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[Brazil 2010 Census Enumeration form]
2010 CD – sample questionnaire

1. Identification - List of addresses (CNEFE)

2. For occupied permanent private housing units - Household characteristics.

2.01 This housing unit is:

[] 1 Owned by a resident - already paid
[] 2 Owned by a resident - being paid
[] 3 Rented
2.011 Rental price R$____.00
[] 4 Ceded by employer
[] 5 Ceded by other means
[] 6 Other condition

Go to 2.02

2.02 The predominant material of this housing unit outside walls is:

[] 1 Masonry - with coating
[] 2 Masonry - without coating
[] 3 Wood suitable for construction (prepared)
[] 4 Coated taipa (coated stucco)
[] 5 Uncoated taipa (uncoated stucco)
[] 6 Reused wood
[] 7 Straw
[] 8 Other material
[] 9 No wall

Go to 2.03

2.03 How many rooms are there in this housing unit?
(Including bathroom and kitchen.)
(Do not consider rooms: corridors, open porches, garages, and other compartments for non-residential purposes.)
_ _

Go to 2.04

2.04 How many rooms are used as bedrooms by residents of this housing unit?
_ _

Go to 2.05

2.05 How many bathrooms are there in this housing unit, exclusively used by residents? (Including those located outside or in the property.)

_ _ bathroom(s) with shower (or bathtub) and toilet
If 9 or more than 9, enter 9. If there is none, enter 0 (zero).
If 0 (zero), go to 2.06. Otherwise, go to 2.07.

2.06 – Does this housing unit have a toilet or hole for the physiological needs, including the toilets located outside or in the property? (Surrounded by walls of any material.)
[Question 2.06 was asked for households that reported no bathrooms for exclusive use of residents, per question 2.05.]
Depending on the region of the country, a toilet is called by different names.

[] 1 Yes (Go to 2.07)
[] 2 No (Go to 2.08)

2.07 The bathroom or toilet drain is connected to:

[] 1 Public sewage or rain system
[] 2 Septic tank
[] 3 Rudimentary septic tank
[] 4 Ditch
[] 5 River, lake or ocean
[] 6 Other sewage system

Go to 2.08

2.08 The form of water supply used in this housing unit is:

[] 1 Public water supply system
[] 2 Spring or well in property
[] 3 Spring or well outside the property
[] 4 Carro-pipa (water tank truck)
[] 5 Rainwater stored in cistern
[] 6 Rainwater stored in another way
[] 7 Rivers, ponds, lakes, and streams
[] 8 Other
[] 9 Spring or well in the village
[] 10 Well or spring outside the village

Go to 2.09

2.09 Is there piped water in this housing unit?

[] 1 Yes, at least in one room
[] 2 Yes, only in the land or property
[] 3 No

Go to 2.10

2.10 The solid waste in this housing unit is:

[] 1 Collected directly by cleaning service
[] 2 Placed in cleaning service bin
[] 3 Burned (in the property)
[] 4 Buried (in the property)
[] 5 Thrown away on vacant lots or public areas
[] 6 Thrown away in river, lake or sea
[] 7 Other destination

Go to 2.11

2.11 Is there electricity in this housing unit?

[] 1 Yes, provided by a distribution company (Go to 2.12)
[] 2 Yes, from other sources (Skip to 2.13)
[] 3 There is no electricity (Skip to 2.13)

[Question 2.12 asked for household with electricity provided by a distribution company.]
2.12 Is there an electricity meter in this housing unit?

[] 1 Yes, for exclusive use
[] 2 Yes, for common use
[] 3 No

Go to 2.13

Does your housing unit have the following items:

2.13 Radio (also as part of a sound equipment)?

[] 1 Yes
[] 2 No

Go to 2.14

2.14 Television?

[] 1 Yes
[] 2 No

Go to 2.15

2.15 Washing machine? (Do not consider semi-automatic models or "tanquinhos")

[] 1 Yes
[] 2 No

Go to 2.16

2.16 Refrigerator?

[] 1 Yes
[] 2 No

Go to 2.17

2.17 Mobile phone?

[] 1 Yes
[] 2 No

Go to 2.18

2.18 Landline phone?

[] 1 Yes
[] 2 No

Go to 2.19

2.19 Personal computer?

[] 1 Yes (Go to 2.20)
[] 2 No (Skip to 2.21)

[Question 2.20 asked of households that reported having a personal computer.]
2.20 Personal computer with internet access?

