National Institute for Statistics and Computing
National Census: 9th Population Census and 6th Housing Census
5. Zone Number ____
6. Section Number ____
7. Urban Census Area [A.E.U.] Number ____
8. Block Number ____
9. Building Number ____
10. Section Number _ _ _
11. Rural Census Area [A.E.R.] Number
Last _ _ _
 1 Avenue
 2 Urban Road [JirÃ³n]
 3 Street
 4 Urban Passage Road [Pasaje]
 5 Highway
 6 Extension [ProlongaciÃ³n]
 7 Other
Door Number ____
Apartment Building [block] ____
Begin the interview with the head of household
13. Sir (Madam), how many groups of people [households] cook separately in this dwelling?
14. Household number ____
Second section: Dwelling characteristics and services
 2 Apartment in a building
 3 Attached independent units [vivienda en quinta]
 4 Dwelling in a tenement [Vivienda en casa de vecindad (callejÃ³n, solar o corralÃ³n)]
 5 Shack or cabin
 6 Improvised dwelling
 7 Premise not intended for human habitation
 8 Other
 10 Boarding house
 11 Hospital, clinic
 12 Jail, rehabilitation center
 13 Retirement home
 14 Children's village, orphanage, etc.
 15 Other
 2 People absent
 3 Occasional use
 5 Under construction or repair
 6 Abandoned/closed
 7 Other
 2 Adobe or mud wall [tapia]
 3 Wood (palm [pona], tornillo tree, etc.)
 4 Cane sticks with clay [quincha o caÃ±a con barro]
 5 Woven straw or reeds [estera]
 6 Stone with clay
 7 Limed or cemented stone or ashlar [piedra o sillar con cal o cemento]
 8 Other material
 2 Cement
 3 Paving stones [losetas], terrazzo, ceramic tile or similar
 4 Parquet or polished wood
 5 Wood (palm [pona], tornillo tree, etc.)
 6 Asphalt membrane, vinyl or similar
 7 Other
 2 Public network outside the dwelling but within the building (potable water)
 3 Public tap (potable water)
 4 Water tanker or similar
 5 Well
 6 River, irrigation ditch, spring or similar
 7 Neighbor
 8 Other
 2 Public sewer system outside of the dwelling but within the building complex
 3 Septic tank
 4 Cesspit, latrine
 5 River, drainage ditch or canal
 6 Doesn't have
 2 Owned, taken over [propia por invasiÃ³n]
 3 Owned, paying off in installments
 4 Owned, completely paid for
 5 Given by job or another household/institution
 6 Other
Third section: Household characteristics
 2 Color television
 3 Audio equipment
 4 Washing machine
 5 Refrigerator or freezer
 6 Computer
 7 None
 2 Gas
 3 Kerosene (go to 2A)
 4 Coal (go to 2A)
 5 Wood (go to 2A)
 6 Manure (go to 2A)
 7 Other
 8 Do not cook
 2 Hearing, even when using hearing aids
 3 Speaking (voicing/vocalizing [entonar/vocalizar])
 4 Using arms and hands/legs and feet
 5 Other impairment or restriction
 6 No one with a disability
Fourth section: Household make-up (only for the head of the household).
2. What is the name and paternal surname of each of the people who slept here the night before the census day? Don't forget to record newborns, seniors, and visitors.
- Spouse or partner
- Single children and/or stepchildren and/or adopted children without children. Record by age, from oldest to youngest.
- Single children and/or stepchildren and/or adopted children with children. Record by age, from oldest to youngest, followed by their children.
- Married or partnered children and/or stepchildren and/or adopted children, and their family.
- Parents and parents-in-law
- Other relatives (aunts and uncles, siblings, etc.)
- Household workers
- Other persons not related to the head of household (friends, co-godparents, etc.)
(A) Order number (01 through 10)
(B) Name and Paternal Surname of the Person
For Collective or Other Dwellings: When you have finished the enumeration, review the fifth section of the census forms you used, add up the total number of people by sex and write them in the respective grid spaces.
_ _ _ _ _ Men
_ _ _ _ _ Women
Fifth section: Population characteristics
 2 Spouse or partner
 3 Child/step-child
 4 Son-in-law/daughter-in-law
 5 Grandchild
 6 Parents/parents-in-law
 7 Other relative
 8 Household worker
 9 Boarder
 0 Other unrelated person
 2 Government health plan for all employed workers and people receiving retirement income [Essalud]
 3 Other health insurance
 4 None
 2 Aymara
 3 AshÃ¡ninka
 4 Other indigenous language
 6 Foreign language
 7 Is deaf-mute
 2 Initial Education
 3 Primary
 6 Non-university higher education -- complete
 7 University higher education -- incomplete
 8 University higher education -- complete
 2 Have your own business, though you did not work?
 3 Do some odd job for payment in cash or kind?
 4 Help out on the farm or in the store or business of a family member without receiving pay?
 5 Not work?
 2 Looking for work for the first time?
 3 Studying and did not work?
 4 Living off a pension or retirement income and did not work?
 5 Living off investment income and did not work?
 6 Taking care of the house and did not work?
 7 Other?
 2 Laborer
 3 Self-employed worker
 4 Employer
 5 Unpaid family worker
 6 Domestic employee