Republic of Costa Rica
General Directorate of Statistics and Censuses
VIII Population Census
IV Housing Census
1984
____Province
____ Canton
____ District
____ Address
_ _ _ _ _ _ _ _ Segment
_ _ _ Dwelling number
_ _ Household
[] 1
____ Canton
____ District
____ Address
_ _ _ _ _ _ _ _ Segment
_ _ _ Dwelling number
_ _ Household
[] 1
Private Dwelling
[] 1 Regular
[] 2 Mobile
[] 3 Small room/shack (tugurio)
[] 4 Temporary
[] 2 Mobile
[] 3 Small room/shack (tugurio)
[] 4 Temporary
[] 5 Collective dwelling (Name) ____
Occupied
[] 1 Rented
_ _ _ _ _ (monthly)
[] 2 Owned
[] 3 Other
_ _ _ _ _ (monthly)
[] 2 Owned
[] 3 Other
Unoccupied
[] 4 For rent or sale
[] 5 Under construction or repair
[] 6 Summer home
[] 7 Other
If 4 - 7 are selected, end the interview here
[] 5 Under construction or repair
[] 6 Summer home
[] 7 Other
If 4 - 7 are selected, end the interview here
Predominant Material and Condition
Wood
[] 01 Good
[] 02 Fair
[] 03 Poor
[] 02 Fair
[] 03 Poor
Brick-cement block
[] 04 Good
[] 05 Fair
[] 06 Poor
[] 05 Fair
[] 06 Poor
Adobe-cane with earth (bahareque)
[] 07 Good
[] 08 Fair
[] 09 Poor
[] 08 Fair
[] 09 Poor
Other
[] 10 Good
[] 11 Fair
[] 12 Poor
[] 11 Fair
[] 12 Poor
Clay tiles
[] 01 Good
[] 02 Fair
[] 03 Poor
[] 02 Fair
[] 03 Poor
Metal sheet
[] 04 Good
[] 05 Fair
[] 06 Poor
[] 05 Fair
[] 06 Poor
Asbestos - cement
[] 07 Good
[] 08 Fair
[] 09 Poor
[] 08 Fair
[] 09 Poor
Other
[] 10 Good
[] 11 Fair
[] 12 Poor
[] 11 Fair
[] 12 Poor
Wood
[] 01 Good
[] 02 Fair
[] 03 Poor
[] 02 Fair
[] 03 Poor
Tile
[] 04 Good
[] 05 Fair
[] 06 Poor
[] 05 Fair
[] 06 Poor
Other
[] 07 Good
[] 08 Fair
[] 09 Poor
[] 08 Fair
[] 09 Poor
None (earth) [] 10
_ _ Total rooms
_ _ Exclusively for sleeping
_ _ Living-dining
_ _ Exclusively kitchen
_ _ Kitchen-dining
_ _ Other uses
_ _ Living-dining
_ _ Exclusively kitchen
_ _ Kitchen-dining
_ _ Other uses
By pipe
Public system
[] 1 Only for this dwelling
[] 2 For this and other dwellings
[] 2 For this and other dwellings
Private system
[] 3 Only for this dwelling
[] 4 For this and other dwellings
[] 4 For this and other dwellings
By other means
[] 5 Well with pump
[] 6 Well without pump
[] 7 River or stream
[] 8 Public tap
[] 9 Rain and other means
[] 6 Well without pump
[] 7 River or stream
[] 8 Public tap
[] 9 Rain and other means
All day
[] 1 Summer
[] 2 Winter
[] 2 Winter
During the morning
[] 2 Summer
[] 2 Winter
[] 2 Winter
During the afternoon
[] 3 Summer
[] 3 Winter
[] 3 Winter
At night
[] 4 Summer
[] 4 Winter
[] 4 Winter
Almost never arrives
[] 5 Summer
[] 5 Winter
[] 5 Winter
[] 1 Only for this dwelling
[] 2 For this and other dwellings
[] 3 None
[] 2 For this and other dwellings
[] 3 None
10. Type and use of toilet facilities
Sewer or septic tank
[] 1 Only for this dwelling
[] 2 For this and other dwellings
[] 2 For this and other dwellings
Concrete pit toilet
[] 3 Only for this dwelling
[] 4 For this and other dwellings
[] 4 For this and other dwellings
Wooden pit toilet
[] 5 Only for this dwelling
[] 6 For this and other dwellings
[] 6 For this and other dwellings
Other
[] 7 Only for this dwelling
[] 8 For this and other dwellings
[] 8 For this and other dwellings
[] 9 None
[] 1 Electricity from public system
[] 2 Electricity from private generator
[] 3 Kerosene/petrol (canf?n)
[] 4 Other
[] 5 None
[] 2 Electricity from private generator
[] 3 Kerosene/petrol (canf?n)
[] 4 Other
[] 5 None
[] 1 Electricity
[] 2 Gas
[] 3 Kerosene/petrol (canf?n)
[] 4 Charcoal
[] 5 Wood
[] 6 Other
[] 7 None (no cooking)
[] 2 Gas
[] 3 Kerosene/petrol (canf?n)
[] 4 Charcoal
[] 5 Wood
[] 6 Other
[] 7 None (no cooking)
13. Appliances in the dwelling
Radio
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Stove
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Electric iron
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Black and white television
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Color television
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Refrigerator
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Washing machine
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Hot water heater for bath (in shower head)
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Telephone
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Vacuum cleaner
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Hot water tank
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Vehicle (not for work)
[] 1 Has
[] 2 Does not have
[] 2 Does not have
Does any person in this household:
1. Have a farm or grow crops between May 1st 1983 and April 30th 1984?
[] 1 Yes
[] 2 No
[] 2 No
2. Own livestock (cattle or pork), or poultry?
[] 1 Yes
[] 2 No
[] 2 No
If at least one of the two responses is affirmative, use as many of the National Agricultural Census forms as necessary.
_ _ Total
_ _ Males
_ _ Females
_ _ Males
_ _ Females
[] 1 Head
[] 2 Spouse or partner
[] 3 Son or daughter
[] 4 Son- or daughter-in-law
[] 5 Grandchild
[] 6 Parents or parents-in-law
[] 7 Other relatives
[] 8 Domestic servants and their families
[] 9 Other non-relatives
[] 2 Spouse or partner
[] 3 Son or daughter
[] 4 Son- or daughter-in-law
[] 5 Grandchild
[] 6 Parents or parents-in-law
[] 7 Other relatives
[] 8 Domestic servants and their families
[] 9 Other non-relatives
[] 1 Male
[] 2 Female
[] 2 Female
[] 00 Under one year
_ _ Years
_ _ Years
[] 8 Here
____ District
____ Canton
____ Province
If born abroad:
____ District
____ Canton
____ Province
If born abroad:
____ Country
_ _ _ _ Year of arrival in Costa Rica
_ _ _ _ Year of arrival in Costa Rica
[a five-character box also appears in the top area of this item]
Costa Rican by:
[] 7 Birth
[] 8 Naturalization
[] 9 Other nationality ____
[] 8 Naturalization
[] 9 Other nationality ____
[a three-character box also appears in the top area of this item]
6. Social Security (Insurance?)
[] 1 Direct
[] 2 Volunteer
[] 3 Family member
[] 4 Other
[] 5 Not insured
[] 2 Volunteer
[] 3 Family member
[] 4 Other
[] 5 Not insured
Only for those 5 years of age and older
[Applies to questions 7 - 9]
7. Place of residence 5 years ago
Where did you live in June of 1979?
[] 8 Here
Canton ____
Province ____
[] 988 Abroad
Canton ____
Province ____
[] 988 Abroad
[a three -character box also appears in the top area of this item]
Are you enrolled in any institution of regular schooling?
[] 1 Yes
[] 2 No
[] 2 No
What is the last year or grade of regular schooling completed?
[] 0 None
[] 1 Primary ____
[] 2 Secondary ____
[] 3 University ____
[] 1 Primary ____
[] 2 Secondary ____
[] 3 University ____
Only for those 10 years of age and older
[Applies to question 10 - 11]
10. Are you able to read and write?
[] 1 Yes
[] 2 No
[] 2 No
[] 1 Consensual union
[] 2 Separated
[] 3 Married
[] 4 Widowed
[] 5 Divorced
[] 6 Single
[] 2 Separated
[] 3 Married
[] 4 Widowed
[] 5 Divorced
[] 6 Single
Only for those 12 years of age and older
[Applies to questions 12-16]
What did you do the week of the 3rd to the 9th of June?
[] 1 Worked or had a job
[] 2 Was unemployed
[] 3 Looked for work for the first time
[] 4 Pensioned or rentier
[] 5 Student
[] 6 Household duties
[] 7 Other
If 4 - 7 are selected, end the interview here
[] 1 Worked or had a job
[] 2 Was unemployed
[] 3 Looked for work for the first time
[] 4 Pensioned or rentier
[] 5 Student
[] 6 Household duties
[] 7 Other
If 4 - 7 are selected, end the interview here
What occupation or type of work did you perform during the week of the 3rd tot the 9th of June, or in your last job?
____ [3 blank lines]
____ [3 blank lines]
[a three-character box also appears in the top area of this item]
[] 1 Salaried
[] 2 Self-employed
[] 3 Owner/Employer
[] 4 Unpaid family worker
[] 2 Self-employed
[] 3 Owner/Employer
[] 4 Unpaid family worker
What does your place of work (or where you worked the last time) primarily do?
____ [4 blank lines]
____ [4 blank lines]
[a four-character box also appears in the top area of this item]
How many hours do you usually work per week?
_ _ Hours
_ _ Hours
Only for women 15 years of age and older
[Applies to questions 17 - 18]
[] 00 None
_ _ Children
_ _ Children
[] 00 None
_ _ Children
_ _ Children
Comments: ____