2017 Population and Housing Census
Mark like this: [completely filled-in oval]
Do not mark like this: [ovals with line and check marks]
Questions 1 and 2 (observation)
 2 Apartment
 3 Traditional indigenous unit (ruka, pae pae or other)
 4 Room in an old house or tenement
 5 Hut, shack, hovel or emergency housing
 6 Mobile housing (tent, trailer or other)
 7 Other kind of privately owned housing unit
 2 Occupants absent
 4 Seasonal housing unit (vacation property or other)
- If the unit is vacant, end the questionnaire.
Begin surveying the informant here:
[The questionnaire begins in question 3]
 2 Masonry: cement, stone or brick blocks
 3 Partition wall, lined on both sides (with wood or steel)
 4 Partition wall, no lining of any kind
 5 Adobe, md, wattle and daub, pirca or other traditional artisanal element
 6 Poor construction materials (tin, cardboard, plastic, etc.)
 2 Concrete slabs
 3 Metallic sheets (zinc, copper, etc) or fiber cement (Pizarreño type)
 4 Phonolite or tarred felt
 5 Straw, thatch, cattail or cane
 6 Poor construction materials (tin, cardboard, plastic, etc.).
 7 No solid roofing
 2 Foundation block, no lining
 3 Cement tile
 4 Cement layer over the ground
 5 Earthen floor
 6 or more
 2 Well or water wheel
 3 Tanker truck
 4 River, spring, stream, channel, lake, etc.
 If more than one, enter the number here _ _
6.a. Do all the persons who stayed at this housing unit last night share food expenses?
 1 Yes (go to section C)
 2 No
6.b. Including your own group, how many groups have separate food expenses?
Each group indicated is considered a household for census purposes. For each household, a separate questionnaire must be used. If there are two or more households in the housing unit, their information must be recorded in separate questionnaires. For subsequent questionnaires:
- Enter the household number in the appropriate space.
- Do not fill in the "b. Housing unit characteristics" box.
- Begin the interview in section "c. Household members who stayed last night.
If more than one household is recorded on question 6.b., separate questionnaires must be used for each of the households identified.
[For each person, record:]
Person No. _ _
Full name ________
Relationship with head of household (male or female) ________
- Persons who died after midnight of April 18-19, 2017.
- Persons who did not stay at the housing unit for reasons of work (night shifts) but returned to the unit during the census day.
- Persons who did not stay at the housing unit because they were at a party, wake or other special case, provided that they were not or will not be recorded elsewhere.
- Another housing unit, boarding room or hotel
- A hospital
- A correctional facility
- Verify that the number of the last person recorded in 6.c. is the same as the total number recorded for this question.
_ _ Total
_ _ Males
_ _ Females
- All persons present at the time you arrive at the housing unit-if not recorded elsewhere - must be recorded.
- No person should be recorded twice.
- If in doubt, a person must be recorded.
If more than eight individuals are staying at a housing unit, in additional questionnaires you must affix the portfolio number sticker, repeat the unit number and household number, and fill in the continuation circle. Then continue to record each person listed in 6.c, section "d. Personal information".
Before continuing with section "d. Personal information". Enter in the first line of each page the first name of every person who stayed at the housing unit last night:
b. On page 2, indicate the name of person no. 2 and then enter all the other members of the household in the same order as indicated in question 6.c
For all persons
[Questions 7 to 16 are asked of all persons]
 2 Husband/wife (spouse)
 3 Civil partner
 4 Common-law husband/wife or partner
 5 Son/daughter
 6 Son/daughter of spouse, common-law husband/wife or partner
 7 Brother/sister
 8 Father/mother
 9 Brother/sister-in-law
 10 Father/mother-in-law
 11 Son/daughter-in-law
 12 Grandson/granddaughter
 13 Grandfather/grandmother
 14 Other relative
 15 Non-relative
 16 Live-in domestic staff
 2 Female
9. How old are you?
Age at last birthday _ _ _
9.a. In which month and year were you born?
Year _ _ _ _
 2 At another housing unit
 4 In another country (enter the name of the country) ____
 2 In this commune
 3 In another commune (enter the name of the commune) ____
In another country:
 5 Argentina
 6 Bolivia
 7 Ecuador
 8 Colombia
 9 Other (enter the name of the country) ____
 2 In another commune ____ (enter the name of the commune)
 5 Argentina
 6 Bolivia
 7 Ecuador
 8 Colombia
 9 Other ____ (enter the name of the country)
If you do not know the year, mark the period in which you arrived in Chile.
 2 Between 2000 and 2009
 3 Between 1990 and 1999
 4 Before 1990
 2 Not at present
 3 Never have (go to 16)
- For those who have completed the tertiary education, enter the number of years of the program
 2 Pre-kinder
 3 Kinder
 6 Primary (old system)
 8 Vocational
 9 Humanities (old system)
 10 Business, industrial, normal-school (olds system)
 12 Professional degree (4 or more years)
 13 Master's Degree
 14 PhD
That is, did you complete elementary or secondary education, or did you receive a diploma or degree for the final level completed?
 2 No
 2 No (go to 17)
 2 Aymara
 3 Rapa Nui
 4 Lican Antai
 5 Quechua
 6 Colla
 7 Diaguita
 8 Kawésqar
 9 Yagán or Yamana
 10 Other (specify) ____
 2 Without remuneration, for a relative
 4 I was looking for a job (go to 19)
 5 I was studying (go to 19)
 6 I was performing household chores (go to 19)
 7 I am retired, or a pensioner or rentier (go to 19)
 8 Other (go to 19)
Specify in at least three words, for example "sale of beverages and groceries".
If self-employed, enter the product you manufacture or the service you render. Avoid answers like "self-employed" or "independent company".
_ _ Number
_ _ Number
_ _ _ _ Year
[Pages 4 to 10 have the same questions (section d) but they are applied to the next household member]