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Population and Dwelling Count II 2005
National Institute of Geographic and Computing Statistics
United Mexican States

Questionnaire

1. Geographic Identification
Federal State ____
Municipality or Delegation ____
AGEB ____
Locality ____
City Block ____
Segment ____

2. Dwelling and Questionnaire Control
Sequential number of the dwelling ____
Number of the household in the dwelling ____
Total number of households in the dwelling ____
Number of the questionnaire in the household ____
Total number of questionnaires in the household ____
Total number of questionnaires in the dwelling ____

3. Address of the Dwelling
Street, Avenue, Alley, Highway, Road

____

Exterior number ____
Interior number ____
Colony, Division, Neighborhood, Habitual Unity

____

4. Private Dwelling
Mark a single answer

[] 1 Independent house
[] 2 Apartment in a building
[] 3 Dwelling or room in a tenement building
[] 4 Dwelling or room in the roof
[] 5 Premises not built for inhabitation
[] 6 Mobile dwelling
[] 7 Shelter

5. Those Responsible
Interviewer ____
Supervisor of interviewers ____

6. Date of the Interview
Day ____
Month ____

7. Collective Dwelling
Write down the class of dwelling ____
Write down the code ____

8. Validation

[] 1 Validated

To verify an error of:

[] 2 Geographic identification
[] 3 Dwelling and questionnaire control
[] 4 Number of people, list of people
[] 5 Number of households, dwelling and questionnaire control
[] 6 List of people, characteristics of people

9. Package Control
Page of the package
Sequential number of the questionnaire in the package

Confidentiality
It conforms to the regulations of Article 38, first paragraph of the Statistical and Geographic Information Law enforcing "The data and information that they provide for statistic purposes or is provided from administrative or civil registers will be managed, for the effects of this law, under the observation of principals of confidentiality and reserve and will not be communicated, in any case, in any nominative or individualized form, nor will be evidence before administrative or physical authority, nor in or nor outside a trial."

Obligatory Nature
In agreement with Article 42, first paragraph of the Statistical and Geographic Information Law enforcing that, "The informants will be obliged to provide with veracity and opportunity the data and information that the competent authorities ask them for statistical, census and geographical purposes, and to provide the aid and cooperation that are required."

Within each box, write down a single number or capital letter in the same clear form, as shown below.

I. Characteristics of the Dwelling

1.1 Floors
What material is the main part of the floor of this dwelling?
Mark a single answer

[] 1 Earth
[] 2 Concrete or solid earth
[] 3 Wood, mosaic or other material

1.2 Number of rooms

How many rooms are used for sleeping without counting hallways?

Write down with a number

____
How many total rooms does this dwelling have counting the kitchen?
(Do not count hallways or bathrooms.)

Write down with a number

____

1.3 Electricity
Is there electric light in this dwelling?
Mark a single answer

[] 1 Yes
[] 2 No

1.4 Appliances
In this dwelling do they have:
Mark one or more answers

[] 1 Television?
[] 2 Refrigerator?
[] 3 Washing machine?
[] 4 Computer?
[] 5 Does it not have any of these appliances?

1.5 Availability of Water
In this dwelling do they have water from:
Mark a single answer

[] 1 The public system within the dwelling?
[] 2 The public system outside the dwelling but within the plot of land?
[] 3 A public faucet (or hydrant)?
[] 4 Another dwelling?
[] 5 A pipe?
[] 6 A well?
[] 7 A river, stream, lake or other?

1.6 Toilet or sanitary service

Does this dwelling have a lavatory, toilet, sanitation services, latrine or pit toilet?
Mark a single answer

[] 1 Yes
[] 2 No Go to 1.7

Does this service:
Mark a single answer

[] 3 Have a water connection?
[] 4 Discharge water to a tank?
[] 5 Does this service not discharge water?

1.7 Drainage
Does this dwelling have drainage or discharge connected to:
Mark a single answer

[] 1 The public system?
[] 2 A septic tank?
[] 3 A pipe that goes to a ravine or crack?
[] 4 A pipe that goes to a river, lake or sea?
[] 5 Does it not have drainage?

II. Residents, households and list of people

2.1 Number of people
How many people normally live in this dwelling counting small children and the elderly? (also count servants who slept here)
Write down with a number

____

2.2 Agricultural, livestock and forestry activities
Do any of these people have or manage land where the earth is seeded or cultivated, animals are raised or trees are felled for wood?
Mark a single answer

[] 1 Yes
[] 2 No

2.3 Number of households

Do all the people who live in this dwelling share a common eating expense?
Mark a single answer

[] 1 Yes
[] 2 No Go to 2.4

So, how many households or groups of people have separate eating expenses counting you?

Write down with a number

____

Apply a questionnaire for each household starting with the list of people

2.4 List of people in a household

What is the name and last name of the members of this household beginning with the head, include small children and the elderly? (also the servants who slept here)
Mark the circle that corresponds to the informant

Person 1
Write down the name and last name of the head of the household

____

[Under the line of boxes for Person 1, there are lines of boxes and circles for persons 2 to 6.]

