maps, you will not see map spots in the digital environment. You must select Paper/PDF to review the address structure points. LUCA Liaison Package Delivery Address. Title 13 materials must be delivered to the LUCA liaison. Please print. Liaison Name r t vvt ` C, lam ` 2� t Department, Organization, or Agency name Number and street name Physical/ 4 U ec�`�� Mailing address CityState zip Code VJ Telephone Email address Area code Number Extension _ ` ��`fi 2S3 — Sg — � � — ��CC Name of the Person Completing This Form (Please print) Name Telephone Area code Number Extension Email address C�C�©�/u: � i<6�1t �Y Date P l S a v 17 Complete this form and return it along with the completed. signed copies of the Registration Form, Self-Assessment Checklist, and Confidentiality Agreement. Use the enclosed postage-paid envelope addressed to ATTN: Geography LUCA Materials 63-E, National Processing Center, 1201 East 10th St, Jeffersonville IN 47132. As an alternative,you may scan your completed forms, including forms with signatures, and email them to LQ 2020.L UCA @ census..go v. II III II II II II II II IIIII II II I II II I I I C. Name and Position of Person Completing This Form- (Please Print) Name ' O VA Telephone Number Ext. Position Email Address ?fl'�6✓G t-.C Date / L1201 plete this form, return it using the enclosed postage-paid envelope, addressed to ATTN: Geography LUCA Materials 63-E, National Processing Center,East 10th St., Jeffersonville, IN 47132. Rather than mailing, you may scan your completed form and email it to GE0.2020.LLJCAQcensus.gov. FORM D-2001 (12-21-2016) FORM D-2005(4-e-2017) OMB No. 0607-0994: Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID CONFIDENTIALITY Economics and Statistics Administration Cunited States ensus AGREEMENT FORM U.S.CENSUS BUREAU PL5335415 202Q 2020 CENSUS LOCAL UPDATE OF Government Name CENSUS ADDRESSES OPERATION (LUCA) Kent city OPERATIONA. TERMS, CONDITIONS, AND RESPONSIBILITIES FOR PARTICIPATING IN THE 2020 CENSUS LUCA All LUCA liaisons,reviewers,and anyone with access to Title 13,United States Code(U.S.C.)LUCA materials must agree to keep confidential.the Title 13 materials to which they have access,including any maps that contain structure points showing the location of living quarters.They may use this information solely for suggesting improvements to the Census Bureau's address list and maps. All individuals who will review or have access to Census Bureau Title 13 materials must sign below to indicate they have read and understand the Census Bureau's Confidentiality and Security Guidelines for LUCA. In addition,those who sign the agreement swear,under penalty of perjury,to maintain the confidentiality of Census Bureau materials protected under Title 13. Further,a signature indicates recognition that the penalty for wrongful disclosurd is a fine of not more than$250,000 or imprisonment for not more than 5 years,or both.Although access to the data is temporary,this commitment is permanent.You must be at least 18 years of age to sign this agreement. By signing this agreement,your government agrees to destroy all Census Bureau Title 13 materials or return them to the Census Bureau at the completion of LUCA. LIAISONB. • • Liaison's Printed Name Area code Telephone number Ext )=n�ul/l� C��c� a'v a J 3 - fj 5 - S � 6 - Liaison's &Qnature Date Month Day Year 1'�4� (J? / ! j 5 u 11 Nam UCA Liaison's Office, Department, or Agency- (Assessor's Office, Planning Department, Regional Planning Agency, etc.)-Please print Address of LUCA Liaison's 0ftice, Department,or Agency-(House number and street name, RR or HC, and box number)-Please print City State ZIP Code kc . (� I NL�'; 2- Email address INFORMATIONC. • Printed name f ` Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I Email address Printed name Area code Telephone number Ext. Signature Date Month Day Year a a Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Section C continued on Cam, Ie- %-3 k��� �y�: �/ the reverse I III II II II II II II IIII III III II III I 37736 C. INFORMATION FOR REVIEWER(S)and PERSON(S)WITH ACCESS TO TITLE 13,U.S.C. MATERIALS-Continued Printed name y Area code Telephone number Ext. Signature Date / /� / Month Day Year l// y`( FT TT I F177Z i t Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code i I Email address L1 lam_✓ u c (c { w,0- Printed name Area code Telephone number Ext. FTT] Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State I ZIP Code I E-mail address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State I ZIP Code I E-mail address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State I ZIP Code I E-mail address Complete this form and return it along with the completed. signed copies of the Registration Form, Self-Assessment Checklist and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN: Geography LUCA 63-E, National Processing Center, 1201 East 10th St., Jeffersonville IN 47132. Rather than mailing, you may scan your completed forms, including forms with signatures, and email them to us at GE0.2020.LUCA Q census...qov FORM D-2005 (4-5-2017) FORM D-2013(6/2017) Instructions to Register for the 2020 Local Update of Census Addresses Operation(LUCA) A. To help you make an informed decision to participate in the 2020 LUCA Operation,please read: 1. 2020 Census Local Update of Census Addresses Operation(LUCA) Information Guide 2. Confidentiality and Security Guidelines B. There are four(4)forms to complete for the LUCA registration. To begin your registration process,complete the forms you received in your invitation package and return them to the Census Bureau in the postage paid, preaddressed enclosed envelope. If you prefer,you may scan your completed,signed forms and email them to GEO.2020.LUCA@census.gov. 1. Registration Form 11 If you are participating in LUCA: • In Section A.1,mark X,"YES Our government is registering for LUCA." Complete Sections B and C. • In Section B.,"Signature of Tribal Chair or Highest Elected/Appointed Official Responding to the LUCA Invitation" provide: i. The printed name and signature of the Tribal Chair or Highest Elected/Appointed Official ii. Position M. Physical/Mailing address iv. Telephone number V. Email address • In Section C,the Tribal Chair or Highest Elected/Appointed Official designates a LUCA Liaison and provides the LUCA Liaison's: i. Printed name ii. Department,organization,or agency name M. Position iv. Physical/Mailing Address V. Telephone number vi. Email address • Please refer to sections 2 through 4 on the following page for instructions on how to complete the remaining three forms. 