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Form number 2B
Individual form
Census of the 1999 Population
French Republic

Check the box which applies to you.
Write in only one number per box.

Section to be filled out by the INSEE

1. Name
_____ Last name
_____ First name

Write the last name in capital letters (example: ALLARD, spouse MAURIN, Fran├žoise)

2. Address ______
3. Sex

[] 1 Male
[] 2 Female

4. Legal marital status

[] 1 Single
[] 2 Married
[] 3 Widow(ed)
[] 4 Divorced
A person cohabitating will check the box corresponding to his/her present legal status. If, for example, the status is single, this person will check the first box. A person in the middle of a divorce or separated from his/her legitimate spouse will check the second box.

5. Date and place of birth.

Born on:
Day _ _
Month _ _
Year _ _ _ _
In (the city of) ____
County _ _
DOM _
(Country if foreigner, territory for the TOM) ____
If you were born in an overseas department or abroad, in which year did you arrive in mainland France?
19_ _

6. What is your nationality?

French
[] 1 You were born French
[] 2 You became French through naturalization, registration, upon becoming an adult or by your own incentive, etc.
Indicate your nationality at birth: ____
[] 3 Foreign
Indicate your nationality: ____

7. Were you enrolled for the 1998-1999 school year in a school?

[] 1 Yes
[] 2 No
If yes, the school is located:
[] 1 In the city where you live (or the district for Paris, Lyon, Marseilles)
[] 2 In another city (or another city sector)
Indicate this other city (specify the city sector)
County _ _
City ____

8. Where were you living on January 1st, 1990?

For every person born before January 1, 1990.
If, on January 1, 1990, you were in the military or a boarding school student, indicate the personal residence at this date and not that of the institution (barracks, boarding school)
[] 1 In the same residence as now
[] 2 In another residence in the same city (in the same city sector if in Paris, Lyon or Marseilles)
[] 3 In another city (or another city sector)
Indicate this other city (specify the city sector)
City ____
County _ _
DOM _
(Country for the foreigner, territory for TOM) ____

For people passing through (see page 3 of printout no. 1) address of the usual residence:
Street number _____
Street (place name) ____
Zip code _ _ _ _ _
City ____
Questions 9 through 24 are only addressed to people 14 years old or more[Questions 9-24 were asked only of persons 14 years or older.]

9. What level of study have you completed?

[] 1 Elementary school
[] 2 Middle school, CAP, BEP
[] 3 Partial or complete high school diploma
[] 4 Higher education (universities, IUT, etc.)

10. Indicate your last diploma obtained

[] 0 No diploma
[] 1 Certificate of elementary studies
[] 2 BEPC, elementary certificate, middle school certificate
[] 3 CAP
[] 4 BEP
[] 5 General high school diploma (Philosophy, Sciences, etc., basic math, A, B, C, D, E, L, S, ES, etc.)
[] 6 Technical diploma (F, G, H, STI, etc.) or professional, professional certificate or technician's certificate, other certificate (BEA, BEC, BEI, etc.) basic legal qualification
[] 7 Bachelor's or Associate's degree, BTS, DUT, diploma of social or health professions
[] 8 Graduate or post-baccalaureate university diploma (including medicine, pharmacy, dentistry), engineering degree, from a teacher-training school.

11. What is your situation?

You work
[] 1 Check the box and continue to the back of the page (questions 15 to 24) including if you are on sick leave or maternity leave, if you help a member of your family in his/her work or if you are apprenticed under contract, or a salaried intern. [skip to question 15]
You don't work (or no longer work)
[] 2 Check the box and answer questions 12 to 14

[Questions 12-14 were asked of persons who do not work per question 11.]
12. Are you a _?

