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National Census of Population, Households and Dwellings 2001

Republic of Argentina
Ministry of Economics
Secretary of Economic Politics
National Institute of Statistics and Censuses

Strictly confidential and reserve character -- Law No. 17. 622.

Cover page of the segment of households

Geographic location of the segment

___ Province
___ Municipality
___ Department/Administrative Area
___ Locality/Place

_ _ Fraction No.
_ _ Range No.
_ _ Segment No.

Information on the external structure of the segment

Instruction: Mark if this Segment has the following characteristics. If a Segment has places in which a characteristic is present and other places where it is not, mark the predominant condition.

Located in an emergency camp:

[] Yes
[] No

Located in a flood-prone zone:

[] Yes
[] No

Has a garbage dump within 300 meters (3 blocks):

[] Yes
[] No

Has sewer:

[] Yes
[] No

Has running water:

[] Yes
[] No

Has electric power through residential network:

[] Yes
[] No

Has street lighting:

[] Yes
[] No

Has gas line (natural gas):

[] Yes
[] No

Has at least one paved city block:

[] Yes
[] No

Has regular service of waste collection (at least 2 times per week):

[] Yes
[] No

Has public transportation available within 300 meters (3 blocks):

[] Yes
[] No

Has public telephone within 300 meters (3 blocks):

[] Yes
[] No

_ _ Last number used for numbering the document
_ _ Total number of forms turned in

Note: Remember to record these totals, transferring the results from form C2:

_ _ _ Total population
_ _ _ Total number of men
_ _ _ Total number of women

___ Name and last name of the enumerator
___ Name and last name of the range chief

[Page break. Title material for the census form is repeated on the original document and is not presented here.]

Geographic location [for the dwelling]

Street ____
No. _ _ _ _ _
Floor _ _
Apt/Room _ _ _

_ _ Fraction No
_ _ Range No
_ _ Segment No
_ _ Block No
_ _ Document No

The interview is not done in this dwelling because:

[This question is asked only in case of a dwelling that cannot be further enumerated.]

Mark an item only after you have returned to the dwelling as many times as necessary.

[] All people are temporarily absent
[] The dwelling is for rent or for sale
[] The dwelling is under construction
[] The dwelling is used as a store/office/doctor's practice
[] The dwelling is used on vacations or weekends
[] The dwelling is closed for unknown reasons
[] The dwelling is abandoned

Enumerator note: Remember that, for the census, a household is a single person or a group of people who share food expenses and live under the same roof.

Guide for identifying households:

1. Upon arriving to the dwelling you must enumerate, inquire how many people spent the night there.
2. Ask if all the people share food expenses.
3. Open a census document for each household identified.

List of people of this dwelling who spent the night here

1. What are the names of the people of this dwelling who spent the night here from Friday to Saturday?

Write down the names and the relationship to the head of household in the following manner: Head, spouse, child, stepchild, daughter/son-in-law, grandchild, parent, mother/father-in-law, other non-relatives, domestic servants, and their families.

If there are more than 7 people: (1) Continue in another document. (2) Fill in the block "Geographic Location" with the information from this document and continue with question 1, writing down the people to be listed, starting with the second line.

Person No. _ _
Name ____
Relationship to the head ____

2. Does anybody in this household descend from or belong to an indigenous population?

[] Yes; to which population?
[] Chané
[] Chorote
[] Chulupí
[] Diaguita Calchaquí
[] Huarpe
[] Kolla
[] Mapuche
[] Mbyá
[] Mocoví
[] Ona
[] Pilagá
[] Rankulche
[] Tapiete
[] Tehuelche
[] Toba
[] Tupí Guaraní
[] Wichí
[] Other indigenous population
[] Unknown
[] No

3. [Disability:] In this household, is anybody:

[] Deaf or needs earphones?
[] Blind in one or both eyes?
[] Missing or has degenerate arms, hands or legs?
[] Retarded or with mental problems?
[] Have any other permanent disability?
[] There are no people with disabilities in the household.

