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The National Statistical Committee of the Kyrgyz Republic

Population and Housing Census of 2009

Census Questionnaire -- Housing

Questions 1 -- 5 to be completed for residential buildings[Questions 1-5]

1. Classification of residential premise by type

[] 1 Building with one housing unit
[] 2 Building with more than one housing unit (block)
[] 3 Building for persons residing in institutional establishments
[] 4 Hostels
[] 5 Hotels
[] 6 Unfinished residential building
[] 7 Dilapidated residential premises
[] 8 Other buildings

2. Number of stories

[] 1 Single-story
[] 2 Two-story
[] 3 3-5- story
[] 4 6-9- story
[] 5 10 and more stories

3. Wall materials of premises

[] 1 Brick
[] 2 Combined reinforced concrete, panel (monolith)
[] 3 Cinder block
[] 4 Wood
[] 5 Adobe brick
[] 6 Mixed material
[] 7 Other

4. Construction period
If rebuilt, extended, year of construction is considered initial year of construction.

[] 1 Before 1946
[] 2 1946-1960
[] 3 1961-1970
[] 4 1971-1980
[] 5 1981-1990
[] 6 1991-2000
[] 7 2001-2005
[] 8 2005-2008

5. Seismic stability

1 [] Constructed for earthquake resistance
2 [] Constructed without seismic stability
3 [] Unknown

Questions 6 -- 10 to be completed for residential premise
[Questions 6-10 were asked for residential premises.]

6. Type of occupied residential premise in a building

[] 1 Separate house
[] 2 Part of separate house
[] 3 Separate apartment
[] 4 Common (multifamily) apartment
[] 5 Room, apartment in hostel
[] 6 Part of house for old and disabled people, children's home, etc.
[] 7 Part of premises in other institutional establishments
[] 8 Premises in hotels
[] 9 Country house (Dachas)
[] 10 Other residential premise (including lodging)
[] 11 Other non-residential premises used for residence
[] 12 Premise is n/a

7. Occupancy

[] 1 Occupied for constant residence
[] 2 Not occupied

8. Type of utilities

[] 1 Electricity
[] 2 Electric stove
[] 3 Gas cooker
[] 4 Network gas (natural)
[] 5 Bottled gas
[] 6 Central heating from SPP (steam power plant)
[] 7 Boiler--house heating
[] 8 Individual steam heating
[] 9 Stove heating
[] 10 Other type of heating
[] 11 Bathroom or shower
[] 12 Running water inside the premise
[] 13 Running water outside the premise
[] 14 Sewerage
[] 15 Toilet
[] 16 Central hot water supply
[] 17 Individual hot water supply
[] 18 Phone
[] 19 Cable television
[] 20 Internet
[] 21 No utilities available

9. Size of area, [m2]

Floor area _ _ _
Residential area _ _ _
o/w for other purposes _ _ _

10. Number of rooms
How many rooms in premise unit, excluding kitchen and bathroom?

_ _ room[s]

Questions 11 -- 13 to be completed by household permanently residing in premise

No. Household (see graph 2 form 1) [not included]

11. Form of property of residential premises

[] 1 Private
[] 2 State-owned
[] 3 Municipal-owned
[] 4 Rented from private landlord
[] 5 Other type of property

12. Size of area occupied by your household in the residential premises, in m2

Floor area _ _ _
Residential area _ _ _

13. Number of occupied rooms
How many rooms are occupied by your household?

_ _ rooms
part of room….99

[p.2]

Census Questionnaire – Population

Full name ________
No. _ _ (from column 2 of Form 1) [not included]

1. Relationship to the person enumerated first in a household

[] 1 First person recorded
[] 2 Spouse
[] 3 Daughter, son
[] 4 Parent
[] 5 Sibling
[] 6 Parent-in-law
[] 7 Daughter-in-law, brother-in-law
[] 8 Grandparent
[] 9 Grandchild
[] 10 Other relative
[] 11 No relation

No. of the mother or father (from column 1 of the list) _ _

2. Sex

[] 1 Male
[] 2 Female

3. Residential status

[] 1 Absent
[] 2 Residing

4. Date of birth

Day _ _
Month _ _
Year _ _ _ _
Age _ _ _

5. Nationality

________

6. Language

6. 1 Mother tongue
________

6. 2 Other fluently spoken languages
________

7. Place of birth (name a town, rayon, country)

________

8. Citizenship

[] 1 Kyrgyz Republic
[] 2 Without citizenship
Citizen of another country (specify the country) _ _ _

9. Constantly residing

9.1 Residing temporarily from birth in this settlement
[] 1 Yes
[] 2 No
If "NO" specify

The year you have been temporarily residing here ________
Place of previous residence (name a town, rayon, country)
________

9.2 Reasons for residence change
[] 1 Economical
[] 2 Social
[] 3 Ecological (climatic)
[] 4 Other reasons

10. Marital status(persons 15 years and over)

[] 1 Never married
[] 2 Registered married
[] 3 Not registered married
[] 4 Widowed
[] 5 Divorced
[] 6 Separated

No. of wife [or] husband (from column 1 of the form [1]) _ _

11. Education(for persons 10 years and over)

[] 1 Higher - Bachelor
[] 2 Higher - Specialist
[] 3 Higher - Magister
[] 4 Higher incomplete
[] 5 Secondary specialized
[] 6 Prevocational (vocational)
[] 7 Secondary general
[] 8 Basic (compulsory general)
[] 9 Elementary general
[] 10 Without elementary general education

11.1 Are you able to read and write?
(for persons without elementary general education)
[] 11 Yes
[] 12 No

11.2 Persons with scientific degree, specify
[] 13 Candidate of sciences
[] 14 Doctor of sciences

11.3 Educational qualification specified in diploma (codes 1,2,3,4,5,6)
________

12. Type of educational establishment you are attendingFor persons 6 years and over

[] 1 Graduate and doctorate
[] 2 Higher educational establishment
[] 3 Secondary specialized educational establishment
[] 4 Vocational school
[] 5 General educational establishment of all types
[] 6 Other school
[] 7 Not attending

13. Are you attending preschool? For persons of preschool age

[] 1 Yes
[] 2 No

14. Sources of income

[] 1 Income from employment
[] 2 Scholarship (stipend)
[] 3 Pension
[] 4 Subsidy
[] 5 Other type of state support
[] 6 Savings
[] 7 Income from property
[] 8 On dependence
[] 9 Other sources

From above listed, specify the main source of income _

15. EmploymentFor persons 12 years and over

15.1 Place of work and activity type of an enterprise, organization (detailed name of activity)________

15. 2 Position or profession (detailed title or position, profession or performed work)________

15. 3 Location of work (name a town, rayon (area), country)________
16 Status in employment
[] 1 Employed
[] 2 Self-employed

17. Looking for work?For unemployed persons 15 years and over

[] 1 Yes
[] 2 No

If yes,
[] 3 Ready to start work next two weeks
if no, specify the reason
[] 4 Absence of work
[] 5 Illness, disability
[] 6 Family reasons
[] 7 No need to work
[] 8 Other reasons

18. Women, 15 years of age and over, specify

How many children have you given birth to?
Boys _ _
Girls _ _

How many children are alive?
Boys _ _
Girls _ _

How many of them live elsewhere?
Boys _ _
Girls _ _