1.2 If you are designating a higher level of government(state or county)to participate on your government's behalf as your LUCA Liaison: • In section A.1,mark X,"YES Our government is registering for LUCA." Complete Sections B and C. • The Tribal Chair or Highest Elected/Appointed Official completes and signs section B. • In section C,the Tribal Chair or Highest Elected/Appointed Official designates the LUCA Liaison. • The LUCA Liaison is required to complete and sign the Confidentiality Agreement Form,Product Preference Form,and Self-Assessment Checklist. • Please return all four forms to the Census Bureau in the postage-paid, preaddressed envelope,or you may scan your completed forms and email there to GEO.2020.LUCA@census.gov. 1.3 If you are designating a Regional Planning Agency,Council of Governments,or other organization as your LUCA Liaison: • In section A.1,mark X,"YES Our government is registering for LUCA." Complete Sections B and C. • The Tribal Chair or Highest Elected/Appointed Official completes and signs section B. • In section C,the Tribal Chair or Highest Elected/Appointed Official designates the LUCA Liaison. • The LUCA Liaison is required to complete and sign the Confidentiality Agreement Form,Product Preference Form,and Self-Assessment Checklist. • Please return all four forms to the Census Bureau in the postage-paid, preaddressed envelope,or you may scan your completed forms and email them to GEO.2020.LUCA@census.gov. 1.4 If a higher level of government(state or county),that includes your jurisdiction is participating in LUCA: • In section A.2, mark X, "NO,Our government is not registering for LUCA." Complete Section B. • Select a,Another level of government(state or county)that includes our jurisdiction is participating in LUCA. • The Tribal Chair or Highest Elected/Appointed Official completes and signs section B. • Please return the form to the Census Bureau in the pre-addressed, postage-paid envelope,or you may scan your completed form and email it to GEO.2020.LUCA@census.gov. NOTE:If you are not participating in LUCA,you do not have to complete and return the remaining three forms (Confidentiality Agreement Form,Product Preference Form,or the Self-Assessment Checklist). Return only the Registration Form. 1.5 If you decide not to participate in the 2020 LUCA Operation: • In Section A.2, mark X,NO, "Our government is not registering for LUCA," Mark X for each reason that applies. Complete Section B. • The Tribal Chair or Highest Elected/Appointed Official completes and signs section B. • Please return the form in the postage paid, preaddressed envelope or you may scan your Registration Form and email it to GEO.2020.LUCA@census.gov. NOTE:If you are not participating in LUCA,you do not have to complete and return the remaining three forms (Confidentiality Agreement Form,Product Preference Form,or the Self-Assessment Checklist).Return only the Registration Form. ►f you are participating in LUCA, the LUCA Liaison is required to complete and sign the remaining three forms. 2. Self-Assessment Checklist for the Confidentiality and Security Guidelines • Read the Confidentiality and Security Guidelines before filling out this form. • Answer yes or no to each question. • Sign and date the form. 3. Product Preference Form—No Signature required • In the first section, mark X,if you choose to use the Census Bureau's Geographic Update Partnership Software(GUPS) OR • Mark X to select the format you choose to use for the address list,either digital or paper. If you select the paper address list,choose your sort preference. • Mark X to select the format you choose to use for the maps;either digital (TIGER partnership shapefiles),or large format paper maps with DVD small format block maps(Title 13 requirements apply),or large format paper maps only(Non-title 13). • Complete the package delivery address for the LUCA Liaison. Title 13 materials must be delivered to the LUCA Liaison. • Provide the name,telephone number,and email address of the person completing the form. 4. Confidentiality Agreement Form • In Section A, read the terms,conditions, and responsibilities for participating in LUCA. • In Section B, provide the LUCA liaison information. i. Printed name ii. Signature iii. Office, department name iv. Office,department address V. Email address • Ensure that the LUCA Liaison signs and dates this form. • In Section C,ensure all reviewers and person(s)with access to Title 13 materials sign and date this form. NOTE:Please return these three forms together with the Registration Form in the postage paid,preaddressed envelope or you may scan your completed forms and email them to GEO.2020.LUCA@census.gov. Cordova, Jim From: Richard T Campbell (CENSUS/LARO-WAH FED) <Richard.T.Campbell@census.gov> Sent: Monday, October 16, 2017 3:50 PM To: Cordova, Jim Subject: US Census Local Update of Census Addresses (LUCA) Registration Forms Attachments: D-2004_ConfidSecurityGuidelines.pdf; D-2013_Instructions for registration.pdf; D-2002_Reg Form.pdf; D-2003_P rod Pref Local.pdf; D-2005ConfAgree Form.pdf; D-2006Self Assmt Checklist.pdf Hi Jim, Thanks for your call. Attached are the forms needed for LUCA registration. Please ensure each form is filled out in its entirety prior to submitting. You may scan and email the completed forms to the GEO.2020.LUCA(@census.gov email address. Please let me know if any questions, and thank you for your interest in LUCA! -Rick --------------------------------------------------------------------- Rick Campbell Geographer Los Angeles Regional Office U.S. Census Bureau Office 206.707.2417 richard.t.cam pbell census.gov census.gov Connect with us on Social Media FORM D-2001 (12-21-2016) OMB No. 0607-0994; Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration United States" pL5335415 U.S.CENSUS BUREAU Census Name 2020 CONTACT INFORMATION UPDATE FORM Kent city 2020 CENSUS LOCAL UPDATE OF Contact ID CENSUS ADDRESSES OPERATION (LUCA) 279747 The person listed in Section A is associated by the Census Bureau as an organizational or program contact for the government listed above, as indicated by the mark in box or boxes below: ❑Highest Elected/Appointed Official ❑Appointed Regional Agency Planner ❑Tribal Chair ❑2010 LUCA Liaison ❑Governor's Liaison ❑Geographic Support System Contact ®Census Contact Liaison ❑Federal State Cooperative for Population Estimates Contact ❑State Data Center Contact ❑National States Geographic Information Council Contact ❑GIS Contact ❑Addressing