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Republic of the Philippines
National Statistics Office
Manila

2000 Census of
Population and Housing

CPH Form 1. Listing sheet

May 1, 2000
NSCB Approval No. NS0-9920-01
Expires on: Dec. 31, 2000

Serial Number [prenumbered, 6-digit sheet number and capital letter "A"]

Guidelines

General Instructions:
[Each line of instruction text is preceded by an instructional symbol.]

The Census 2000 form will be processed by a computerized imaging system.

Please write neatly and legibly; use only NSO-supplied pencils when filling-up this form.

Use clean erasers when making corrections.

Complete all information to maintain data accuracy and consistency.

Do not make unnecessary folds and creases on the form.

Do not write unnecessary marks or comments on the form.

Write the appropriate digits (0...9) in the designated boxes. Please make sure each digit is written neatly inside each box as shown here.

Please make sure the cross mark is written neatly inside the circle as shown here.

__ __ Month of Visit

Geographic Identification

__ __ Page of __ __ Pages.
__ __ Province
__ __ City/Municipality
___ Barangay
__ __ __ Enumeration Area
__ __ Random Start

Cerification

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

___ Enumerator (Signature over printed name)
___ Date signed

Interview Record

[There follows a table with 11 columns and 5 rows per page. Some columns have two lines per row: boxes to enter numbers with a fill-in circle underneath to check the "Indicator." The eleven columns record information for these 11 items:]

_ _ Day of Visit / Indicator
_ _ _ _ Building Serial Number
_ _ _ _ Housing Unit Serial Number
_ _ _ _ Household Serial Number / Indicator
_ _ _ _ Institutional Serial Number

[20 spaces] Name of Household Head or Name / Type of Institution
(If vacant housing unit, write VHU; if vacant building, write VBLDG) /
[20 spaces] Address (Enter house number and street or sitio name)
Population count
_ _ _ Total / Indicator
_ _ _ Male
_ _ _ Female

Remarks

Page 2:

The members of the household are:

1. Those who live or intends to live in the housing unit.
2. The overseas workers who are away at the time of the census.
3. Those who are temporarily away but are expected to be back after time of departure.

- Within 6 months, when on vacation, on business/pleasure trip, or studying/training somewhere in the Philippines or abroad
- At least once a week when working or attending school in some other place.
- Within 6 months when confined in hospitals, detained in jails or military camps or being trained by AFP.
List the household members in this order:
Head
Spouse of the head
Never-married children of head/spouse from the oldest to the youngest
Ever-married children of head/spouse and their families from the oldest to the youngest.
Other relatives of head
Non-relative of head

Household Size

Are there more than 8 members in this household? (Please cross out one of the selections below)

[] Yes (Please use another booklet)
[] No
Are there any other persons such as small children or infants who were not listed? (Please cross out one of the selections below)

[] Yes
[] No

Demographic information for all persons

P1. Who is the head of this household?

Who are the persons usually residing here as of May 1, 2000?

(Please enter the column number of the person or household number)
___ Last name
___ First name

P2. What is [respondent]'s relationship to the head of the household?
(Please see code book)

P3. Family Nucleus
(Please cross out one of the selections)

[] No family
[] 1st family
[] 2nd family
[] 3rd family
[] 4th family and so forth

P4. In what month and year was [respondent] born?

_ _ MM
_ _ _ _ YYYY

P5. Was [respondent]'s birth registered with the LCR?

[] Yes
[] No

P6. What is [respondent]'s age as of his/her last birthday?

_ _

P7. Is [respondent] male or female?

[] Male
[] Female

P8. Is [respondent] an overseas worker?
(For persons below 10 years old, mark No)

[] Yes
[] No

P9. What is [respondent]'s marital status?
(Please cross out one of the selections)
(For persons below 10 years old, cross out single)

[] Single
[] Legally Married
[] Widowed
[] Divorced/Separated
[] Common Law/Live-in
[] Unknown

P10. What is [respondent]'s religious affiliation?
(Please see code book)

_ _

[There are no questions P.11 or P.12]

P13. Does [respondent] have any physical or mental disability? (If no skip to P15)

[] Yes
[] No
P14. What type of disability does [respondent] have?
(Please see code book)

_ _

P15. How does [respondent] classify himself/herself? Is he/she an Ibaloi, Kankanaey, Mangyan, Manobo, Chinese, Ilocano or what?
(Please see code book)

For Persons 5 years Old and Over

P16. Can [respondent] read and write a simple message in any language or dialect?

[] Yes
[] No

P17. Is [respondent] able to speak Filipino/Tagalog?

[] Yes
[] No

P18. Is [respondent] able to speak English?

[] Yes
[] No

P19. Did [respondent] attend school at anytime from June 1999 to March 2000? ( If no, skip to P22)

[] Yes
[] No

P20. In what city/municipality did [respondent] attend school?

