Congratulations on having been selected for the Long-Probe B form of the United States Census. Remember: filling out the form is non-compulsory, but failure to submit may result in an income tax audit, foreclosure on all property, and Department of Justice agents egging your home. Also, remember: census data can only be used in arranging voting districts, allocating public money, and singling-out undesirables. This data cannot be redistributed to other government agencies, sold to direct-mailing companies, or passed around the office to amuse census workers and their friends.
Name used in underage porn chat rooms:
Gender (original): M F
How much did you earn last year?
How much did you claim you earned on last year's tax forms?
I pay my Federal Income Tax: Sometimes Occassionally Never
Are you or have you ever been a member of a(n):
Big Money P.A.C.
Philanthropic Buddhist Temple
If so, enter name and contact info:
Are you an illegal alien? Yes No
Do you know any illegal aliens? Yes No
Do you listen to Ricky Martin in English or in Spanish?
Do you own a bathtub? Yes No
How often do you bathe?
Whenever the illegal aliens in my bathtub complain about the smell.
When you have completed the form, please submit.