Republic of Peru
National Institute of Statistics and Informatics
IX Population and IV Housing
National Censuses
1993
Census Questionnaire
Protected by Statistical Secrecy, Legislative Decree No. 604
First Section: Location of the Dwelling
____ District
Populated area [centro poblado]
____ Category
[] 2 No
____ Floor number
____ Interior
____ Section number
____ Urban Census Area [A.E.U.] number
____ Block number
____ Dwelling number
____ Household number
3. Rural area
____ Rural Census Area [A.E.R.] number
____ Dwelling number
____ Household number
Second Section: Dwelling Characteristics and Services
[Sidebar bracketing items 1 and 2]
Fill in these questions by direct observation.
A) Private dwelling
[] 3 Apartment in a building
[] 4 Dwelling in a quinta (dwelling that is part of a group of one- or two-story dwellings located along an open-air patio)
[] 5 Dwelling in a tenement [Vivienda en casa de vecindad (callejón, solar o corralón)]
[] 6 Shack or cabin
[] 7 Improvised dwelling
[] 8 Place not intended for human habitation
[] 9 Other type (specify) ____
[] 12 Hospital, clinic
[] 13 Boarding house
[] 14 Prison, reformatory
[] 15 Retirement home or hospice
[] 16 Other type (specify) ____
[] 2 With people absent
[] 3 Occasional use
[] 5 Under repair
[] 6 Other reason (specify) ____
[Sidebar: Beginning of interview]
If number 1 was circled in question 2, begin the interview with the person responsible for the dwelling.
[] 1 Rented
[] 2 Owned, bought in installments
[] 3 Owned, completely paid for
[] 4 Used with the authorization of the owner, without payment
[] 5 De facto occupied (squatted)
[] 6 Other form (specify) ____
[] 2 Limed or cemented stone or ashlar, [piedra o sillar con cal o cemento]
[] 3 Adobe or mud wall (tapia)
[] 4 Cane sticks with clay (quincha o caña con barro)
[] 5 Stone with clay
[] 6 Wood
[] 7 Woven straw or reeds (estera)
[] 8 Other material (specify) ____
[] 2 Wood
[] 3 Tile
[] 4 Calamina [type of roof tile], fibrocement or other sheet material
[] 5 Cane sticks or woven plant material with clay
[] 6 Straw, palm leaves, etc.
[] 7 Other material (specify) ____
[] 2 Asphalt membrane, vinyl or similar
[] 3 Paving stone [losetas], terrazzo, ceramic tile, or similar
[] 4 Wood (planks)
[] 5 Cement
[] 6 Earth
[] 7 Other material (specify) ____
[] 1 Public network, inside the dwelling
[] 2 Public network, outside the dwelling but within the building
[] 3 Public tap
[] 4 Well
[] 5 Water tanker or similar
[] 6 River, irrigation ditch, spring or similar
[] 7 Other (specify) ____
[] 1 Public system, inside the dwelling
[] 2 Public system, outside the dwelling but inside the building
[] 3 Cesspit, latrine
[] 4 An irrigation ditch or canal
[] 5 Doesn't have toilet facilities
[] 1 Yes
[] 2 No
9. Sir (Madam): If a household is a group of people who cook their food separately and sleep in the same dwelling, how many households are there in this dwelling?
[] 1
[] 2
[] 3
[] 4
[] 5
Enumerator's instructions:
a) If the dwelling has only one household or is the principal household of a dwelling with various households, continue with the third section.
b) For secondary households, proceed as follows:
- For each household use one or more forms as necessary
- List the same information in the first section as for the principal household
- Leave the second section blank
- Begin the interview with the third section
Third Section: Household Characteristics
[] 1 For the exclusive use of this household
[] 2 For shared use with another household
[] 3 There is no separate room for cooking
[] 1 For the exclusive use of this household
[] 2 For shared use with another household
[] 3 There are no sanitary facilities
[] 1 Yes
[] 2 No
[] 2 Black and white television
[] 3 Color television
[] 4 Stereo equipment
[] 5 Video recorder
[] 6 Washing machine
[] 7 Refrigerator
[] 8 Vacuum cleaner
[] 9 Floor polisher
[] 2 Knitting machine
[] 3 Computer
[] 4 Telephone
[] 2 Car for work use
[] 3 Light truck for work use
[] 4 Motorcycle/motor scooter
[] 5 Bicycle
[] 6 Tricycle for work
Fourth Section: People who make up the household
[Only for the head of the household]
1. In this household, including newborns and elderly people, how many people spent the night here the night before the day of the census?
