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Republic of Belarus
Population Census of 2009

Description of habitation, list of persons, regularly (permanently) residing in the household

Form 1-premise

[Dwelling Questionnaire]

Number of enumeration area _ _
Number of instructors' district _ _
Number of enumeration district _
Number of premise within enumeration district _ _ _

Oblasts, the Minsk city ____
District or city district ____
City or urban settlement ____
Rural council ____
Rural settlement ____
Avenue, street, lane _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
House number _ _ _
Building number _ _ _
Apartment _ _ _ _
Phone number ____

In case there is no house number, indicate:
Name and initials of owner, tenant (subtenant) ____

Section I. Description of habitation

1. Type of habitation:

[] 1 Apartment residential house [to question 2]
[] 2 Apartment [to question 2]
[] 3 Garden apartment, dacha
[] 4 Dormitory for pupils and students
[] 5 Dormitory (other than dormitory for pupils and students)
[] 6 Hotel
[] 7 Other dwelling premise
[] 8 Non-dwelling premise, used to live
[For responses from code number 3 to 8 end of interview on section 1]

[Questions 2-5 were asked of households whose type of habitation was apartment residential house or apartment.]

2. Period of construction of the house:

[] 1 Prior to 1946
[] 2 1946-1960
[] 3 1961-1970
[] 4 1971-1980
[] 5 1981-1990
[] 6 1991-2000
[] 7 2001-2005
[] 8 2006-2009

3. Material used to build outer walls of the house:

[] 1 Brick, stone
[] 2 Concrete panels
[] 3 Blocks
[] 4 Monolith
[] 5 Wood
[] 6 Mixed material
[] 7 Other material

4. Please, specify total area of your one-apartment house or an apartment:

_ _ _ (square meters, in whole figures)

5. Please, indicate all amenities, available at your house or apartment:

[] 1 Water supply
[] 2 Sewage
[] 3 Bath and (or) shower cabin
Heating:
[] 4 Centralized
[] 5 Individual boiler or unit
[] 6 Stove or furnace heating
Natural gas supply:
[] 7 Network or pipeline
[] 8 Liquidized (bottled)
Hot water:
[] 9 Centralized
[] 10 Individual boiler
[] 11 Electric range
[] 12 Telephone line

Section II. List of households and their members
[Questions were asked of all households]

1. How many households live in this particular place? _

Start filling in Section II with first person, whom the household members would define themselves and in relation to whom all household members have to identify their kinship.

List of members of household No. _

1. No. _ _ _
2. Name, middle and last name ____
3. Relative or other kinship to the person listed first in the household ____
4. Was temporary absent in the course of census_
Indicate:
5. The reason ____
6. Length of being absent, months (in case less than a month -- "0") _ _

7. Failure to read a line_

In case the number of household members exceeds 7 please, continue filling the list on the page 3. Upon completion the list please, specify if you were temporarily staying in this household:

During the night 13-14 October respondents permanently residing outside the Republic of Belarus

[] Yes -- fill in the Form 3BB
[] No

Within the period 14-24 October respondents permanently residing the Republic of Belarus that nobody is able to provide the information about their permanent address

[] Yes -- fill in the control questionnaire
[] No

Section III. Housing conditions of the household No. _
(Filled for households, residing in one-apartment dwelling houses, apartments at multistoried dwellings)

1. Who owns the building or the habitation?

[] 1 State-owned
[] 2 Private property of citizens
[] 3 Private property of non-state legal persons
[] 4 Space is rented from other citizens

2. How many rooms does your household occupy?

[] 1 _ _
[] 2 Part of the room

3. Does your household or one of its members owns other habitation (other than mentioned in Section 1 question 1)?

[] 1 An apartment residential house
[] 2 A part of an apartment residential house
[] 3 Apartment
[] 4 Separate room in the apartment
[] 5 Garden apartment, dacha
[] 6 No

