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Individual Form
French Republic
Population Census 1990

Form number 2
Write very legibly.
Sign your name on the bottom of page two.
Box to be filled in by the INSEE

[] 1
[] 2
[] 3

Stamp of city hall

1. Name

Last name, first names
Write your last name in capital letters
example: ALLARD, wife MAURIN, Francoise

2. Address

3. Sex
[] 1 Male
[] 2 Female

4. Legal marital status
A person living in free union will check the box corresponding to his or her legal status. If single, for example, check the first box.
A divorced person, or a person separated from his or her legitimate partner will check the second box.
[] 1 Single
[] 2 Married or remarried
[] 3 Widowed
[] 4 Divorced

5. Date and place of birth
Born ____
(day, month, year)
in (county): ____
Department: ____
(country for foreigners, territory those from the TOM (Overseas Territories))

6. Nationality
[] 1 French by birth (including reintegration)
[] 2 Naturalized citizen by naturalization, marriage, official statement upon becoming an adult
Indicate your former nationality
[] 3 Foreigner
Indicate your nationality

7. Where were you living on January 1st, 1982?
(for all people born before January 1st, 1982)
If, on January 1982, you were in the military or a student intern, indicate the address of your personal residence on this date and not that of the establishment (barracks, boarding school)
[] 1 In the same dwelling as now
[] 2 In another dwelling of the same county, or the same city neighborhood [arrondissement] if in Paris, Lyon, or Marseille)
[] 3 In another county (or in another city neighborhood if in Paris, Lyon, or Marseille)
Indicate this other county
County (for Paris, Lyon, Marseille specify the city neighborhood) ____
Department (country for foreigners, territory for the TOMs) ____

Questions 8 through 21 are only for those people 14 years old or more

8. Indicate your highest grade level or degree
[] 1 Certificate of primary studies
[] 2 BEPC (Brevet d'études du premier cycle - certificate of first cycle studies), elementary certificate, junior high school certificate
[] 3 CAP (Certificat d'aptitutude professionnelle - certificate of professional aptitude)
[] 4 BEP (Brevet d'études professionelles - certificate of professional studies)
[] 5 High school diploma, professional certificate or technical certificate, other certificate (BEA [Brevet d'Enseignment Agricole - c. of agricultural education], BEC [Brevet d'etudes commerciales - c. of management studies], BEI [Brevet d'Enseignement Industrielles -c. of industrial education], etc.)
[] 6 University Bachelor's degree, BTS [Brevet de Technicien Supérieur - superior technician c.], DEST [Diplome d'études supérieures techniques - superior technical studies diploma], DUT [Diplome Universitaire de Technologie - technological university diploma], diploma of social professions or of health
[] 7 University graduate degree, Engineering degree, from a Grande Ecole [school of superior studies, admission to which is highly competitive], etc.

If you work, go to the back of the page (questions 12 to 21)
If you are on sick leave or maternity leave
If you help a member of your family in his or her work without pay
If you are apprenticed under contract, a paid intern (TUC, SIVP..), etc.

If you do not work (or do not work anymore), answer questions 9-11

9. Are you?
[] 1 High school student, university student, volunteer intern
[] 2 Unemployed (enrolled or not with the ANPE [Agence nationale pour l'emploi - National agency for unemployment])
[] 3 Retired (formerly paid) or retired early
[] 4 Retired from business (former farmer, former artist, former merchant)
[] 5 Housewife
[] 6 Other (not active at this time) (including people not receiving anything but a reversion benefit)

10. Have you already worked?
[] 1 Yes -- What was your main profession?
[] 2 No

11. Are you looking for work?
[] 1 You are not looking for work
You have been looking for work since:
[] 2 - less than 3 months
[] 3 - 3 moths to less than a year
[] 4 - 1 year to less than 2 years
[] 5 - 2 years or more

Sign the form on the bottom of page 2
For people passing through (see page 3 of form number 1, address of regular residence)

You are employed

12. Profession currently practiced

Be very specific. Examples; an electrical maintenance worker, a driver of heavy loads, a vendor of household appliances, a chemical engineer, self-service cashier, etc.

