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Republic of the Philippines
National Statistics Office
Manila

1990 Census of population and housing
Sample household questionnaire

CPH Form 3
MAY 1, 1990

NSCB Approval No. A0477-R193-MS
Expires on - December 31, 1990

Confidentiality:

This census is authorized by Commonwealth Act No. 591 and B.P. Blg. 72.
All information is held strictly Confidential

Geographic Identification

Booklet __ of __ booklets

_ _ Province ____________________________
_ _ City/Municipality _____________________
_ _ _ Barangay ___________________________
_ _ Enumeration Area No.
_ _ _ CB Building Serial No.
_ _ _ Building Serial No.
_ _ _ Housing Unit Serial No.
_ _ _ Household Serial No.
_ _ Line Number of Respondent
Name of Household Head __________________
Address (House No. and Street Name or Name of Sitio) _____________________

Certification

I hereby certify that the data set forth were obtained/reviewed by me personally and in accordance with the instructions.

Signature over printed name of enumerator _________________________________
Date accomplished ______________
Signature over printed name of team supervisor ______________________________
Date reviewed __________________

Appendix G

Population Census Questions

Who is the head of this household?

Who are the persons usually residing here as of May 1, 1990?

P1. Name

__________________List in this order (family name first)

Head
Spouse of the head
Never-married children of head/spouse (oldest to youngest)
Ever-married children of head/spouse and their families (oldest to youngest)
Other relatives of head
Non-relatives of head

(Be sure to include babies and elderly persons and members of households temporarily away on vacation, on business, in the hospital, etc.)

Encircle line no. of respondent

Are there more then 8 members in this household?

1 Yes, use another booklet
2 No

P2. [Is respondent an overseas worker?]

_____ Enter

1 If overseas worker
2 If otherwise

All Persons
[Questions P3 to P14 apply to all persons]

P3. Relationship to HH Head

What is [respondent] 's relationship to the household head?

___ Enter appropriate code listed below:

01 Head
02 Spouse
03 Son
04 Daughter
05 Stepson
06 Stepdaughter
07 Son-in-law
08 Daughter-in-law
09 Grandson
10 Granddaughter
11 Father
12 Mother
13 Brother
14 Sister
15 Uncle
16 Aunt
17 Nephew
18 Niece
19 Other relative
00 Non-relative

Age

P4. Date of Birth

Enter month and year
___ Mo.
___ Yr.


P5. What is [respondent]'s age as of his/her last birthday?

___ If age is less than one year, enter "00".

P6. Sex

Encircle code.

1 Male
2 Female

P7. Marital Status

What is [respondent] 's marital status?

___ Enter code

1 Single
2 Married
3 Widowed
4 Divorced/Separated
5 Others
6 Unknown

For persons below 10 years old enter "1"'.

P8. Religious Affiliation

What is [respondent] 's religious affiliation?

___ Enter appropriate code listed below.

If others, specify.
00 None
01 Roman Catholic
02 Aglipay
03 Islam
04 Iglesia ni Cristo
05 United Churches of Christ in the Philippines.
__ Others, specify

Citizenship

P9. Is [respondent] a citizen of the Philippines?

Encircle code

1 Yes, skip to P11
2 No


P10. What country is [respondent] a citizen of?

___ Enter appropriate code listed below.
If others, specify.

01 People's Republic of China
02 U.S.A.
03 Indonesia
04 India
05 Japan
06 Iran
07 Australia
08 United Kingdom
__ Others, specify

Disability

P11. Does [respondent] have any physical or mental disability?

Encircle code

1 Yes
2 No, skip to P13.


P12. What type of disability does [respondent] have?

___ Enter appropriate code listed below.
If others, specify.

1 Blindness
2 Deafness
3 Muteness
4 Deafness/Muteness
5 Speech Impairment
6 Mental Illness
7 Mental Retardation
8 Orthopedic Handicap
9 Multiple Disability
0 Others, specify

P13. Mother Tongue

What is the [respondent] 's dialect/language spoken at earliest childhood?

