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VI National Census of Population and Housing 1981

Dominican Republic

How to fill in the form

General Instructions:

Use one form for each census household.
Read the questions exactly as they appear on the form.
Do not make any notations before receiving the replies.
Fill in the appropriate circle according to the response given with a pencil, without going outside of the lines. Do not mark with an X.
On questions with more than one possible response, one and only one should be marked.
Write in responses on the unbroken lines.
Follow the special instructions which are given in some questions for writing and filling in a circle at the same time.
If you make a mistake, erase. Do not cross off.
Do not fill in any shaded area of the form.

For Office Use Only

_ _Province
_ _Municipality or Municipal District
_ _Urban Zone or Section
_ _ _Segment
_ _C. P.
_ _ _Supervision area
_ _B/P
_ _ _Block
_ _Dwelling order number enumerated
_ Household order number

Chapter I. Geographic Identification

Work area code

_ _ Province
_ _ Municipality or Municipal District
_ _ Urban Zone or Section
_ _ _ Segment

____ Municipality or Municipal District
____ Polygon number
____ C.P.
____ Supervision area number
____ B.P.
____ Block number

House address

____ Street
____ House number

____ Dwelling order number of the enumerated dwelling

Chapter II. Identification of the Household

1. Do the people who live in this household have a common budget for food?

[] 1 Yes (Go on to Chapter III)
[] 2 No

2. How many groups of people or single people have a separate budget for food?

____ Groups

3. Of these groups,

____ How many have a separate exit?
____ How many do not have a separate exit?

4. ____ Order number of the household within the dwelling

Chapter III. Identification of Agricultural and Livestock Producers

5. Does anyone live here who has a planted field or who has harvested during the last 12 months?

[] 1 Yes
If yes, fill in the table:
____ Name of the person [lines for up to three people]
Amount of land being worked
____ Planted
____ Harvested during the last 12 months
[] 2 No

6. Does anyone live here who has any animals?

[] 1 Yes
If yes, fill in the table:

____ Name of the person [lines for up to three people]

Number of animals
____ Cattle
____ Sheep, goats
____ Ducks, turkeys, geese, rabbits
____ Hens, roosters, chickens, guinea fowl
____ Beehives

____ Supervisor's name
____ Signature
____ Enumerator's name
____ Signature

Chapter IV. Dwelling Information

7. Dwelling type

a) Private dwellings
[] 1 Independent house
[] 2 Apartment
[] 3 Room in a tenement
[] 4 Others
b) Collective dwellings
[] 5 Hotel, inn, or guesthouse
[] 6 Barracks and prisons
[] 7 Hospital, health center or clinic
[] 8 Religious institutions and boarding schools

8. Occupancy status

a) Occupied
[] 1 With people present
[] 2 With people absent
b) Unoccupied
[] 3 For sale
[] 4 For rent
[] 9 Others

9. Is this a summer home or for occasional use?

[] 1 Yes
[] 2 No

10. Exterior walls

Predominant material in the exterior walls of the dwelling.
[] 1 Palm
[] 2 Wood
[] 3 Cement block or concrete
[] 4 Tile (tejamanil)
[] 5 Asbestos-cement
[] 6 Yagua palm
[] 7 Zinc
[] 8 Corrugated cardboard (Cart?n piedra)
[] 9 Others

11. Roof

Predominant material in the roof of the dwelling.
[] 1 Zinc
[] 2 Asbestos-cement
[] 3 Cane
[] 4 Yagua palm
[] 5 Concrete
[] 6 Tiles
[] 7 Zinc sheets
[] 9 Others

12. Floor

Predominant material in the floor of the dwelling.
[] 1 Cement
[] 2 Earth
[] 3 Wood
[] 4 Mosaic, granite or marble
[] 5 Brick
[] 9 Others

13. Kitchen

a) Does this dwelling have a kitchen?
[] 1 Inside the dwelling
[] 2 Outside of the dwelling
[] 3 Does not have
b) What fuel is used for cooking?
[] 1 Wood
[] 2 Propane gas
[] 3 Charcoal
[] 4 Kerosene
[] 5 Electricity
[] 6 Others
[] 9 Do not cook