Authority Contact ®Boundary and Annexation Survey Contact FPIease indicate the status of the information in Section A by marking the appr priate box. ction A is CORRECT. (Return the form, even if the information is correct.) X.Section A is INCORRECT. (Update Section B and return the form.) A.Contact Information B. New Contact and/or Updated Information (Please Print) Title Title-Mark(X)one. XMr. ❑Mrs. ❑Miss ❑Ms. ❑ Dr. [:]The Honorable First Name MI First Name MI Jimmie A Last Name Last Name Cordova Name Suffix Name Suffix— (Jr., Sr., ll, tli, etc.) Department Name Department Name-(e.g., Board of Commissioners,Planning and Development) PW/Engr-GIS Position Position (e.g., Chairman, Supervisor, Mayor) GIS Analyst Term Expiration Date Term Term Expiration Date—(mmlddlyyyy) Term—(e.g.,2 years, 4 years) Preferred Address Preferred Address—(Number and street name or P.Q. Box) 220 4th Ave S City State City State Kent WA ZIP Code ZIP +4 ZIP Code ZIP +4 98032 5895 Alternate Address Alternate Address— (Number and street name) City State City State ZIP Code ZIP +4 ZIP Code ZIP+4 98032 Telephone Number Ext Telephone Number Ext (253) 856-5526 Alternate Telephone Number Fax Alternate Telephone Number(includes cell) Fax Email Email q jcordova@ci.kent.wa.us Continue with Section C on reverse • IIIIIIIIIIIIIIIIIIIIIIII IIIIIIII 22936 FORM D-2002(2-22-e017) OMB No.0607-0994:Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration U.S.CENSUS BUREAU PL533541� CU"��� REGISTRATION FORM ensus VL ��CENSUS LOCAL UPDATE OR CENSUS Government Name ADDRESSES OPERATION (LUCA) Kent city RESPONSEA. PARTICIPATION Deadline1. R YES Our government is registering for LUCA.— Complete Sections B and C. 2. ❑ NO Our government is not registering for LUCA. — Complete Section B and mark an(X) for each reason that applies: a• ❑ Another level of government(state or county) f. ❑ Concerns about Census Bureau Title 13 materials that includes our jurisdiction is participating in LUCA g. ❑ Restrictions on using Census Bureau Title 13 materials for other purposes b• ❑ Insufficient staff b• ❑ Other reason—Specify(Please print) c• ❑ Lack of funds d. ❑ No time/too busy e. ❑ No local address list available Thank you for your comments. We will use them to help improve future LUCA operations. B. SIGNATURE OF TRIBAL CHAIR OR HIGHEST ELECTED/APPOINTED OFFICIAL RESPONDINGTO THE LUCA INVITATION 1. Printed name of Tribal Chair or Highest EWed OfficiallAppointed Official—First, middle initial, last S4 7-6-f e— A 2. Signatures Tribal Chair or Highest El cted Official/Appointed Official Date /J Month Day Year LM oq_ � avI 4� IC Po 'ion(—_ e.g., Tribal Chair, Governor, Commissioner, Mayor; Supervisor;please do not abbreviate)—Please print r Number and street name 4. PhysicaU Mailing City State ZIP Code address I I S. Telephone 6. Email address Area code Number Extension C. LIAISON • - • DesignateThis is the person . , Code. Complete this section only if you are participating in LUCA 1. Name—(Please print) r✓1 n�i G O`f- c '0 \/G- 2. Department, Organization or Agency name—(e.g., Planning and Zoning, Regional Planning Agency;please do not abbreviate) 3. Position— (e.g., Tribal President, Director, Assb9sor, Planner,pl ase do not abbreviate) 4. Number and streef name Physical/ 2,7-Fi f 17�-(f✓L Mailing City State ZIP Code address I I J n � S. Telephone 6. Email address Area code Number Extension w Complete this form and return it along with the completed,signed copies of the Product Preference Form,Self-Assessment Checklist and Confidentiality Agreement.Use the enclosed postage-paid envelope addressed to ATTN:Geography LUCA Materials 63-E,National Processing Center, 1201 East 10th St,Jeffersonville IN 47132.As an altemafive,you may scan your completed forms,including forms with signatures,and email them to GE0.2020.LUCA@census.gov. FORM D-2005(4-e-e017) OMB No. 0607-0994: Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID United States, CONFIDENTIALITY Economics and Statistics Administration 415 Census AGREEMENT FORM U.S.CENSUS BUREAU 2020 2020 CENSUS LOCAL UPDATE OF Goovernmvernm enntt Name CENSUS ADDRESSES OPERATION (LUCA) Kent city A. TERMS, CONDITIONS, AND RESPONSIBILITIES FOR PARTICIPATING IN THE 2020 CENSUS LUCA OPERATION All LUCA liaisons. reviewers,and anyone with access to Title 13, United States Code(U.S.C.)LUCA materials must agree to keep confidential the Title 13 materials to which they have access,including any maps that contain structure points showing the location of living quarters.They may use this information solely for suggesting improvements to the Census Bureau's address list and maps. All individuals who will review or have access to Census Bureau Title 13 materials must sign below to indicate they have read and understand the Census Bureau's Confidentiality and Security Guidelines for LUCA. In addition,those who sign the agreement swear,under penalty of perjury,to maintain the confidentiality of Census Bureau materials protected under Title 13. Further,a signature indicates recognition that the penalty for wrongful disclosurd is a fine of not more than$250,000 or imprisonment for not more than 5 years,or both.Although access to the data is temporary.this commitment is permanent.You must be at least 18 years of age to sign this agreement. By signing this agreement,your government agrees to destroy all Census Bureau Title 13 materials or return them to the Census Bureau at the completion of LUCA. INFORMATION0. LIAISON Liaison's Printed Name Area code Telephone number Ext Liaison's SWnature Date Month Day Year / / / 5 E= Nam&IUCA Liaison's Office, Department, or Agency- (Assesso ^"__ .,___ _-_. -:_ �1 Planning Agency, etc.)