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1980 Population and housing census
Malaysia

Household
Form 3a.

Note: A household is a group of people who make common provision for food and other essentials of living. Each of these forms is to be filled in for one household.

1.
(a) State ____

(b) Admin. District ____

(c) Census District ____

(d) Circle Number ____

(e) Enumeration Block ____

(f) Locality (Sahah and Sarawak)

2. Address: ________

3. Start interview here

[] 1st sheet
[] 2+ sheet
4. Living Quarters Number _ _ _

5. Household Number _

[Question 6 to 10 and 12 to 14 were filled for each person in a household.]

Household members listing order:

-- Head of household
-- Spouse of head
-- Unmarried children of head
-- Married children of head and their families
-- Mother/father of head or of spouse of head
-- Brother/sister of head or of spouse of head
-- Other relatives of head
-- Servants, lodgers, boarders and other persons not related to head

6. List the names of all persons who belong to this household ____

7. Relationship to head of household ____

8. Sex ____

9. Here on Census Night (/) _

10. Person Number ____

11. Count the ticks [/] in 9 [in this household] and write totals here.

Males ____
Females ____
Total ____

12. List the names of any friends or other persons who slept here on Census Night. ________

13. Sex ____

14. Person Number ________

[Questions 15-21 were asked of households.]

15. Total visitors from 13 [in a household]

Males ____
Females ____
Total ____

16. Grand total (11 + 15) [in a household]

Males ____
Females ____
Total ____

17. Grand total _ _ _

[The number comes from Total in Question 16.]

18. (a) Do you pay rent for your accommodation?

[] Yes (Skip to 19)
[] No

(b) Does this household own this housing unit?

[Question 18 (b) is asked of those who did not pay rent for their accommodation.]
[] Yes
[] No

19. Does your household have any of the following items?

Motor car:
[] 1
[] 2
[] 3
[] 4+
Land rover/van:
[] 1
[] 2
[] 3
[] 4+
Motor cycle/scooter:
[] 1
[] 2
[] 3
[] 4+
Bicycle:
[] 1
[] 2
[] 3
[] 4+
[] Radio
[] B/w. T.V.
[] Color T.V.
[] Telephone
[] Newspaper
[] Sewing machine
[] Electric iron
[] Electric fan
[] Refrigerator
[] Air conditioner
[] Water heater
[] Piano/Organ
[] Clock
[] Boat with motor
[] Boat without motor
[] None of the above

20. Which income class below best describes the monthly income of your household?

(This question is to be asked after all persons forms for the household have been completed.)

Please include the income of all earners of his household. (Show income class card and read instructions to respondent.)

[] Below $50
[] $50 - $99
[] $100 - $149
[] $150 - $299
[] $300 - $599
[] $600 - $999
[] $1000 - $1,999
[] $2000 - $4,999
[] $5,000 and above

21. LQ's Code _ _

Persons
Form 4a.

Write ethnic code in the boxes provided and write the ethnic group along the line provided. _ _ ________

____ State
____ Administrative District
____ Circle Number
____ Enumeration Block
____ Locality (Sabah/Sarawak)

Start Interview her

____ Living Quarters No.
____ Household Number
____ Person Number

1. Name: ________

2. Sex:

[] Male
[] Female

3. Relationship to head of household: ____

4. How old are you?

Completed years ____

Month from last birthday to Census Day ____

5. What is your date of birth?

Day ____
Month ____
Year ____

6. What is your Chinese date of birth?

Day ____
Month ____
Year ____

7. To what ethnic group, community or dialect group do you belong? _ _

8. What is your religion?

[] Islam
[] Christianity
[] Hinduism
[] Buddhism
[] Confucianism, Taoism and other traditional Chinese religion
[] Tribal, fork religion
[] Other
[] No religion

9. What citizenship do you have?

[] Under 12 years of age (Skip to 11)
[] Malaysia
[] Singapore
[] Indonesia
[] Philippines
[] Thailand
[] Other foreign
[] Unknown

10. What is the color of your Malaysia identify card?

[Question 10 was asked of persons who are 12 years old or above.]

[] None
[] Blue
[] Red
[] Green
[] Others

11. Have you ever been to school? (excluding adult education and kindergarten)

[] Currently Attending
[] Completed
[] No (Skip to 14)

[Questions 12-13 were asked of persons who had ever been to school.]