14. Lighting

[] 1 From the CDE
[] 2 Private system
[] 3 From the CDE and a private system
[] 4 From a generator exclusive to the dwelling
[] 5 From the CDE and a generator exclusive to the dwelling
[] 6 Propane gas lamp
[] 7 Kerosene gas lamp
[] 9 Others

15. Water supply

a) Is there piped running water installed?
[] 1 Inside the dwelling and water arrives
[] 2 Inside the dwelling and water does not arrive
[] 3 Outside the dwelling but within 100 meters
[] 4 Does not have
b) Where does the water used come from?
[] 1 Aqueduct
[] 2 Aqueduct and cistern
[] 3 Spring
[] 4 River or stream
[] 5 Rain, collection tank
[] 6 Well
[] 7 Tank truck
[] 9 Others

16. Toilet facilities

a) Does this dwelling have toilet facilities?
[] 1 Toilet connected to sewer
[] 2 Toilet connected to a septic tank
[] 3 Toilet of unknown connection
[] 4 Latrine
[] 5 Does not have
b) Are the toilet facilities for the exclusive use of this dwelling?
[] 1 Yes
[] 2 No

17. Bath

a) Does this dwelling have a bath room?
[] 1 Inside the dwelling
[] 2 Outside of the dwelling
[] 3 Does not have
b) Is the bath for the exclusive use of this dwelling?
[] 1 Yes
[] 2 No

18. Rooms in the dwelling

How many rooms total does this dwelling have? (Not including the kitchen or bathroom)
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9 or more

19. Year of construction

In what year was construction of this dwelling completed?
[] 1 Before 1979
[] 2 In 1979
[] 3 In 1980
[] 4 In 1981

20. Administration of the dwelling

Is this dwelling administered by Bienes Nacionales?
[] 1 Yes
[] 2 No
[] 3 Doesn't know

21. Waste

How is garbage removed from the dwelling?
[] 1 The city council picks it up
[] 2 Another institution picks it up
[] 3 Thrown in the yard or in another place
[] 4 Incinerated
[] 9 Other form

22. Rooms occupied by the household

a) How many rooms does this household occupy (not counting bath or rooms used in common with another household)?
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9 or more
b) Of these rooms, how many are used for sleeping?
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9 or more

23. Ownership/Tenure

a) In what form of tenure does this household occupy the dwelling or part of the dwelling?
[] 1 Owned, completely paid
[] 2 Owned, paying
[] 3 Rented
[] 4 Sub-rented
[] 5 Ceded
[] 9 Other form
b) If owned, paying, rented, or sub-rented, how much is paid monthly?
____ $RD

24. Appliances
Which of the following appliances does this household have?

Refrigerator

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Stove

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Iron

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Blender

[] Electric
[] Does not have
Quantity
[] 1
[] 2

Washing machine

[] Electric
[] Does not have
Quantity
[] 1
[] 2

Heater

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Television

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Fan

[] Electric
[] Does not have
Quantity
[] 1
[] 2

Air conditioner

[] Electric
[] Does not have
Quantity
[] 1
[] 2

Radio

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Stereo

[] Electric
[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

Vehicle

[] Non-electric
[] Does not have
Quantity
[] 1
[] 2

25. Home-based industry

Is any article produced or made in this household?
[] 1 Yes
[] 2 No

Chapter VI. Composition of the household

Write the name and surname of each of the people in the household who habitually live in this dwelling. Write as well the name and surname of people who do not habitually live in this dwelling, but who slept here the night before the day of the census. (Be sure to include children, newborn infants, and elderly persons.)

