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Presidency of the Republic's Planning Secretariat
Brazilian Institute of Geography and Statistics
X Brazilian General Census 1991
Demographic Census
Enumeration Form

Group 1 [Household Location and Identification]


1. Municipality

____


For internal use
[Applies to question 2 -3]

2. Folder

____
3. Folder number
____

4. District

_ _

5. Subdistrict

_ _

6. Sector Number

_ _ _ _
7. Block
_ _
8. Side
_ _
9. Number on CD 1.07
_ _ _ _
10. Number on CD 1.03
_ _ _ _


Household Residents
[Applies to questions 11 - 12]


11. Males

_ _


12. Females
_ _

13. Informant

_ _

14. Supplemental questionnaire

[] don't have
[] have
[] this is it

2 Dwelling Characteristics


1. Class [of dwelling]

Private:
[] 1 permanent
[] 2 improvised
[] 3 collective


The following questions are only for permanent private households


2. Type [of dwelling]

House:
[] 1 separate or in housing community
[] 2 housing project
[] 3 in subnormal agglomerate
Apartment:
[] 4 separate or in housing community
[] 5 housing project
[] 6 in subnormal agglomerate



3. Walls

[] 1 masonry
[] 2 close-fitting wood
[] 3 uncoated lathe and plaster
[] 4 found material
[] 5 straw
[] 6 other



4. Roof

[] 1 concrete slab
[] 2 clay tiles
[] 3 cement- asbestos tiles
[] 4 zinc
[] 5 close-fitting wood
[] 6 straw
[] 7 found material
[] 8 other



5. Water supply

With interior plumbing:
[] 1 general system
[] 2 well or spring
[] 3 other form
With exterior plumbing:
[] 4 general system
[] 5 well or spring
[] 6 other form


Sanitation installation
[Applies to question 6 - 7]


6. Drainage?

[] 1 general drainage
Cesspit:
[] 2 connected to river system
[] 3 without drainage
[] 4 rudimentary cesspit
[] 5 primary sewage system
[] 6 other
[] 7 don't know
[] 0 don't have



7. Sanitation: Use [of toilet facilities]

[] 1 only for the household
[] 2 common to more than 1 [household]
[] 0 don't have



8. Condition of ownership

Owned:
[] 1 building and land
[] 2 building
[] 3 rented
Ceded by:
[] 4 employer
[] 5 private
[] 6 other



9. Monthly rent (in Cr$=cruzeiros)

[] 0 don't pay rent
_ _ _ _ _ _ Cr$



10. Fuel used for cooking

[] 1 piped gas
[] 2 only bottled gas
[] 3 only wood
[] 4 bottled gas and wood
[] 5 charcoal
[] 6 other
[] 0 neither stove nor hearth



11. Total number of rooms (when number less than 10 put 0 in first field)

_ _



12. Rooms used as bedroom

[] 1 1 room
[] 2 2 rooms
[] 3 3 rooms
[] 4 4 rooms
[] 5 5 rooms
[] 6 6 rooms
[] 7 7 rooms
[] 8 8 rooms
[] 9 9 rooms or more



13. Bathrooms

[] 1 1 bathroom
[] 2 2 bathrooms
[] 3 3 bathrooms
[] 4 4 bathrooms
[] 5 5 bathrooms or more
[] 0 don't have



14. Waste disposal

Collected:
[] 1 directly
[] 2 indirectly
[] 3 burned
[] 4 buried
Thrown:
[] 5 vacant lots
[] 6 river, lake, ocean
[] 7 other


15. Do Children under 2 years, including any newborns, live in this household?

[] 1 yes
[] 2 no


16. Water Filter

[] 1 have
[] 2 don't have



17. Telephone

[] 1 1 line
[] 2 2 or more lines
[] 0 don't have



18. Private Automobile

[] 1 1 car
[] 2 2 cars
[] 3 3 or more cars
[] 0 don't have



19. Automobile for work

[] 1 owned
[] 2 ceded
[] 0 don't have



20. Radio

[] 1 have
[] 0 don't have



21. Lighting

Electric:
[] 1 with meter
[] 2 without meter
[] 3 oil or kerosene
[] 4 other



The following questions are to be filled out for those with electricity
[Applies to questions 22 - 27]


22. Refrigerator

[] 1 1 door
[] 2 more than one door
[] 0 don't have



23. Black and White Television

[] 1 have
[] 0 don't have



24. Color Television

[] 1 1 television
[] 2 2 televisions
[] 3 3 televisions
[] 0 don't have



25. Freezer

[] 1 have
[] 0 don't have



26. Washing Machine

[] 1 have
[] 0 don't have



27. Vacuum Cleaner

[] 1 have
[] 0 don't have


3. [Individual Characteristics]


1. Sex

[] 1 male
[] 3 female



2. Family relationship or relationship with head of dwelling

[] 1 head
[] 2 spouse
[] 3 child
[] 4 stepchild
[] 5 father or mother
[] 6 mother or father in law
[] 7 grandparent/great grandparent
[] 8 grandchild
[] 9 daughter- or son-in-law
[] 10 brother or sister
[] 11 sister- or brother-in-law
[] 12 other relative
[] 13 person who has permanent residence in the domicile, without being a relative, boarder or employee (agregado)
[] 14 boarder
[] 15 domestic servant



