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IV Census of Population
and
III of Housing

November 14th, 1982

[In the original document 14th is crossed out and 28th is written.]

____ Dwelling number (visit order)

I - Geographic location

____ 1. Province
____ 2. Canton
____ 3. Parish
____ 4. Name of the City or Parish head
____ 5. Name of the locality
____ 6. Zone number
____ 7. Sector number
____ 8. Block number
____ 9. Enumeration area number
10. Home address:

____ Street and number
____ Lot number
____ Floor number
____ Apartment number
____ Route or highway

II - Dwelling

1. Dwelling type

Private
[] 01 House or villa
[] 02 Apartment
[] 03 Rooms in a tenement
[] 04 Mediagua (small unit with sloped roof )
[] 05 Rancho (poor construction possibly with cane or straw roof) or shack (covacha)
[] 06 Rustic cabin (choza)
[] 07 Others
[] 08 Places not intended for use as a dwelling
Collective
[] 11 Hotel, inn or boarding house
[] 12 Military or police barracks
[] 13 Hospital, clinic, etc.
[] 14 Convent, religious institution
[] 15 Others
If a collective dwelling, skip to questions on population.

2. Occupancy of the dwelling

[] 1 Occupied, with people present
[] 2 Occupied, with people absent
[] 3 Unoccupied
[] 4 Under construction

3. Predominant materials in the dwelling

A. Roof or covering
[] 1 Reinforced cement roof (Losa de hormigón)
[] 2 Asbestos (Eternit), Ardex or similar
[] 3 Zinc or similar
[] 4 Tile
[] 5 Straw or similar
[] 6 Other materials

B. Exterior walls
[] 1 Cement, brick or block
[] 2 Adobe or mud wall (tapia)
[] 3 Wood
[] 4 Covered cane
[] 5 Uncovered cane
[] 6 Other materials

C. Floor
[] 1 Wood
[] 2 Parquet, floor tile or vinyl
[] 3 Brick or cement
[] 4 Cane
[] 5 Earth
[] 6 Other materials

4. Tenure of the dwelling

The dwelling is:

[] 1 Owned
[] 2 Rented
[] 3 Free
[] 4 For services
[] 5 Other (for example, sharecropping)

5. Water is supplied to the dwelling via:

Public system
[] 1 Inside the dwelling
[] 2 Outside the dwelling but within the building
[] 3 Outside of the building
Other sources:
[] 4 Well or spring
[] 5 River or stream
[] 6 Delivery truck
[] 7 Other

6. What toilet facilities (W.C.) are available in the dwelling?

[] 1 Toilet for exclusive use of the dwelling
[] 2 Shared use toilet
[] 3 Latrine
[] 4 None

7. The wastewater elimination system for this dwelling is:

[] 1 By public sewer system
[] 2 Septic tank
[] 3 None

8. The electric service available in the dwelling is:

[] 1 From public system
[] 2 From private generator
[] 3 None

9. How many rooms in total does the dwelling have?

____ (Not including kitchen or bathroom)

10. Of these rooms, how many are used exclusively for sleeping?

____

11. Does the dwelling have a separate room for cooking?

[] 1 Yes
[] 2 No

12. What is the primary fuel used for cooking?

[] 1 Kerosene or gasoline
[] 2 Wood or charcoal
[] 3 Gas
[] 4 Electricity
[] 5 Other
[] 6 None (no cooking)

13. Is any part of the dwelling used for handcrafts, small industry, business or other activities?

[] 1 Only handcrafts
[] 2 Only small industry
[] 3 Only business
[] 4 Business and handcrafts
[] 5 Business and small industry
[] 6 Other activities
[] 7 Dwelling only

Summary of the population

____ Number of males
____ Number of females
____ Total

____ Name of enumerator
____ Date
____ Name of sector head
____ Date

Comments: ____

III. Population

[The following is a table with space for the responses of three people. Except for question 2, the response options for all people are the same.]

A. General Characteristics

For all individuals

1. What is the name and surname of each person who spent the night of the 13th to the 14th of November in this household? Do not forget to note infants and the elderly

____

2. What is your relationship to the head of the household? Mark the appropriate box.

Person 1:
[] 0 Head
Persons 2 and 3:
[] 1 Spouse, partner
[] 2 Son/daughter
[] 3 Son- or daughter-in-law
[] 4 Grandchild
[] 5 Parents or parents-in-law
[] 6 Other relatives
[] 7 Other non-relatives
[] 8 Domestic employee [explicitly female]

3. Are you male or female? Mark the appropriate box.

[] 1 Male
[] 2 Female

4. How old are you?

Write the age at last birthday. For those under one year write "00".