Column 1 Person number

Column 2

Strictly follow this order for listing the habitual residents.
Head of household (list on the first line)
Spouse or partner of the head
Unmarried children (list in order of age)
Married children (list in order of age)
Spouse or partner of children
Parents and parents-in-law
Grandchildren
Other relatives (brother, brother-in-law, uncle, etc.)
Domestic servants
Other non-relatives
[8 blank lines for listing names]

Column 3

Residence status
[] Permanent resident
[] Absent resident
[] Non-resident

Column 4

Write the relationship or link to the head of the household

Column 5

Sex
[] Male
[] Female

Column 6

Fill in the circle if the person is 18 years of age and older

26. Is there anyone recently born not listed?

[] Yes
List the information of children born up until 12 midnight the night before the day of the census.
[] No

27. Is there any person listed who has a residence in another dwelling and slept here the night before the day of the census?

[] Yes
Ensure that "non-resident" is marked.
[] No

28. In addition to the people listed, is any member of this household who habitually lives in this dwelling absent (due to vacation, work, business or illness)?

[] Yes
List the information of this/these person/people and mark "absent resident".
[] No

29. In addition to the people listed, is there any other person who does not habitually live in this dwelling, but who slept here the night before the day of the census?

[] Yes
List the information of this person and mark "non-resident"
[] No

Comments

______
Summary of the resident population
(This summary includes only present residents plus absent residents)

____ Total
____ Males
____ Females
____ Total individuals 18 years of age and older

Chapter VII. Personal characteristics

____ Person number
____ Name

Residence status

[] 1 Present resident
[] 2 Absent resident
[] 3 Non-resident

For all individuals[Applies to questions 30-40.]

A. General characteristics

30. What is the relationship or link of the interviewed person to the head of the household?

[] 1 Head
[] 2 Spouse or companion
[] 3 Child
[] 4 Parents or parents-in-law
[] 5 Grandchild
[] 6 Spouse or companion of child
[] 7 Other relatives
[] 8 Domestic servants
[] 9 Other non-related

31. Sex

[] 1 Male
[] 2 Female

32. What is your date of birth?

____ Day
____ Month
____ Year
(If unable to remember the date of birth, write the age.)
If a year or more old, write only the age in years completed. If less than one year old, write the age only in months completed.

33. Where were you born?
(Fill in the circle here if born in the same place, city, section or rural location (paraje) where enumerated.)

[] Here
In another part of the country
____ City, Section or Paraje
____ Municipality or Municipal District
____ Province
In another country
____ Country

Only for foreigners [Applies to question 34.]

34. Do you habitually live in this country?

[] 1 Yes
____ Year of arrival
[] 2 No - Skip to question 38

35. Do you habitually live in this dwelling?

[] 1 Yes - Skip to question 38
[] 2 No

36. Is there anyone in the dwelling where you habitually live who can provide your information?

[] 1 Yes
[] 2 No

37. Where do you habitually live?

____ City, section or rural location (Paraje)
____ Municipality or Municipal District
____ Province
____ Country

38. Is your mother alive?

[] 1 Yes
[] 2 No
[] 3 Doesn't know

39. Does the interviewed person have any of the following disabilities?
(More than one option may be marked)

[] 1 Blind
[] 2 Deaf
[] 3 Mute
[] 4 Physical disability
[] 5 Mental disability
[] 6 Doesn't have

40. According to physical characteristics and accent when speaking, the enumerated person is:

[] 1 Dominican
[] 2 Haitian
[] 3 Other nationality

For individuals 5 years of age and older [Applies to questions 41-47.]

41. Where did you live in 1976? (Fill in the circle Here is living in the same place, city, section or paraje in 1976).

[] Here
In another part of the country
____ City, Section or Paraje
____ Municipality or Municipal District
____ Province
In another country
____ Country

B. Educational Characteristics

42. Are you able to read and write?
(If only able to read or only able to write, mark the circle No)

[] 1 Yes
[] 2 No

43. Do you currently attend or did you attend any establishment of regular schooling?

Currently attending
[] 1 Public
[] 2 Private
[] 3 Not attending but did attend
[] 4 Never attended
[] 9 Unknown

Only for those who answered attending, or not attending but did attend, in question 43. [Applies to questions 44 - 46]

44. What is the highest level that you studied or are studying?

[] 1 Pre-primary
[] 2 Primary
[] 3 Intermediate
[] 4 High school
[] 5 Reformed secondary (media de la reforma)
[] 6 University
[] 9 Unknown

45. Did you complete this level?

[] 1 Yes
[] 2 No

46. What is the highest grade or year completed at this level?

____ Year or grade
____ Semester or ____ trimester

Only for those who answered University in question 44.[Applies to question 47.]

