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Ministry of Economy
General Statistic Department

Republic of Guatemala
III Census of Housing and VIII of Population
March 1973

Office use: [blank shaded box]

Form number ____ of ____

I. Geographic location

____ 1. Department

____ 2. Municipality

3. Cartographic code:

____ Department
____ Municipality
____ Section
____ Sector

4. Area:

[] 1 Urban
[] 2 Rural

Number of populated center (office use) ____

5. Number of populated center ____

6. Category of locality

[] 1 City
[] 2 Villa
[] 3 Town
[] 4 Village
[] 5 Hamlet
[] 6 Station (paraje)
[] 7 Farm

7. Address of the building where the dwelling is located ____

II. Characteristics of the dwelling place

1. Dwelling type

[] 1 Separate house
[] 2 Apartment
[] 3 Room in a tenement
[] 4 Shack or other rustic housing
[] 5 Improvised housing (shed, hut)
[] 6 Other type

2. Year of construction of the building

When was the building constructed?

[] 1 In 1973
[] 2 In 1972
[] 3 In 1971
[] 4 In 1970
[] 5 Before 1970
[] 6 Unknown

3. Predominant material in the exterior walls of the building

[] 1 Brick and/or concrete block
[] 2 Adobe
[] 3 Wood
[] 4 Cane and mud (bahareque)
[] 5 Lepa, sticks, or cane
[] 6 Other

4. Predominant material in the roof of the building

[] 1 Concrete
[] 2 Metal sheet
[] 3 Asbestos or cement
[] 4 Clay tile
[] 5 Straw, palm, and similar
[] 6 Other (specify) ____

5. Predominant material in the floor of the dwelling

[] 1 Cement tile
[] 2 Clay tile
[] 3 Cement slab (torta de cemento)
[] 4 Wood
[] 5 Dirt
[] 6 Other (specify) ____

6. Occupancy condition type

[] 1 Occupied with people present
[] 2 Occupied with people absent
[] 3 Vacant

7. Reason for vacancy

[] 1 For sale
[] 2 For rent
[] 3 Other reason

8. Utility services in the dwelling

a. Water

Is the dwelling connected to a public water distribution system?
[] 1 Yes
[] 2 No

b. Wastewater

Is the dwelling connected to a public sewer system?
[] 1 Yes
[] 2 No

c. Electric lighting

Is the dwelling connected to a public electrical distribution system?
[] 1 Yes
[] 2 No

9. Total number of rooms in the dwelling (include the kitchen but not the bathroom) ____

10. Number of households residing in the dwelling ____

III. Dwelling situation

1. Water service

What type of water service does the dwelling have?

[] 1 Running water for exclusive use
[] 2 Running water for various households
[] 3 Public tap (outside of the building)
[] 4 Well
[] 5 River, lake, spring
[] 6 Other

2. Toilet facilities

What type of toilet facilities are available in the household?

Toilet connected to public system
[] 1 For exclusive use
[] 2 For various households
Toilet connected to a septic tank
[] 3 For exclusive use
[] 4 For various households
[] 5 Toilet connected to a drain, without water supply
[] 6 Pit toilet
[] 7 None

3. Lighting service

What type of lighting is available in the household?

[] 1 Electricity from the public system
[] 2 Electricity from a private system
[] 3 Gas (kerosene), gasoline
[] 4 Candle
[] 5 Other

4. Number of rooms

a. What is the total number of rooms in the household? (Include the kitchen but not the bathroom.) ____

b. How many of these rooms are used as bedrooms? ____

5. Kitchen

Does the household have a room used only for cooking?

[] 1 For exclusive use
[] 2 For various households
[] 3 Does not have

6. Fuel used for cooking

What type of fuel is used for cooking?

[] 1 Electricity
[] 2 Propane gas
[] 3 Natural gas
[] 4 Charcoal
[] 5 Wood
[] 6 No cooking

7. Ownership system

What is the system of ownership of the household?

[] 1 Completely paid
[] 2 Paying in installments
[] 3 Rented
[] 4 Ceded
[] 5 Other

8. Monthly payment amount (paying in installments) or monthly rental amount (rented place)

What is the amount of the monthly mortgage or rental payment?

Quetzales [Guatemalan currency] ____

9. Appliances in the household
Does the household have any of the following appliances?

Radio
[] Yes
[] No

Television
[] Yes
[] No

Telephone
[] Yes
[] No

Refrigerator
[] Yes
[] No

IV. Social characteristics of the members of the household
[For all persons]

Do the members of the household, or the majority of them, habitually:

1. Speak an indigenous language?
[] 1 Yes
[] 2 No

2. Use traditional indigenous outfit?
[] 1 Yes
[] 2 No

3. Use:
[] 1 Shoes
[] 2 Caites
[] 3 None

V. Present and resident population in the household
[For all persons]

1. Present population

How many people slept in this household the night of the 25th and the 26th of March, 1973?

