[p. 1]

Confidential when completed

This information is collected under the authority of the Statistics Act (R.S.C. 1985, c. Sl9) and must be provided by law.

1991 Census of Canada
Census Form 2B Questionnaire
Statistics Canada

To be completed June 4, 1991

A Message from the Chief Statistician of Canada:
The information collected by the 1991 Census is essential to planning Canada's future as we prepare for the twenty-first century. Your answers will be kept strictly confidential - but when combined with the replies of all other Canadians, they will provide the information necessary for a better understanding of our country and our different communities. The results of the census are used in making informed decisions at a national, provincial and local level. Your help is vital in this national endeavour. Please complete your census form by following the steps and mail it back on June 4.
Thank you for your co-operation.
Ivan P. Fekgi
Chief Statistician of Canada

STEP 1: Begin here by printing your address

No. and street or lot and concession ____
Apt No. ____
City, town, village, Indian reserve ____
Province/territory ____
Postal code _ _ _ _ _ _
Telephone number _ _ _ _ _ _ - _ _ _ _

Turn page and continue with STEP 2
[p. 2]
1991 Census Form 2B Questionnaire - continued

STEP 2: How to complete this questionnaire

To answer the questions:
[] Mark a circle
or
_ _ Enter a number in a box
or
____Print in a box

If you require help with any of the questions, use the Guide or call us free of charge. The numbers to call are on page 28.

STEP 3

[] If all persons in this household are foreign residents (see below), mark here and do not complete this questionnaire.
Mail it in the enclosed postage-paid envelope.
Foreign residents are: government representatives of another country attached to the embassy, high commission or other diplomatic body of that country in Canada, and their families; members of the Armed Forces of another country who are stationed in Canada, and their families; or residents of another country visiting in Canada temporarily.

STEP 4

If all persons in this household are staying here temporarily and have a usual home somewhere else in Canada, enter the total number of persons in this box and do not complete this questionnaire ____
Mail it in the enclosed postage-paid envelope.

STEP 5: List below all persons who usually live here as of Tuesday, June 4, 1991.

(Please see Guide for special situations.)
Begin the list with: either the husband, wife or common-law partner of a couple living here; or the parent, where one parent lives with his/her never-married son(s) or daughter(s). If neither of the above applies, begin with any adult living here.
Continue the list with: the wife, husband or common-law partner of Person 1; never-married children of Person 1 (including adopted and stepchildren); other relatives of Person 1 and members of their families, if living here; persons not related to Person 1 and members of their families, if living here.
Be sure to include: children, relatives, room-mates, boarders and live-in employees; anyone temporarily away on June 4, including students away at school, or a husband, wife or others working away from home; anyone who stayed here overnight between June 3 and June 4, who has no usual home somewhere else; anyone who is now in an institution, such as a hospital, a home for the aged or a prison, but only if that person was admitted after December 4, 1990. Don't forget to include yourself!
Person 1 [There is a list for Person 1 up to Person 10 - not shown here.]

Family name ____
Given name ____
Initial ____
If you need more space, use the Comments section on page 28.

[p. 3]

1991 Census Form 2B Questionnaire - continued

STEP 6: Did you leave anyone out of Step 5 because you were not sure the person should be listed?

For example: other relatives living here; a student away at school; a lodger who also has another home; live-in help; or a member of this household who is away in an institution.
[] No
[] 01 Yes - Print the name of each person left out and the reason.

Name ____
Reason ____
Name ____
Reason ____
Name ____
Reason ____
If you need more space, use the "Comments" section on page 28.

STEP 7: How many persons who have a usual home somewhere else in Canada stayed here overnight between June 3 and 4, 1991?

[] None
Or
[] Number of persons ____

STEP 8: Does anyone in this household operate a farm, ranch or other agricultural holding?

Other agricultural holdings include, for example: feedlots; greenhouses; mushroom houses; nurseries; fur farms; and beekeeping, sod, berry and maple syrup operations.
[] No
[] Yes

STEP 9: Turn the page and copy the names from Step 5 into the spaces across the top of the page.

Then continue with the questionnaire.
Note: If there are more than six persons in this household, enter the first six on this questionnaire and continue on a second questionnaire. If you do not have a second questionnaire, not this in the "Comments" section on page 28. A census representative will contact you.