-Please print Address of LUCA Liaison's Office, Department, or Agency-(House ��f�,�I$ 7d box number)-Please print City State ZIP�Code (� I (a 5, Email address C. INFORMATION FOR REVIEWER(S)and PERSON(S)WITH ACCESS TO TITLE 13, U.S.C. MATERIALS Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I Email address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I I E-mail address Section C continued on C�-'-- CD �k� a the reverse IIII II II II II II II IIII II I I I II II III 37736 F C. INFORMATION FOR REVIEWER(S)and PERSON(S)WITH ACCESS TO TITLE 13, U.S.C. MATERIALS- Printed name Area code Telephone number Continued Ext. e a-H, a l«e-J--f- Z S 3 —Fil,�— (v — K� i -7 — Si�at re � Date Month Day Year FM/ -L EJ 0 t Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code i I Email address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Printed name Area code Telephone number Ext. Signature Date - Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Complete this form and return it along with the completed, signed copies of the Registration Form, Self-Assessment Checklist and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN:Geography LUCA 63-E, National Processing Center, 1201 East 10th St.. Jeffersonville IN 47132. Rather than mailing,you may scan your completed forms, including forms with signatures, and email them to us at GEO.2020.LUCA @ census.gov FORM D-2005(4-5-2017) FORM D-2005(4-5-2017) OMB No. 0607-0994: Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID United States, CONFIDENTIALITY Economics and Statistics AtlminietEAU U.S.CENSUS BUREAU PL5335415 Census AGREEMENT FORM 2020 2020 CENSUS LOCAL UPDATE OF Government Name CENSUS ADDRESSES OPERATION (LUCA) Kent city CONDITIONS,A. TERMS, All LUCA liaisons,reviewers,and anyone with access to Title 13, United States Code(U.S.C.)LUCA materials must agree to keep confidential the Title 13 materials to which they have access,including any maps that contain structure points showing the location of living quarters.They may use this information solely for suggesting improvements to the Census Bureau's address list and maps. All individuals who will review or have access to Census Bureau Title 13 materials must sign below to indicate they have read and understand the Census Bureau's Confidentiality and Security Guidelines for LUCA. In addition,those who sign the agreement swear,under penalty of perjury,to maintain the confidentiality of Census Bureau materials protected under Title 13.Further,a signature indicates recognition that the penalty for wrongful disclosure is a fine of not more than$250,000 or imprisonment for not more than 5 years,or both.Although access to the data is temporary,this commitment is permanent.You must be at least 18 years of age to sign this agreement. By signing this agreement,your government agrees to destroy all Census Bureau Title 13 materials or return them to the Census Bureau at the completion of LUCA. LIAISON0. • • Liaison's Printed Name -�t� /� p Area code Telephone number Ext v 1 Yl'1 v1�11 cc,C c%\ o V*" = - Liaison's nature Date h Month Day Year r � r s , Nam UCA Liaison's Office, Department, or Agency- (Assessor's Office, Planning Department, Regional Planning Agency, etc.)-Please print Address of LUCA Liaison's 0ftice, Department, or Agency-(House number and street name, RR or HC, and box number)-Please print City State n ZIP Code Email address C. INFORMATION FOR • TO TITLE 13, U.S.C. MATERIALS Printed name Area code Telephone number Ext. Signature Date `_ Month Day Year 5"e- Gi`7�'�� Address, if different from Liaison-(House number and street name, RR or HC, and box number)-Please print City State ZIP Code I Email address Printed name Area code Telephone number Ext. Signature Date C /.Q-� Month Day Year Il T 1 Uall 1,31 ( Address, if different from Liaison-(House number and street name, RR or HC, and box number)-Please print Cit State Y ZIP Code I I E-mail address Section C continued on the reverse I II I I I I I I I I I I I I I I I I I I I I �I I I II II II III 37736 C. INFORMATION FOR REVIEWER(S)and PERSON(S)WITH ACCESS TO TITLE 13, U.S.C. MATERIALS-Continued Printed name /� Area code Telephone number Ext. e-a q, 5v-a 4.k e-1-1- 2 3 - Fs 5 (n - KTT771 ITM - Sig at re // Date Month Day Year i 1 11171 2 0 l Address, if different from Liaison-(House number and street name, RR or HC, and box number)-Please print City State ZIP Code i I Email address ( 1 kto_1-Q L'G�+T_ � vVt o-, l. cv vv� Printed name Area code Telephone number Ext. Signature Date Month Day Year O .2 (, 0 1 S Address,if different from Liaison-(House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address,if different from Liaison-(House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Printed name Area code Telephone number Fxt. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Complete this form and return it along with the completed, signed copies of the Registration Form, Self-Assessment Checklist and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN:Geography LUCA 63-E, National Processing Center, 1201 East 10th St., Jeffersonville IN 47132. Rather than mailing, you may scan your completed forms, including forms with signatures, and email them to us at G E0.2020.LUCA @ census.ciov FORM D•2005(4-5-2017) FORM D-2002(2-22-2017) OMB No.0607-0994:Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration U.S.CENSUS BUREAU PL5335415 2020�"���- REGISTRATION FORM 2020 CENSUS LOCAL UPDATE OF CENSUS Government Name L ADDRESSES OPERATION (LUCA) Kent city RESPONSEA. PARTICIPATION December 15, 2017) 1. N.YES Our government is registering for LUCA.- Complete Sections B and C. 2. ❑ NO Our government is not registering for LUCA. - Complete Section B and mark an(X)for each reason that applies: a. ❑ Another level of government(state or county) f. ❑Concerns about Census Bureau Title 13 materials that includes our jurisdiction is participating g. ❑ Restrictions on using Census Bureau Title 13 materials for in LUCA other purposes b- ❑ Insufficient staff h. ❑ Other reason- Specify(Please print) c. ❑ Lack of funds d. ❑ No time/too busy e. ❑ No local address list available Thank you for your comments. We will use thy-- It LUCA operations. S. SIGNATURE OF TRIBAL CHAIR OR HIGHEST ELECIII N' - I If 1. Printed name of Tribal Chair or Highest Elected OfficiaUAp, �i tst :54t -z-e, iio� ""' 0 "", 2. Signature--o Tribal Chair or Hi El cted Official/Appointe Date Month Day Year as a . Po 'ion- e.g., Tribal Chair, Governor, Commissioner, Mayor, -.se do not abbreviate)-Please print Number and street name 4. Physical/ Mailing City State ZIP Code address I S. Telephone 6. Email address Area code Number Extension LIAISONC. • i •esignate your LUCA Liaison. This is the person responsible for protecting the confidential Census Bureaucovered Complete this section only if you are participating in LUCA 1. Name- (Please print) 2. Department, Organization or Agency name- (e.g., Planning and Zoning, Regional Planning Agency;please do not abbreviate) !DDT- Vs - i--r) C pee Y'd 1 � Ci l t,T 'o ' 3. Position- (e.g., Tribal President, Director, Assegsor, Planner,pl6ase do not abbreviate) Gts A In61I s �- 4. Number and street name �] Physical/ Mailing City State ZIP Code address L 5. Telephone 6. Email address Area code Number Extension Complete this form and return 0 along with the completed,signed copies of the Product Preference Form,Self-Assessment Checklist,and