____ Total
____ Males
____ Females

2. Resident population

a. How many people habitually resided in this household on March 25th, 1973?

____ Total
____ Males
____ Females

b. How many of these people were in another municipality or another country on March 25th, 1973? ____

Comments: ________

Enumerator's signature

Family type (office use)

VI. People in the census household

A - Personal characteristics
(For all individuals)

1. Name and last names ____

What is the name and last name of each of the people who habitually resided in this household on March 25th, 1973?

2. Relationship

What is your relationship to the head of the household?

[] 0 Head
[] 1 Spouse or partner
[] 2 Child or stepchild
[] 3 Parents or parents-in-law
[] 4 Grandchild
[] 5 Other relative
[] 6 Domestic employee
[] 7 Other non-relative
[] 9 Unknown

3. Sex

Are you male or female?

[] 1 Male
[] 2 Female

4. Age

How old are you in years completed?

Years (under one year write 00) ____

5. Marital status

Are you single, married, in a consensual union, widowed, or divorced?
For those younger than 13, mark an "X" in the box "single."

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

6. Orphanhood condition

Is your mother alive?

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

7. Ethnic group

Are you indigenous?

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

B - Geographic characteristics
(For all individuals)

8. Place of birth:

In which municipality were you born?

[] 1 Here
[] If born in this country write the name of the municipality and department.
Municipality ____
Department or country____
If born abroad, write the name of the country ____

9. Habitual residence in March 1968: only for those 5 years of age and older

[Question 10 was asked only of persons age 5+ years old]

In which municipality did you live 5 years ago?

[] 1 Here

Write the name of the municipality and department [if the habitual residence was in the country]
____ Municipality
____ Department or country
If living abroad of the country [write country name] ____

10. Year of arrival in the country: only for those born abroad.

[Question 10 was asked only of persons who born abroad]

In what year did you come to live permanently in the country?

[] Year 19 _ _
[] 9 Unknown

C - Cultural characteristics
(For those 7 years of age and older)
[Questions 11 to 14 are asked of persons age 7+ years old]

11. Literacy

Are you able to read and write?

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

12. Educational level

What was the highest grade or year of schooling you completed in primary, secondary, or higher education?

Write the grade or year according to the type of schooling indicated.

[] 00 None
[] 1 Elementary ____
[] 2 Secondary____
[] 3 Higher____
[] 99 Unknown

13. Career or course of studies

To what career or course of studies does the highest grade or year completed belong?

If the answer corresponds to higher education, write also the course of studies pursued in secondary education.

[] 00 None and elementary
[] Secondary ____
[] Higher ____

14. School attendance

Do you currently attend an institution of elementary, secondary, or higher education?

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

D - Economic characteristics
(For those 10 years of age and older)
[Questions 15 to 19 are asked of persons age 10+ years old]

15. Type of activity

What did you do during the week prior to the census date? (from the 19th to the 25th of March, 1973)

(Ask each question indicated until receiving a positive response)
[] 1 Worked
[] 2 Did not work but had a job
[] 3 Had worked before and looked for a job
[] 4 Looked for work for the first time
[] 5 Lived from investments or retirement income
[] 6 Studied
[] 7 Domestic duties in your home
[] 8 Other
[] 9 Unknown

16. Principal occupation

Only for persons who answered 1-3 in question 15.
[Questions 16-19 were asked of persons who answered 1-3 in question 15]

What occupation, position or type of work did you carry out during the week of March 19th to 25th or in the last job you had? ____

17. Branch of activity

What kind of activity does the enterprise, establishment, factory, workshop, service, etc., where you work or worked for the last time? ____

18. Occupational category

Which category or position did you have in the occupation indicated above (question 16)?

[] 1 Owner
[] 2 Self-employed
[] 3 Salaried or waged employee
[] 4 Unpaid family member
[] 9 Unknown

19. Membership with IGSS [Guatemalan Institute of Social Security]

Are you currently affiliated with the IGSS?

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

E - Fertility characteristics
(For all women ages 15 and older)
[Questions 20 to 23 were asked of women age 15+ years old]

20. Total children born alive

How many children born alive have you had in total?

[] 00 None
[] Number ____
[] 99 Unknown

21. Total children surviving

How many of these children are currently alive?

[] 00 None
[] Number ____
[] 99 Unknown

Date of birth and survival of last child

22. What was the date of birth of your last child (born alive)?

[] 0 Has not had children
[] Day ____
[] Month ____
[] Year 19 ____

23. Is your last child alive?

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