[p. 4]

1991 Census Form 2B Questionnaire - continued
[Space is given for up to 6 household member responses: not shown here.]

1. Name

Make sure you copy the names in the same order as you list in Step 5.
Family name ____
Given name ____
Initial ____

2. Relationship to Person 1

For each person living here, describe his/her relationship to Person 1.
Mark one circle only.
If you mark the circle "other," use the box provided to indicate this person's relationship to Person 1.
Examples of "other" persons related to Person 1: cousin, grandfather/grandmother, son's common-law partner, nephew/niece.
Examples of "other" persons not related to Person 1: lodger's husband/wife or common-law partner, lodger's son/daughter, room-mate's son/daughter, employee.
Person 1:

[] Person 1

Person 2:

[] Husband/wife of Person 1
[] Common-law partner of Person 1
[] Son/daughter of Person 1
[] Son-in-law/daughter-in-law of Person 1
[] Grandchild of Person 1
[] Father/mother of Person 1
[] Father-in-law/mother-in-law of Person 1
[] Brother/sister of Person 1
[] Brother-in-law/sister-in-law of Person 1
[] Lodger/boarder
[] Room-mate
[] Other, specify ____

3. Date of birth

Print day, month and year.
Example: If this person was born on the 10th of February 1945, enter:
If exact date is not known, enter best estimate.
Day _ _
Month _ _
Year 1_ _ _

4. Sex

[] Male
[] Female

5. Legal marital status.

Mark one circle only.
[] Legally married (and not separated)
[] Legally married and separated
[] Divorced
[] Widowed
[] Never married (single)

6. Is this person currently living with a common-law partner?

[] Yes
[] No

[p. 5]
[Space to fill out answers from questions on page 4 for household members 3 through 6.]
[p. 6]

1991 Census Form 2B Questionnaire - continued

Language

7. Can this person speak English or French well enough to conduct a conversation?

Mark one circle only.
[] English only
[] French only
[] Both English and French
[] Neither English or French

8. What language(s), other than English or French, can this person speak well enough to conduct a conversation?

[] None
Or
[] Specify other language(s) ________

9. What language does this person speak most often at home?

[] English
[] French
[] Other, specify ____

10. What is the language that this person first learned at home in childhood and still understands?

If this person no longer understands the first language learned, indicate the second language learned.
[] English
[] French
[] Other, specify ____

Place of birth

11. Where was this person born?

Mark or specify one only, according to present boundaries.
In Canada:

[] Nfld.
[] P.E.I.
[] N.S.
[] N.B.
[] Que.
[] Ont.
[] Man.
[] Sask.
[] Alta.
[] B.C.
[] Yukon
[] N.W.T.

Outside Canada:

[] United Kingdom
[] Italy
[] U.S.A.
[] West Germany
[] East Germany
[] Poland
[] Other, specify ____

[p. 7]

[Space to fill out answers from questions on page 6 for household members 3 through 6.]
[p. 8]
1991 Census Form 2B Questionnaire - continued

Citizenship

12. Of what country is this person a citizen?

Mark more than one circle, if applicable.
[] Canada, by birth
[] Canada, by naturalization
[] Same as country of birth (other than Canada)
[] Other country

Immigration

13. Is this person now, or has this person ever been, a landed immigrant?

[] No -- go to Question 15
[] Yes -- continue with Question 14

14. In what year did this person first become a landed immigrant in Canada?

[Question 14 was asked of persons who have ever been a landed immigrant, per question 13.]
If exact year is not known, enter best estimate.
Year 1 _ _ _

Ethnic origin

15. To which ethnic or cultural group(s) did this person's ancestors belong?

Mark or specify as many as applicable.
Note: While most people of Canada view themselves as Canadian, information about their ancestral origins has been collected since the 1901 Census to reflect the changing composition of the Canadian population and is needed to ensure that everyone, regardless of his/her ethnic or cultural background, has equal opportunity to share fully in the economic, social, cultural and political life of Canada. Therefore, this question refers to the origins of this person's ancestors.
See Guide.
Examples of other ethnic or cultural groups are: Portuguese, Greek, Indian from India, Pakistani, Filipino, Vietnamese, Japanese, Lebanese, Haitian, etc.
[] French
[] English
[] German
[] Scottish
[] Italian
[] Irish
[] Ukrainian
[] Chinese
[] Dutch (Netherlands)
[] Jewish
[] Polish
[] Black
[] North American Indian
[] Métis
[] Inuit/Eskimo
[] Other ethnic or cultural group(s), specify ____

