Data Cart

Your data extract

0 variables
0 samples
View Cart


Republic of Cuba
National Office of Statistics and Information


Population and Housing
Census
Cuba 2012

[p. 1]

Census questionnaire form C-1

____ Questionnaire number
____ Sheet number
____ Housing unit number

The information requested is obligatory and confidential. Article 8, Decree 291 of 2011.

Section I. Geographical location and address of the housing unit

____ Province
____ Municipality
____ Settlement

Plan Turquino

[] 1 Yes
[] 3 No

____ District
____ Segment
____ Block
____ Popular council
____ Street or avenue
____ Number
____ Apartment
____ Floor
____ Cross-streets
____ Highway, road, km.
____ Name of the estate or site

Household summary

Housing unit number ____
Total households _
Household number _

Total people in this household

By sex
_ _ Total
_ _ Male
_ _ Female
By age group
_ _ 0-15
_ _ 16-59
_ _ 60 and above

For office use

Plan Turquino _
Popular council _ _
Settlement _ _ _
Block_ _ _ _

Section II. Classification of housing units

[] 1 Private housing: go to Section III. Private housing data.
[] 3 Workplaces (with permanent residents): go to Section IV. Personal data.
[] 5 Collective housing (with permanent residents): go to Section IV. Personal data.

Section III. Private housing data
[Applies to questions 1-16]

1. Housing type

(Only mark one)

[] 1 House
[] 2 Apartment
[] 3 Room in bunkhouse or tenement
[] 4 Thatched hut [Bohio]
[] 5 Improvised
[] 6 Other (go to section IV)

2. The home is occupied...?

(Only mark one)

If answered 3-5, end of interview

[] 1 By permanent residents
[] 2 By absent occupants (closed)
[] 3 By temporary residents
[] 4 Seasonally
[] 5 No one (vacant)

3. What is the status of the home?

(Only mark one for houses and apartments)

[] 1 Personal property
[] 2 State leased
[] 3 Vinculada or media básico [public ownership ceded in use]
[] 4 Other
[] 5 Unknown

4. What is the date of construction of the home?

(Only mark one for houses and apartments)

[] 01 Before 1920
[] 02 From 1920 to 1933
[] 03 From 1934 to 1945
[] 04 From 1946 to 1958
[] 05 From 1959 to 1970
[] 06 From 1971 to 1981
[] 07 From 1982 to 1989
[] 08 From 1990 to 2001
[] 09 From 2002 to the date of the census
[] 10 Unknown

5. What is the main material in the home's...

(Only mark one per subsection)

A) the roof?
[] 1 Concrete sheet or slab
[] 2 Beam and slab
[] 3 Wood and mud shingle
[] 4 Wood and tar paper
[] 5 Fiber cement sheet
[] 6 Metallic plate
[] 7 Wood and palm leaf
[] 8 Other

B) the floor?
[] 1 Ceramic slab, granite or tile
[] 2 Cement
[] 3 Wood
[] 4 Dirt
[] 5 Other

C) the exterior walls?
[] 1 Concrete, brick, or blocks
[] 2 Wood
[] 3 Adobe or mud
[] 4 Palm planks
[] 5 Other

6. What defects are present in the home ...

(More than one mark is allowed per subsection)

A) on the roof or mezzanine?

[] 1 Partial collapse
[] 2 Leak
[] 3 Moisture
[] 4 Warping or chipping
[] 5 Crack
[] 6 Exposed steel
[] 7 Rotten wooden in supports
[] 8 None

B) in columns, beams, and architraves?
[] 1 Crack or split
[] 2 Exposed steel
[] 3 None
[] 4 None of the above

C) on the wall and floor?
[] 1 Crack or split
[] 2 Collapse
[] 3 Warping or chipping
[] 4 Leak
[] 5 Sinking of the floor
[] 6 None

D) Does the home have internal and/or external underpinning?
[] 1 Yes
[] 3 No

7. [Number of rooms]

_ _ A) How many rooms does the home have? (Do not count bathrooms, hallways, balconies, open rooms such as: entryways, terraces, galleries, etc.)
_ _ B) How many bedrooms does the home have?
_ _ C) How many rooms are commonly used for sleeping?

8. Does the home have a place to cook?

(Only mark one)

[] 1 Used exclusively by the home
[] 2 Shared by several homes
[] 3 Not present

9. What type of fuel do you use most often for cooking?

(Only mark one)

[] 1 Electricity
[] 2 Manufactured gas (from pipes)
[] 3 Liquefied gas (from a tank)
[] 4 Kerosene
[] 5 Petroleum
[] 6 Alcohol
[] 7 Wood, charcoal, or other
[] 8 None

10. [Water supply]

(Only mark one per subsection, except D and E)

A) How is water supplied to the home?
[] 1 By pipes inside the home
[] 2 By pipes outside of the home
[] 3 By haulage and/or water truck

B) What is the source or origin of the water consumed in the home?
[] 1 Aqueduct
[] 2 Well
[] 3 River or spring
[] 4 Other