4. Is there a computer in the household?

[] 1 Yes
Is there access to Internet?
[] 1 Yes
[] 2 No
[] 2 No

Form 2H: Personal Questionnaire

Number of enumeration area _ _
Number of instructors' district _ _
Number of enumeration district _
Number of premise within enumeration district _ _ _
Number of household within the premise _

Number of person (from column 1 of the list of household members in Form 1-premise) _ _ _
Name, initials and last name ____

1. Please, tell the date of your birth

Date _ _
Month _ _
Year _ _ _ _
Years old _ _ _

2. Gender (sex)

[] 1 Male
[] 2 Female

3. What relationship are you in with an individual, listed first in the household?

[] 1 Listed first
[] 2 Wife, husband
[] 3 Daughter, son, step-daughter, step-son
[] 4 Mother, father
[] 5 Sister, brother
[] 6 Mother-in-law, father-in-law
[] 7 Daughter-in-law, son-in-law
[] 8 Grandmother, grandfather
[] 9 Granddaughter, grandson
[] 10 Other type of kinship
[] 11 Not relative

Number of mother (or father) (from column 1 of the list of household members in Form 1-premise) _ _ _

4. Your marital status?

For individuals 15 years old and senior.
[Question 4 was asked of persons age 15+.]

[] 1 Was never married
[] 2 Married
[] 3 In common law marriage
[] 4 Widow, widower
[] 5 Officially divorced
[] 6 Split

Number of (cohabiter) spouse (from column 1 of the list of household members in Form 1-premise) _ _ _
[This question was asked of persons who were married or were in common law marriage.]

5. Place of your birth?

[] 1 Republic of Belarus
[] 2 Other country, indicate name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

6. Have you been residing in this urban settlement or rural area district permanently from birth?

[] 1 Yes [to question 8]
[] 2 No

6.1 Indicate the period when you arrived to this locality:
[] 1 Till 2005 [to question 8]
[] 2 From 2005 till October 13 of the current year (indicate month and year): month _ _ year _ _ _ _

6.2 Indicate the place of your previous residence:

[] 1. Republic of Belarus
[] 1 City
[] 2 Urban settlement
[] 3 Rural area
Indicate the name of the city, urban settlement, administrative district _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[] 2. Other country, indicate name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ [to question 7.3]

7. Have you lived for more than 1 year in any other country from 2005 till October 13 of the current year?

[Question 7 was asked of persons who arrived at their current residence between 2005 and October 13 of the current year.]

[] 1 Yes
[] 2 No [to question 8]

7.1 From which country did you arrive to the Republic of Belarus for permanent abiding place? ____

7.2 Indicate month and year of your arrival:

Month _ _ year _ _ _ _

7.3 Why did you arrive to the Republic of Belarus for the permanent abiding place? (Indicate only one main reason)

[] 1 Employment
[] 2 Studies
[] 3 Marriage
[] 4 Return to previous place of residence
[] 5 Family circumstances
[] 6 Asylum seeking
[] 7 Other reason

[Questions were asked of all persons]

8. Your citizenship

[] 1 Republic of Belarus
[] 2 Other country, indicate name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
[] 3 Without citizenship

9. Which nationality you consider yourself belonging to? (based on self-determination and desire of the interviewed person)

[] 1 Belarussian
[] 2 Belarussian
[] 3 Polish
[] 4 Ukrainian
[] 5 Other, indicate the nationality ____
[] 6 declined to name the nationality

10. Please indicate your mother tongue (the tongue of your childhood):

[] 1 Belarussian
[] 2 Russian
[] 3 Other, please indicate which ____

11. Which language do you usually speak at home?

[] 1 Belarussian
[] 2 Russian
[] 3 Other, please indicate which ____

12. Which other language(s) do you use freely?

[] 1 Belarussian
[] 2 Russian
[] 3 Other, please indicate which language(s) ____
[] 4 Do not know

For individuals aged 10 and senior.
13. Which is your education level?
[Question 13 was asked of persons age 10+]

[] 1 Primary basic
[] 2 Basic general
[] 3 Secondary general
[] 4 Vocational technical
[] 5 Special secondary

[] 6 Higher
Do you have the scientific degree?
[] 1 Yes
[] 1 Candidate of science
[] 2 Doctor of science
[] 2 No
[] 7 Have no education
Can you read and write?
[] 1 Yes
[] 2 No


For individuals aged 6-60 years.