3. Family relationship or relationship with head of household

[] 1 head
[] 2 spouse
[] 3 child
[] 4 stepchild
[] 5 father or mother
[] 6 mother or father in law
[] 7 grandparent/great grandparent
[] 8 grandchild
[] 9 daughter- or son-in-law
[] 10 brother or sister
[] 11 sister- or brother-in-law
[] 12 other relative
[] 13 person who has permanent residence in the domicile, without being a relative, boarder or employee (agregado)
[] 14 boarder
[] 15 domestic servant



4. Belong to which family

[] 1 individual
[] 2 collective dwelling
Multiple families:
[] 1 1st
[] 2 2nd
[] 3 3rd
[] 4 4th
[] 5 5th



5. If the mother resides in the household, indicate the order number in which she was enumerated. If she doesn't live in the household, indicate if she is alive, dead or unknown.

Resides:
_ _ person number
Doesn't reside:
[] 70 alive
[] 80 dead
[] 90 don't know



6. Month and year birth (do not register the day)

_ _ Month
_ _ Year


7. Presumed age (If don't know the month and/or year of birth, indicate number of years thought to have; if less than one year, indicate number of months
_ _ _ 20 1 year or more
_ _ 400 Less than 1 year

8. Age group

[] 1 less than five years
[] 2 five to nine years
[] 3 ten years or more


9. Color

[] 1 white
[] 2 black
[] 3 yellow
[] 4 mixed (parda)
[] 5 indigenous



10. Religion

____



11. Physical or mental handicap

[] 1 blind
[] 2 deaf
[] 3 paralysis on one or both sides
[] 4 paralysis of the legs
[] 5 total paralysis
[] 6 missing extremities or parts thereof
[] 7 mental deficiency
[] 8 more than one
[] 0 none listed



12. In this municipality, lived

[] 1 only in urban zone
[] 2 only in rural zone
[] 3 both rural and urban zone



13. If in question 12, box 3 was selected, indicate how many years ago the last move was made.

_ _ number of years
[] 98 never moved



14. Born in this municipality (if box 1, skip to question 23. If 2, skip to question 17. If 3, respond the following questions.

[] 1 yes and always lived in this municipality
[] 2 yes, but have already lived in another
[] 3 no



[Questions 15-18 only for people who responded number three on question 14]


15. If naturalized or foreign resident, indicate the year that established residency in country

[] 100 native Brazilian
_ _ 2 naturalized Brazilian
_ _ 3 foreigner



16. State or foreign country of birth

____



17/18. Number of years lived without interruption

_ _ number of years in state
_ _ number of years in municipality



For persons who in questions 17/18 responded less than 10 years, in the space "number of years in municipality"
[Applies to questions 19 - 22]


19. Indicate the state abbreviation and the name of the municipality or of the foreign country in which resided before moving to this municipality

_ _ abbreviation
____ name



20. In the locality indicated in question 19, resided in:

[] 1 urban zone
[] 2 rural zone



The following questions are only to be filled out for persons 5 years or older (born before 01 September 1985)
[Applies to questions 21 - 22]


21. Indicate the state abbreviation and the name of the municipality or of the foreign country in which resided on 01 September 1985 (if lived in current municipality, mark box 7 "this one")

_ _ abbreviation
____ name



22. In the locality indicated in question 21, before moving, resided in:

[] 1 urban zone
[] 2 rural zone



23. Knows how to read and write

[] 1 knows how to read and write
[] 2 doesn't know



For persons attending school (if not attending, mark the 0 boxes)
[Applies to questions 24 - 26]


24. Grade attending (for person who is attending adult literacy courses, masters or doctorate, mark 0 "none")

[] 1 1st grade
[] 2 2nd grade
[] 3 3rd grade
[] 4 4th grade
[] 5 5th grade
[] 6 6th grade
[] 7 7th grade
[] 8 8th grade
[] 0 none



25. Level of the grade attending

[] 1 primary or elementary
[] 2 middle/junior school
[] 3 higher
Supplemental general education:
[] 4 1st level
[] 7 2nd level
[] 0 none



26. For the person who is attending non-graded courses (if attending graded course, mark the 0 box)

[] 1 preschool
[] 2 adult literacy course
Supplemental:
[] 3 1st level
[] 4 2nd level
[] 5 college entrance exam
[] 6 masters or doctorate
[] 0 none



For persons not attending school. (If attending school or never attended school, mark the 0 boxes)
[Applies to questions 27 - 28]


27. Last grade passed (for the person who passed adult literacy courses, masters or doctorate, mark 0 "none")

[] 1 1st grade
[] 2 2nd grade
[] 3 3rd grade
[] 4 4th grade
[] 5 5th grade
[] 6 6th grade
[] 7 7th grade
[] 8 8th grade
[] 9 never attended
[] 0 none



28. Last level passed

[] 1 adult literacy course
[] 2 primary or elementary
[] 3 middle/junior school
[] 4 1st level
[] 5 2nd level
[] 6 senior high or middle school
[] 7 higher
[] 8 masters or doctorate
[] 0 none


The following questions are to be filled out only for the person 10 years or older (born before 01 September 1980)
[Applies to questions 29 - 61]


29. Type of the highest course passed

____



30. Do you live or have you lived in the company of a spouse, common-law husband or wife, etc.? (If responded 2, skip to question 35 or 45, depending on what applies.)