16. Is this person a registered Indian as defined by the Indian Act of Canada?

See Guide.
[] No
[] Yes, registered Indian
[] Specify Indian Band or First Nation (for example, Musqueam) ____

[p. 9]
[Space to fill out answers from questions on page 8 for household members 3 through 6.]
[p. 10]
1991 Census Form 2B Questionnaire - continued

Religion

17. What is this person's religion?

Indicate a specific denomination or religion even if this person is not currently a practising member of that group.
For example, Roman Catholic, Ukrainian Catholic, United Church, Anglican, Presbyterian, Lutheran, Baptist, Pentecostal, Greek Orthodox, Jewish, Mennonite, Jehovah's Witnesses, Salvation Army, Islam, Buddhist, Hindu, Sikh.
[] Specify one denomination or religion only ____
[] No religion

Activity limitations

18. Is this person limited in the kind or amount of activity that he/she can do because of a long-term physical condition, mental condition or health problem:

See Guide.
At home?

[] No, not limited
[] Yes, limited

At school or at work?

[] No, not limited
[] Yes, limited
[] Not applicable

In other activities, e.g. transportation to or from work, leisure time activities?

[] No, not limited
[] Yes, limited

19. Does this person have any long-term disabilities or handicaps?

See Guide.
[] No
[] Yes

STEP 10: Answer Questions 20 to 45 for each person aged 15 and over.

Mobility

20. Where did this person live 1 year ago, that is, on June 4, 1990?

Mark one circle only.
[] Lived at the same address as now
[] Lived in the same province/territory, but at a different address
[] Lived in a different province/territory in Canada

Print name of province/territory ____

[] Lived outside Canada

Print name of country ____

[p. 11]
[Space to fill out answers from questions on page 10 for household members 3 through 6.]
[p. 12]
1991 Census Form 2B Questionnaire - continued
21. Did this person live at this present address 5 years ago, that is, on June 4, 1986?

[] Yes, lived at the same address as now - go to Question 23
[] No, lived at a different address

22. Where did this person live 5 years ago, that is, on June 4, 1986?

[Question 22 was asked of persons age 15+ who lived at a different address, per question 22.]
Some large cities are made up of smaller cities or towns called municipalities. Where applicable, distinguish between the municipality and the large city, such as Anjou and Montréal, Scarborough and Toronto, Burnaby and Vancouver, Saanich and Victoria.
Mark one circle only.
[] Lived in the same city, town, village, township, municipality or Indian reserve
Or
[] Lived in a different city, town, village, township, municipality or Indian reserve in Canada - print below

City, town, village, township, municipality or Indian reserve ____
County (if known) ____
Province/territory ____

Or
[] Lived outside Canada

Print name of country ____

23. For women only:

How many children were ever born to this person?
Count all children including those who may have died since birth or who may now be living elsewhere. Do not include stillbirths.
[] None
Or
[] Number of children ____

Education

24. What is the highest grade (or year) of secondary (high school) or elementary school this person ever attended?

Enter highest number (1 to 13) of grades or years, excluding kindergarten.
Enter number (1 to 13) of grades or years of secondary and/or elementary school ____
Or
[] Never attended school or attended kindergarten only

25. How many years of education has this person completed at university?

[] None
[] Less than 1 year (of completed courses)
[] Number of completed years at university ____

[p. 13]
[Space to fill out answers from questions on page 12 for household members 3 through 6.]
[p. 14]
1991 Census Form 2B Questionnaire - continued
26. How many years of schooling has this person ever completed at an institution other than a university, a secondary (high school) or an elementary school?