2. What are the names and surnames of each person?
In column (B), the name and surnames of each person, following this order:
- Head
- Spouse or partner
- Single, childless children and stepchildren
- Married or partnered children and stepchildren and their families
- Parents or parents-in-law
- Other relatives (uncles, brothers, etc.)
- Household workers
- Boarders
- Other people not related to the head (friends, compadres, and
their families)
b) If there are more than 6 people in the household, use one or more Additional Census Forms.
c) On each Additional Form, repeat the same form number and circle the number 1 in the "Additional Form" box.
d) Then, copy the information from the first section: location of the dwelling and leave the second, third, and fourth sections blank.
(A) Order number (01 through 14)
(B) Name and surnames of the person
For enumerator use only:
Upon completing the interview in this household, review each census form used, then add up the total number of people enumerated according to sex (Question 2, fifth section) and list them in the following figure:
Males____
Females____
Fifth Section: Population Characteristics
Person number____
Name: ____
[Applies to questions 1 - 6]
[] 1 Head
[] 2 Spouse/partner
[] 3 Son/daughter
[] 4 Son-in-law/daughter-in-law
[] 5 Grandchild
[] 6 Parents/parents-in-law
[] 7 Other relatives
[] 8 Household workers
[] 9 Boarders
[] 0 Other non-relative
[] 1 Male
[] 2 Female
For those under 1 year, write the number of months, for those under 1 month write 00.
Months completed _ _
[] 1 Born in this district
Name of the district ____
Name of the province or country ____
[] 1 Total blindness
[] 2 Total deafness
[] 3 Muteness
[] 4 Mental retardation
[] 5 Mental illness
[] 6 Polio
[] 7 Loss or paralysis of upper extremity
[] 8 Loss or paralysis of lower extremity
[] 9 Other (specify) ____
[] 0 No disability
[] 1 Yes
[] 2 No
[] 3 Do not know
[Applies to questions 7 - 11]
[] 1 Lived in this district
Name of the district____
Name of the province or country____
[] 1 Quechua
[] 2 Aymara
[] 3 Other indigenous (native) language
[] 4 Spanish
[] 5 Foreign language
[] 1 Yes
[] 2 No
[] 1 Not currently attending, but did attend
[] 2 Currently attending
[] 3 Never attended - Skip to question 12
[] 0 No level
[] 1 Initial or preschool
[] 2 Primary
[] 3 Secondary
[] 4 Basic regular
[] 5 Basic vocational (craftsmanship)
[Bracket around responses 2-5:] ____ Write the year or grade completed
Higher non-university:
[] 7 Complete
[] 9 Complete
[Applies to question 12 - 17]
Circle the appropriate number:
[] 1 Working for an income
[] 2 Did not work but had a job
[] 3 Helping a relative without any payment
[] 4 Looking for a job, having worked before
[] 5 Looking for work for the first time
[] 6 Taking care of your home and not working
[] 7 Studying and not working
[] 8 Living from a pension or retirement and not working
[] 9 Living from investment income and not working
[] 0 Other, specify ____ (child, elderly, recruit, disabled, etc.)
[Bracket around responses 5-0:] Skip to question 18, if appropriate.
[] 1 Laborer
[] 2 White-collar or professional employee
[] 3 Unpaid family worker
[] 4 Domestic worker
[] 5 Self-employed worker
[] 6 Employer or owner
[] 1 Fewer than 5 people
[] 2 Between 5 and 10 people
[] 3 More than 10 people
[Applies to questions 18 -19]
[] 1 Cohabiting
[] 2 Married
[] 3 Widowed
[] 4 Divorced
[] 5 Separated
[] 6 Single
[] 1 Evangelical Christian
[] 2 Catholic
[] 3 Other (specify) ____
[] 4 None
[Applies to questions 20 -23]
_ _ Year
[] 1 Yes
[] 2 No