Confidentiality Agreement.Use the enclosed postage paid envelope addressed fo ATTN:Geography LUCA Ma�and E,National Processing Center, i20i East 10th St,Jeffersonville IN 47132.As an alternative,you may scan your completed forms,including forms with signatureail them to GE0.2020.LUCAC�3census.gov. FORM D-2001 (12-21-2016) OMB No. 0607-0994; Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration PL5335415 United States U.S.CENSUS BUREAU Census Government Name 202 CONTACT INFORMATION UPDATE FORM Kent city 2020 CENSUS LOCAL UPDATE OF Contact ID CENSUS ADDRESSES OPERATION (LUCA) 279747 The person listed in Section A is associated by the Census Bureau as an organizational or program contact for the government listed above, as indicated by the mark in box or boxes below: ❑Highest Elected/Appointed Official ❑Appointed Regional Agency Planner ❑Tribal Chair ❑2010 LUCA Liaison ❑Governor's Liaison ❑Geographic Support System Contact N Census Contact Liaison ❑Federal State Cooperative for Population Estimates Contact ❑State Data Center Contact ❑National States Geographic Information Council Contact ❑GIS Contact ❑Addressing Authority Contact ®Boundary and Annexation Survey Contact Please indicate the status of the information in Section A by marking the appr priate box. El Section A is CORRECT. (Return the form, even if the information is correct.) Xsection A is INCORRECT. (Update Section B and return the form.) A.Contact Information B. New Contact and/or Updated Information (Please Print) Title Title-Mark(X)one. 19'Mr. ❑Mrs. ❑Miss ❑ Ms. ❑ Dr. ❑The Honorable First Name MI First Name MI Jimmie A Last Name Last Name Cordova Name Suffix Name Suffix- (Jr., Sr., Il, Ill, etc.) Department Name Department Name-(e.g., Board of Commissioners, Planning and Development) PW/Engr-GIS Position Position (e.g., Chairman, Supervisor, Mayor) GIS Analyst Term Expiration Date Term Term Expiration Date- (mmidd/yyyy) Term- (e.g.,2 years, 4 years) Preferred Address Preferred Address- (Number and street name or P.O. Box) 220 4th Ave S City State City State Kent WA ZIP Code ZIP +4 ZIP Code ZIP +4 98032 5895 Alternate Address Alternate Address- (Number and street name) City State City State ZIP Code ZIP +4 ZIP Code ZIP +4 98032 Telephone Number Ext Telephone Number Ext (253)856-5526 Alternate Telephone Number Fax Alternate Telephone Number(includes cell) Fax Email Email jcordova@ci.kent.wa.us ��><'C�rJ�►�ti�. l� �� (JJC� =C' s� Continue with Section C on reverse • I I II I I II II II II II II II II II II I I I I I 22936 C. Name and Position of Person Completing This Form- (Please Print) Name ,F [� C'f- p 77 Telephone Number I Ext. Position 651)--5 Sz E Email Address JCG C)IjCl- tl,,V, Cz h jOv, Date 1/c; j.2 f Complete this form, return it using the enclosed postage-paid envelope, addressed to ATTN: Geography LUCA Materials 63-E, National Processing Center, 1201 East 10th St., Jeffersonville, IN 47132. Rather than mailing, you may scan your completed form and email it to GEO.2020.LUCA@census.gov. FORM D-2001(12-21-2016) FORM D-2006(5-24-2017) OMB. No. 0607-0994:Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration U.S.CENSUS BUREAU ihriteclstates PL5335415 Census SELF-ASSESSMENT CHECKLIST Government Name 2020 2020 CENSUS LOCAL UPDATE OF CENSUS ADDRESSES OPERATION (LUCA) Kent city Confidentiality & PROTECTING CENSUS BUREAU TITLE 13 MATERIALS Security Circle Y, Guidelines N or NA Reference 1. Do you understand that the Census Bureau's Title 13 data, including addresses and latitude/longitude coordinate data(structure points),cannot be used to create, update, 3 N nor modify a tribal, state, or local jurisdiction address data base? 2. Will you store Title 13 materials in a secure location? 4.1, 4.2 Y N 3. Will you secure Title 13 materials to prevent unauthorized staff from accessing these materials?This includes staff members other than those who signed the Confidentiality 4.1, 4.2 Y N Agreement, that have access to the offices,cabinets, or other areas where Title 13 materials are stored. 4. Will you construct electronic security profiles to allow only those who signed the Confidentiality Agreement to access the Census Bureau's Title 13 materials, if the Title 13 4.1 q N NA information is placed on a shared computer system? Required if you are selecting GUPS, the digital address list, or the Paper/PDF maps. 5. Will you ensure that your IT system restricts the read,write, delete,and execute functions applicable to the Census Bureau's Title 13 materials to only those individuals that signed 4.1 Y N NA the Confidentiality Agreement? Required if you are selecting GUPS, the digital address list,or the Paper/PDF maps. 6. Will you assign an encrypted, unique user-ID and password for each LUCA liaison, reviewer, and anyone with access to Title 13 materials? Required if you are selecting 4.1 Y N NA GUPS,the digital address list, or the Paper/PDF maps. 7. Will you keep Title 13 data separate from your other data?Title 13 data cannot be backed-up, mixed with, nor stored with other data? Required if you are selecting GUPS, 4.1 Y N NA the digital address list, or the Paper/PDF maps. Confidentiality & Security Circle REPORTING AN INCIDENT Guidelines Y or N Reference S. Will you report to the Census Bureau all violations of unauthorized viewing or loss of 4.3 % Y N Title 13 materials within 24 hours of discovery? Confidentiality & Security Circle ON-SITE VISITS Guidelines Y or N Reference 9. Do you understand that the Census Bureau may conduct on-site visits to your office to 4.4 DYN inspect your security measures regarding the Census Bureau's Title materials? Confidentiality & SecuDESTRUCTION OR RETURN OF CONFIDENTIAL MATERIALS Guidelines Guidelins Circle N Reference 10. Will you destroy(the preferred method)or return the Title 13 materials according to the 4.5, 4.6 N approved destruction or return methods outlined in the Confidentiality and Security Guidelines? LUCA Liaison Signature i LUCA Liaison Name (Print) F Date Complete this form and return it along with the completed, signed copies of the Registration Form, Confidentiality Agreement, and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN: Geography LUCA Materials 63-E, National Processing Center, 1201 East loth St, Jeffersonville IN 47132. Rather than mailing, you may scan your completed forms, including forms with signatures, and email them to us at.GE0.2020.LUCA0census.gov. FORM D-2003 (7-10-2017) OMB No. 0607-0994; Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration U.S.CENSUS BUREAU United states PL5335415 Census