[] 1 Yes
[] 2 No

Go to 2.21

2.21 Motorcycle for private use?

[] 1 Yes
[] 2 No

Go to 2.22

2.22 Car for private use?

[] 1 Yes
[] 2 No

Go to 3.01

3. For private housing units - International emigration

3.01 Was any person who used to live with you living in another country on July 31, 2010?

[] 1 Yes (Go to 3.02)
[] 2 No (Skip to 4.01)

3.02 Name (go to 3.03) ____

3.03 Sex

[] 1 Male
[] 2 Female

Go to 3.04

3.04 Year of birth _ _ _ _

Go to 3.05

3.05 Year of last departure to live in another country _ _ _ _

Go to 3.06

3.06 Country of residence on July 31, 2010 _ _ _

Go to 4.01

4. Information on residents

4.01 How many people were living in this housing unit on July 31, 2010?____

Go to 4.02

For private housing units:

4.02 This household in under the responsibility of:
(A responsible person is that one recognized as such by other residents of the household)

[] 1 Only one resident
[] 2 More than one resident

Go to 5.01

5. List of residents on July 31, 2010
[Programming instructions omitted.]
Enumerator, read to the respondent:
"In order to fill in the list of relationships, it is necessary to indicate a resident as head of household, who is the person recognized as such by other residents."

5.01 Name of resident____

Go to 5.02

5.02 What is the relationship of this person to the head of household?
Relationship to the head of household

[] 1 Head of household
[] 2 Spouse or partner of different sex
[] 3 Spouse or partner of the same sex
[] 4 Son/daughter of the household head and spouse
[] 5 Son/daughter of the household head only
[] 6 Stepchild
[] 7 Son-in-law or daughter-in-law
[] 8 Father, mother, stepfather or stepmother
[] 9 Father-in-law / Mother-in-law
[] 10 Grandchild
[] 11 Great grandchild
[] 12 Brother or sister
[] 13 Grandparent
[] 14 Other relative
[] 15 Agregado (Non-paying unrelated resident)
[] 16 Housemate
[] 17 Roomer
[] 18 Domestic employee
[] 19 Relative of domestic employee
[] 20 Individual in a collective living quarter

Go to 5.04

5.04 Person number

Go to 5.05

Point out the end of the list of residents.
(After this item has been checked, open the next question)

5.05 Were all the residents, including the absent, elderly and children, listed?

[] 1 Yes (Go to 6.01)
[] 2 No (Go back to the list for inclusion)

6. Resident characteristics

6.00 Person's name ____

6.01 Sex

[] 1 Male
[] 2 Female

Go to 6.02

6.02 What is your month and year of birth?

6.021 Month _ _
6.022 Year _ _ _ _
If month or year is missing, go to 6.03
If month and year are complete, skip to 6.04

6.03 How old were you on July 31, 2010?
[Question 6.03 was asked of persons for whom month and/or year of birth were missing, per question 6.02.]

6.031 If one year or more:
_ _ _ Years
6.032 If less than a year:
_ _ Months

Go to 6.04

6.04 Is your mother alive? (Consider only the biological mother.)

[] 1 Yes, and lives in this household (Go to 6.05)
[] 2 Yes, and lives in another household (Skip to 6.06)
[] 3 No (Skip to 6.06)
[] 4 Unknown (Skip to 6.06)

6.05 Name of the resident's mother

[Question 6.05 was asked of persons who reported that their mother was alive and lives in the same household.]
____

Go to 6.06

6.06 Your color or race is:

[] 1 White
[] 2 Black
[] 3 Yellow
[] 4 Brown
[] 5 Indigenous (skip to 6.08)

(If applied to indigenous land in the sector type and codes 1 to 4 on this item, go to 6.07)
(If sector type is different of indigenous land and codes 1 to 4, skip to 6.12)

6.07 Do you consider yourself indigenous?

[] 1 Yes (Go to 6.08)
[] 2 No (Skip to 6.12)

6.08 What ethnic group or people do you belong to? ____

Go to 6.09

6.09 Do you speak an indigenous language in the household? (Including the use of sign language)

[] 1 Yes (Go to 6.10)
[] 2 No (Skip to 6.11)

6.10 What indigenous languages do you speak in the household (Specify the indigenous language(s) spoken – up to two records.)
[Question 6.10 was asked of persons who reported that an indigenous language was spoken in the household, per question 6.09.]

