Dominican Republic
Fourth National Census of Population
1960
____ Form number
____ For office use
A. Location of the Census Household
____ Province
____ Municipality or Municipal district
____ City or Section
____ Neighborhood or settlement
____ Rural location (paraje)
____ D. E. (Enumeration district)
____ Block number
____ Building or house number
____ Floor
____ Dwelling in a patio or farm
____ Census household number
Municipality or Municipal district
City or Section
Neighborhood or settlement (poblado)
Block
Patio or farm
B. Information on the dwelling occupied
(Mark an X in the appropriate box)
[] 2 Collective [group quarters]
____ Name if collective
[] 2 Tenement (Vecindad)
[] 3 Apartment
[] 4 Other
[] 2 Running water outside
[] 3 Tank, well or cistern
[] 4 River, stream or spring
[] 5 Other
[] 2 Shared toilet
[] 3 Private latrine
[] 4 Shared latrine
[] 5 Other
[] 6 None
[] 2 Gas
[] 3 Other
[] 2 Rented
[] 3 Ceded
[] 4 Other
____ Code
1. Complete name and surnames.
2. Relationship to the head of the family (Wife, partner, son, brother, boarder, servant, etc.)
Head of the family
[2nd person]
____
4. Age in years completed
____
M = mulatto
N = black
A = Asian
6. Marital status (For those 12 years of age and older)
C = married
U.L. = consensual union
V = widowed
D = divorced
S.L. = legally separated
____
____
Place of birth [Applies to questions 8 and 9]
8. For those born in the Dominican Republic, the name of the municipality. For foreigners, the name of the country.
9. (Only for those born in the Dominican Republic) For those born in a city, the name of the city. For those born in a section, its name.
10. Nationality (Only for those born abroad). Write the current nationality of the informant.
11. Able to read and write?
Write yes or no.
12. Last year of schooling completed.
Add the letter P when the last year corresponds to primary, the letter S when secondary, the letter U when university.
13. School attendance (For those 5 years of age and older.)
The year underway or just completed, followed by the letter P, S or U. Write U.A. for those who attend a literacy center.
For those individuals 10 years of age and older
[Applies to questions 14 - 18]
____
15. Profession, position or occupation.
____
____
____
18. Monthly income from wages or salary.
____
For Office Use
____ Card number
____ Total
____ Males
____ Females