Household and Housing Conditions Questionnaire (long form)
Governorate: ____
City: ____
District/Markaz: ____
Shyakha/Village: ____
Enumeration area number: ____
Road/Hamlet name: ____
Road/Hamlet number: ____
Block number: ____
Building number or owner's name: ____
Census building number: ____
Location of the living quarter from the building: ____
Household serial number: ____
Tribe name (boundaries governorate): ____
[] 2 More than one apartment
[] 3 Villa
[] 4 Farm building
[] 5 One or more rooms in a housing unit
[] 6 Independent room or more
[] 7 Tent
[] 8 Grave yard enclosure
[] 9 Other
[] 2 Furnished rent
[] 3 Owned
[] 4 Publicly owned
[] 5 Grant
[] 6 In return of services
[] 7 Other
[] 2 Pump
[] 3 Well
[] 4 Others
[] 2 Tap inside building
[] 3 None
[] 2 Kerosene
[] 3 Propane
[] 4 Other
[] 2 Natural gas
[] 3 Kerosene
[] 4 Electricity
[] 5 Other
[] 2 Share
[] 3 None
[] 2 Shared
[] 3 None
[] 2 Shared
[] 3 None
[] 2 Shared
[] 3 None
[] 2 Electric washing machine
[] 3 T. V. black and white
[] 4 T. V. colored
[] 5 Cooker
[] 6 Water heater
[] 7 Deep freezer
[] 8 Video
[] 9 None
[] 2 Motorcycle
[] 3 Bicycle
[] 8 None
[In the following section, space is given for answers from up to five household members' answers. Not shown here. See original document for details.]
2. Relationship to the head of the household
[] 2 Female
[] 2 Christian
[] 3 Jewish
[] 4 Other
[] 2 Foreigner
6. Birth date or age (completed years)
Age ____
7. Educational status or last educational certificate
[Question 7 was asked of persons 10 years and over.]
[] 2 Illiterate
[] 3 Read and write (literate)
[] 4 Certificate
Persons six years and over
[Questions 8-11 asked of persons six years and over.]
[] 2 Employer
[] 3 Self-employed
[] 4 Employee
[] 5 Unpaid worker
[] 6 Seeking work (old)
[] 7 Seeking work (new)
[] 8 Student
[] 9 Housewife
[] 10 Not willing to work
[] 11 Retired
[] 12 Aged not working
[] 13 Unable to work
9. Name of establishment the person is working in ____
[] 2 Governmental
[] 3 Public
[] 4 Private
[] 5 Foreign
[] 6 Not working
12. Main occupation ____
[ Question 12 was asked of persons 15 years and over.]
13. Marital status
[Question 13 was asked of males 18 years and over and females 16 and over.]
[] 2 Never married
[] 3 Married
[] 4 Engaged
[] 5 Divorce
[] 6 Widowed
14. Number or current wives ____
District/Markaz: ____
Governorate: ____
18. Place of work or study ____
19. Previous residence prior to the present ____
20. Cause of changing previous residence
[] 2 Study
[] 3 Marriage
[] 4 Divorce/Widowed
[] 5 Accompanied
[] 6 Other
[] 7 No change
21. Duration of residence prior to the present ____
Female ____
Number of household members ____
[] Christian
[] Other
6-9 years ____
12-64 years ____
65 years and over ____
Literate ____
Less than university degree ____
University degree ____
Unemployed ____
Married ____
Engaged ____
Divorced /Widowed ____
Part D: Contractually married persons but not living as wife and husband
The year of marriage contract ____
Female ____
Total ____
Part F: Ever married women
[Questions 1-6 were asked only of married women.]
Individual data
Person number ____
2. Total marital duration ____
3. Order of current or last marriage ____
4. Number of live births from all marriages
Female ____
5. Number of survival births residing with the household
Female ____
6. Number of survival births not residing with the household
Female ____
[] 2 Female
[] 2 Christian
[] 3 Jewish
[] 4 Other
5. Educational status or last educational certificate
[Question 5 was asked of persons 10 years and over.]
[] 2 Illiterate
[] 3 Read and write (literate)
[] 4 Certificate
6. Main occupation ____
[Question 6 was asked of persons 15 years and over.]
Persons six years and over
[Questions 7-10 were asked of persons six years and over.]
[] 2 Unemployed
8. The state of being present recently ____
9. Total duration of residence abroad ____
10. The reason for being abroad
[] 2 Study
[] 3 Treatment
[] 4 Visited
[] 5 Accompanied
[] 6 Other
F: Summary data of persons abroad
Female ____
[] 2 Christian
[] 3 Jewish
[] 4 Other
6-9 years ____
12-64 years ____
65 years and over ____
Read and write ____
Certificate ____
Unemployed ____
African ____
Asian ____
European ____
America and Australia ____