6.101 First indigenous language spoken ____
6.103 Second indigenous language spoken____

Go to 6.11

6.11 Do you speak Portuguese in the household? (Including the use of sign language)

[] 1 Yes
[] 2 No

Go to 6.12

6.12 What is your religion or cult?
_ _ _ _

If the person is 10 years old or younger, go to 6.13. Otherwise, skip to 6.14

For residents age 10 and younger

(Check the first option in where the person falls, in the order listed)
6.13 Do you have the following type of birth certificate?

[] 1 Birth certificate at registry office
[] 2 Certificate of live birth issued in the maternity or hospital (DNV)
[] 3 Administrative registration of indigenous birth (RANI)
(Only for self-reportedly indigenous people)
[] 4 No
[] 5 Not known

Go to 6.14

Disability - for all residents

6.14 Do you have any permanent difficulty in seeing?
(If you wear glasses or contact lenses, make your evaluation while wearing them)

[] 1 Yes, cannot do it at all
[] 2 Yes, major trouble
[] 3 Yes, some difficulty
[] 4 No, no difficulty

Go to 6.15

6.15 Do you have any permanent difficulty in hearing?
(If you wear a rearing aid, make your evaluation while wearing it)

[] 1 Yes, cannot do it at all
[] 2 Yes, major trouble
[] 3 Yes, some difficulty
[] 4 No, no difficulty

Go to 6.16

6.16 Do you have any permanent difficulty in walking or climbing stairs?
(If you use a prosthesis, cane or assistive device, make your evaluation while using it)

[] 1 Yes, cannot do it at all
[] 2 Yes, major trouble
[] 3 Yes, some difficulty
[] 4 No, no difficulty

Go to 6.17

6.17 Do you have any permanent mental or intellectual disability that limits you in your daily activities such as working, going to school, playing, etc.?

[] 1 Yes
[] 2 No

Go to 6.18

Internal migration and international immigration

6.18 Were you born in this municipality?

[] 1 Yes, and always lived in it (If 5 years or older, skip to 6.27. Otherwise, skip to 6.28)
[] 2 Yes, but have lived in another municipality or foreign country (Skip to 6.23)
[] 3 No (Go to 6.19)

6.19 Were you born in this federation unit (state)?

[Question 6.19 was asked of persons who were not born in their current town, per 6.18.]
[] 1 Yes, and have always lived in it (Skip to 6.24)
[] 2 Yes, but have lived in another federation unit or foreign country (Skip to 6.23)
[] 3 No (Go to 6.20)

6.20 What is your nationality?

[Question 6.20 was asked of persons who were not born in their current state of residence, per 6.19.]
[] 1 Native Brazilian (Go to 6.22)
[] 2 Naturalized Brazilian (Go to 6.21)
[] 3 Foreigner (Go to 6.21)

6.21 In what year did you move to Brazil?

[Question 6.21 was asked of persons who reported that their nationality was either naturalized Brazilian or foreigner, per 6.20.]
_ _ _ _

Go to 6.22

6.22 What is the federation unit (state) or foreign country of birth?

[Question 6.22 was asked of persons who were born in a foreign country or born in a state other than that of their current residence.]
[] 1 Federation unit ____
[] 2 Foreign country_ _ _

Go to 6.23

[Questions 6.23 and 6.24 were asked of persons who have ever lived somewhere other than their current town (per Question 6.18).]

6.23 How long has this person lived without interruption in this federation unit (state)?

(If less than 1 year, record zero)
Number of years ____

Go to 6.24

6.24 For how long have you lived without interruption in this municipality?
(If less than 1 year, record zero)
Number of years____

If for less than 10 years, go to 6.25.
If for 10 years or more and if you are 5 years old or over, go to 6.27. Otherwise, skip to 6.28.

6.25 In which federation unit (state) and municipality or foreign country had you lived before moving to this municipality?

