National Statistics Institute
Population and Housing Census
2011
Write the first and last name of each person that habitually lives in this dwelling.
The children students that are absent during the academic year
The children in shared custody if they live in the dwelling the majority of the time.
Yourself if you live here
First and last names (Example):
Person N. 2 _ _ _ _ _ _ _ _
Person N. 3 _ _ _ _ _ _ _ _
Person N. 4 _ _ _ _ _ _ _ _
Person N. 5 _ _ _ _ _ _ _ _
Person N. 6 _ _ _ _ _ _ _ _
Remember! If more than 6 people live in this dwelling call the free telephone number 900 XXX XXX
2. Property of the dwelling
The dwelling is?
[] Owned, sold, with payments pending (mortgages)
[] Owned by inheritance or donation
[] Rented
[] Freely given or at a low price (by another household, paid for by the company...)
[] Other form
3. Which of the following installations does the dwelling have?
[] Individual
[] Does not have a heating installation but has some apparatus that heats some room (for example: electric radiators)
[] Does not have heating
[] no
[] no
4. Does the dwelling have a contract with an Internet access service?
[] no
5. What is the water supply system?
[] Running water from a private source or private to the building
[] Does not have running water
6. Approximately, what is the useful floor space of the dwelling?
_ _ _ m2
7. How many rooms does the dwelling have?
_ _ rooms
Attention! Fill out the Individual Questionnaire for each one of the persons that has been included in the List of People above. Please, make sure to follow the same order of the List of People.
Individual Questionnaire of Person 1
Write the following information for the person that appears in first place (Person N. 1) in the List of People.
First and Last Names _ _ _ _ _ _ _ _
Date of Birth
_ _ day _ _ month _ _ _ _ year
[] Woman
Country of birth:
[] Spain. Write the municipality and province:
Province _ _ _ _ _ _ _ _
[] Other country _ _ _ _ _ _ _ _
What is his/her nationality?
If he/she has double nationality, Spanish and another, mark both options and write the corresponding country.
If he/she has double nationality but neither is Spanish, write only one of them.
[] From another country _ _ _ _ _ _ _ _
Attention! Answer the questions in order and following the indications.
1. Since what year does he/she reside in this dwelling?
[] Since he/she was born (continue on to question 3)
And in this municipality?
[] Since he/she was born (continue on to question 3)
And in this autonomous community?
[] Since he/she was born
And in Spain?
[] Since he/she was born
Where did he/she reside before arriving to this municipality the last time?
Province _ _ _ _ _ _ _ _
[] In another country _ _ _ _ _ _ _ _
2. Where did he/she reside 1 year ago?
[] In another municipality _ _ _ _ _ _ _ _
Province _ _ _ _ _ _ _ _
[] In another country _ _ _ _ _ _ _ _
Where did he/she reside 10 years ago?
[] In another municipality _ _ _ _ _ _ _ _
Province _ _ _ _ _ _ _ _
[] In another country _ _ _ _ _ _ _ _
3. Space reserved for specific questions about language in Autonomous Communities with co-official languages different than Spanish (go to question 4).
4. In the last twelve months, has he/she spent more than 14 nights (even if not continuous) in another municipality of Spain or in another country?
It can be because of work, studies, weekends, vacations, or because he/she resides in more than one municipality.
[] Yes - Include the place where he/she has spent more nights and the approximate number of nights that he/she has spent there:
[] Other municipality _ _ _ _ _ _ _ _
Province _ _ _ _ _ _ _ _
[] In another country _ _ _ _ _ _ _ _
Does he/she have a second dwelling available in this place (whether property, rental, or freely given)?
[] no
5. What is the marital status of Person 1?
Mark his/her legal situation, even if it does not coincide with the informal status
[] Married
[] Separated
[] Divorced
[] Widowed
6. Do the following family members of Person 1 live in this dwelling?
When you mark yes, write the number of this family member as it appears on the List of People on page 2.
[] yes, Person No. _ _
[] yes, Person No. _ _
[] yes, Person No. _ _
[] yes, Person No. of one of them _ _
7. Where was the father of Person 1 born?
Respond only if the father does not live in this dwelling:
[] Other country _ _ _ _ _ _ _ _
8. Where was the mother of Person 1 born?
Respond only if the mother does not live in this dwelling:
[] Other country _ _ _ _ _ _ _ _
If the Person 1 is 16 years or older, go to question 10. If he/she is younger than 16 years continue with question 9.
9. Does he/she attend a school center (including daycare)?
[] no (the Individual Questionnaire of Person 1 is finished)
10. What is the highest level of studies that he/she has completed?
Mark only one option.