Household
[Questions 4-24.]

4. This household occupies:

Instruction: determine by observation

[] House
[] Shack
[] Hut
[] Apartment
[] Room/s in a tenement home
[] Room/s in a hotel or boarding house
[] Place not built for habitation
[] Mobile dwelling
[] On the street; go to person 1 [skip questions 5-24]

[Questions 5-24 were asked in the case of households that occupied some structure, per question 4.]

5. What is the predominant material of the floor?

[] Ceramic, floor tile, mosaic floor, marble, wood or carpeted
[] Cement or set bricks
[] Dirt or loose bricks
[] Others

6. What is the predominant material in the exterior walls?

[] Brick, stone, block or concrete
[] Adobe
[] Wood [skip question 7]
[] Metal sheet of cement fiber [skip question 7]
[] Straw-and-clay mix, cardboard, palm leaf, straw or waste material [skip question 7]
[] Others [skip question 7]

7. Do the outside walls have plaster/external covering (including exposed brick)?

[Questions 7 was asked in the case of households with brick, stone, block or concrete and adobe as predominant material in the exterior walls, per question 6.]

[] Yes
[] No

8. What is the predominant material of the exterior covering of the roof?

[] Asphalt covering or membrane
[] Floor tile or flat stone (without covering)
[] Slate or tile
[] Metal sheet (without covering)
[] Fibrocement [asbestos] sheet or plastic
[] Cardboard sheet
[] Cane, board or straw with mud, only straw
[] Others

9. Does the ceiling have interior panels or covering?

[] Yes
[] No
[] Unknown

10. [Water supply:] Does it have water?

[] By pipes within the dwelling
[] Outside the dwelling but within the property
[] Outside the property

11. Where does the water used for drinking and cooking come from?

[] From public network (running water)
[] From perforation with a motorized pump
[] From perforation with a hand pump
[] From a well with a pump
[] From a well without a pump
[] From rain water
[] From a cistern truck
[] From a river, canal, stream

12. Does it have a bathroom/latrine?

[] Yes
[] No [skip questions 13-16]

13. The bathroom, does it have a toilet?

[] Yes
[] No [skip questions 14-15]

14. Does the toilet have a button/chain/tank?

[] Yes
[] No

15. The toilet is discharged:

[] To a public system (sewer)
[] To a septic chamber or septic tank
[] Only to a septic tank
[] Hole, excavation in the ground, etc.

16. The bathroom / latrine is:

[] Used only by this home
[] Shared by other homes

17. Does it have a place for cooking?

[] Yes
[] No [skip question 18]

18. In this place, are there water installations?

[] Yes
[] No

19. What fuel is used principally for cooking?

[] Gas from network
[] Gas in a tube
[] Gas from cylinder
[] Firewood or coal
[] Other

20. How many rooms for sleeping does this home have? _ _

[Specify] number of rooms it has for sleeping.

21. In total, how many rooms does this dwelling have (apart from bathrooms and kitchens)? _ _

[Specify] total number of rooms.

22. The dwelling that occupies this household, is:

[] Owned
[] Rented [skip question 23]
[] Loaned [skip question 23]
[] Ceded by work [skip question 23]
[] Other situation [skip question 23]

23. Is the plot of land owned?

[Question 23 was asked in the case of owned dwellings, per question 22.]

[] Yes
[] No
[] Unknown

24. Do you have:

Refrigerator with freezer / single freezer?
[] Yes
[] No
Refrigerator without freezer?
[] Yes
[] No

Automatic washer?
[] Yes
[] No
Common washer?
[] Yes
[] No

Video cassette player / player?
[] Yes
[] No

Cellular telephone?
[] Yes
[] No
Landline telephone?
[] Yes
[] No

Cable television?
[] Yes
[] No

Microwave oven?
[] Yes
[] No

Computer with connection to the internet?
[] Yes
[] No
Computer only?
[] Yes
[] No

Population
[Question 1-40.]

Complete a population questionnaire for each member of the household.