Include years of schooling at community colleges, institutes of technology, CEGEPs (general or professional), private trade schools or private business colleges, diploma schools of nursing, etc.
[] None
[] Less than 1 year (of completed courses)
[] Number of completed years at community colleges, trade schools, CEGEPs, etc. ____

27. In the past nine months (that is, since last September), was this person attending a school, college or university?

Include attendance at elementary or secondary schools, business or trade schools, community colleges, institutes of technology, CEGEPs, etc., for courses which can be used as credits towards a certificate, diploma or degree.
Mark one circle only.
[] No, did not attend in past nine months
[] Yes, full time
[] Yes, part time, day or evening

28. What certificates, diplomas or degrees has this person ever obtained?

Include all qualifications obtained from secondary (high) schools, or trade schools and other postsecondary educational institutions.
Mark as many circles as applicable.
[] None - go to Question 30
[] Secondary/high school graduation certificate or equivalent
[] Trades certificate or diploma
[] Other non-university certificate or diploma (obtained at community college, CEGEP, institute of technology, etc.)
[] University certificate or diploma below bachelor level
[] Bachelor's degree(s) (e.g., B.A., B.Sc., LL.B.)
[] University certificate or diploma above bachelor level
[] Master's degree(s) (e.g., M.A., M.Sc., M.Ed.)
[] Degree in medicine, dentistry, veterinary medicine or optometry (M.D., D.D.S., D.M.D., D.V.M., O.D.)
[] Earned doctorate (e.g., Ph.D., D.Sc., D.Ed.)

[p. 15]
[Space to fill out answers from questions on page 14 for household members 3 through 6.]
[p. 16]
1991 Census Form 2B Questionnaire - continued
29. What was the major field of study or training of this person's highest degree, certificate or diploma (excluding secondary or high school graduation certificates)?

For example, accounting, carpentry, civil engineering, history, legal secretary, welding.
[Question 29 was asked of persons 15+ who had obtained certificates, diplomas or degrees, per question 28.]
Major field of study or training ________
Or
[] This person's highest qualification is a secondary/high school graduation certificate

Work

30. Last week, how many hours did this person work (not including volunteer work, housework, maintenance or repairs for his/her own home)?

Include as work: working without pay in a family farm or business (e.g., assisting in seeding, doing accounts); working in his/her own business, farm or professional practice, alone or in partnership; working for wages, salary, tips or commission.
Number of hours (to the nearest hour) - go to Question 36 ____
Or
[] None - continue with the next question

31. Last week, was this person on temporary lay-off or absent from his/her job or business?

Mark one circle only.
[] No
[] Yes, on temporary lay-off from a job to which this person expects to return
[] Yes, on vacation, ill, on strike or locked out, or absent for other reasons

32. Last week, did this person have definite arrangements to start a new job within the next four weeks?

[] 08 No
[] 09 Yes

33. Did this person look for work during the past four weeks?

For example, did this person contact a Canada Employment Centre, check with employers, place or answer newspaper ads?
Mark one circle only.
[] No -- go to Question 35
[] Yes, looked for full-time work
[] Yes, looked for part-time work (less than 30 hours per week)

[p. 17]
[Space to fill out answers from questions on page 16 for household members 3 through 6.]
[p. 18]
1991 Census Form 2B Questionnaire - continued
34. Could this person have started work last week had a job been available?

[Question 34 was asked of persons 15+ who were looking for work during the past four weeks, per question 33.]
Mark one circle only.
[] Yes, could have started work
[] No, already had a job
[] No, temporary illness or disability
[] No, personal or family responsibilities
[] No, going to school
[] No, other reasons

35. When did this person last work, even for a few hours (not including volunteer work, housework, maintenance or repairs for his/her own home)?

[] In 1991 -- continue with the next question
[] In 1990 -- continue with the next question
[] Before 1990 -- go to Question 45
[] Never worked in lifetime -- go to Question 45

Note: Questions 36 to 42 refer to this person's job or business last week. If this person held no job last week, answer for the job of longest duration since January 1, 1990. If this person held more than one job last week, answer for the job at which he/she worked the most hours.

36. For whom did this person work?

Name of firm, government agency, etc. ________
Department, branch, division, section or plant ________

37. What kind of business, industry or service was this?

Give full description. For example, wheat farm, trapping, road maintenance, retail shoe store, secondary school, temporary help agency, municipal police.
Kind of business, industry or service ________
_ _ _ _

[p. 19]
[Space to fill out answers from questions on page 18 for household members 3 through 6.]
[p. 20]
1991 Census Form 2B Questionnaire - continued
38. At what address did this person usually work?