[Question 6.25 was asked for persons who had lived in their current town for less than ten years, per question 6.24.]
[] 1 Federation unit /municipality

6.251 Federation unit _ _ _
6.253 Municipality_ _ _
[] 2 Foreign country
6.255 Foreign country _ _ _

In item 6.24, if the person has lived in their current municipality for less than 6 years and is 5 years old or over, proceed to 6.26.
In item 6.24, if the person has lived in their current municipality for 6 years or more and is 5 years old or over, skip to 6.27.
If the person is less than 5 years old, skip to 6.28.

6.26 In which federation unit and municipality or foreign country were you living on July 31, 2005?

[Question 6.26 was asked for persons are 5 years of age or more and who have lived in their current town for less than 6 years.]
[] 1 Federation unit /municipality

6.261 Federation unit _ _ _
6.263 Municipality_ _ _
[] 2 Foreign country
6.265 Foreign country _ _ _

If the person is 5 years old or over, go to 6.27. Otherwise, skip to 6.28.

Education
For people aged 5 years or more
[Questions 6.27 to 6.36 were asked for persons 5 years old or over.]

6.27 Can you write and read?

[] 1 Yes
[] 2 No

Go to 6.28

6.28 Are you currently attending school or day care?

[] 1 Yes, public (Go to 6.29)
[] 2 Yes, private (Go to 6.29)
[] 3 No, but have attended before (skip to 6.33)
[] 4 No, have never attended (If the person is age 10 or older, skip to 6.37. Otherwise, skip to 6.70)

For persons who attend school or day care.

6.29 What type of school or day care do you attend?

[Question 6.29 was asked for persons who reported that they attended school or day care, per question 6.28.]
[] 01 Day care (skip to 6.36)
[] 02 Pre-school (kindergarten and maternal) (Skip to 6.36)
[] 03 Literacy class (Skip to 6.36)
[] 04 Youth and adult literacy (Skip to 6.36)
[] 05 Regular elementary school (Go to 6.30)
[] 06 Youth and adult elementary education -- or supplementary elementary school (Skip to 6.36)
[] 07 Regular high school (Skip to 6.31)
[] 08 Youth and adult upper secondary education -- or supplementary high school (Skip to 6.36)
[] 09 College (skip to 6.32)
[] 10 Graduate specialization (at least 360 hours) (Skip to 6.35)
[] 11 Master's degree (Skip to 6.35)
[] 12 Doctorate (Skip to 6.35)

6.30 What grade/year are you attending?

[Question 6.30 was asked for persons who reported attending regular elementary school, per question 6.29.]
[] 01 First year
[] 02 First grade/second year
[] 03 Second grade/third year
[] 04 Third grade/fourth year
[] 05 Fourth grade/fifth year
[] 06 Fifth grade/sixth year
[] 07 Sixth grade/seventh year
[] 08 Seventh grade/eighth year
[] 09 Eighth grade/ninth year
[] 10 Non-graded course

Skip to 6.36

6.31 What grade are you attending?

[Question 6.31 was asked for persons who reported attending high school, per question 6.29.]
[] 01 First grade
[] 02 Second grade
[] 03 Third grade
[] 04 Fourth grade
[] 05 Non-graded course

Skip to 6.36

6.32 Have you finished another higher education course?

[Question 6.32 was asked for persons who reported attending college, per question 6.29.]
[] 1 Yes (Skip to 6.35)
[] 2 No (Skip to 6.36)

For people who were not attending school or day care, but had attended before.

6.33 What was the highest level course you have attended?

[Question 6.33 was asked for persons who were older than age 5, not attending school or day care, but had attended school or daycare in the past, per question 6.28.]
[] 01 Day care, pre-school (kindergarten and maternal), literacy classes (Go to 6.34)
[] 02 Youth and adult literacy (Go to 6.34)
[] 03 Former primary education (elementary) (Go to 6.34)
[] 04 Former lower secondary education ( ginásio or middle 1st cycle) (Go to 6.34)
[] 05 From 1st to 3rd grade / from 1st to 4th year (if person is 10 years or older, go to 6.37. If person is less than 10 years of age skip to 6.70)
[] 06 From 4th to 5th year (if person is 10 years or older, go to 6.37. If person is less than 10 years of age skip to 6.70)
[] 07 From 5th to 8th grade / from 6th to 9th year (Go to 6.34)
[] 08 Supplementary elementary school or 1st level (Go to 6.34)
[] 09 Former upper secondary education (scientific, classical, etc., or middle 2nd cycle) (Go to 6.34)
[] 10 Youth and adult upper secondary education (Go to 6.34)
[] 11 College (Go to 6.34)
[] 12 Graduate specialization (at least 360 hours) (Go to 6.34)
[] 13 Master (Go to 6.34)
[] 14 Doctorate (Go to 6.34)