C) How often do you receive or acquire water?
[] 1 Daily (24 hours)
[] 2 Daily (less than 24 hours)
[] 3 On alternate days
[] 4 Up to once a week
[] 5 Other

D) Does the home or building have a cistern and/or tank for water storage?
Cistern
[] 1 Yes
[] 3 No
Tank
[] 1 Yes (go to 10E below)
[] 3 No (go to question 11)

E) How does water enter the tank?
[] 1 Gravity or by force of the aqueduct
[] 2 Electric pump
[] 3 Internal combustion pump
[] 4 Windmill
[] 5 Hand pump
[] 6 Other

11. What kind of waste water system does the home have?

(Only mark one)

[] 1 Sewage system
[] 2 Pit or septic tank
[] 3 Other

12. How is garbage normally disposed of in the home?

(Only mark one)

[] 1 Pick-up at home
[] 2 Emptied into a container or public receptacle
[] 3 Dumped in a landfill or common area
[] 4 Burned
[] 5 Buried
[] 6 Removed in another way

13. [Bathroom]

Only mark one per subsection.

A) Does the home have a bath or shower with running water and drainage...?
[] 1 Used exclusively by the home
[] 2 Shared by several homes
[] 3 Not present (go to question 14)
B) The bath or shower is located
[] 1 Within the home
[] 3 Outside of the home

14. [Toilet]

(Only mark one per subsection)

A) Does the home have sanitation services...?
[] 1 Used exclusively by the home
[] 2 Shared by several homes
[] 3 Not present (go to question 15)
B) What kind of sanitation services does the home have?
[] 1 Flush toilet
[] 2 Latrine
[] 3 Outhouse or septic tank
C) The sanitation service is located
[] 1 Within the home
[] 3 Outside of the home

15. What source of energy do you use for lighting the home?

(Only mark one)

[] 1 Union Electrica [electric company]
[] 2 Industrial plant
[] 3 Kerosene
[] 4 Mini hydroelectric
[] 5 Solar panel
[] 6 Biogas
[] 7 Own plant
[] 8 Other

16. For each of the following items, state how many are owned and how many are functional.

a) Radio
____ Number
____ Working

b) Video players (DVD-VCD)
____ Number
____ Working

c) Audio players
____ Number
____ Working

d) Black and white TV
____ Number
____ Working

e) Color TV
____ Number
____ Working

f) Electric stove or burner
____ Number
____ Working

g) Refrigerator
____ Number
____ Working

h) Washing machine
____ Number
____ Working

i) Blender / food processor
____ Number
____ Working

j) Rice cooker and/or pressure cooker
____ Number
____ Working

k) Microwave oven
____ Number
____ Working

l) Electric iron
____ Number
____ Working

m) Fan
____ Number
____ Working

n) Air conditioning
____ Number
____ Working

o) Sowing machine
____ Number
____ Working

p) Computer
____ Number
____ Working

q) Landline telephone (includes 400 minutes)
____ Number
____ Working

r) Mobile phone
____ Number
____ Working

s) Car and/or jeep
____ Number
____ Working

t) Truck and/or tractor
____ Number
____ Working

u) Motorcycle and/or moped
____ Number
____ Working

v) Bicycle
____ Number
____ Working

w) Fixed water heater or electric shower
____ Number
____ Working

[next page]

Section IV. Personal data
[Applies to questions 1-23]

[Original questionnaire includes multiple copies of questions for all household members in page 2-4, and only one copy of questions in page 4 is shown here.]

1. Person number _

Name(s) and surnames ____

2. What type of relationship do you have with the head of household?

[] 0 Head of household
[] 1 Spouse or partner
[] 2 Child
[] 3 Stepchild
[] 4 Son or daughter-in-law
[] 5 Grandchild
[] 6 Parents or in-laws
[] 7 Other relative
[] 8 Other non-relative
[] 9 Member of the collective (go to question 4)

3. What number appears on your mother's, father's and spouse's questionnaire?

(If they do not form part of the household, mark ''0'')

_ _ Child of (mother)
_ _ Child of (father)
_ _ Spouse of

4. Sex

(Only mark one)

[] 1 Male
[] 3 Female

5. What is your date of birth and age (in full years)?

Day _ _
Month _ _
Year _ _ _ _
Age _ _ _

6. What is your skin color?

(Only one mark)

[] 1 White
[] 2 Black
[] 3 Mestizo or mulatto

7. Where did your mother live when you were born?

A) [Location]
[] 1 In this place or settlement (go to question 8A)
[] 3 In another place, settlement, or country (go to question 7B)
[] 9 Unknown (go to question 8A)
B) List the place or settlement, municipality, province and country.
Place or settlement _ _ _
Municipality _ _
Province _ _
Country _ _ _

8A) Have you always lived in this place or settlement?

[] 1 Yes (go to question 10)
[] 3 No (go to question 8B)

8B) In which place or settlement, municipality, province and country did you reside before moving here?