___ Enter appropriate code listed below.

If others, specify.

01 Tagalog
02 Cebuano
03 Hiligaynon
04 Ilocano
05 Ibanag
06 Pampango
07 Pangasinan
08 Waray
09 Bicol
10 Maguindanao
11 Maranao
__ Others, specify

P14. Mother's Usual Residence

___ Where was [respondent]'s mother's usual residence at the time of his/her birth?

7 Foreign country
8 Same city/municipality
9 Unknown

If another city/mun., specify city/municipality and province.

5 Years Old and Older
[Questions P15-P22 apply to persons 5 years old and over]

Previous residence

P15. In what city/municipality did [respondent] live before moving to this place?

___

7 Foreign country
8 Same city/municipality
9 Unknown

If another city/mun., specify city/municipality and province.

P16. When did [respondent] move to this city/municipality?

___ Enter "0" if since birth.

Otherwise, enter month and year.
__ Mo.
__ Yr.

P17. Residence 5 Years Ago

___ In what city, municipality and province did [respondent] reside on May 1, 1985?

7 Foreign country
8 Same city/Municipality
9 Unknown

If another city/municipality, specify the city/mun. and province.

P18. Language

Is [respondent] able to speak Tagalog/Filipino?

Encircle code

1 Yes
2 No

P19. Literacy

Can [respondent] read and write a simple message in any language or dialect?

Encircle Code

1 Yes
2 No

P20. School Attendance

Did [respondent] attend school at any time from June 1989 to March 1990?

Encircle Code

1 Yes
2 No, skip to P22.

P21. Place of School

___ In what city/municipality did [respondent] attend school?

7 Foreign Country
8 Same City/Municipality
9 Unknown

If another city/mun., specify the city/mun. and province.

P22. Highest Educational Attainment

___ What is the highest grade/year completed by [respondent]?

___ If graduate of post-secondary or college course, specify field of study.

[Enter code from list below.]

0000 No grade completed
0100 Pre-school

Elementary

1100 Grade 1
1200 Grade 2
1300 Grade 3
1400 Grade 4
1500 Grade 5
1600 Grade 6 or 7

High School

2100 1st Year
2200 2nd Year
2300 3rd Year
2400 4th Year
3000 Undergraduate post-secondary

College

3100 1st Year
3200 2nd Year
3300 3rd Year
3400 4th Year
3500 5th Year

10 Years Old and Older

[Questions P23-P31 apply to persons 10 years old and over]

P23. Usual Activity/Occupation

___ What was [respondent] 's usual activity/occupation during the past twelve months?

Describe occupation as fully as possible.
Examples: Palay Farmer, Filing Clerk, Fruit Vendor, Student, etc.
If housewife, student, or retiree, skip to P25.

P24. Kind of Business

___ In what kind of business or industry did [respondent] work during the past twelve months?

Describe industry as fully as possible.
Examples: Palay Farming, Textile Manufacturing, Fruit Retailing.

P25. Employment Status

Did [respondent] have a job or business during the past seven days ?

Encircle code

1 Yes
2 No, skip to p29.

P26. Occupation in Past Week

___ What was [respondent] 's activity/occupation during the past seven days?

Describe occupation as fully as possible.

P27. Industry in Past Week

___ In what kind of business or industry did [respondent] work during the past week?

Describe industry as fully as possible.

P28. Place of work

___ In what city/municipality did [respondent] work during the past seven days?

7 Foreign Country
8 Same City/Municipality
9 Unknown

If another city/municipality, specify the city/municipality and province. Skip to P32

P29. Availability for Work

Was [respondent] available for work during the past seven days?

Encircle code

1 Yes
2 No, skip to P32.

P30. Looking for Work

Did [respondent] look for work during the past seven days?

Encircle code

1 Yes, skip to P32
2 No

P31. Reason for not Looking for Work

Why did [respondent] not look for work?

___ Enter appropriate code listed below.

If others, specify.