_ _ _ _ Province /City/Municipality
0007 Foreign Country
0008 Same City/Municipality
0009 Unknown

If another city/municipality, specify city/municipality and province (Please see code book)
_ _ _ _ Province/City/Municipality
___ City/Municipality
___ Province

P21. In what type of school?
(Please cross out one of the selections)

[] Government/Public
[] Private
[] Madrasah
[] Others

P22. What is the highest grade/year completed by [respondent]?
(Please see code book)

_ _

P23. Residence 5 years ago

In what city/municipality did [respondent] reside on May 1, 1995?
_ _ _ _ Province /City/Municipality
0007 Foreign Country
0008 Same City/Municipality
0009 Unknown

If another city/municipality, specify city/municipality and province (Please see code book)
_ _ _ _ Province /City/Municipality
___ City/Municipality
___ Province

For Persons 10 Years Old and Over

P24. Residence 10 years ago

In what city/municipality did [respondent] reside on May 1, 1990?
_ _ _ _ Province /City/Municipality
0007 Foreign Country
0008 Same City/Municipality
0009 Unknown

If another city/municipality, specify city/municipality and province (Please see code book)
_ _ _ _ Province /City/Municipality
___ City/Municipality
___ Province

P25. What was [respondent]'s usual activity/occupation during the past 12 months?
(Please see code book)
If housewife, student or retiree, skip to P29.

_ _ _ _

P26. In what kind of business or industry did [respondent] work during the past 12 months?
(Please see code book)

_ _ _

P27. In what city/municipality did [respondent] work during the last 12 months?

_ _ _ _ Province /City/Municipality
0007 Foreign Country
0008 Same City/Municipality
0009 Unknown

If another city/municipality, specify city/municipality and province (Please see code book)
_ _ _ _ Province /City/Municipality
___ City/Municipality
___ Province

P28. For whom or where did [respondent] work? (Please see code book)

_

Females 15-49 Years Old

P29. How many children have been born alive to [respondent]?

_ _

P30. How many are still living?

_ _

P31. How many children have been born alive to [respondent] from May 1, 1999 to April 30, 2000?

_

P32. What is [respondent]'s age at first marriage? (If answer in P9 = single, leave blank).

_ _

[Summary totals at the end of 30 records.]
Total

Vacant

Total Household Population

Total Institutional Population

Total Population


Housing Census Questions

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

B1. Type of building/house
(Please cross out one of the selection below)

[] Single house
[] Duplex
[] Multi-unit residential (three units or more)
[] Commercial/industrial/agricultural (office, factory, rice mill, etc.)
[] Institutional living quarters (hotel, hospital, etc.)
[] Other housing unit (boat, cave, etc.)

B2. Construction material of the roof
(Please cross out one of the selections below)

[] Galvanized iron/aluminum
[] Tile concrete/clay tile
[] Half galvanized iron and half concrete
[] Wood
[] Cogon/nipa/anahaw
[] Asbestos
[] Makeshift/salvaged/improvised materials
[] Others, specify___

B3. Construction material of the outer walls
(Please cross out one of the selections below)

[] Concrete/brick/stone
[] Wood
[] Half concrete/brick/stone/ and half wood
[] Galvanized iron/aluminum
[] Bamboo/sawali/cogon/nipa
[] Asbestos
[] Glass
[] Makeshift/salvaged/improvised materials
[] Others, specify___
[] No walls

B4. State of repair
Determine the current condition of the building/house
(Please cross out one of the selections below)

[] Needs no repair/needs minor repair
[] Needs major repair
[] Dilapidated/condemned
[] Under renovation/being repaired
[] Under construction
[] Unfinished construction

B5 is to be Asked from Any Household in the Building

B5. Year building/house was built
When was this building/house built?
(Please cross out one of the selections below)

[] 2000
[] 1999
[] 1998
[] 1997
[] 1996
[] 1991-1995
[] 1981-1990
[] 1971-1980
[] 1961-1970
[] 1960 or earlier
[] Not applicable
[] Don't know

D1 is to be Asked from Any Household in the Housing Unit

D1. Floor area of the housing unit
What is the estimated floor area of this housing unit?
(Please cross out one of the selections below)

Square meter/Square feet

[] Less than 10 / Less than 108
[] 10-19 / 108-209
[] 20-29 / 210-317
[] 30-49 / 318-532
[] 50-69/ 533-748
[] 70-89 / 749-963
[] 90-119 / 964-1286
[] 120-149 / 1287-1609
[] 150-199 / 1610-2147
[] 200 and over / 2148 and over

H1 to H16 are to be Answered by All Households

H1. Fuel for lighting
What kind of fuel does this household use for lighting?
(Please cross out one of the selections below)

[] Electricity
[] Kerosene (gas)
[] Liquefied Petroleum Gas (LPG)
[] Oil (vegetable, animal, etc)
[] Others, specify ___

H2. Fuel for cooking
What fuel does this household use most of the time for cooking?
(Please cross out one of the selections below)

[] Electricity
[] Kerosene (gaas)
[] Liquefied Petroleum Gas (LPG)
[] Charcoal
[] Wood
[] Others, specify ___
[] None