[] 1 University student (university, IUT, teacher-training school, etc.)
[] 2 Student (middle school, high school)
[] 3 Unpaid intern
[] 4 Unemployed (registered or not with the ANPE)
[] 5 Early retirement
Retired
[] 6 Former employee
[] 7 Former independent worker (farmer, artisan, businessman, etc.)
[] 8 Other (woman or man working from home, person receiving only a surviving spouse's benefit, disability retirement, etc.)

13. Are you looking for a job?

[] 1 You are not looking for a job
You have been looking for a job for:
[] 2 Less than a year
[] 3 More than a year

14. Have you worked before?

[] 1 Yes
What was your main profession? ______
[] 2 No

[Questions 15-21 were asked of persons who work per question 11.]
15. Profession currently practiced ____

Be specific (ex. robotics maintenance electrician, insurance accountant, chemical technician, etc.)
If you are an agent of public services for the state or cities (including HLMs, public hospitals), specify your rank (organization, category) ____

16. Do you work?

[] 1 Full time
Part-time
Part-time is determined in relation to the average work time in your company.
[] 2 More than part-time
[] 3 Part-time or less

17. Does your main activity consist of helping a member of your family in his/her work? (where you earn a salary or not)

(Farming or artisanal work, business, profession)
[] 1 Yes
[] 2 No

18. Where do you work?

a) Address of your workplace: (ex. 18, boulevard Pasteur) ____
If you work at home, write "at home"
If you work at an individual's home, write "individual"
If the workplace is variable, write "variable"
Is work in the city where you live? (or in the city neighborhood in the case of Paris, Lyon or Marseille)
[] 1 Yes
[] 2 No
If not, write in the city where you do work: (specify the city neighborhood)
City ____
County _ _
b) ____ Name (or corporate name) of the establishment which employs you or which you manage
c) ____ Address of this establishment if it is different than that specified in question 18a.
d) ____ Activity of this establishment
Be very specific: (ex. wholesale business of fruits and vegetables, production of mechanical equipment, etc.)

19. What mode of transportation do you use the most often to go to work?

[] 1 No transportation (working from home)
[] 2 Walking only
One single mode of transportation
[] 3 Two wheels
[] 4 Personal vehicle
[] 5 Public transportation
[] 6 Several modes of transportation

[Illegible footnote]
20. Are you:

[] 1 Independent worker or self-employed (including family assistance without salary)
[] 2 Salaried head of company PDG, minority manager of SARL, co-manager
[] 3 Salaried employee, including salaried family assistance

21. If you are self-employed or the head of a company

How many salaried employees do you have?
[] 1 None
[] 2 1 or 2
[] 3 3 to 9
[] 4 10 or more
Do not include interns or housekeepers. In agriculture, count only the permanent workers.

Questions 22 to 24 are only for employees and salaried interns[Questions 22 to 24 were asked only of persons who work per question 11 and who are employees and salaried interns per question 20.]
22. Indicate your type of contract or job

[] 1 Apprentice under contract
[] 2 Placed by a temporary employment agency
[] 3 CES (Social and Economic Council) or other assisted employment (CIE, qualification, youth employment, etc.)
[] 4 Salaried intern (SIFE, etc.)
[] 5 Short-term contract (including short contract, seasonal contract, etc.)
[] 6 Permanent staff member of public services (state, locale, hospitals)
[] 7 Long-term contract (or job) of indeterminable duration

23. Indicate the professional category of your job

[] 1 Unskilled worker, specialized worker (OS1, OS2, OS3, etc.)
[] 2 Qualified worker or very qualified (P1 to P3, TA, OQ, OHQ, etc.)
[] 3 Service worker, assistant nurse, housekeeper
[] 4 Business employee, office worker, administrator of category C or D of public services
[] 5 Supervisor in charge of workers, administrative commercial or computer manager
[] 6 Manager in charge of technicians or other supervisors
[] 7 Technician, designer, VRP
[] 8 Teacher, nurse, social worker, medical technician, administrative personnel of category B of Public Services
[] 9 Engineer, business executive (technicians and supervisors should not be classified here, even if they pay dues in a pension fund)
[] 0 Personnel of category A of Public Services and other management officials

