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
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) _____________________
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 __________________
Who is the head of this household?
Who are the persons usually residing here as of May 1, 1990?
__________________List in this order (family name first)
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?
2 No
P2. [Is respondent an overseas worker?]
_____ Enter
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:
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
Enter month and year
___ 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.
2 Female
P7. Marital Status
What is [respondent] 's marital status?
___ Enter code
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.
00 None
01 Roman Catholic
02 Aglipay
03 Islam
04 Iglesia ni Cristo
05 United Churches of Christ in the Philippines.
__ Others, specify
Citizenship
Encircle code
2 No
P10. What country is [respondent] a citizen of?
___ Enter appropriate code listed below.
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
Encircle code
2 No, skip to P13.
P12. What type of disability does [respondent] have?
___ Enter appropriate code listed below.
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.
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?
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?
___
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.
__ Mo.
__ Yr.
P17. Residence 5 Years Ago
___ In what city, municipality and province did [respondent] reside on May 1, 1985?
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
2 No
P19. Literacy
Can [respondent] read and write a simple message in any language or dialect?
Encircle Code
2 No
P20. School Attendance
Did [respondent] attend school at any time from June 1989 to March 1990?
Encircle Code
2 No, skip to P22.
P21. Place of School
___ In what city/municipality did [respondent] attend school?
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.]
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?
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?
Examples: Palay Farming, Textile Manufacturing, Fruit Retailing.
P25. Employment Status
Did [respondent] have a job or business during the past seven days ?
Encircle code
2 No, skip to p29.
P26. Occupation in Past Week
___ What was [respondent] 's activity/occupation during the past seven days?
P27. Industry in Past Week
___ In what kind of business or industry did [respondent] work during the past week?
P28. Place of work
___ In what city/municipality did [respondent] work during the past seven days?
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
2 No, skip to P32.
P30. Looking for Work
Did [respondent] look for work during the past seven days?
Encircle code
2 No
P31. Reason for not Looking for Work
Why did [respondent] not look for work?
___ Enter appropriate code listed below.
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]?
P33. How many are still living?
P34. How many children were born alive to [respondent] from May 1, 1989 to April 30 1990?
P35. What was [respondent]'s age at first marriage?
Appendix G
B1 to B4 are to be answered by mere observation. If doubtful, ask the respondent.
B1. Type of Building/House
___ Enter code
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
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
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
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
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
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
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
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
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
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
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?
___ Enter code
2 No
B. Government assistance: PAG-IBIG, GSIS, SSS, DBP, etc.
___ Enter code
2 No
C. Private banks/foundations/cooperatives
___ Enter code
2 No
D. Employer assistance
___ Enter code
2 No
E. Private persons
___ Enter code
2 No
F. Others, specify
___ Enter code
2 No
H7. Tenure status of the lot
What is the tenure status of the lot?
___ Enter code
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
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
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
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?
___ Enter code
2 No
B. Television
___ Enter code
2 No
C. Refrigerator
___ Enter code
2 No
D. Telephone
___ Enter code
2 No
E. Motor Vehicle
___ Enter code
2 No
H12. Land ownership
Does any member of this household own the following?
___ Enter code
2 No
B. Agricultural land(s)
___ Enter code
2 No
C. Other land(s)
___ Enter code
2 No
H13. Language/Dialect Generally Spoken
What is the language/dialect generally spoken at home by members of this household?
___ Enter code
02 Cebuano
03 Hiligaynon
04 Ilocano
05 Ibanag
06 Pampango
07 Pangasinan
08 Waray
09 Bicol
10 Maguindanao
11 Maranao
12 Tausug
__ Others, specify