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[Chile1992 Census Enumeration Form]

The information solicited by the INE is confidential. Article 29, Law 17374 establishes statistical secrecy.


RepĂșblica de Chile
Instituto Nacional de EstadĂ­sticas

XVI National Census of Population and Housing

1992 Census Questionnaire

____ Dwelling number
____ Household number

When it is necessary to use more than one form for a household, fill in this circle

[] Continued
I. Geographic and Census Identification

Instructions: Transfer to these spaces the numbers corresponding to those on the cover of the folder: Municipality, District, Census Zone, Block, Enumeration Sector and Area

____Municipality

____District

____Census Zone

____Block

____Enumeration Sector

Area:

[] Urban
[] Rural

For office use:

Dwelling [fill-in ovals, 2-digits, 0 through 9]
Household [fill-in ovals, 2-digits, 0 through 9]

Dwelling address

Urban:

____ Street
____ Number
____ Floor
____ Apartment number
____ Locality
____ Entity

Rural

____ Route
____ Locality
____ Entity

II. Dwelling

Dwelling information

1. Indicate the type of dwelling:

A. Private dwelling

[] 1 House
[] 2 Apartment in a building
[] 3 Rooms in an older house or conventillo (tenement, high-density slum dwellings in converted older houses)
[] 4 Improved shack, government-issued emergency housing (mejora, mediagua)
[] 5 Shack in a farm (rancho), Indian dwelling, rustic huts
[] 6 Mobile (tent, boxcar, etc.)
[] 7 ____ Other (specify)

B. Collective dwelling (group quarters)

[] 8 Rooming house or boarding house
[] 9 Hotel, motel, inn
[] 10 Institution (boarding school dormitory, hospital, military regiment, etc)
[] 11 ____ Other (specify)

If a collective dwelling, skip to section III, People in the household." Do not forget to find out whether there is a private dwelling within group quarters; if so, use another questionnaire to complete the information for that dwelling, household, and individuals.

2. Indicate whether the dwelling is:

A. Occupied

[] 1 With people present
[] 2 With people absent

B. [] 3 Unocuppied

If the dwelling is unoccupied and questions 1 and 2 have been completed, end the interview here.

Only for private, occupied dwellings with people present (applies to questions 3 through 16)

3. The dwelling that you live in is:

[] 1 Owned (completely paid for)
[] 2 Owned (paying in installments)
[] 3 Rented
[] 4 Ceded in return for services
[] 5 Free
[] 6 ____ Other condition (specify)

4. The predominant construction material is:

A. In the exterior walls

[] 1 Brick, concrete, cement block
[] 2 Wood or sawed plank
[] 3 Adobe
[] 4 Clay with straw, stone, mud-and-stick
[] 5 Waste materials (tin, cardboard, etc.)
[] 6 ____ Other materials (specify)

B. In the roof covering

[] 1 Zinc
[] 2 Concrete tile
[] 3 Slate
[] 4 Tiles
[] 5 Wooden tiles
[] 6 Tar corrugated paper sheets
[] 7 Clay-covered straw
[] 8 ____ Other materials (specify)

C. In the floor

[] 1 Parquet, wood board
[] 2 Ceramic tile
[] 3 Wall-to-wall carpeting
[] 4 Plastic (Flexit or other)
[] 5 Cement paving, flatwork [radier]
[] 6 Brick
[] 7 Earth
[] 8 ____ Other materials (specify)

5. The electricity used in lighting is from:

[] 1 Public system (Electric company)
[] 2 Generator (private or community)
[] 3 ____ Other (specify)
[] 4 Doesn't have electric lighting

6. The water used in this dwelling comes from:

[] 1 Public system
[] 2 Well or water wheel chain pump
[] 3 River, spring, stream, etc.
[] 4 ____ Other (specify)

7. Water arrives at this dwelling via:

[] 1 Pipe inside the dwelling
[] 2 Pipe outside of the dwelling but on the lot
[] 3 Doesn't have piped water

8. The toilet (W.C.) is:

[] 1 Connected to a sewer or septic tank
[] 2 A pit or latrine (pozo negro)
[] 3 On a river or canal
[] 4 Connected to another system
[] 5 Doesn't have toilet facilities

9. Is there a shower and/or bath?

[] 1 Yes
[] 2 No

10. Without including bathrooms, how many total rooms are in this dwelling? (Do not forget to include the kitchen.)

Total number of rooms

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

Indicate the uses of each room [For rooms numbered up to 10, fill-in ovals appear below each of the possible uses.]