24. Indicate the main function of your work

[] 1 Production, manufacturing, construction, farming
[] 2 Installation, regulating, repair, maintenance
[] 3 Gardening, cleaning, domestic cleaning
[] 4 Handling equipment, storage, transportation, logistics
[] 5 Secretariat, ticket booths, data entry, switchboard operating, reception
[] 6 Managing, accounting, administrative function, organization
[] 7 General director or adjunct director, staff
[] 8 Commerce, sales, technical-commercial
[] 9 Research, study, methods, computers
[] 0 Teaching, training, health, social work, news, advertizing, arts, shows, sports

Thank you for your participation
In (city) ____, the _______ 1999
Signature of the respondent ______

Form number 1A
Housing form to be filled out for every dwelling, occupied or not
Population Census 1999
French Republic

Section to be filled out by the census agent
Number of the census district _ _ _ _ _
Location of the building in the district _ _ _
Location of the dwelling in the building _ _
Mayor's stamp
Fill out the four pages legibly

1. First and last name of the occupant: ______
2. Address of the dwellingNumber ____
Street (or place name) ______
County _ _
City (for Paris, Lyon, Marseille, specify the city neighborhood) ____

3. Location of the dwelling in the building (if the former is comprised of two dwellings or more)

a. ____ Stairs
b. ____ Floor
c. ____ Location on the stairway landing
If the entry door of the dwelling has a number, indicate this number: ____

4. Dwelling category

[] 1 Main residence (dwelling or independent room where the household stays most of the year). A room rented by a student will be his/her main residence.
[if option 1 marked] Fill out an individual form for each person recorded in list A, page 2.
[] 2 Occasional dwelling (dwelling or independent room used as a residence for professional reasons by a person having his/her main residence somewhere else).
[] 3 Secondary residence or dwelling rented (or to be rented) for pleasure or vacation.
No individual form except if the people are living in the dwelling at the time of the census. In that case, make corresponding individual forms while taking care to fill out the box "people passing through".
[if options 2 or 3 marked] Do not fill out pages 2 or 3 of the dwelling form.
[] 4 Vacant dwelling (without an occupant, available or not for sale or for rent).
[if option 4 is marked] No individual form. Do not fill out pages 2 and 3 of the dwelling form.
[] 5 Trailer, mobile residence.
[if option 5 is marked] Fill out an individual form for each person recorded in list A. Do not fill out page 4, to be classified separately.

General Recapitulation

To be filled out by the census agent
(5) Number of number 2 forms gathered (list A only) _ _
To be filled out by the mayor
(6) Number of number 2 forms deleted (used twice with forms number 5 reintroduced or with domiciliations completed) _ _
(7) Number of forms number 2 added (forms received for people traveling) _ _
(8) Number of forms number 5 returned _ _
(9) Population after returns (9) = (5) - (6) + (7) + (8)
Number of number 2 bis forms established _ _

[Illegible note at bottom of the page]

People living in the dwelling
Each person normally living in a dwelling, even if he/she is absent at the time of the census must be recorded either in list A or list B (see example at the bottom of the page). Don't forget young infants.

List A
Permanent occupants of the dwelling

Record the people living in the dwelling in the right-hand chart including yourself and the people absent on the date of the census (people on business or leisure trips, sick people staying short-term at the hospital or in a clinic, etc), not including people who find themselves in a situation described in list B below.Special cases. Also record:

  • Employees in your service, apprentices, young babysitters who are living at your house;
  • Sub-letters or people you are hosting, occupying one part of your dwelling, except if it is a section completely separate constituting then another dwelling.

For each person appearing in this list, fill an individual questionnaire.
[The following questions appear in a table with space for 11 individual responses.]