6.34 Have you completed this course?

[] 1 Yes
[] 2 No

(If codes 12, 13 or 14 in question 6.33, go to 6.35)
(If code 11 at question 6.33 and code 1 in this question, go to 6.35)
(If code 11 at question 6.33 and code 2 in this question, skip to 6.37)
(If codes 01 to 10 at question 6.33 and has 10 years of age or older, skip to 6.37)
(If codes 01 to 10 at question 6.33 and has less than 10 years of age, skip to 6.70)

[Asked to people who have completed or are currently attending post-secondary education]
6.35 What is the highest course you have concluded?

[] 1 College _ _ _ _ _
[] 2 Master's degree _ _ _ _ _
[] 3 Doctorate_ _ _ _ _

(If code 1 or 2 in item 6.28, follow 6.36. Otherwise, skip to 6.37)

Commuting (for people who are attending school or day care)

6.36 In what city and federation unit (state) or foreign country are you attending school (or day care)?

[] 1 This municipality (If the person is 10 years or older, go to 6.37. Otherwise, skip to 6.70)
[] 2 In another municipality
6.361 Federation Unit _ _ _
6.363 Municipality _ _ _
[] 3 In a foreign country
6.365 Foreign country _ _ _

Nuptiality
For persons 10 years of age or older
[Questions 6.37 to 6.40 were asked for persons 10 years of age and older.]

6.37 Do you live with a spouse or partner?

[] 1 Yes
(If woman in indigenous area, go to 6.38)
(If woman, in a non-indigenous area, and relationship with the responsible person from 04 to 19, go to 6.38. Otherwise, skip to 6.39)
[] No, but have lived with spouse or partner before (Skip to 6.40)
[] No, have never lived with spouse or partner (Skip to 6.40)
(In the system, the serial number of the person indicated should be recorded)

6.38 - Name of spouse or partner (a)____

6.39 What is the nature of the union?

[] 1 Civil and religious marriage
[] 2 Only civil marriage
[] 3 Only religious marriage
[] 4 Consensual union

Go to 6.40

6.40 What is your marital status?

[] 1 Married
[] 2 Separated or legally separated
[] 3 Divorced
[] 4 Widowed
[] 5 Single

Go to 6.41

Work and earnings
For persons aged 10 years or older
[Questions 6.41 to 6.59 were asked for persons 10 years of age or older.]

In the week of 25 to 31 July, 2010, for at least 1 hour:
6.41 Did you work in some paid activity: for cash, products, goods or benefits?
(Benefits: housing, food, training, etc.)

[] 1 Yes (Skip to 6.45)
[] 2 No (Go to 6.42)

In the week of 25 to 31 July, 2010:
6.42 Did you have any paid work from which you were temporarily away?
(Due to: vacations, leave, voluntary absence, strike, disease, bad weather conditions, etc.)

[Question 6.42 was asked of persons who had not worked and earned in the reference week, per question 6.41.]
[] 1 Yes (Skip to 6.45)
[] 2 No (Go to 6.43)

In the week of 25 to 31 July, 2010, for at least 1 hour:
6.43 Did you have any kind of work without payment, like helping another member of household who is paid for this work?

[Question 6.43 was asked for persons who had not worked for pay in the reference week and did not report being temporarily away from paid work in that time period, per 6.42.]
[] 1 Yes (Skip to 6.45)
[] 2 No (Go to 6.44)

In the week of 25 to 31 July, 2010, for at least 1 hour:
6.44 Did you work in any agricultural, animal breeding or fishing activities for only household members' consumption?
(Including hunting, and vegetal extraction.)