PRODUCT PREFERENCE FORM 20 2020 CENSUS LOCAL UPDATE OF CENSUS Government Name ADDRESSES OPERATION (LUCA) Kent city Please mark (X) to select a product preference format (Choose #1 OR #2 below) 1,XGUPS; -The Census Bureau's Geographic Update Partnership Software (GUPS) is a self-contained Geographic Information System (GIS) tool. It includes the Census Bureau's address list, address count list by census block, and partnership shapefiles. GUPS allows you to add external geospatial data (shapefiles, geodatabases, and imagery) for comparison and update pur- poses. GUPS functions on Windows XP, Vista, and Windows 7, 8, and 10, and Apple Mac OS X with additional bridge software. OR 2. ❑ Select one address list format in Section A and one map format in Section B. A. Address List- Select Digital or Paper B. Maps-Select Digital or Paper ❑ Digital - Requires the use of a spreadsheet or ❑ Digital - Partnership shapefiles that require the use of GIS database software. We will provide the files in Excel software. Address structure points are not included in the Comma Delimited Text (.csv) format. partnership shapefiles but can be created from the Iat/long coordinates included on the digital address list. OR OR ❑ Paper- Available only to governments with 6,000 ❑ Paper/PDF- Large format paper map(s) (42" x 36") with a or fewer addresses. Each 8 1/2" x 14" page contains six DVD of small format (8-1/2" x 14") block maps in Adobe PDF (6) addresses (1,000 pages maximum). Choose one format that contain address structure coordinates showing the address sort preference below: location of residential addresses. Title 13 requirements apply. OR ❑ Census Tract#/Block#/Street Name/House#/Unit# ❑ Paper- Large format paper map(s) (42" x 36") only. This does not include a DVD of small format (8-1/2" x 14") block maps in ❑ Street Name/House#/Unit/Census Tract#/Census Adobe PDF format that contain address structure coordinates Block# (alphanumeric sort) showing the location of residential addresses. Non-Title 13. You may access the current number of addresses by Note: The shapefiles do NOT contain address points. census block the Census Bureau has on file for your If you choose a paper address list and digital jurisdiction at http://www.census.gov/geo/partnerships/luca.html. maps, you will not see map spots in the digital environment. You must select Paper/PDF to review the address structure points. LUCA Liaison Package Delivery Address. Title 13 materials must be delivered to the LUCA liaison. Please print. Liaison Name 11 Department, Organization, or Agency name Number and street name Physical/ Mailing City State ZIP Code address 9 Telephone Email address Area code Number Extension Name of the Person Completing This Form (Please print) Name Telephone I--._, Area code Number Extension Email �f address gip( L�O� 1 ��6�'► I � d mr Date " l S 2-v 17 Complete this form and return it along with the completed, signed copies of the Registration Form, Self-Assessment Checklist, and Confidentiality Agreement. Use the enclosed postage-paid envelope addressed to ATTN. Geography LUCA Materials 63-E, National Processing Center, 1201 East 10th St, Jeffersonville IN 47132. As an alternative, you may scan your completed forms, including forms with signatures, and email them to GE0.2020.LUCACalcensus..gov. I III II II II II II II IIII III I II II I I I FORM D-2005(4-5-2017) OMB No. 0607-0994: Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID andtatistics United States CONFIDENTIALITY EconomicsU.SSCENSUS BUREtAU PL5335415 Census AGREEMENT FORM Government Name 20202020 CENSUS LOCAL UPDATE OF CENSUS ADDRESSES OPERATION (LUCA) Kent city CONDITIONS,A. TERMS, • • PARTICIPATING IN THE 2020 CENSUS LUCA OPERATION All LUCA liaisons, reviewers, and anyone with access to Title 13, United States Code(U.S.C.) LUCA materials must agree to keep confidential the Title 13 materials to which they have access, including any maps that contain structure points showing the location of living quarters.They may use this information solely for suggesting improvements to the Census Bureau's address list and maps. All individuals who will review or have access to Census Bureau Title 13 materials must sign below to indicate they have read and understand the Census Bureau's Confidentiality and Security Guidelines for LUCA. In addition,those who sign the agreement swear, under penalty of perjury,to maintain the confidentiality of Census Bureau materials protected under Title 13. Further,a signature indicates recognition that the penalty for wrongful disclosurd is a fine of not more than$250,000 or imprisonment for not more than 5 years,or both.Although access to the data is temporary,this commitment is permanent.You must be at least 18 years of age to sign this agreement. By signing this agreement,your government agrees to destroy all Census Bureau Title 13 materials or return them to the Census Bureau at the completion of LUCA. LIAISONB. • • Liaison's Printed Name Area code Telephone number Ext wc\ y 3 - 6 - S - Liaison's nature Date - � 2 Month Day Year 71 1 s o1 Nam UCA Liaison's Office, Department, or Agency- (Assessor's Office, Planning Department, Regional Planning Agency, etc.)-Please print Olt Address of LUCA Liaison's Office, Department,or Agency- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code Email address �c C,<'(� v V G LY)t (,.kt,.�cj�� C. INFORMATION FOR • TO TITLE 13, U.S.C. MATERIALS Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I Email address Printed name Area code Telephone number Ext. a -I u I 5 (r, - 5 5 - Signature Date Month Day Year F l am IX-c Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State I ZIP Code I E-mail address Section C continued on the reverse III II II II II II II IIII III III II III 37736 C. INFORMATION FOR REVIEWER(S)and PERSON(S)WITH ACCESS TO TITLE 13, U.S.C. MATERIALS- Printed name Area code Telephone number Continued Ext. Sig at re Date XMonth Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code i I Email address ii Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I E-mail address I Printed name Area code Telephone number Ext. Signature Date Month Day Year M FT-1 Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I E-mail address l Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I E-mail address I Complete this form and return it along with the completed, signed copies of the Registration Form, Self-Assessment Checklist and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN:Geography LUCA 63-E, National Processing Center, 1201 