Use of the rooms:
Bedroom ____
Living-dining ____
Living ____
Dining ____
Kitchen ____
Paid work ____
Other use ____

11. How many groups of people (households) cook separately?

[] 1

For the first household, continue with the Household Information questions on the reverse.

[] 2
[] 3
[] 4

Enumerator: for the other households in the dwelling, proceed in the following manner:
Use one questionnaire for each additional household; on each repeat the dwelling number and write the next household number, and fill in the same information under Geographic and Census Identification.
Leave Section II (Dwelling) blank.
Begin the interview with "Household Information," questions 12 and following.

Household Information

12. What is the fuel primarily used for cooking?

A. Cooking is done with:

[] 1 Gas
[] 2 Paraffin
[] 3 Wood or charcoal
[] 4 Electricity
[] 5 Other

B. No cooking

13. How many rooms does this household use exclusively for sleeping?

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

14. Does the household have any of the following appliances?

Radio, radio cassette player

[] Yes
[] No

Black and white television

[] Yes
[] No

Color television

[] Yes
[] No

Video-recorder, Video cassette player (VCR)

[] Yes
[] No

Minicomponent stereo system and/or High-fidelity equipment

[] Yes
[] No

Programmable washing machine

[] Yes
[] No

Washing machine

[] Yes
[] No

Refrigerator

[] Yes
[] No

Microwave oven

[] Yes
[] No

Cellular telephone

[] Yes
[] No

Telephone

[] Yes
[] No

15. Does the household have any of the following vehicles exclusively for private use?

Bicycle

[] Yes
[] No

Motorcycle or motorscooter

[] Yes
[] No

Automobile or wagon

[] Yes
[] No

Truck or wagon

[] Yes
[] No

16. Does the household have any of the following vehicles used for purposes of work?

Bicycle or tricycle

[] Yes
[] No

Motorcycle or motorscooter

[] Yes
[] No

Automobile (Taxi or other work use)

[] Yes
[] No

Wagon or jeep

[] Yes
[] No

Light truck or utility wagon

[] Yes
[] No

Truck

[] Yes
[] No

Tractor

[] Yes
[] No

Cart (carreta o carretela)

[] Yes
[] No

A. People who make up the household (Do not forget babies and elderly people.)

What are the names and surnames of each of the people who spent the night here last night?
Enumerator: Write names and surnames of each person in the following order:
Head [explicitly male or female] of the household
Spouse, live-in partner
Unmarried children or stepchildren from oldest to youngest
Married children and their spouses or partners and children
Other relatives (parents, parents-in-law, etc.)
Brothers/sisters, uncles/aunts, nephews/nieces, etc.
Other people not related to the head (Guests, domestic servants, etc.)

[Table with lines for up to six people, and the following headers:]
____ Person number
____ Names and surnames
____ Relationship to the head of household

If there are more than 6 people in the household, use a second questionnaire, repeating: Dwelling number, household, number, geographic and census identification, and fill in the circle marked "continued" on the first page.

B. Number of people in the household

Enumerator: Add up all of the people noted in A, separated by sex.
Write in these spaces the total number of people in the household, separated by sex.
____ Males
____ Females
____ Total

____ Enumerator's name
____ Signature

III. People in the Household

For all individuals [applies to questions 1 to 6]

1. What is your relationship to the head of household?

[] 1 Head
[] 2 Spouse
[] 3 Live-in partner
[] 4 Child, stepchild
[] 5 Son- or daughter-in-law
[] 6 Grandchild
[] 7 Siblings, siblings-in-law
[] 8 Parents/parents-in-law
[] 9 Other relative
[] 10 Other non-relative
[] 11 Domestic servant
[] 12 Member of a collective household

2. Sex

[] 1 Male
[] 2 Female

3. What is your age in years completed? ____

[Fill-in ovals of two digits from 0 to 9]
For those under 1 year, fill in 00
For those under 10 years, fill in 01, 02, 03, etc. as appropriate
For those 10 years and above, fill in 10, 19, 43, 65, etc. as appropriate
For those over 99 years fill in 99

If a person does not remember his or her age, write the year of birth here.
____ Year of birth

4. Do you have any of the following characteristics?

[] 1 Total blindness
[] 2 Total deafness
[] 3 Muteness
[] 4 Paralyzed or injured
[] 5 Mental deficiency

5. When you were born, in what municipality or place did your mother live?

[] 1 In this municipality

In another municipality

____ Name of the municipality or place
____ Province

In another country

____ Name of the country

Year of arrival in this country [fill-in ovals, 2 digits, 0 through 9]

6. Do you habitually live in this municipality?

[] 1 Yes
[] 2 No

In what municipality do you habitually live?