____ Years completed

5. Where were you born?

If born in the rural parish or city where enumerated, mark the box Here; otherwise write the name of the rural parish or city and province. If born abroad, write just the name of the country.

[] 00 Here
____ Rural parish or city
____ Province
____ Foreign country
[] 99 Unknown

6. In what rural parish or city do you habitually live?

If the place of habitual residence is the rural parish or city where enumerated, mark the box Here; otherwise write the name of the rural parish or city and province. If living abroad, write just the name of the country.

[] 00 Here
____ Rural parish or city
____ Province
____ Foreign country
[] 99 Unknown

7. How long have you lived in the place indicated?

Write the period of residence in the place indicated in question 6. If living there less than one year, write "00."

[] 98 Always (Skip to question 9)
____ Number of years
[] 99 Unknown

8. In what rural parish or city did you live before?

Write the name of the rural parish or city and province. If abroad, write just the name of the country.

____ Rural parish or city
____ Province
____ Foreign country
[] 99 Unknown

B. Educational characteristics.

For all individuals 6 years of age and older

9. Do you know how to read and write?

If only able to read or only able to write mark the box "no."

[] 1 Yes
[] 2 No

10. Do you attend any institution of regular schooling, whether a literacy center, primary, secondary, or post-secondary (superior)?

[] 1 Yes, attending
[] 2 Not attending
[] 9 Unknown

11. What is the highest grade, class or year of schooling completed in the literacy center, primary, secondary, or post-secondary school?

Write the number of the highest grade, course or year completed on the corresponding line.

[] 00 None
____ 1. Literacy center
____ 2. Primary
____ 3. Secondary
____ 4. Post-secondary
[] 99 Unknown

C. Economic characteristics

For all individuals 12 years of age and older

12. Are or were you a participant in the social security?

[] 1 Yes
Currently contributing?
[] 3 Yes
[] 4 No
[] 2 No

13. What did you do the greater part of the days between the 7th and the 13th of November?

Ask the questions in the order indicated: Worked? Did not work but had a job? Etc. and upon receiving a reply, mark the respective box and go on the next appropriate question.

[] 1 Worked?
[] 2 Did not work but had a job?
[] 3 Unemployed? (Looked for work having worked before)

For responses 1-3, continue with question 14

[] 4 Looked for work for the first time?
[] 5 Studied exclusively?
[] 6 Did household tasks exclusively?
[] 7 Exclusively retired or pensioner?
[] 8 Others
[] 9 Unknown
For responses 4 - 9, women skip to 17, men skip to 21

Questions 14 - 16 are only for those who answered 1, 2, or 3 in question 13.

14. What is the occupation that provided the greatest income in the days from November 7th to 13th, or what was your last occupation if unemployed?

Write with some detail the work performed.

____ [In addition to the space for the response, a blank, 3-character box also appears in the corner of this item.]

15. What does the establishment where you engage in the occupation indicated primarily do?

Write for example: Primary education, doctor's office, textile factory, restaurants, livestock ranch, etc.

____ [In addition to the space for the response, a blank, 3-character box also appears in the corner of this item.]

16. What was the category or position in the occupation indicated?

Ask the questions in the order given and upon receiving an answer; mark the appropriate box.

[] 1 Owner or active partner?
[] 2 Own-account?

Worker or salaried employee?
[] 3 Public sector
[] 4 Private sector
[] 5 Unpaid family worker?
[] 6 Others
[] 9 Unknown

D. Fertility characteristics

Only for women 15 years of age and older

17. How many children born alive have you had?

[] 00 None Skip to question 21
____ Number
[] 99 Unknown

18. Of these children, how many are currently alive?

[] 00 None
____ Number
[] 99 Unknown

19. What was the date of birth of your last child born alive?

Date: ____ Month
19_ _ Year

20. Is your last child currently alive?

[] 1 Yes
[] 2 No
[] 9 Unknown

E. Marital Status

For all individuals 12 years of age and older

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

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