If street address is unknown, print the name of the building or nearest street intersection. Some large cities are made up of smaller cities or towns called municipalities. Where applicable, distinguish between the municipality and the large city, such as Anjou and Montréal, Scarborough and Toronto, Burnaby and Vancouver, Saanich and Victoria.
[] Worked at home (including farms)
[] Worked outside Canada
[] Worked at the address specified below

Street address ________
City, town, village, township, municipality or Indian reserve ____
County (if known) ____
Province/territory ____
Postal code _ _ _ _ _ _

39. What kind of work was this person doing?

For example, medical lab technician, accounting clerk, manager of civil engineering department, secondary school teacher, supervisor of data entry unit, food processing labourer, fishing guide (if in the Armed Forces, give rank only).
Kind of work ________

40. In this work, what were this person's most important duties or activities?

For example, analysing blood samples, verifying invoices, co-ordinating civil engineering projects, teaching mathematics, organizing work schedules and monitoring data entry systems, cleaning vegetables, guiding fishing parties.
Most important duties or activities ________

[p. 21]
[Space to fill out answers from questions on page 20 for household members 3 through 6.]
[p. 22]
1991 Census Form 2B Questionnaire - continued
41. In this job, was this person mainly:

[] Working for wages, salary, tips or commission? Go to Question 43
[] Working without pay for his/her spouse or another relative in a family farm or business? Go to Question 43
[] Self-employed without paid help (alone or in partnership)? Continue with the next question
[] Self-employed with paid help (alone or in partnership)? Continue with the next question

42. If self-employed, was this person's farm or business incorporated?

[] No
[] Yes

43. In how many weeks did this person work in 1990?

[] None -- go to Question 45
Or
[] Number of weeks --continue with the next question ____

44. During most of those weeks, did this person work full time or part time?

Mark one circle only.
[] Full time (30 hours or more per week)
[] Part time (less than 30 hours per week)

[p. 23]
[Space to fill out answers from questions on page 22 for household members 3 through 6.]
[p. 24]
1991 Census Form 2B Questionnaire - continued
Income in 1990
45. During the year ending December 31, 1990, did this person receive any income or suffer any loss from the sources listed below?

Answer "yes" or "no" for all sources. If "yes," also enter the amount; in case of a loss, also mark "loss." Do not include Family Allowances and Child Tax Credits. Consult the Guide for details.
(a) Total wages and salaries including commissions, bonuses, tips, etc., before any deductions

[] Yes

Dollars ____ Cents _ _

[] No

(b) Net income from unincorporated non-farm business, professional practice, etc., on own account or in partnership (gross receipts minus expenses)

[] Yes

Dollars ____ Cents _ _

[] No
[] Loss

(c) Net farm self-employment income from agricultural operations on own account or in partnership (gross receipts minus expenses)

[] Yes

Dollars ____ Cents _ _

[] No
[] Loss

(d) Old Age Security Pension and Guaranteed Income Supplement from federal government only (provincial income supplements should be reported in (g))

[] Yes

Dollars ____ Cents _ _

[] No

(e) Benefits from Canada or Quebec Pension Plan

[] Yes

Dollars ____ Cents _ _

[] No

(f) Benefits from Unemployment Insurance (total benefits before tax deductions)

[] Yes

Dollars ____ Cents _ _

[] No

(g) Other income from government sources including provincial income supplements and grants and social assistance, e.g., veterans' pensions, workers' compensation, welfare payments (do not include Family Allowances and Child Tax Credits)

[] Yes

Dollars ____ Cents _ _

[] No

(h) Dividends and interest on bonds, deposits and savings certificates, and other investment income, e.g., net rents from real estate, interest from mortgages

[] Yes

Dollars ____ Cents _ _

[] No
[] Loss

(i) Retirement pensions, superannuation and annuities

[] Yes

Dollars ____ Cents _ _

[] No

(j) Other money income, e.g., alimony, scholarships

[] Yes

Dollars ____ Cents _ _

[] No

(k) Total income from all of the above sources

[] Yes

Dollars ____ Cents _ _

[] No
[] Loss

[p. 25]
[Space to fill out answers from questions on page 24 for household members 3 through 6.]
[p. 26]
1991 Census Form 2B Questionnaire - continued

STEP 11: Answer Questions H1 to H8 about this dwelling.

H1. Print the name(s) of the person(s) who pay the rent or mortgage, taxes, electricity, etc., for this dwelling.