1 Believe no work available
2 Awaiting results of previous job application
3 Temporary illness/disability
4 Bad weather
5 Waiting for rehire/job recall
6 Too young, too old or retired, permanent disability
7 Housekeeping
8 Schooling
9 Others, specify

For Females 15-49 Years
[Questions P32-P35 apply to females 15-49 years old]

Fertility

P32. How many children have been born alive to [respondent]?

___ If none, enter "00".
P33. How many are still living?
___ If none, enter "00".
P34. How many children were born alive to [respondent] from May 1, 1989 to April 30 1990?
___ Enter actual number.

P35. What was [respondent]'s age at first marriage?

___ Enter age.

Appendix G

Housing census questions

B1 to B4 are to be answered by mere observation. If doubtful, ask the respondent.

B1. Type of Building/House

___ Enter code

1 Single house
2 Duplex
3 Multiunit residential (3 units or more)
4 Commercial/Industrial/Agricultural (office, factory, etc.)
5 Institutional living quarters (hotel, hospital, etc.)
6 Other housing unit (boat, cave, etc.)

B2. Construction Material of the Roof

___ Enter code

1 Galvanized Iron/Aluminum
2 Tile/Concrete/Clay tile
3 Half galvanized iron and half concrete
4 Wood
5 Coson/Nipa/Anahaw
6 Asbestos
7 Makeshift/Salvaged/Improvised materials
8 Others, specify __

B3. Construction Material of the Outer Walls

___ Enter code

01 Concrete/Brick/Stone
02 Wood
03 Half concrete/brick/stone and half wood
04 Galvanized Iron/Aluminum
05 Bamboo/Sawali/Cogon/Nipa
06 Asbestos
07 Glass
08 Makeshift/Salvaged/Improvised materials
09 Others, specify __
10 No walls

B4. State of Repair

Determine the current condition of the building/house

___ Enter code

1 Needs no repair/needs minor repair
2 Needs major repair
3 Dilapidated/condemned
4 Under renovation/being repaired
5 Under construction
6 Unfinished construction

B5 is to be asked from any household in the building/house.

B5. Year Building/House was Built

When was this building/house built?

___ Enter code

01 1990
02 1989
03 1988
04 1987
05 1986
06 1981-1985
07 1971-1980
08 1961-1970
09 1951-1960
10 1950 or earlier
98 Not applicable
99 Don't know

D1 is to be asked from any household in this housing unit.

D1. Floor Area of this Housing Unit

What is the estimated floor area of this housing unit ?

___ Enter code

01 less then 10 square meters / less then 108 square feet
02 10-19 square meters / 108-209 square feet
03 20-29 square meters / 210-317 square feet
04 30-49 square meters / 318-532 square feet
05 50-69 square meters / 533-748 square feet
06 70-89 square meters / 749-963 square feet
07 90-119 square meters / 1964-1286 square feet
08 120-149 square meters / 1287-1609 square feet
09 150-199 square meters / 1610-2147 square feet
10 200 and over square meters / 2148 and over square feet

H1 to EM are to be answered by all households.

H1. Fuel for Lighting

What kind of fuel does this household use for lighting?

___ Enter code

1 Electricity
2 Kerosene(gaas)
3 Liquefied petroleum gas (LPG)
4 Oil (vegetable, animal, etc.)
5 __ Others, specify

H2. Fuel for Cooking

What fuel does this household use most of the time for cooking?

___ Enter code

1 Electricity
2 Kerosene(gaas)
3 Liquefied petroleum gas (LPG)
4 Charcoal
5 Wood
6 ___ Others, specify
7 None

EM. Main Source of Drinking Water

What is this household's main source of drinking water?

___ Enter code

1 Own use, faucet, community water system
2 Shared, faucet, community water system
3 Own use, tubed / piped deep well (at least 100 feet or 30 meters deep)
4 Shared, tubed / piped deep well (at least 100 feet or 30 meters deep)
5 Tubed / piped shallow well
6 Dug well
7 Spring, lake, river, rain, etc.
8 Peddler

H4, H7, H11 and H12 are to be answered by all households.