47. What title/degree did you obtain, or what major did you pursue or are you pursuing?

____

For individuals 10 years of age and older[Applies to questions 48-50.]

48. Do you currently attend or did you attend any center of vocational, technical, or commercial training?

[] 1 Attending
[] 2 Not attending but did attend
[] 3 Never attended
[] 9 Unknown

(Only for those who answered that they are attending, or not attending but did attend in question 48).[Applies to questions 49-50.]

49. What course of studies did you pursue or are you pursuing?

____

50. Did you complete this course of studies?

[] 1 Yes
[] 2 No

For individuals 10 years of age and older[Applies to questions 51-64.]

C. Economic Characteristics

51. Did you do any work or did you have a job during the last week?
(Even if you did not attend for reason of vacations, illness, etc.)

[] 1 Yes - Skip to question 58
[] 2 No

52. Did you receive or will you receive pay for any work done in your home or outside of it during the last week?

[] 1 Yes - Skip to question 58
[] 2 No

53. Did you look for work during the last week?

[] 1 Yes
[] 2 No

54. During the last week, did you engage in any unpaid work in your house or in any establishment?

[] 1 Yes - Skip to question 58
[] 2 No

55. If you did not work, what did you do during the majority of your time during the last week?

[] 1 Studied
[] 2 Took care of the household
[] 3 Lived from income (rentier)
[] 4 Retired or pensioner
[] 9 Other

56. Have you previously done any work for which you received payment in money?

[] 1 Yes
[] 2 No - Skip to question 65

57. How long have you been without work?

[] 1 Fewer than 6 months
[] 2 From 7 to 11 months
[] 3 For 12 months or more
(For all of these responses: Skip to question 59)

58. How many hours did you work last week in all of your jobs?
(For those who were ill or on vacation, etc., give the hours normally worked per week.)

____ Number of hours

59. For whom did you principally work last week, or when you last had a job?

[] 1 For the government
____ (note)
[] 2 For a private company
____ (note)
[] 3 For own-account
[] 4 In a family home
[] 9 For others

60. What does the organization, company, business or agricultural enterprise in which you work (or worked) do?

____

61. What is the occupation, job or position that you hold or held in the place where you work or worked?

____

62. In this job are or were you a:

[] 1 Public sector employee
[] 2 Private sector employee
[] 3 Employer or owner
[] 4 Own-account worker
[] 5 Unpaid family worker
[] 6 Worker in a family home
[] 9 Other (specify) ____

63. How much did you earn in your principal job or employment during the year 1980, or during the last month?

____ $RD Monthly or ____ $RD Yearly

64. How much did you earn total from all sources during the year 1980, or during the last month?

____ $RD Monthly or ____ $RD Yearly

For individuals 12 years of age and older[Applies to question 65.]

65. Are you currently in a consensual union, married, separated, divorced, widowed, or single?

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

For women 12 years of age and older [Applies to questions 66-72.]

D. Fertility Characteristics

66. How many children born alive have you had in total?

____ Total
____ Males
____ Females

67. What was the date of the birth of your last child born alive, regardless of whether this child is currently alive or dead?

____ Month
____ Year

68. Is this last child alive?

[] 1 Alive
[] 2 Deceased
[] 9 Unknown

69. How many currently live in the country?

____ Total
____ Males
____ Females

70. How many currently live abroad?

____ Total
____ Males
____ Females

71. Of how many do you not know the place of residence?

____ Total
____ Males
____ Females

72. How many have died?

____ Total
____ Males
____ Females