East loth St., Jeffersonville IN 47132. Rather than mailing,you may scan your completed forms, including forms with signatures, and email them to us at GE0.2020.LUCA @census.gov FORM D•2005(4-5-2017) 4.1 Protecting Digital Tile 13 Materials — Continued Password Guidelines The IT systems must use logon routines that require a user-ID and password that conform to the following guidelines: • Unique user-ID and password required for the LUCA liaison, the LUCA reviewers, and anyone who has signed the Confidentiality Agreement. • Must consist of at least twelve, nonblank characters consisting of at least one alphabet letter and either one number or one special character (for example: $,*, or &). • Reject passwords that are the same as the user-ID or that have been used within the last six months. • Encrypt passwords. • Disable passwords after three failed attempts. • Mask passwords. • Require password changes every 90 days or immediately, if compromised. • Require user to change an assigned password to a unique password the first time the user accesses a new account. 4.2 Protecting Paper Title 13 Materials • Do not leave Title 13 materials unattended. Secure all Title 13 materials in a locked room. If possible, store Title 13 materials in locked desks or cabinets. • Copy only the Title 13 materials necessary to complete the LUCA review. Do not leave the copy machine unattended while making copies. All copied materials containing Title 13 information must bear the statement: "This document contains information, the release of which is prohibited by Title 13, U.S.C, and is for U.S. Census Bureau official use only. Wrongful disclosure or release of information can be punished by fine or imprisonment (Public Law 99-474)." • Do not disclose precise or even anecdotal information about Census Bureau addresses or locations to anyone who has not signed the Confidentiality Agreement. 4.3 Reporting an Incident If you discover that any Title 13 materials have been viewed by unauthorized persons or are missing from your inventory, you must: 1) Contact the Census Bureau through the Census Incident Response Team (CIRT) at (301) 763-3333 within 24 hours. You must provide the following information: • Jurisdiction Name. • Date and time of the incident. • Name of the contact person. • Phone number of contact person. • Site address of incident. 2) Immediately secure all remaining materials. Prohibit any further access, by anyone, including the LUCA liaison and anyone who signed the Confidentiality Agreement. Census Bureau staff will contact your office within 48 hours with information on how to proceed. 3 FORM D-2004(6-28-2017) 4.4 On-site Visits The Census Bureau may make an on-site visit to review a participant's security procedures. The Census Bureau will strive not to disrupt office operations. A visit may include a review of: • Storage and handling of Title 13 materials. • Employee access to Title 13 materials. • Physical safeguard of stored Title 13 materials. • IT Systems, including use of passwords. • Employee awareness of their responsibilities to Title 13 materials. 4.5 Destruction of Census Bureau Confidential Materials After the entire LUCA operation has concluded, all Title 13 materials must be destroyed (preferred method) or returned according to the Census Bureau's specific guidelines. The LIJCA liaison is required to verify the destruction or return of any Title 13 materials, both paper and digital, including all paper copies, backup files, etc., by signing and returning the Destruction or Return of Title 13, U.S.C. Materials form. In addition, anyone who signed the Confidentiality Agreement is required to sign this form once their participation in LUCA has ended. Should any liaison, reviewer, or anyone who signed the Confidentiality Agreement leave before the completion of LUCA, they must sign and date this form. If any liaison, reviewer, or anyone who signed the Confidentiality Agreement is unable to sign and date the form, the current liaison must sign and date on their behalf. Only individuals who signed the Confidentiality Agreement are permitted to destroy Title 13 materials: • Never deposit Title 13 materials in a trash or recycle container, or dispose of information in a landfill before destruction procedures are completed. • Destruction must prevent recognition or reconstruction of paper or digital Title 13 materials. Use one of the following methods: o Shredding or pulping. o Chemical decomposition. o Pulverizing (such as, hammer mills, choppers, etc.). o Burning (facility approved by the Environmental Protection Agency). o Clear dedicated digital media containing Title 13 materials before reuse. Overwrite Title 13 digital data minimally three times using a commercial disk utility program. o Clearing or sanitizing all print servers and multifunction printing or scanning devices with stored images or print files containing Title 13 data. o Destroying CDs and DVDs using a shredder or other method suitable for rendering them un-usable. Note: Hand tearing is an unacceptable method of disposal before destruction. See the National Institute of Standards and Technology, Special Publication 800-88, Revision 1, Guidelines for Media Sanitization for further information on acceptable methods for digital media and office equipment sanitization. <http://nvlpubs.nist.gov/nistpubs/SpecialPublications/NISTSP800-88r1 pdf> 4 FORM D-2004(6-28-2017) 4.6 Returning Census Bureau Title 13 Materials After the entire LUCA operation has concluded,all Title 13 materials must be destroyed (preferred method) or returned according to the Census Bureau's specific guidelines. If you choose to return the Title 13 materials rather than destroying them, follow these guidelines: 1) Ship the Title 13 materials, double-wrapping them by using an inner and an outer envelope (or container), one within the other. These should be durable enough to prevent someone from viewing or tampering with the enclosed material. 2) Label both sides of the inner envelope (or container) with the notice: "DISCLOSURE PROHIBITED BY Title 13, U.S.C" 3) Place the inner envelope (or container) into the outer envelope. 