Person No. _ _

Write down the order number assigned in the List of people who spent the night in the dwelling.

1. Relationship [to the head of the household]

[] Head
[] Spouse
[] Child / stepchild
[] Son-/daughter-in-law
[] Grandchild
[] Father/mother/father-/mother-in-law
[] Other relatives
[] Other non-relatives
[] Domestic service and their relatives

2. Sex

[] Male
[] Female

3. How old are you?

[] Still under 1 year old
[] If one year old or older, mark the years with two digits _ _
[] Older than 99 years old, write down the age _ _ _

4. Do you know how to read and write?

[] Yes
[] No

5. Do you receive retirement payments or pensions?

[] Yes
[] No

6. Are you:

A member of an emergency medical service?
[] Yes
[] No
A member of a private or mutual health plan?
[] Yes
[] No
Affiliated with a social institution?
[] Yes
[] No

7. Do you habitually live:

Remember to always complete the corresponding bubble.

[] In this locality or place?
[] In this province but in another locality or place?
If the answer is the city of Buenos Aires, write down Federal Capital.

____ Province
____ Locality or place
[] In another province of Argentina?
If the answer is the city of Buenos Aires, write down Federal Capital.

____ Province
____ Locality or place
[] In another country? Country: ____

8. Where did you live five years ago:

Remember to always complete the corresponding bubble.

[] In this locality or place?
[] In this province but in another locality or place?
If the answer is the city of Buenos Aires, write down Federal Capital

____ Province
____ Locality or place
[] In another province of Argentina?
If the answer is the city of Buenos Aires, write down Federal Capital

____ Province
____ Locality or place
[] In another country? Country: ____
[] Had not been born yet
[] Ignored

9. Were you born in Argentina?

[] Yes. Province of Birth: ____ [skip question 10]
[] No. Country of Birth: ____

10. For how many years have you lived in Argentina? _ _

Only for those born in another country [per question 9].

[] Unknown

For persons 3 years old or older

[Questions 11-19 were asked of persons age 3+.]

11. Do you attend any educational establishment?

[] Yes
[] No [skip questions 12-14]

[Questions 12 was asked of persons age 3+ attending any educational establishment.]

12. The establishment is:

[] Public
[] Private

[Questions 13 were asked of persons age 3+ attending any educational establishment.]

13. What level do you currently attend?

[] Initial (kindergarten or preschool) (End questionnaire) [skip questions 14-40]
[] Primary
[] E.G.B. (basic general education)
[] Secondary
[] Multidisciplinary (Polimodal)
[] Non-university tertiary
[] University

14. What grade or year are you in? ____

[Question 14 was asked of persons age 3+ attending any educational establishment at a level higher than initial, per questions 11 and 13.]

[Specify and skip questions 15-19.]

[Questions 16-17 were asked of persons age 3+ who were not currently attending an educational establishment, but attended it in past, per questions 11 and 15.]

16. What was the highest level that you attended?

[] Initial (kindergarten or preschool)
[] Primary
[] E.G.B. (basic general education)
[] Secondary
[] Multidisciplinary (Polimodal)
[] Non-university tertiary
[] University
[] Unknown

17. Did you complete this level?

[] Yes
If university level was marked, go to 19 [skip question 18]
If a level different than university was marked, go to 20 [skip questions 18-19]
[] No
[] Unknown

18. What was the last grade or year that you passed?

[Specify and] turn page [skip question 19]

[] None
[] [Specify] ____
[] Unknown

19. What is the name of the university career that you completed? (Only for those who completed the university level)

[Question 19 was asked of persons age 3+ who were not currently attending any educational establishment but attended one in past, and who completed the highest level attended, per questions 11, 15 and 17.]

For women and men 14 years old or older

[Questions 20-36 were asked of persons age 14+.]