12. What was/is the highest level of schooling you completed/are currently attending?

Primary:
[] Std. 1
[] Std. 2
[] Std. 3
[] Std. 4
[] Std. 5
[] Std. 6
Secondary:
[] Remove/Form 1
[] Form 2
[] Form 3
[] Form 4
[] Form 5
[] Lower 6
[] Upped 6
Vocational:
[] Form 4
[] Form 5
Tertiary:
[] University/College

13. What is the highest certificate you obtained?

[] None
[] S.R.P./L.C.E.
[] S.P.M/S.P./M.C.E/S.C.
[] S.P.V.M./M.C.V.E.
[] S.T.P./H.S.C.
[] Diploma
[] Degree

14. Have you received any vocational training?

[] Currently Receiving
[] Completed
[] No (Skip to 16)

15. What field of vocational training are you currently receiving/have you received?

[Question 15 was asked of persons who had ever received any vocational training.]

[] 1 Building and woodworking
[] 2 Metal work including automotive repair and maintenance work
[] 3 Electrical and electronics work including radio and TV repair work
[] 4 Commercial work
[] 5 Agricultural work including logging
[] 6 Service work, including hotel and catering, beauty culture/hairdressing, tailoring and dressmaking
[] 7 Printing, printing, draftsman's work
[] 8 Others

16. Were you born in Malaysia?

[] Yes
[] No (Skip to 18)
[] Unknown (Skip to 19)

17. In which state were you born?

[Question 17 was asked of persons who were born in Malaysia.]

[] Johore
[] Kedah
[] Kelantan
[] Malacca
[] Negri Sembilan
[] Pahang
[] Penang
[] Perak
[] Perlis
[] Selangor
[] Trengganu
[] Federal Territory
[] Sabah
[] Sarawak
[] State Unknown
(Skip to 19)

18. In which country were you born?

[Question 18 was asked of those who were not born in Malaysia.]

[] Singapore
[] Thailand
[] Indonesia
[] Philippines
[] Vietnam
[] China
[] India/Pakistan/Bangladesh/Sri Lanka
[] Other countries
[] Unknown

19. How long have you lived in Malaysia? (in years)

[] Less than 1
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6-9
[] 10
[] 11-20
[] 21 and over

20. How long have you lived in this kampung/town? (in years)

[] Less than 1
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6-9
[] 10
[] 11-20
[] 21 and over

21. Where did you last live previous to this kampung/town?

[] In some other kampung/town in Malaysia
[] In this kampung/town since birth (Skip to 24)
[] Outside Malaysia (Skip to 24)

[Questions 22-23 were asked of those who lived in some other kampung/town in Malaysia previous to the current one.]

22. What is the name of the kampung/town where you lived previously?

(a) Name of kampung:
(i) Not in a town: ____ or
(ii) In a town: ____
(b) Name of town: ____
(c) Mukim: ____
(d) Administrative District/Jajahan: ____
(e) Residency (Sahah)/ Division (Sarawak): ____
(f) State: ____

23. Why did you move to this present kampung/town?

[] 1 On work transfer
[] 2 To look for a job; believe no suitable work available in previous locality
[] 3 Starting on a job offered
[] 4 For better income
[] 5 To participate in a rural development project
[] 6 Educational reasons
[] 7 Marriage
[] 8 Following family
[] 9 Shifting cultivation
[] 10 Others

24. Do you have any physical handicap?

[] None
[] Blind
[] Deaf/Dumb
[] Others

For persons 10 years of age and over
[Questions 25-44b were asked of those who are 10 years old or over.]

25. Did you work for pay or profit, at least 1 day, during the last 7 days?

[] Yes (Skip to 31)
[] No

26. Did you help in a family farm or business at least 1 day during the last 7 days?

[Question 26 was asked of persons who did not work for pay or profit at least one during the last 7 days.]

[] Yes
[] No (Skip to 28)

27. How many hours per day did you work?

[Question 27 was asked of persons who did not work for pay or profit at least 1 day during the last 7 days, and helped in a family farm or business at least 1 day during the last 7 days.]