Last Name ______
Write in capital letters
Example: ALLARD: spouse MAURIN

First name ______
Kinship or relationship ______ to the person recorded on line 1;write, for example: wife (or husband, partner, son, daughter, father, mother, grandson, daughter-in-law, nephew, friend, subletter, etc.)

[Underneath the three questions above]

Write on the first line the name of one person in the couple (and, on the second line, the name of their spouse or partner, or in the absence of one, the name of another adult living in the dwelling)

Section reserved for students living here only for their studies and having their family residence elsewhere

  • If you are hosting a student during the school year, note below (on the line corresponding to him/her) the address of his/her family residence.
  • If you yourself are a student living here for your studies, write below (on the line corresponding to you) the address of your family residence.
If there are more than 11 people, indicate the number of additional people _ _

List B
People who are a part of your household but who are currently in one of the following situations:

Record in the chart on the right the people who are in the following situations:

  • Children living in a boarding school;
  • Children in the care of another parent (following a divorce for example);
  • Students living somewhere else during the school year (in a home, in a university dormitory, in an independent dwelling or a room in the city;
  • Conscript servicemen and women;
  • Servicemen serving outside of France;
  • Workers living in another home;
  • Elderly people living in a retirement or nursing home;
  • People being hospitalized long-term;
  • People living in another community but spending a part of the year in your dwelling

Do not fill out any individual form for these people; their forms will be filled out in the place where they usually live.
[The following questions appear in a table with space for 3 responses]

______ Last Name

______ First name

______ Kinship or relationship with the person recorded on line 1 of list A

Date of birth

Born on ______

Is this person a student?

(secondary education after the high school diploma)
[] Yes
[] No

Name and address of the establishment (or address of the dwelling)

where the person usually lives ______
Example
  • The Maurin household lives in Saint-Malo. M. Maurin and his wife have four children of which only one, Christophe, is at home all week.
  • The Maurin household rents a room of his dwelling to a student, Yves Couedec, whose family lives in Roscoff.
  • One of the Maurin sons, Laurent, is carrying out his military service in the middle of France.
  • One of the Maurin's daughters, Sophie, lives in a student home in Paris.
  • The other daughter, Nathalie, is a student in the university of Rennes, city where she rents a room.

List A

1 Maurin / Michel
2 Allard, wife of Maurin / Fran├žoise / Spouse
3 Maurin / Christophe / Son
4 Couedec / Yves / Subletter / 18, rue du Port. 29680 ROSCOFF

Four individual forms.

List B

1 Maurin / Laurent / Son / Born on 8.21.1976 / [] Yes [x] No / Military camp 23100 La Courtine
2 Maurin / Sophie / Daughter / Born on 4.7.1978 / [x]Yes [] No / Foyer les Bruyeres 9, rue ds Colleges 75005 Paris
3 Maurin / Nathalie / Daughter / Born on 12.11.1980 / [x]Yes [] No / At the home of Melle Bouvier 3, rue d'Arras 35000 Rennes

No individual forms.

People passing through
The people who are at your home at the time of the census but who usually live somewhere else (with parents, friends, etc.) should not be recorded on either of the two lists.
Special case: If a person is absent from his home during the entire length of the census and if someone else cannot answer census questions in his/her place at his/her home

1. Establish his/her individual form without recording it on list A or B while mentioning his/her address in the box reserved for this purpose on the form.
2. Send this form separately to the census agent.

General Characteristics of the Building
1. Type of dwelling

[] 1 Dwelling-home for seniors
[] 2 Hotel room
[] 3 Temporary construction, make-shift home
[] 4 Independent room (having its own entrance)
[] 5 Private home, farm
[] 6 Dwelling in a apartment building
[] 7 Dwelling in a building used as more than a dwelling (factory, studio, office building, store, school, middle school, hospital, city hall, post office, stadium, etc)

2. Year of the completion of the construction of the house or building

[] 1 Before 1915
[] 2 From 1915 to 1948
[] 3 From 1949 to 1967
[] 4 From 1968 to 1974
[] 5 From 1975 to 1981
[] 6 From 1982 to 1989
[] 7 1990 or after
In this case, specify 199_
[] 8 Building still being constructed partially inhabited
If various parts are not from the same time period, indicate the year of completion of the part where people live or the most important part inhabited.