H4. Tenure Status of the Housing Unit

What is the tenure status of this housing unit?

___ Enter code

1 Owned/being amortized
2 Rented (enter code, go to H8)
4 Being occupied for free with consent of owner (enter code, go to H9)
5 Being occupied for free without consent of owner (enter code, go to H9)

H5. Acquisition of Housing Unit

How did you acquire this housing unit?

___ Enter code

1 Purchased .
2 Constructed by the owner/occupants with or without help of friends/relatives
3 Constructed by hired/skilled workers
4 Constructed by an organized contractor
5 Inherited (Enter code, go to H7)
6 Others (lottery, gift) (Enter code, go to H7)

H6. Source of Financing

Did you avail of the following sources of financing in the construction/purchase of this housing unit?

A. Own resources/interest-free loans from relatives/friends

___ Enter code

1 Yes
2 No


B. Government assistance: PAG-IBIG, GSIS, SSS, DBP, etc.

___ Enter code

1 Yes
2 No


C. Private banks/foundations/cooperatives

___ Enter code

1 Yes
2 No


D. Employer assistance

___ Enter code

1 Yes
2 No


E. Private persons

___ Enter code

1 Yes
2 No


F. Others, specify

___ Enter code

1 Yes
2 No

H7. Tenure status of the lot

What is the tenure status of the lot?

___ Enter code

1 Owned/being amortized (Enter code, go to H9)
2 Rented
3 Being occupied for free with consent of owner (Enter code, go to H9)
4 Being occupied for free without consent of owner (Enter code, go to H9)

H8. Monthly rental of housing unit and/or lot

How much is the monthly rental?

___ Enter code

01 Below 50 [Philippines Pesos]
02 50-99
03 100-149
04 150-199
05 200-299
06 300-499
07 500-699
08 700-999
09 1000-1499
10 1500-1999
11 2000-4999
12 5000 and over

H9. Kind of Toilet Facility

What type of toilet facility does this household use?

___ Enter code

1 Water-sealed, sewer/septic tank, used exclusively by the household
2 Water-sealed, sewer/septic tank, shared with other households
3 Water-sealed, other depository, used exclusively by the household
4 Water-sealed, other depository, shared with other households
5 Closed pit (without a water-sealed bowl and the depository is constructed usually of large circular tubes made of concrete or clay covered on top and has a small opening: antipolo, etc.)
6 Open pit (same as closed pit but without covering)
7 Others (pail system, etc.)
8 None

Water-sealed bowls are those where after water is flushed or poured into the bowl, a small amount of water is left and seals the bottom of the bowl from the pipe leading to the depository.

H10. Usual Manner of Garbage Disposal

How does this household usually dispose of its kitchen garbage such as left-over food, peelings of fruits and vegetables, fish and chicken entrails, etc.

___ Enter code

1 Picked up by garbage truck
2 Dumping in individual pit (not burned)
3 Burning
4 Composting (later used as fertilizer)
5 Burying
6 Feeding to animals
7 __ Others, specify

H11. Presence of Household Conveniences

Does this household have the following household conveniences in working condition?

A. Radio/Radio cassette

___ Enter code

1 Yes
2 No


B. Television

___ Enter code

1 Yes
2 No


C. Refrigerator

___ Enter code

1 Yes
2 No


D. Telephone

___ Enter code

1 Yes
2 No


E. Motor Vehicle

___ Enter code

1 Yes
2 No

H12. Land ownership

Does any member of this household own the following?

A. Other residential land(s)

___ Enter code

1 Yes
2 No


B. Agricultural land(s)

___ Enter code

1 Yes
2 No


C. Other land(s)

___ Enter code

1 Yes
2 No

H13. Language/Dialect Generally Spoken

What is the language/dialect generally spoken at home by members of this household?

___ Enter code

01 Tagalog
02 Cebuano
03 Hiligaynon
04 Ilocano
05 Ibanag
06 Pampango
07 Pangasinan
08 Waray
09 Bicol
10 Maguindanao
11 Maranao
12 Tausug
__ Others, specify