Place or settlement _ _ _
Municipality _ _
Province _ _
Country _ _ _

9. How long have you lived here since moving from the previous place of residence?

Years _ _
[] 00 Less than one year
[] 99 Unknown

10. Do you suffer from any of the following?

[] 01 Permanent speech impairment
[] 02 Hearing loss (hypoacusis)
[] 03 Deafness
[] 04 Blindness
[] 05 Impaired vision
[] 06 Physical or motor limitation
[] 07 Chronic mental illness
[] 08 Mental retardation
[] 09 Chronic kidney failure
[] 10 None of the above

For people over 6 years of age
(End of interview for persons under this age.)
[Questions 11-15 were asked persons over 6 years old]

11. What is the highest grade or level of education passed?

[] 0 None: go to question 15
[] 1 Elementary (1 to 6) _
[] 2 Basic secondary (7 to 10) _
[] 3 Qualified worker (1 to 5) _
[] 4 Pre-university (10 to 13) _
[] 5 Intermediate technical (1 to 5) _
[] 6 Intermediate pedagogy (1 to 5) _
[] 7 Higher education or university (1 to 7) _

12. What is the highest level of education you finished completely?

(Only mark one)

[] 0 None (go to question 15)
[] 1 Elementary
[] 2 Basic secondary
[] 3 Qualified worker
[] 4 Pre-university
[] 5 Intermediate technical
[] 6 Intermediate pedagogy
[] 7 Higher education or university

13. What is the highest degree or title you have achieved? ____

(Examples: intermediate technical in accounting, degree in economics, qualified welder)

According to CE classifications _ _

14. [Postgraduate academic degree]

(Only if you marked 7 on question 12)
[Question 14 was asked of persons whose highest level of education is higher education or university]

A) Do you have any postgraduate academic degrees?
[] 1 Yes
[] 3 No: go to question 15
B) Which?
[] 1 Postgraduate specialist
[] 2 Master
[] 3 Doctorate

15. Do you know how to read and write?

(Mark ''Yes'' without asking if they passed 2nd grade or higher)

[] 1 Yes
[] 3 No

For persons 12 years and older
(End of interview for persons under this age.)
[Question 16 was asked of persons age 12 and older.]

16. What is your civil and/or marital status?

(Only mark one)

[] 1 Married
[] 2 In a civil union
[] 3 Divorced
[] 4 Separated
[] 5 Widowed
[] 6 Single

For persons 15 years and older
(End of interview for persons under this age.)
[Questions 17-23 were asked of persons age 15 and older.]

17. What did you do the week before September 14th?

If answered 01 or 02, go to question 18. If answered 03-13, end an interview.

[] 01 Worked
[] 02 Employed but did not work
[] 03 Looked for work due to loss of job
[] 04 Looked for a job for the first time
[] 05 Retired or pensioned due to age
[] 06 Other pensioners
[] 07 Landlord or received economic assistance
[] 08 Household chores
[] 09 Student
[] 10 Disabled for work purposes
[] 11 Did not perform any activity
[] 12 In hospital or asylum
[] 13 Other situation

18. What is your primary occupation or trade that you perform in this job? ____

(Examples: electrical motor rewinder, teacher, secretary, mechanical engineer, etc.)

According to CNUO classifications _ _ _

19A) What was the name of the workplace where you worked in that week? ____

(Examples: textile combination, maternity hospital, cafeteria, self-employed, cooperative, etc.)

19B) Which work is primarily performed in said workplace? ____

(Examples: ranching, clothing repair, food service, housing services, etc.)

According to NAE classifications (catalogue of economic activities) _ _

20. In your main occupation, were you employed by...?

[] 01 The state
[] 02 Cuban commercial societies
[] 03 A mixed partnership
[] 04 A foreign company
[] 05 Self-employed
[] 06 UBPC (basic cooperative production unit)
[] 07 CPA (agricultural production cooperative)
[] 08 In other cooperatives
[] 09 Small farmer, associated or not with CCS (credit and service cooperative)
[] 10 Beneficial owner of the land associated or not associated with CCS
[] 11 Permanently or temporarily contracted in agricultural activities
[] 12 Privately contracted (non-agricultural) and in homes
[] 13 Unpaid family helper

21. In which municipality do you work...?

[] 1 In this municipality (go to question 22)
[] 3 In another municipality or province (If 3, indicate the municipality or province below)
_ _ Municipality
_ _ Province

22. Do you have a secondary occupation?

(For a secondary occupation to exist, the worker must perform more than one job simultaneously)

[] 1 Yes
[] 3 No (end of the interview)

23. What is your occupation or job in your secondary activity?

(Examples: electrical motor rewinder, teacher, secretary, mechanical engineer, etc.)

According to CNUO classifications _ _ _

Name and surnames of enumerator ____
Enumeration date

____ Day
____ Month

Primary review

____ Supervisor
____ Area Office

[next page]

Form C-lb

List of permanent residents in the housing unit, by household

Please tell me the names of the people who live in the census household, starting with the head of household, followed by the spouse or partner, children, stepchildren, sons- and daughters-in-law, parents or in-laws, other relatives, or other non-relatives.

Remember to start with the primary census household and then continue with the rest.

____ Household number
____ Person number
____ Name(s) and surnames
____ Relationship