[] 3 hours or less (Skip to 29)
[] More than 3 hours (Skip to 31)

28. Do you have any employment, work on farm, enterprise or other family enterprise to return to?

[Question 28 was asked of persons who did not work for pay or profit at least 1 day during the last 7 days, and did not help in a family farm or business at least 1 day during the last 7days.]

[] Yes (Skip to 31)
[] No

29. Were you looking for a job or work during the last 7 days?

[Question 27 was asked of persons who did not work for pay or profit at least 1 day during the last 7 days, and (1) did not help in a family farm or business at least 1 days during the last 7 days and did not have any employment, work on farm, enterprise or other family enterprise to return to; or (2) did help in a family farm or business at least 1 day during the last 7 days, but for 3 hours or less per day.]

[] Yes (Skip to 31)
[] No

30. Why are you not seeking work during the last 7 days?

[Question 30 was asked of persons who did not work for pay or profit at least 1 day during the last 7 days, were not looking for a job or work during the last 7 days, and (1) did not help in a family farm or business at least 1 days during the last 7 days and did not have any employment, work on farm, enterprise or other family enterprise to return to; or (2) did help in a family farm or business at least 1 day during the last 7 days, but for 3 hours or less per day.]

[] 01 Schooling
[] 02 Housework
[] 03 Believe no suitable job available
[] 04 Bad weather
[] 05 Illness/confinement
[] 06 New job to start soon
[] 07 Going for further studies
[] 08 Disabled
[] 09 Not interested
[] 10 Waiting for answers to job applications/have looked for work prior to last 7 days
[] 11 No qualifications
[] 12 Retired
[] 13 Too young
[] 14 Others

[Questions 31-34 were asked of persons other than those who did not work for pay or profit, at least 1 day during the last 7 days, did not help in a family farm or business at least one day during the last 7 days, did not have any employment, work on farm, enterprise or other family enterprise to return to, and were not seeking work during the last 7 days.]

31. What is your employment status?

[] Employer
[] Employee
[] Own account worker
[] Unpaid family worker
[] Looking for first job (Skip to 35a)

32. What is your principal occupation? (Describe the nature of your work in two or more words) ________

33. What is the name and address of the establishment where you work? ________

34. What are the main activities/products of this establishment? ________

35a. What did you do most of the time during the last 12 months?

[] Employer
[] Employee
[] Own account worker
[] Unpaid family worker
[] Looking for work (Skip to 36)
[] House work (Skip to 36)
[] Student (Skip to 36)
[] Other (Skip to 36)

35b. Usual industry?

[Question 35b was asked of persons who were 10 years old or over and were not looking for work, did house work, were students, or others most of the time during the last 12 months.]

[] Padi
[] Logging/timber
[] Fishing
[] Rubber
[] Other agriculture
[] Manufacturing/construction
[] Commerce
[] Transport/communication
[] Services
[] Others

36. Can you converse in any of the following languages?

[] Fluent Bahasa Malaysia
[] Elementary Bahasa Malaysia
[] English
[] Chinese
[] Tamil
[] Iban
[] Kadazan/Dusun
[] Bajau
[] Other languages
[] Dumb

37. Can you read a newspaper or a letter?

[] Yes
[] No (Skip to 40)

38. Can you write a simple letter?

[Question 38 was asked of persons who could read a newspaper or a letter.]

[] Yes
[] No (skip to 40)

39. In what languages can you write?

[Question 39 was asked of persons who could write a simple letter.]

[] Bahasa Malaysia
[] English
[] Chinese
[] Tamil
[] Iban
[] Kadazan/Dusun
[] Bajau
[] Other Languages

40. Are you

[] Never married (End)
[] Currently married
[] Widowed
[] Divorced/Permanently separated

[Questions 41-42 were asked of those who were ever married.]

41. Is this your first marriage?

[] Yes
[] No

42. How old were you when you first got married? _ _

For Ever-Married Women
[Questions 43-44b were asked of ever-married women who are 10 years of age and above.]

43. Have you given birth to any child?

[] Yes
[] No (End)

[Questions 44a-b were asked of married women who had given birth to any child.]

44a. How many children in total have ever been born alive to you? (Excluding stillbirths) ____

44b. How many are still living? ____