[Question 6.44 was asked of persons who reported not working for pay, not being on leave, and not helping with the paid work of other members of the household during the reference week, per question 6.43.]
[] 1 Yes (Skip to 6.46)
[] 2 No (Skip to 6.54)

[Questions 6.45 to 6.53 were asked for persons who reported working for pay, being temporarily away from a paid job, or helping another member of the household with a paid job during the reference week.]

6.45 How many jobs did you have?

[] 1 One
[] 2 Two or more

Go to 6.46

Questions 6.46 to 6.49 should refer to the single or main job that the person had during the reference week.

Attention

Criteria to define the main job during the reference week:
1. Greater number of hours usually worked per week;
2. Greater usual monthly income;
3. Work that has been done for the most time.

6.46 What was your occupation in the job? ____

Go to 6.47

6.47 What was the main activity of the enterprise (business, firm, company, institution, authority, etc.) in which you were employed?____

(If code 1 in question 6.44, skip to 6.53. Otherwise, go to 6.48)

6.48 In this work, were you:

[] 01 Employee with a formal contract
[] 02 Army, navy, air force, police and firemen military member (Skip to 6.51)
[] 03 Public sector employee
[] 04 Employee without a formal contract (Skip to 6.50)
[] 05 Self-employed
[] 06 Employer (Go to 6.49)
[] 07 Unpaid worker (If code 1 in item 6.45, skip to 6.53. If code 2 in item 6.45, skip to 6.50)

6.49 How many people have you employed in this enterprise?

[Question 6.49 was asked of persons who reported being an employer (per 6.48).]
[] 1 1 to 5 persons
[] 2 6 people or more

Go to 6.50

6.50 Did you contribute to social security in any job you had in the week of 25 to 31 July, 2010?

[Question 6.50 was asked of persons who reported working during the reference week but were not in the military.]
[] 1 Yes, in the main work
[] 2 Yes, in another work
[] 3 No

Go to 6.51

6.51 In your main job, what was your usual gross monthly income (or withdrawal) in July, 2010?

[] 1 In cash, products or goods ____
[] 2 Only in benefits (housing, food, training, etc.).
[] 0 None
6.511 R$____.00

(If code 1 in question 6.45, skip to 6.53. If code 2 in 6.45 go to 6.52)

6.52 In other jobs, what was your usual gross monthly income (or withdrawal) in July, 2010?

[Question 6.52 was asked of persons who reported having two or more jobs during the reference period, per question 6.45.]
[] 1 In cash, products or goods ____
[] 2 Only in benefits (housing, food, training, etc.).
[] 0 None
6.521 R$____.00

Go to 6.53

6.53 In your main job, how many hours per week do you usually work?

Hours _ _ _

Skip to 6.56

6.54 During the period of 02 to 31 July, 2010, have you taken steps to get a job?

[Question 6.54 was asked for persons who reported not having worked during the reference period, per questions 6.41 to 6.44.]
[] 1 Yes (Go to 6.55)
[] 2 No (Go to 6.56)

6.55 If you had found a job, would you have been available to start working in the week of 25 to 31 July, 2010?

[] 1 Yes
[] 2 No

Go to 6.56

In July, 2010, did you have a usual monthly income from:

6.56 Retirement or pension from official social security institution (federal, state or municipal)?

[] 1 Yes
[] 0 No

Go to 6.57

6.57 Social program family grant (Bolsa-Família) or program of eradication of child labor (PETI)?

[] 1 Yes
[] 0 No

Go to 6.58

6.58 Income from other social programs or transfers?
Continuous cash benefit (BPC/LOAS), allowance or donation of a non-resident, alimony, unemployment benefits, scholarship, other programs, etc.

[] 1 Yes
[] 0 No

Go to 6.59

6.59 Other sources (interest on savings, financial investments, rent, or retirement of private social welfare, etc.)

[] 1 Yes
[] 0 No

If the person has answered "yes" to at least one of the questions 6.56 to 6.59, go to 6.591. Otherwise, see commands below.
6.591 In July 2010, what was the total amount of your income?