[] Can read and write but attended school for less than five years (go to question 12)
[] Attended school for five or more years but did not complete compulsory secondary education (ESO), basic general education (EGB), or elementary baccalaureate (go to question 12)
[] Completed compulsory secondary education (ESO), basic general education (EGB), elementary baccalaureate, or received completion certificate for compulsory education (go to question 12)
[] Baccalaureate (LOE, LOGSE), unified secondary school diploma (BUP), higher baccalaureate, university orientation course (COU), or pre-university (PREU) (go to question 12)
[] Intermediate professional formation (FR), professional formation I (FP I), official industrial course or equivalent, intermediate professional music and dance training, offical langauge school certificate
[] Higher professional formation, professional formation II (FP II), industrial masters or equivalent
[] General university degree (diplomatura), technical architecture degree, technical engineering degree, or equivalent
[] Bachelor's degree (grado) or equivalent
[] Bachelor's degree (licenciatura), architecture degree, engineering degree, or equivalent
[] Official university master's degree (following 2006), medical specialties, or equivalent
[] Doctorate (PhD)
11. These studies correspond with which field?
Mark only one option and write the name of the title obtained in the row of squares.
[] Arts and humanities (history, language, audio-visual communications...)
[] Law and social sciences (administration, psychology, economics, journalism...)
[] Sciences (biology, chemistry, physics, mathematics...) and information sciences (including information engineering)
[] Architecture, construction, technical formation and industries (mechanical, metal, electronic, design, clothing, food, etc., including engineering of these fields)
[] Agriculture, livestock production, fishing, and veterinary (including agricultural engineering or similar)
[] Health and social services (medicine, nursing, pharmacy, social work...)
[] Other services (tourism, hotels, hair Salons, nautical, military teaching...)
Write the name of the title obtained _ _ _ _ _ _ _ _
12. During the last week, did he/she carry out any of the following tasks without receiving money in exchange?
You can mark various options
[] Care for a person with important health problems
[] Charitable work or social service volunteer
[] Complete the majority of the domestic tasks of the household
[] Did not carry out any of these tasks
13. If Person 1 is a woman, has she had children?
Consider all those that were born alive
[] yes (How many? _ _)
14. In what labor situation was she last week?
[] part-time
[] Unemployed, seeking employment for the first time (go to question 18)
[] Person with permanent labor disability (go to question 18)
[] Retired, pre-retired, pensioned, or rentier (go to question 18)
[] Other situation (go to question 18)
15. What is/was his/her occupation?
If he/she is unemployed, refer to his/her last occupation. Look for it in the Table of Occupations of the Attached pamphlet and note the letter and number to which it corresponds:
Number _
If you have not found his/her occupation or have doubts, write it below: _ _ _ _ _ _ _ _
16. What is/was the principal activity of the establishment or premise where he/she works/worked?
If he/she is unemployed, refer to his/her last occupation. Look for it in the Table of Industries of the Attached pamphlet and note the number to which it corresponds:
If you have not found his/her activity or have doubts, write it below: _ _ _ _ _ _ _ _
17. What is/was his/her professional situation?
Mark only one option
[] that doesn?t employ personnel
[] occasional or temporary
[] member of a cooperative
18. Is he/she receiving some kind of education (including academies, courses organized by the company...)?
[] Basic professional qualification
[] Baccalaureate
[] Intermediate professional formation (FP), plastic arts, design, sports education or equivalent
[] Official language school
[] Professional music and dance
[] Higher professional formation (FP), plastic arts, design, sports education or equivalent
[] General university degree (diplomatura), technical architecture degree, technical engineering degree, or equivalent
[] Bachelor's degree (grado), arts degree, or equivalent
[] Bachelor's degree (licenciatura), architecture degree, engineering degree, or equivalent
[] Official university master's degree (following 2006), medical specialties, or equivalent
[] Doctorate (PhD)
[] Other formal course (basic adult education, etc.)
[] Public service employment course
[] Other informal course
19. Where is his/her place of work or study?
If he/she works and studies, we will inquire about the place where he/she worked last week
[] In various municipalities (commercial, driver...) (the Individual Questionnaire for Person 1 is finished)
[] In this municipality
[] In another municipality _ _ _ _ _ _ _ _
Province _ _ _ _ _ _ _ _
[] In another country _ _ _ _ _ _ _ _
Postal code of his/her center of work or of studies _ _ _ _ _
20. How many round trips does he/she make each day from this dwelling to the place of work or study?
[] One daily (that?s to say, one leaving and one returning)
[] Two or more daily
21. How does he/she normally go from his/her house to the place of work or study?
If he/she utilized various means of transportation, mark the two with which he/she covered the most distance
[] in car or van as passenger
[] in autobus, autocar, minibus
[] in metro
[] in motorcycle
[] walking
[] in train
[] in bicycle
[] other means
22. How much time does it normally take him/her to arrive from the dwelling to the place of work or study?
[] between 10 and 19 minutes
[] between 20 and 29 minutes
[] between 30 and 44 minutes
[] between 45 and 59 minutes
[] between 1 hour and hour and a half
[] more than an hour and a half
The Individual Questionnaire of Person 1 is finished. Continue with the Person 2, or if there are not more people, the census is filled out completely. Insert this little notebook in the free shipping envelope and send it via mail. Many thanks for your collaboration!