H3. Source of water supply for drinking and/or cooking
What is this household's main source of water supply for drinking and/or cooking?
(Please cross out one of the selections below)

[] Own use. faucet, community water system
[] Shared, faucet, community water system
[] Own, use, tubed/piped deep well (at least 100 ft/30 m deep)
[] Shared, tubed/piped deep well
[] Tubed/piped shallow well
[] Dug well
[] Spring, lake, river, rain, etc.
[] Peddler
[] Bottled water
[] Others, specify ___

H4. Source of water supply for laundry and/or bathing
What is this household's main source of water supply for laundry and/or bathing?
(Please cross out one of the selections below)

[] Own use. faucet, community water system
[] Shared, faucet, community water system
[] Own, use, tubed/piped deep well (at least 100 ft/30 m deep)
[] Shared, tubed/piped deep well
[] Tubed/piped shallow well
[] Dug well
[] Spring, lake, river, rain, etc.
[] Peddler
[] Others, specify ___

H5. Tenure of the housing unit
Do you own or amortize this housing unit occupied by your household or do you rent it, do you occupy it rent-free with consent of owner or rent-free without consent of owner?
(Please cross out one of the selections below)

[] Owned/being amortized
[] Rented (Skip to H9)
[] Rent-free with consent of owner (Skip to H10)
[] Rent-free without consent of owner (Skip to H10)

H6. Acquisition of housing unit
How did you acquire this housing unit?
(Please cross out one of the selections below)

[] Purchased
[] Constructed by the owner/occupants with or without help of
friends/relatives
[] Constructed by hired/skilled worker
[] Constructed by an organized contractor
[] Inherited (Skip to H8)
[] Others (lottery, gift) (Skip to H8)

H7. Souce of financing
Do you avail of the following sources of financing in the construction/purchase of this housing unit?
(Please cross out yes or no on the selections below)

Yes / No
[] / [] Own resources/interest-free loans from relatives/friends
[] / [] Government assistance, PAG-IBIG, GSIS, SSS, DBP, etc.
[] / [] Private banks/foundations/cooperatives
[] / [] Employer assistance
[] / [] Private persons
[] / [] Others, specify ___

H8. Tenure status of the lot
Do you own or amortize this lot occupied by your household or do you rent it, do you occupy it rent-free with consent of owner or rent-free without consent of owner?
(Please cross out one of the selections below)

[] Owned/being amortized
[] Rented
[] Rent-free with consent of owner
[] Rent-free without consent of owner

H9. Monthly rental of the housing unit or lot
How much is the monthly rental?

(Please cross out one of the selections below)

[] Below 100
[] 100-199
[] 200-499
[] 500-999
[] 1000-1999
[] 2000-4999
[] 5000-9999
[] 10000 and over

H10. Usual manner of garbage disposal
How does your household usually dispose of your kitchen garbage such as leftover food, peeling of fruits and vegetables, fish and chicken entrails, etc.?
(Please cross out one of the selections below)

[] Picked-up by garbage truck
[] Dumping in individual pit (not burned)
[] Burning
[] Compositing
[] Burying
[] Feeding to Animals
[] Others, specify ___

H11. Kind of toilet facility
What type of toilet facility does this household use?
(Please cross out one of the selections below)

[] Water-sealed, sewer septic tank, used exclusively by household
[] Water-sealed, sewer septic tank, shared with other households
[] Water-sealed, other depository, used exclusively by household
[] Water-sealed, other depository, shared with other household
[] Closed pit (without a water-sealed bowl and depository is constructed usually of large circular tubes made of concrete or clay covered on top and has a small opening; ex. Antipolo, etc.)
[] Open pit (same as closed but without covering)
[] Others (pail system, etc.)
[] None

H12. Presence of household conveniences

Does this household have the following household conveniences in working condition?
(Please cross out yes or no on the selections below)

Yes / No
[] / [] Radio/Radio Cassette
[] / [] Television Set
[] / [] Refrigerator/Freezer
[] / [] Video/Cassette/Recorder
[] / [] Telephone/Cell phone
[] / [] Washing machine
[] / [] Motorized Vehicle

H13. Land ownership
Does any member of this household own the following?
(Please cross out yes or no on the selections below)

Yes / No
[] / [] Other residential land (s)
[] / [] Agricultural land (s), landowner
[] / [] Agricultural land (s) acquired through CARP, Agrarian Reform Beneficiary
[] / [] Other land (s)

H14. Language/dialect generally spoken
What is the language/dialect generally spoken at home by members of this household?
(Please see code book)

_ _

H15. Residence five years from now
In what city/municipality does this household intend to reside on May 1, 2005?

_ _ _ _ Province/City/Municipality
0007 Foreign Country
0008 Same City/Municipality
0009 Unknown
If another city/municipality, specify city/municipality and province (Please see code book)

_ _ _ _ Province/City/Municipality
___ City/Municipality
___ Province