R $____.00

If code 1 or 2 on question 6.45, go to 6.60
If code 1 on question 6.44, go to 6.60
Otherwise, if the person is a woman, skip to 6.63. If the person is a man, skip to 6.70

Commuting to work

6.60 In which municipality and federation unit or foreign country do you work?

[] 1 In own home (If the person is a woman, skip to 6.63. If the person is a man, skip to 6.70)
[] 2 Only in this municipality, but not in own home (go to 6.61)
[] 3 In another municipality (go to 6.601 and 6.603)
6.601 Federation unit (go to 6.61) _ _ _
6.603 Municipality within the federation unit indicated (go to 6.61)_ _ _

[] 4 In a foreign country (go to 6.605)
6.605 Foreign country (go to 6.61) _ _ _
[] 5 In more than one municipality or country (If the person is a woman, go to 6.63. If the person is a man, go to 6.70)

6.61 Do you return home from work every day?

[] 1 Yes (Go to 6.62)
[] 2 No (If the person is a woman, skip to 6.63. If the person is a man, go to 6.70)

6.62 What is your usual commute time to work?

[] 1 Up to 5 minutes
[] 2 For 6 minutes to half hour
[] 3 Half an hour to an hour
[] 4 More than one hour to two hours
[] 5 More than two hours

If the person is a woman, go to 6.63. If the person is a man, skip to 6.70.

Fertility
For women aged 10 years or more
[Questions 6.63 to 6.69 were asked for women aged 10 years or more]

6.63 How many live births did you have up to July 31, 2010?

[] 1 Live births
6.631 _ _ number of male children (go to 6.64)
6.632 _ _ number of female children (go to 6.64)

[] 2 None (skip to 6.69)

6.64 Among the live births, how many were alive on July 31, 2010?

[] 1 Alive children on July 31, 2010
6.641 _ _ male (go to 6.65)
6.642 _ _ female (go to 6.65)
[] 2 Not known (male and female) alive on July 31, 2010

6.65 What is the sex of the last child born alive by July 31, 2010?

[] 1 Male (follow 6.66)
[] 2 Female

6.66 What is the month and year of your last live birth until July 31, 2010? If you do not know, fill in only the box for presumed age.

6.661 Month _ _
6.662 Year _ _ _ _
6.663 Presumed age on 07/31/2010 if month and year of birth are unknown _ _

Go to 6.67

6.67 Was this child alive on July 31, 2010?

[] 1 Yes (skip to 6.69)
[] 2 No (go to 6.68)
[] 9 Not known (skip to 6.69)

6.68 What was the month and year that this child died?

[] 1 Know year and month or year or month only
6.681 Month _ _
6.682 Year _ _ _ _
[] 2 Not known

Go to 6.69

6.69 How many children born dead did you have until July 31, 2010?
(Seven-month gestation or longer with no vital sign at delivery. Do not include miscarriages.)

[] 1 Number of children born dead (go to 6.691 to 6.693)
6.691 Male_ _
6.692 Female _ _
6.693 Total _ _
[] 2 None (skip to 6.70)
[] 3 Not known (skip to 6.70)

Go to 6.70

(Special Command: The system should enable the 6.693 field only if the item 6.69 is equal to 1 and fields 6.691 or 6692 is(are) blank)

For all residents

6.70 Indicate who provided the information about this person:

[] 1 The own person (end interview with the person)
[] 2 Another resident (end interview with the person)
6.71 Name of other resident____
[] 3 A non-resident (end interview with the person)

(Open list with residents to identify who provided the information)
(In the system, the serial number of the person must be recorded)

7 For private households -- mortality

7.01 Between August, 2009, to July, 2010, did any person who used to live with you die?
(Including neonates and elderly people.)

[] 1 Yes (go to 7.02)
[] 2 No (end interview)

7.02 Name of person who died ____

Go to 7.03

7.03 Month and year of death

[] 1 August, 2009
[] 2 September, 2009
[] 3 October 2009
[] 4 November 2009
[] 5 December 2009
[] 6 January 2010
[] 7 February 2010
[] 8 March 2010
[] 9 April 2010
[] 10 May 2010
[] 11 June, 2010
[] 12 July, 2010

Go to 7.04

7.04 Sex

[] 1 Male
[] 2 Female

Go to 7.05

7.05 Age at death

7.051 In years (if one year or more) _ _ _
7.052 In months (if less than a year) _ _