I. Forms
Republic of Colombia
XVI National Population and V Housing Censuses
October 24, 1993
Census Form Number 1
National Statistics Administrative Department
Confidential
The information that DANE collects in these forms is strictly confidential and cannot serve fiscal or judicial purposes under any condition (Articles 74 and 75 of Decree 1633 of 1960).
If this is an additional form, mark this box with an X.
I. Identification
Paste the sticker with the A.E. number here. If you do not have the sticker, copy the number.
A.E. _ _ _ _ _ _
Ask how many groups of persons that cook separately are in the dwelling. Find out if the access for each household in the dwelling is independent to determine the number of dwellings and the number of households. Fill out one form for each household. In each case, assign an order number of the dwelling and the number of the household within the dwelling.
2. _ _ Number of the household within the dwelling.
3. ____ Neighborhood
4. ____ Address
5. ____ Name of the farm, administrative section, administrative unit or precinct
II. Information about the dwelling
(Only for household number one)
6. Type of dwelling:
[] 2 Apartment
[] 3 Room
[] 4 Other dwelling (tent, wagon, boat, natural refuge, bridge, etc)
7. Occupancy of the dwelling
[] 2 Occupied, but no people present (end here)
[] 3 Vacant (end here)
8. Predominant material in the exterior walls:
[] 2 Pressed mud [similar to adobe]
[] 3 Cane with earth (bahareque)
[] 4 Coarse Wood
[] 5 Reeds, Cane, grass, other types of vegetable material
[] 6 Zinc, cloth, cardboard
[] 7 Without walls
9. Predominant material in the floor
[] 2 Cement
[] 3 Coarse Wood
[] 4 Other material (polished wood, carpet, tile, vinyl)
10. How is trash eliminated?
[] 2 Thrown in yard, field, ditch, or empty lot
[] 3 Incineration, burial
[] 4 Picked up by public or private garbage service
11. Does the dwelling have?
[] 1 Has electricity
[] 2 Has piped water
[] 3 Has sewer connection
[] 4 Has a telephone
[] 5 None
(For each of the households in the dwelling)
12. This household lives in
[] 2 Dwelling owned and they are still paying for it
[] 3 Dwelling rented or sub-rented
[] 4 Other situation
13. How many rooms does the dwelling have access to?
14. The toilet facilities used by the household are:
[] 2 Latrine
[] 3 Expelled to running water like ditch or stream (bajamar)
[] 4 Doesn't have toilet facilities (continue with 16)
15. The toilet facilities are:
[] 2 Shared
16. This household cooks:
[] 2 Living-dining room without
[] 3 Living-dining room with
[] 4 Patio hallway
[] 5 Kitchen room
[] 6 Nowhere (continue with number 19)
17. What is the principal cooking fuel?
[] 2 Petroleum gasoline, kerosene, cocinol [locally available cooking fuel]
[] 3 Gas
[] 4 Wood
[] 5 Coal
[] 6 Waste materials
18. Water for preparing meals comes from:
[] 2 Well or cistern
[] 3 Public tank/tap
[] 4 River or stream
[] 5 Rainwater
[] 6 Bottled water
IV. List of residents of the household:
19. What is the name and surname of each person who live in this household?
Person Number _ _
Given names and last names ________
If there are more than ten persons, use the addition forms as needed and do not forget to mark them with an X on the first page.
20. Are there other persons who reside in this household and who have not been included in the previous list?
[] 1 Yes. Add this person(s) to the list.
[] 2 No
21. Does any of the persons listed reside elsewhere?
[] 2 No
22. Total residents of the household _ _
-Those who live in the home, but at the time of the census were absent in or outside of the country and who do not have a separate residence. This is the case for traveling workers, persons who are on vacation, in the hospital, or merchant marines.
-In general, all of the persons who belong to the home, such as domestic employees, renters, relatives, etc., who do not have a separate residence in another place.
-Remember that the persons who on the census of the prison, enlisted in military service in the Army, Air Force, or Navy, boarding school, asylums, convents, monasteries, or work camps should not be registered in this form.
Name of census taker
Given and last names ____
Supervisor
Given and last names ____
IV. List of residents of the household
F1. Ask these questions to all persons.
25. What is the person's relationship to the head of the household?
[] 2 Spouse
[] 3 Child
[] 4 Son- or daughter-in-law
[] 5 Grandchild
[] 6 Parents or parents-in-law
[] 7 Other relative
[] 8 Domestic employee
[] 9 Other non-relative
26. Man or woman?
[] 2 Female
27. Age in years completed:
[] Age in years _ _
[] 98 years old or more _ _
28. Does the person have any of these limitations?
[] 1 Loss of hearing
[] 1 Mute
[] 1 Retardation or mental deficiency
[] 1 Paralysis or missing upper appendages
[] 1 Paralysis or missing lower appendages
[] 2 None of the above limitations
[Numbering shown as appears in the original language form]
29. Does the person belong to any ethnicity, indigenous groups or black community?
[] 2 No
30. In what municipality was he/she born?
[] 2 Other municipality
Write the department ____
F.2 Ask these questions of all persons who are five years old or more.
31. In what municipality did he/she live in 1988?
[] 2 Other municipality
Write the department ____
32. Does he/she know how to read and write?
[] 2 No
33. Does he/she currently attend pre-school, elementary school, high school or a university?
[] 2 No
34. What is the highest level of education that he/she attended?
[] 2 Primary
[] 3 Secondary
[] 4 University (Continue with F 3)
[] 5 Graduate studies (Continue with F 3)
[] 6 None (Continue with F 3)
35. How many years did he/she complete in this level?
F3. Ask these questions of all persons who are ten years old or more.
36. He/she is currently. . .
[] 2 Separated
[] 3 Widowed
[] 4 Married
[] 5 Single
37. Principal activity of last week -- you . . .
[] 2 Looked for work for the first time (continue with F 4)
[] 3 Did not work, on vacation or leave or other reason
[] 4 Worked
[] 5 Student (continue with F 4)
[] 6 Household domestic duties (continue with F 4)
[] 7 Disabled (continue with F 4)
[] 8 Retired (continue with F 4)
[] 9 Other situation (continue with F 4)
38. What does the company where he/she work produce or what is the principal activity of the company?
b. ____
39. In this job, he/she was
[] 2 Owner, employer
[] 3 Own-account worker
[] 4 Domestic employee
[] 5 Family worker
F 4. Ask these questions of all women who are twelve years old or more.
40. How many children have you had in your life (live births)?
_ _ Number of daughters
00 None (continue with the next person)
41. Of the children you had, how many are still alive?
_ _ Number of female children
00 None (continue with the next person)
42. How many of your children currently live outside of Colombia?
_ _ Number of female children
00 None (continue with the next person)
43. In what year was your last child born (live birth)?
[] 1 January
[] 2 February
[] 3 March
[] 4 April
[] 5 May
[] 6 June
[] 7 July
[] 8 August
[] 9 September
[] 10 October
[] 11 November
[] 12 December