4) Use the mailing label that was included in the initial mail-out of materials.If you have misplaced the mailing label, please contact the Census Bureau to have a replacement label sent to you. 5) Include with the returned materials, a signed D-2012,Destruction or Return of Title 13, U.S.C. Materials Form. Ensure that all reviewers and anyone with access to the Title 13 LUCA materials signs this form. 6) If you do not use the mailing label, ship using a service that provides tracking information, such as U.S. Postal Service trackable delivery, FedEX, United Parcel Service (UPS), or similar service. INNER ENVELOPE OUTER ENVELOPE DISCLOSURE PROHIBITED ATIN: Geography LUCA BLDG 63-E BY 15t1e 13,U.S.C. National Processing Center 1201 East 10th Street (on both sides) Jeffersonville,IN 47132 5 FORM D-2004(6-28-2017) FORM D-2005(4-5-2017) OMB No. 0607-0994: Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID ,United States CONFIDENTIALITY Economics and Statistics Administration Census AGREEMENT FORM U.S.CENSUS BUREAU PL5335415 2020 2020 CENSUS LOCAL UPDATE OF Government Name CENSUS ADDRESSES OPERATION (LUCA) Kent city CONDITIONS,A. TERMS, OPERATION All LUCA liaisons, reviewers,and anyone with access to Title 13, United States Code(U.S.C.)LUCA materials must agree to keep confidential the Title 13 materials to which they have access,including any maps that contain structure points showing the location of living quarters.They may use this information solely for suggesting improvements to the Census Bureau's address list and maps. All individuals who will review or have access to Census Bureau Title 13 materials must sign below to indicate they have read and understand the Census Bureau's Confidentiality and Security Guidelines for LUCA. In addition.those who sign the agreement swear,under penalty of perjury,to maintain the confidentiality of Census Bureau materials protected under Title 13. Further,a signature indicates recognition that the penalty for wrongful disclosurd is a fine of not more than$250,000 or imprisonment for not more than 5 years,or both.Although access to the data is temporary.this commitment is permanent.You must be at least 18 years of age to sign this agreement. By signing this agreement,your government agrees to destroy all Census Bureau Title 13 materials or return them to the Census Bureau at the completion of LUCA. LIAISONB. • • Liaison's Printed Name Area code Telephone number Ext Liaison's i nature Date Month Day Year / l 1 o i Nam&iUCA Liaison's Office, Department, or Agency- (Assessor's Office, Planning Department, Regional Planning Agency, etc.)-Please print Address of LUCA Liaison's Office, Department, or Agency-(House number and street name, RR or HC, and box number)-Please print 22& 9`-r4 City State n ZIP Code } {N .�—/ I Email address `\ C. INFORMATION FOR • TO TITLE 13, U.S.C. MATERIALS Printed name Area code Telephone number Ext. J L t45 r) - - - Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code i I Email address Printed name Area code Telephone number Ext. L a Vt\e r j v\ ucA-- 5 -PM - 5 5 - Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Section C continued on Cam, � �q� � ' C,v the reverse I I IIII III II III II II II IIII III III II III 37736 C. INFORMATION FOR REVIEWER(S)and PERSON(S)WITH ACCESS TO TITLE 13,U.S.C. MATERIALS-Continued Printed name Area code Telephone number Ext. [_+e_Q'q, --FP,a 4f-ke--1- - Z S 3 - ,t _, - M 3F i 7 - Sig at re Date Month Day Year l r z iE I Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code i I Email address kb)_v-CL C__k cf,{ Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Printed name Area code Telephone number Ext. 7-1 FTT71 Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Printed name Area code Telephone number Ext. Signature Date Month Day Year Address, if different from Liaison- (House number and street name, RR or HC, and box number)-Please print City State ZIP Code I I E-mail address Complete this form and return it along with the completed, signed copies of the Registration Form, Self-Assessment Checklist and the Product Preference Form. Use the enclosed postage-paid envelope addressed to ATTN:Geography LUCA 63-E, National Processing Center, 1201 East 10th St., Jeffersonville IN 47132. Rather than mailing, you may scan your completed forms, including forms with signatures, and email them to us at GE0.2020.LUCAQcensus.4ov FORM D-2005 (4-5-2017) FORM D-2002(2-22-2017) OMB No.0607-0994:Approval Expires 12/31/2019 U.S. DEPARTMENT OF COMMERCE Entity ID Economics and Statistics Administration U.S.CENSUS BUREAU PL5335415 2020�"��� REGISTRATION FORM 2020 CENSUS LOCAL UPDATE OF CENSUS Government Name L L ADDRESSES OPERATION (LUCA) Kent city RESPONSEA. PARTICIPATION 1. N.YES Our government is registering for LUCA.— Complete Sections B and C. 2. ❑ NO Our government is not registering for LUCA. — Complete Section B and mark an(X) for each reason that applies: a. ❑ Another level of government (state or county) f. ❑ Concerns about Census Bureau Title 13 materials that includes our jurisdiction is participating in LUCA 9- ❑ Restrictions on using Census Bureau Title 13 materials for b. other purposes c. ❑ insufficient staff h. ❑ Other reason —Specify(Please print) 7 ❑ Lack of funds d. ❑ No time/too busy e. ❑ No local address list available Thank you for your comments. We will use them to help improve future LUCA operations. B. SIGNATURE OF TRIBAL CHAIR OR HIGHEST ELECTED/APPOINTED OFFICIAL RESPONDING TO THE LUCA INVITATION 1. Printed name of Tribal Chair or Highest Elected Official/Appointed Official—First middle initial,last C5u 7- fly 11 0per% 2. Signatures Tribal Chair or Hi hest El cted Official/Appointed Official Fae Day Year ion—_ e.g., Tribal Chair, Governor, Commissioner, Mayor, Supervisor;please do not abbreviate)—Please print Number and street name 4. Physical/ Mailing city State ZIP Code address I I 5. Telephone 6. Email address Area code Number Extension LIAISONC. • - • DesignateThis is the person . . Complete this section only if you are participating in LUCA 1. Name—(Please print) r ro rl/l I q, o y- Ao �10. 2. Department, Organizations or Agency name— (e.g., Planning and Zoning, Regional Planning Agency,please do not abbreviate) 3. Position— (e.g., Tribal President, Director, Assdsor, Planner;pl6ase do not abdreviate) 4. Number and stree#name Physical/ 2 j ' V�' ✓o u' O Mailing City State ZIP Code address I I I AJ ) J .15 Z 5. Telephone 6. Email address Area code Number Extension ^� 1 Complete this form and return it along with the completed,signed copies of the Product Preference Form,Self-Assessment Checklist,and Confidentiality Agreement.Use the enclosed postage-paid envelope addressed to ATTN.Geography LUCA Materials 63-E,National Processing Center, 1201 East 10th St,Jeffersonville IN 47132.As an alternative,you may scan your completed forms,including forms with signatures,and email them to GEO.2020.LUCA@census.gov.