[] 1 yes
[] 2 no



[Questions 31 to 34 were asked of those who live or have lived in the company of a spouse, common-law husband or wife, etc.]




31. If answer to question 30 was 1, indicate the month and year entered into first union

_ _ month
_ _ year
[] 13 don't remember



32. If live with partner - spouse, companion, etc., indicate the nature of the relationship

[] 1 civil and religious marriage
[] 2 only civil marriage
[] 3 only religious marriage
[] 4 consensual union



33. If not living with partner - spouse, companion, etc., indicate if it is:

[] 5 non judicial separation
[] 6 separated
[] 7 abandoned (desquitado)
[] 8 divorced
[] 9 widowed



34. If responded to question 32 indicate the month and year the current union began. If responded to question 33, indicate the month or year that indicated situation began.

_ _ month
_ _ year
[] 13 don't remember



Questions 35 - 44 are to be answered by women (if had children of only one gender, mark 00 in the box corresponding the other gender)


35/36. Children that live in this household

[] 7 don't have
[] male
[] female


37/38. Children that live in other household
[] 7 don't have
[] 8 don't know
[] male
[] female


39/40. Children that were born alive that are now dead (don't include children born dead)
[] 7 don't have
[] 8 don't know
[] male
[] female


41/42. Children that were born dead (gestation time no less than 7 months with no sign of life at birth). Do not include abortions.
[] 8 don't know
_ _ / _ _ 1 male (month/year)
_ _ / _ _ 2 female (month/year)


43/44. Sex, month and year of birth of last live birth

[] 7 don't have
male
_ _ month and _ _ _ _ year
female
_ _ month and _ _ _ _ year



45. Worked all or part of the last 12 months (1 September 1989 to 31 August 1990). If 3 (didn't work), skip to question 58.

Worked:
[] 1 regularly
[] 2 sporadically
[] 3 didn't work



46. Occupation, profession, task, function, etc., that was exercised for the longest time. (If changed occupations definitively note current occupation)

____



47. Sector or area activity of establishment, business, institution, etc., where exercised occupation in question 46.

____



48. Type of establishment, organization, institution, etc., where exercised occupation in question 46

____



49. Position in the establishment, organization, institution, etc. declared in question 31

[] 1 migrant agricultural worker
Share cropper:
[] 2 employed
[] 3 self-employed
Domestic worker:
[] 4 employed
[] 5 self-employed
[] 6 employed in private sector
Employed in Public Sector:
[] 7 public servant
[] 8 state employee
[] 9 self-employed
[] 10 employer
[] 11 without remuneration



50. Have signed workers' card

[] 1 yes
[] 2 don't know
[] 3 don't have
[] 4 not employed



51. Number of people that work in the establishment declared in question 48

Number of employees:
[] 1 1 or 2
[] 2 3 or 4
[] 3 5 to 9
[] 4 10 or more
[] 5 work alone
[] 6 with partner or not remunerated
[] 7 domestic worker
[] 8 don't know



52. Locale of work in the occupation declared in question 46

At home:
[] 1 without specific locale
[] 2 with specific locale
Public roadways:
[] 3 with heavy equipment
[] 4 with light equipment or no equipment
[] 5 agricultural/fisheries
[] 6 business or firm
[] 7 in the home of client or boss
[] 8 other



53. Is contributor to social security (Previdenica Publica)

[] 1 yes
[] 2 don't know
[] 3 not a contributor



54/55. Hours usually worked per week (when only worked in one occupation write in 00 in spot for other occupations)

[] occupation in question 46
[] other occupations



56. Monthly gross income in August 1990 received in money in the occupation declared in question 46

[] 0 don't have
_ Number of digits
_ _ _ _ _ _ .00 Cr$



57. Monthly gross income in August 1990 received in money in other occupations

[] 0 don't have
_ Number of digits
_ _ _ _ _ _ .00 Cr$



58. If in question 45, responded "don't work", indicate the situation or occupation currently in, following the enumerated order. If "worked", skip to question 59.

Seeking work:
[] 1 have worked
[] 2 never worked
[] 3 retired
[] 4 pensioner
[] 5 live on rent
[] 6 prisoner
[] 7 student
[] 8 sick or invalid
[] 9 homemaker
[] 0 no occupation



59. Indicate if person is retired and/or pensioner

[] 0 neither
[] 1 retired
[] 2 pensioner
[] 3 pensioner and retired



60. Gross monthly income for the month of August 1990, resulting from retirement and/or pension.

[] 0 don't have
_ _ _ _ _ _ Cr$



61. Gross monthly income for the month of August 1990, or monthly average of other sources of income that don't fall into any of the abovementioned categories, such as rents, leases, donations, capital earnings, etc.

[] 0 don't have
_ _ _ _ _ _ Cr$