If in a household there are more than 6 people, use another questionnaire and continue with the list

Upon finishing the list, copy the names of each one of the people in the spaces meant for them in section III.

III Characteristics of people

Now I am going to ask you for your (Name):
Write down first and second names

____

[Next to the text are twenty three boxes, then the text "Person 1."]

[For the questions on III Characteristics of people, the word (Name) is substituted for the person's name.]

For all people

3.1 Relationship
What is (Name) to the head of household?
Mark a single answer

[] 1 Head
[] 2 Spouse or companion
[] 3 Child
[] 4 Grandchild
[] 5 Other
Write down the relationship
____

3.2 Sex
(Name) is a man
(Name) is a woman
Mark a single answer

[] 1 Man
[] 2 Woman

3.3 Age
How many completed years old is (Name)?
Under one year, write down "000"

Write down with a number

____

3.4 Insurance subscriber
Does (Name) have the right to medical service:
Mark one or more answers

[] 1 In the Social Security (IMSS)?
[] 2 In the ISSSTE?
[] 3 By Pemex, Defense or Navy?
[] 4 By Seguro Popular?
[] 5 By insurance in private institutions?

In another institution?
Write down the name of institution
____

[] 6 So, you do not have the right to medical service?

For people 5 years old or older

3.5 Place of residence five years ago
Five years ago, in October of 2000, in what state of the Republic or in what country did (Name) live?
Mark a single answer or write down

[] 1 Here, in this state

In another state
Write down the name of the state
____

[] 2 In the United States of America
[] 3 In another country

3.6 Indigenous language

Does (Name) speak any indigenous language or dialect?
Mark a single answer

[] 1 Yes
[] 2 No Go to 3.7

What indigenous language or dialect does (Name) speak?
Write down the name of the indigenous language

____

Does (Name) also speak Spanish?
Mark a single answer

[] 3 Yes
[] 4 No

3.7 Illiteracy
Does (Name) know how to read and write a message?
Mark a single answer

[] 1 Yes
[] 2 No

3.8 Attendance
Does (Name) currently attend school?
Mark a single answer

[] 1 Yes
[] 2 No

3.9 Level of instruction

Up to what year or grade did (Name) pass in school?

Write down with a number the last grade in the corresponding level.

[] 0 None (Write down "0") ____
[] 1 Preschool ____
[] 2 Primary ____
[] 3 Secondary ____
[] 4 Preparatory ____

[0 to 4 are grouped under 'GO TO 3.11.']

[] 5 Normal ____
[] 6 Technical or commercial career ____
[] 7 Professional ____
[] 8 Masters ____
[] 9 Doctorate ____

3.10 Required studies
What studies was (Name) required to have as prerequisites to join (normal, technical or commercial career, professional, masters, doctorate)?
Mark a single answer

[] 1 Primary
[] 2 Secondary
[] 3 Preparatory
[] 4 Licensed or professional
[] 5 Masters

For women 12 years old and older
[Question 3.11 was asked of all women 12 years and older.]

3.11 Number of children

Altogether, how many children who were born alive has (Name) had?
Write down with a number

____

None, write down "00" and go to the next person

How many of (Name)'s children are currently living?
Write down with a number

____

None, write down "00".

Inventory of dwellings
1. Geographic Identification
Federal Entity ____
Municipality or Delegation ____
AGEB ____
Locality ____
City Block ____
Segment ____

2. Inventory control
Inventory number
Total number of inventories in the city blocks or segment

3. Validation
1. Validated
2. To verification

4. Name and key of those responsible
Interviewer
One responsible from AGEB
Supervisor of interviewers
Validator

5. Drawing of the work area
Draw the city block, segment or access route to the rural locality; respective to geographic north.

6. Observations

____

Within each box, write down a single number or capital letter in the same clear form, as shown below.

List of dwellings
Address of the dwelling

____

Sequential number of the dwelling ____
Street, avenue, alley, highway, road ____
Exterior number (visible) ____
Interior number (visible) ____

Total number of dwellings
Write down how many dwellings (houses, apartments) there are on this piece of land (plot of land, lot, site, address, building) counting your own.

____

Result code
Visit number
[Below the text are five columns, labels 1 to 5.] ____

Questionnaires received
Subtotal (page) ____

Codes of the results of the visit

1. Complete interview
2. Incomplete interview
3. Absence of informant
4. Refused to give information
5. Uninhabited
6. Temporary use
7. Is not a private dwelling

Observations ____

Advance report ____

Final date ____

[Below the text are two groups, "Day" and "Month." Under them are ten lines, representing the dates 05 October, 08 October, 12 October, 15 October, 19 October, 22 October, 26 October, 29 October, 03 November, 05 November.]

With interview (Codes 1 and 2) ____
Impoverished (Codes 3 and 4) ____
Uninhabited (Code 5) ____
Temporary use (Code 60 ____