A dwelling is a separate set of living quarters with a private entrance from the outside or from a common hallway or stairway inside the building. This entrance should not be through someone else's living quarters.
_ _ 01
Family name ____
Given name ____
_ _ 02
Family name ____
Given name ____
_ _ 03
Family name ____
Given name ____
_ _ 04
Family name ____
Given name ____
_ _ 05
Family name ____
Given name ____
_ _ 06
Family name ____
Given name ____
Note: One of these persons should answer Questions H2 to H8. If no one living here makes such payments, mark here...and answer these questions yourself.

[] 07

H2. Is the dwelling:

Mark one circle only.
[] Owned by you or a member of this household (even if it is still being paid for)?
[] Rented (even if no cash rent is paid)?

H3(a). How many rooms are there in this dwelling?

Include kitchen, bedrooms, finished rooms in attic or basement, etc. Do not count bathrooms, halls, vestibules and rooms used solely for business purposes.
Number of rooms ____

H3(b). How many of these rooms are bedrooms?

Number of bedrooms ____

H4. When was this dwelling originally built?

Mark the period in which the building was completed, not the time of any later remodelling, additions or conversions. If year is not known, give best estimate.
[] 1920 or before
[] 1921-1945
[] 1946-1960
[] 1961-1970
[] 1971-1980
[] 1981-1985
[] 1986-1990
[] 1991

H5. Is the dwelling in need of any repairs?

Do not include desirable remodelling or additions.
[] No, only regular maintenance is needed (painting, furnace cleaning, etc.)
[] Yes, minor repairs are needed (missing or loose floor tiles, bricks or shingles, defective steps, railing or siding, etc.)
[] Yes, major repairs are needed (defective plumbing or electrical wiring, structural repairs to walls, floors or ceilings, etc.)

[p. 27]
1991 Census Form 2B Questionnaire - continued

Answer Questions H6 to H8 for only the dwelling that you now occupy, even if you own or rent more than one dwelling. If the exact amount is not known, please enter best estimate.

Note: If you are a farm operator living on the farm you operate, mark here...and go to Step 12.

[] 01

[Questions H6-H8 were asked of non-farm operators.]

H6. For this dwelling, what are the yearly payments (last 12 months) for:

(a) Electricity?

[] None
[] Included in rent or other payments
Or
[] Dollars ____ Cents per year _ _

(b) Oil, gas, coal, wood or other fuels?

[] None
[] Included in rent or other payments
Or
[] Dollars ____ Cents per year _ _

H7. For renters only:

What is the monthly cash rent paid for this dwelling?
[] Rented without payment of cash rent
Or
[] Dollars ____ Cents per year _ _

H8. For owners only, answer parts (a) through (f):

(a) What are the total regular monthly mortgage or loan payments for this dwelling?

[] None -- go to part (c)
or
[] Dollars ____ Cents per year _ _

(b) Are the property taxes (municipal and school) included in the amount shown in part (a)?

[] Yes -- go to part (d)
[] No

[] None
Or
[] Dollars ____ Cents per year _ _

(d) If you were to sell this dwelling now, for how much would you expect to sell it?

Dollars ____

(e) Is this dwelling part of a registered condominium?

[] Yes -- continue with part (f)
[] No -- go to Step 12

(f) What are the monthly condominium fees?

[] None
Or
[] Dollars ____ Cents per year _ _

STEP 12: You have now completed your questionnaire. Please mail it today. Thank you for your co-operation.

If you have any comments, please enter them on the back cover.

[p. 28]
1991 Census Form 2B Questionnaire - continued

Telephone assistance service
If after reading the Guide you need further assistance, do not hesitate to call our Telephone Assistance Service. It is available from 9 a.m. to 9 p.m. from Thursday, May 30 through Friday, June 7 (excluding Sunday).
If you live within the local calling area of the places listed below, dial the number shown. In all other areas, dial 1-800-267-1991 (no charge).

St. John's (Nfld.) 722-1991
Halifax 426-1991
Moncton 851-1991
Montréal 283-1991
Ottawa 951-1991
Toronto 973-1991
Winnipeg 983-1991
Regina 780-7750
Edmonton 495-4000
Vancouver 666-1991

For TDD/TTY (Telecommunication Devices for the Deaf/Teletype Machines only) - users call: 1-800-267-5558 (no charge).

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