3. Number of residential rooms _ _

Count rooms such as dining room, living room, bedrooms, whatever their surface space.
Do not count the kitchen except if the surface space is more than 12 meters squared.
Do not count such rooms as the hallway, shower, W.C., laundry room, etc.
Do not count rooms used only for professional reasons (examples: medical office, artisan's studio, etc.)

4. Surface space of the dwelling

Include all the rooms, including the hallway, kitchen, shower, W.C., etc.
Do not include balconies, terraces, verandas, cellars, parking lots or attics.
[] 1 Less than 40 meters squared
[] 2 From 40 to less than 70 meters squared
[] 3 From 70 to less than 100 meters squared
[] 4 From 100 to less than 150 meters squared
[] 5 150 meters squared or more

5. Are you?

[] 1 Owner of the dwelling (including the various selling rights)
[] 2 Renter or subletter of an unfurnished rented dwelling
[] 3 Renter or subletter of a rented furnished dwelling or a hotel room
[] 4 Living for free, for example through the parents, friends or your employers (including the case of people occupying a dwelling which they have sold for a life annuity or for which they have life interest.)

6. In which year did you move into the dwelling?

19_ _
If all the current occupants of the dwelling did not arrive at the same time, indicate the moving date of the first person's arrival. If this person has always lived in the dwelling, give his/her date of birth.

7. Does the dwelling belong to an HLM (low-income housing) organization?(office, OPAC in the company)

[] 1 Yes
[] 2 No

8. Bathroom facilities

[] 0 No bathtub, no shower in the dwelling
[] 1 Bathtub or shower in a room not normally used as a bathroom
[] 2 One shower room (room reserved as a bathroom containing at least a shower or a bathtub)
[] 3 Two shower rooms or more

9. W.C.

Are they located inside the dwelling?
[] 1 Yes
[] 2 No

10. Drainage of water used

[] 1 Sewer drainage
[] 2 Septic tank (for W.C. and household water)
[] 3 Other cases

11. Means of heating the dwelling

[] 1 Shared central heating (shared by all or most of the dwellings in the building including urban heating)
[] 2 Individual central heating with a stove in the dwelling
[] 3 All electric heating with wall radiators
[] 4 Other means of heating (pan, chimney, stove, movable radiators, water heaters, etc.)

12. Principal fuel for the heat (mark only one box)

[] 1 Urban heating
[] 2 City gas or network gas
[] 3 Oil
[] 4 Electricity
[] 5 Bottled gas or cistern gas
[] 6 Coal
[] 7 Wood

13. Garage - Stall - Parking lot

Do you have, for your private use, a parking spot located in the building or on the property?
[] 1 Yes
[] 2 No

14. Number of cars which the inhabitants of the dwelling use?

[] 0 None
[] 1 1
[] 2 2 or more

15. Is the dwelling the center of a farm?

[] 1 Yes
[] 2 No

If yes:
a) Farming acreage used:
hectares _ _ _
acres (100 square meters) _ _
Do not count woods, ponds, building land, parks and flower gardens, uncultured meadows and fields, buildings and yards.

b) Purpose of agricultural production
Farming with a main production
[] 1 Mixed farming (cultivation of workable fields)
[] 2 Market gardening or horticulture
[] 3 Vines or fruit-bearing trees
[] 4 Raising of herbivores (bovine, ovine)
[] 5 Raising of granivorous animals (pork, poultry)
Other cases:
[] 6 Mixed farming - breeding
[] 7 Raising of herbivores and granivorous animals
[] 8 Other