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:
[] No
Located in a flood-prone zone:
[] No
Has a garbage dump within 300 meters (3 blocks):
[] No
Has sewer:
[] No
Has running water:
[] No
Has electric power through residential network:
[] No
Has street lighting:
[] No
Has gas line (natural gas):
[] No
Has at least one paved city block:
[] No
Has regular service of waste collection (at least 2 times per week):
[] No
Has public transportation available within 300 meters (3 blocks):
[] No
Has public telephone within 300 meters (3 blocks):
[] 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 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:
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:
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?
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?
[] Chorote
[] Chulupí
[] Diaguita Calchaquí
[] Huarpe
[] Kolla
[] Mapuche
[] Mbyá
[] Mocoví
[] Ona
[] Pilagá
[] Rankulche
[] Tapiete
[] Tehuelche
[] Toba
[] Tupí Guaraní
[] Wichí
[] Other indigenous population
[] Unknown
3. [Disability:] In this household, is anybody:
[] 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.
4. This household occupies:
[] 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?
[] Cement or set bricks
[] Dirt or loose bricks
[] Others
6. What is the predominant material in the exterior walls?
[] 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)?
[] Yes
[] No
8. What is the predominant material of the exterior covering of the roof?
[] 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?
[] No
[] Unknown
10. [Water supply:] Does it have water?
[] Outside the dwelling but within the property
[] Outside the property
11. Where does the water used for drinking and cooking come from?
[] 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?
[] No [skip questions 13-16]
13. The bathroom, does it have a toilet?
[] No [skip questions 14-15]
14. Does the toilet have a button/chain/tank?
[] No
15. The toilet is discharged:
[] To a septic chamber or septic tank
[] Only to a septic tank
[] Hole, excavation in the ground, etc.
16. The bathroom / latrine is:
[] Shared by other homes
17. Does it have a place for cooking?
[] No [skip question 18]
18. In this place, are there water installations?
[] No
19. What fuel is used principally for cooking?
[] Gas in a tube
[] Gas from cylinder
[] Firewood or coal
[] Other
20. How many rooms for sleeping does this home have? _ _
21. In total, how many rooms does this dwelling have (apart from bathrooms and kitchens)? _ _
22. The dwelling that occupies this household, is:
[] 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?
[] Yes
[] No
[] Unknown
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
Complete a population questionnaire for each member of the household.
Person No. _ _
1. Relationship [to the head of the household]
[] Spouse
[] Child / stepchild
[] Son-/daughter-in-law
[] Grandchild
[] Father/mother/father-/mother-in-law
[] Other relatives
[] Other non-relatives
[] Domestic service and their relatives
3. How old are you?
[] 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?
[] No
5. Do you receive retirement payments or pensions?
[] No
6. Are you:
[] No
[] No
[] No
7. Do you habitually live:
[] In this locality or place?
[] In this province but in another locality or place?
____ Province
____ Locality or place
____ Province
____ Locality or place
8. Where did you live five years ago:
[] In this locality or place?
[] In this province but in another locality or place?
____ Province
____ Locality or place
____ Province
____ Locality or place
[] Had not been born yet
[] Ignored
9. Were you born in Argentina?
[] No. Country of Birth: ____
10. For how many years have you lived in Argentina? _ _
[] Unknown
For persons 3 years old or older
[Questions 11-19 were asked of persons age 3+.]
11. Do you attend any educational establishment?
[] No [skip questions 12-14]
[Questions 12 was asked of persons age 3+ attending any educational establishment.]
12. The establishment is:
[] Private
[Questions 13 were asked of persons age 3+ attending any educational establishment.]
13. What level do you currently attend?
[] Primary
[] E.G.B. (basic general education)
[] Secondary
[] Multidisciplinary (Polimodal)
[] Non-university tertiary
[] University
14. What grade or year are you in? ____
[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?
[] Primary
[] E.G.B. (basic general education)
[] Secondary
[] Multidisciplinary (Polimodal)
[] Non-university tertiary
[] University
[] Unknown
17. Did you complete this level?
If a level different than university was marked, go to 20 [skip questions 18-19]
[] Unknown
18. What was the last grade or year that you passed?
[] None
[] [Specify] ____
[] Unknown
19. What is the name of the university career that you completed? (Only for those who completed the university level)
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?
[] Married
[] Divorced
[] Legally separated
[] Widowed
[] Unknown
21. Do you live with a partner or in matrimony?
[] 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?
[] Yes
[] No -- go to question 24 [skip question 23]
23. In what year did you begin living together?
[Specify and] go to question 24
[] [Specify] _ _ _ _
[] Unknown
24. During last week, did you work, even if for only a few hours?
[] No
[] Unknown
25. Did you perform any non-chore activity at home or did you help anyone in a business, small farm or job?
[] 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.?
[] Yes -- go to 28 [skip question 27]
[] No
[] Unknown
27. During the last four weeks, did you look for work?
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:
[] Boss [skip questions 32-33]
[] Own-account worker [skip questions 32-33]
[] Family worker [skip questions 32-34]
32. Do you work in. . .
[] 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?
[] Yes [skip questions 34-35]
[] No
[] Unknown
34. In this job, do you voluntarily contribute for your retirement?
[] Yes
[] No
[] Unknown
35. Do you receive a [money] wage?
[] Yes [go to 33]
[] No
[] Unknown
36. What is the total number of people who work in the establishment or place where you work?
[] 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?
[] 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? _ _
40. What is the date of birth of your last child born alive?
_ _ Month
_ _ Year