20. What is your legal civil state?

[] Single
[] Married
[] Divorced
[] Legally separated
[] Widowed
[] Unknown

21. Do you live with a partner or in matrimony?

[] Yes
[] No -- go to question 24 [skip questions 22-23]

22. Is this the first time that you have lived with a partner or in matrimony?

[Question 22 was asked of persons age 14+ who live with a partner or in matrimony, per question 21.]

[] Yes
[] No -- go to question 24 [skip question 23]

23. In what year did you begin living together?

[Question 23 was asked of persons age 14+ who live with a partner or in matrimony for the first time, per questions 21-22.]

[Specify and] go to question 24

[] [Specify] _ _ _ _
[] Unknown

24. During last week, did you work, even if for only a few hours?

[] Yes -- go to 28 [skip questions 25-27]
[] No
[] Unknown

25. Did you perform any non-chore activity at home or did you help anyone in a business, small farm or job?

[Question 25 was asked of persons age 14+ who did not indicate that they formally worked last week, per question 24.]

[] Yes -- go to 28 [skip questions 26-27]
[] No
[] Unknown

26. Did you have a job but were on-leave because of sickness, vacations, etc.?

[Question 26 was asked of persons age 14+ who did not indicate that they worked last week, either formally or informally, per questions 24-25.]

[] Yes -- go to 28 [skip question 27]
[] No
[] Unknown

27. During the last four weeks, did you look for work?

[Question 27 was asked of persons age 14+ who did not indicate that they worked last week, either formally or informally, and did not indicate that they have a job, per questions 24-26.]

If female: continue with question 37 [skip questions 28-36].
If male: end questionnaire [skip questions 28-40].

[] Yes
[] No
[] Unknown

In the main job, in that where you work the most hours:

[Questions 28-36 were asked about the main job where the person works the most hours.]

[Questions 28-31 were asked of persons age 14+ who worked last week or had a job, per questions 24-26.]

28. In the place or establishment where you work, what activity is the main activity or what the main service rendered? ____

29. What is the name of the occupation? ____

30. What duties do you perform in this job? ____

31. In the principal job, you are:

[] Worker or employee
[] Boss [skip questions 32-33]
[] Own-account worker [skip questions 32-33]
[] Family worker [skip questions 32-34]

32. Do you work in. . .

[Question 32 was asked of persons age 14+ who worked last week or had a job as a worker or employee, per questions 24, 25, 26, and 31.]

[] A public sector job (national, provincial or municipal)?
[] A private sector job?
[] Unknown

33. In this job, is there a deduction [from your salary] for your retirement?

[Question 33 was asked of persons age 14+ who worked last week or had a job as a worker or employee (per questions 24, 25, 26 and 31) or as a family worker with a wage (per question 35).]

[] Yes [skip questions 34-35]
[] No
[] Unknown

34. In this job, do you voluntarily contribute for your retirement?

[Questions 34 was asked of persons age 14+ who worked last week or had a job, excluding family workers without wage, per questions 24, 25, 26, 31, and 35.]

[] Yes
[] No
[] Unknown

35. Do you receive a [money] wage?

[Questions 35 was asked of persons age 14+ who worked last week or had a job as a family worker, per questions 24, 25, 26 and 31.]

[] Yes [go to 33]
[] No
[] Unknown

36. What is the total number of people who work in the establishment or place where you work?

[Questions 36 was asked of persons age 14+ who worked last week or had a job, per questions 24-26.]

[] 1 to 5
[] 6 to 39
[] 40 or more
[] Unknown

If female: continue with question 37
If male: end questionnaire [skip questions 37-40]

For women 14 years old or older

[Questions 37-40 were asked of women age 14+.]

37. Did you have children born alive?

[] Yes
[] No -- end questionnaire [skip questions 38-40]

[Questions 38-39 were asked of women age 14+ who had children born alive, per question 37.]

38. How many children have you had born alive? _ _

39. How many children are currently alive? _ _

If the respondent is 50 years old or older, end questionnaire [skip question 40]

40. What is the date of birth of your last child born alive?

[Question 40 was asked of women age 14-49 who had children born alive, per question 37.]

_ _ Month
_ _ Year