13. Do you help a member of your family in his or her work?
(farming or industrial operation, business, self-employed, etc.)

[] 1 Yes
[] 2 No

14. If you are a state employee, from a local community, from a public hospital, a public service (EDF [Electricité de France - French Electric Company], SNCF [Societe Nationale des Chemins de Fer - National Railroad Organization], etc.) or military by career, specify your classification (corps, rank, etc.)

15. Where do you work?
a) Address of your workplace.
Number ____ street or lieudit [a place usually deep in the countryside, with no address but named after its function or by the landmark it is close to] name
County: (for Paris, Lyon, and Marseille specify city neighborhood) ____
Department (or country): _ _ ____
b) Name (or corporate name) of the establishment which employs you or which you yourself direct:
c) Activity of this establishment:
Be very precise. Examples: wholesale wine business, manufacturing of steel structures, highway transport of passengers, etc.
d) Address of this establishment, if it is different from the one declared in question 15a.

16. Are you?
[] 1 Paid
[] 2 Self-employed
(farmer, artisan, merchant, manufacturer, self-employed, unpaid family helper, etc)

17. Do you work
[] 1 Part time?
[] 2 Full time?

18. If you are self-employed
How many employees do you have?
(Don't count apprentices or servants. In farming, count only people on a salary.)
[] 1 None
[] 2 1 or 2
[] 3 3 to 9
[] 4 10 or more

Questions 19 to 21 are only addressed to people who are paid and to paid interns

19. If you are in one of the following situations, check the box which best describes your situation:
[] 1 Apprenticed under contract
[] 2 Practicing beneficial community work (TUC [Travail d'utilité collective], etc.)
[] 3 Under a Contrat d'adaptation (contract for young people ages 16 to 25 who needed additional education in order to quickly get a job; replaced November 2004 by the Contrat de professionalisation ) or Contrat de qualification (same contract, but for people 26 years of age or older)
[] 4 Intern (mainly in a business: SIVP [Stage d'Insertion à la vie professionnelle - Internship of integration into professional life], etc.)
[] 5 Intern (mainly in an educational center: FPA [Formation Professionnelle Accélérée - Accelerated Professional Education], etc.)
[] 6 Placed by an interim agency
[] 7 Under work contract for a determined duration

20. Indicate the professional description of your current job
[] 1 Unskilled worker (OS1, OS2, OS3, [Ouvrier spécialisé] etc)
[] 2 Qualified worker or highly qualified (P1, P2, P3, TA, OQ [Ouvrier qualifié], etc)
[] 3 Supervisor over workers, administrative or commercial supervisor
[] 4 Supervisor over technicians or other supervisors
[] 5 Technician, designer, VRP [Vendeurs représentants placiers - Sales representative] (not an executive)
[] 6 Lecturer, assistant, social worker, nurse, and personnel of category B of civil service
[] 7 Engineer or executive (the employees, technicians, supervisors not having the status of executive should not classify themselves here even if they subscribe to an executive pension fund)
[] 8 Professor and personnel in category A of civil service
[] 9 Office employee, business employee, service agent, nurse's aid, day-care worker, personnel from category C or D of civil service
[] 0 Other situation. _____ Specify.

21. What are your main duties?
[] 1 Production, manufacturing, construction
[] 2 Installation, maintenance, regulating, repair
[] 3 Cleaning, gardening, household work
[] 4 Handling, warehousing, transportation
[] 5 Secretarial, typist, ticket booth, switchboard
[] 6 Management, accounting, administrative functions
[] 7 Business, sales, technical sales
[] 8 Research, studies, methods, computer science
[] 9 General director or one his or her direct assistants
[] 0 Other situation ____ Specify (teaching, health, news, etc):