14. Do you study at the educational institution?

[] 1 Yes, indicate the type of educational institution:
[] 1 Secondary
[] 2 Vocational technical
[] 3 Special secondary
[] 4 Higher

[] 2 No

For children aged 3-7 years that do not go to school.
15. Does the child go to pre-school educational institution?

[] 1 Yes
[] 2 No

16. Indicate the sources of means for existence available to you in the current year:

[] 1 Employment (other than in personal plot)
[] 2 Personal subsidiary plot
[] 3 Scholarship
[] 4 Pension (other than disability pension)
[] 5 Disability pension
[] 6 Benefit (other than unemployment one)
[] 7 Unemployment benefit
[] 8 Other type of state benefit
[] 9 Renting out space, property, interests, dividends
[] 10 Savings
[] 11 Dependent
[] 12 Other source

In case the interviewed person has a number of sources, please indicate the main one _ _

17. Did you work during the last week prior to census (7-13 October 2009 of the current year)? (any paid job or income-generating activity, unpaid job in family business)

[] 1 Yes [to question 17.1]
[] 2 Temporarily did not work because of illness, paid leave, maternity leave, child care leave up to 3 years old, work on the rotational basis and other specific work type, taking extension courses and so on [to question 17.1]
[] 3 No [to question 18]

If the respondent had two or more places of employment, questions 17.1-17.4 should refer to the place of employment which he/she considers the main.
[After responding to questions 17.1-17.4, skip question 18.]

17.1 Whereabouts of your place of employment?
[] 1 At the territory of your locality

[] 2 At the territory of other locality of the Republic of Belarus
[] 1 City
[] 2 Urban settlement
[] 3 Rural area

Indicate the name of the city, urban settlement, administrative district ____
[] 3 At the territory of other country, indicate name ____

17.2 What type of products produced or services rendered does the company (employer) you have been employed with? (For individual entrepreneurs -- kind of activity)
Please provide the detailed answer. ____

Indicate full name of the organization (employer) or its unit you have been employed. ____

17.3 Describe your position, functional duties or the work you have been doing, indicating major occupation (for example, drug-store manager, chemical engineer, chief economist, head of department, truck rider, car driver, seller at the market)
Please provide the detailed answer. ____

17.4 What was your position at work?
[] 1 Hired worker
Self-employed:
[] 2 Involving hired workers
[] 3 Without hiring workers
[] 4 Family member, assisting a relative without pay
[] 5 Other

18. Have you been seeking employment during the last month before the population census (from 13 September till 13 October of the current year)?

[Question 18 were asked of persons age 15+ who did not work during the last week prior to census (7-13 October 2009 of the current year), per question 17.]

[] 1 Yes
In case you find the job, would you be able to start in two weeks?
[] 1 Yes
[] 2 No
[] 2 No
Please indicate one main reason:
[] 1 Found employment, started own business and would do it in the nearest 2 weeks
[] 2 Found employment expecting the answer
[] 3 Expecting the start of working season
[] 4 Lost hope to find employment
[] 5 Retired
[] 6 Health status
[] 7 Study at educational institution
[] 8 Housewife, take care of children and other family members
[] 9 No need or desire to work
[] 10 Other reason ____

19. How many children did you give birth to?

For females aged 15 and senior.
[Question 19 was asked of females age 15+.]

[] Please indicate total number of children born alive: _ _
[] No one