____ Name of the municipality or place
____ Province

In another country

____ Name of the country

For all individuals 5 years of age and older [applies to questions 7 to 9]

7. In what municipality or place did you live in April, 1987?

[] 1 In this municipality

In another municipality
____ Name of the municipality or place
____ Province

In another country
____ Name of the country

8. What is the last grade of regular schooling you completed?

1st ____
2nd ____
3rd ____
4th ____
5th ____
6th ____
7th ____
8th ____

Type of regular schooling

[] 1 Kindergarten
[] 2 Basic or primary
[] 3 Common middle school
[] 4 Humanities
[] 5 Commercial secondary
[] 6 Industrial secondary
[] 7 Agricultural secondary
[] 8 Maritime secondary
[] 9 Mining
[] 10 Feminine technical
[] 11 Teaching-training
[] 12 Technical training center
[] 13 Professional institute
[] 14 University
[] 0 Never attended

Enumerator: only for those who answered "never attended" or lower than 4th grade of basic or primary completed.

9. Are you able to read and write?

If only able to read or only able to write, fill in "no."

[] 1 Yes
[] 2 No

For all individuals 14 years of age and older [applies to questions 10 to 16]

10. What is your current marital status?

[] 1 Married
[] 2 Consensual union
[] 3 Single
[] 4 Widowed
[] 5 Separated
[] 6 Annulled

11. Which of the following was your situation during the last week?

[] 1 Working for pay
[] 2 Not working, but having a job
[] 3 Working for a family member without receiving payment in money
[] 4 Looking for work, having worked before

For any of the above answers, go on to question 12.

[] 5 Looking for work for the first time
[] 6 Engaged in household duties
[] 7 Studying, without also working
[] 8 Retired or pensioner without also working
[] 9 Permanently disabled for purposes of work
[] 10 Other situation

For answers 5 through 10, if female, skip to question 15 and following; if male, skip to only questions 15 and 16.

12. Describe the occupation, position, or type of work carried out in the current job (or previously, if unemployed). Examples: bricklayer, pediatrician, tailor, auto mechanic, textile machinist, street vendor, etc. [3 blank lines for answer]

13. In this job (or in previous job), are or were you a (n)

[] 1 Owner or employer
[] 2 Own-account worker
[] 3 Worker in household domestic service
[] 4 Salaried worker (white-collar, manual laborer or day laborer)
[] 5 Unpaid family worker

14. Describe the principal activity or product of the establishment, company, business, factory, etc. where you work (or where you worked if unemployed). Examples: Shirt factory, hospital, Government ministry, livestock ranch, bank, supermarket, radio and tv studio, etc.
[3 blank lines for answer]

15. What is your religion?

[] 1 Catholic
[] 2 Protestant
[] 3 Evangelical
[] 4 Indifferent or atheist
[] 5 ____ Other religion (specify)

16. If you are Chilean, do you consider yourself to belong to any of the following cultures?

[] 1 Mapuche
[] 2 Aymara
[] 3 Rapanui
[] 4 None of the above

For all women 14 years of age and older [applies to questions 17 to 19]

17. How many children born alive have you had?

[] 0 None
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9
[] 10
[] 11
[] 12
[] 13
[] 14
[] 15
[] 16
[] 17
[] 18 or more

18. Of those, how many are currently alive?

[] 0 None
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9
[] 10
[] 11
[] 12
[] 13
[] 14
[] 15
[] 16
[] 17
[] 18 or more

19. What is the date of birth of your last child born alive?

____ Month
____ Year

Month
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9
[] 10
[] 11
[] 12

Year
[] 87
[] 88
[] 89
[] 90
[] 91
[] 92