Eighth General Population and Housing Census

Confidentiality guaranteed under the 1949 Census Law, Government Bulletin 1949, no. 110, under the 2002 Statistics Law, Bulletin of Acts and Decrees of 2002, no. 97 and under the Eighth General Census Law, Bulletin of Acts and Decrees of 2012.

Household identification

District _ _
Resort _ _
Counting block _ _ _ _
Building no. _ _ _
Living quarter no. _ _ _
Household no. _ _ _

Name of the place / area: (e.g. district, plantation, village) ____
Code _ _ _ _ _ _

Address of the household:

Street name ____
House no. / lot no. _ _ _ _ _ _
Letter(s) _ _ _ _ _ _
Apartment / room no. _ _ _ _

Only for institutions in the special operations category

Name of institution _____
Apartment / room no. _ _ _ _

Enumerator's statement of visits:
Visit no. ____
Date of visit

__ Day
__ Month

Time of

Start of visit ____ hr.
End of visit ____ hr.

Duration of visit (in minutes) ____
Result

[] 1 all questions completed
[] 2 part of questions completed
[] 3 no suitable respondent at home / nobody at home
[] 4 language barrier (make note of language)
[] 5 refuses to answer
[] 6 other

Note ____

Enumerator:

Full name ____
Short signature ____
Code ____
Day _ _
Month _ _

Supervisor:

Full name ____
Short signature ____
Code ____
Day _ _
Month _ _

Reviewer:

Full name ____
Short signature ____
Code ____
Day _ _
Month _ _

Screener:

_ _ Code
_ _ Day
_ _ Month
_ _ Year

Coder:

_ _ Code
_ _ Day
_ _ Month
_ _ Year

Keyer 1:

_ _ Code
_ _ Day
_ _ Month
_ _ Year

Keyer 2:

_ _ Code
_ _ Day
_ _ Month
_ _ Year

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Personal module

Listing of persons
[Table 1A and Table 1B]

Table 1 A: listing of household members

To establish the total number of persons in Suriname, we need to know the number of members of this household. We would therefore like you to list all those that on 13 August 2012 belonged to this household.
Please start by providing the details of the head of the household. If there is no head of the household, please start by providing the details of the most senior member.

Note for the interviewer: Below you can fill in the information of each person that was a member of the household on 13 August 2012, including those who have died since. N.B.: Babies born on or after 13 August 2012 must be excluded from the count.

Household member no. _ _

Family name ____
First (and any middle) name(s) ____

Sex

[] 1 M
[] 2 F

Age ____

Nationality

[] 1 Surinamese
[] 2 Dutch
[] 3 Guyanese
[] 4 French
[] 5 Brazilian
[] 6 Haitian
[] 7 Chinese
[] 8 US
[] 9 Other Caricom (Caribbean Community)
[] 10 Other
[] 97 Don't know
[] 99 No response

During the night of the census, this person was

[] Present in the living quarter
Absent

[] Elsewhere in Suriname
[] Abroad

Interviewer
: Census night is from 12 Aug 18.00 hrs to 13 Aug 06.00 hrs 2012
: Census moment is 13 Aug 2012 00.00 hrs (12 Aug 2012 24.00 hrs)

Total number of persons in the household

____ Male
____ Female
____ Total

Once you have completed this section, please proceed to Table 1B!

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Please make sure you have completed Table 1A before proceeding to Table 1B

Table 1B: listing of visitors to the household

In addition to the permanent members of the household, were there any visitors or guests on 13 Aug 2012 staying with the household for less than 6 months?

[] 1 Yes (complete table below)
[] 2 No (go to question P01)
[] 7 Don't know (go to question P01)
[] 9 No response (go to question P01)

[If answer 1, complete the following question. Elsewise, go to question P01.]

Note for the interviewer:
Below you should provide the details of those not belonging to the household on 13 Aug 2012, but staying temporarily (less than 6 months) with the household as visitors / guests.

Vis no. _ _
Family name ____
First name + initials ____
Sex

[] 1 M
[] 2 F

Age ____
Nationality

[] 1 Surinamese
[] 2 Dutch
[] 3 Guyanese
[] 4 French
[] 5 Brazilian
[] 6 Haitian
[] 7 Chinese
[] 8 US
[] 9 Other Caricom (Caribbean Community)
[] 10 Other
[] 97 Don't know
[] 99 No response

This visitor usually lives

[] Elsewhere in Suriname
[] Abroad

During the night of the census, this visitor was

[] Present in the household
[] Elsewhere in Suriname

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All persons in the household
[Questions P01a to P06c were asked of all persons in the household.]

District _ _
Resort _ _
Counting block _ _ _ _
Building no. _ _ _
Living quarter no. _ _ _
Household no. _ _ _
P-module questionnaire _ of _

P00. Serial no. of this person _

P01a. Starting with the head of the household, please provide the family names and first and middle names of all those belonging to this household.

N.B.: In the case of married women: married name first, followed by maiden name, first name, and middle name.
If there is no head of the household, start with the most senior member of the household.

If identity no. has been provided, proceed to P02.

If no identity number has been entered, proceed to P01b

Person's family name and first and middle names ____
Identity number _

P01b. What is the reason no ID-number has been provided for this person under P01?

[] 1 Person is under 16
[] 2 Didn't leave identity document
[] 3 Person hasn't made an ID card
[] 4 ID card lost / stolen
[] 5 Other, please specify ____
[] 6 None
[] 7 Don't know
[] 9 No response

P02. Which Civil Affairs Office is this person registered with?

See flash card for coding

Name of Civil Affairs Office ____

[] Code _
[] 9997 Don't know

P03. What sex is this person?

[] 1 Male
[] 2 Female

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P04. What age was this person on 13 Aug 2012?

If this person is = 0 years, enter: 000.
If the answer is ''don't know'', provide estimated age

____ Age
____ Estimated age

P05. What is this person's date of birth?

Write the year in full
If the day or the month is unknown, enter 97
If the year is unknown, enter 9997

P05a. Day _ _
P05b. Month _ _
P05c. Year _ _ _

P06a. What is this person's relationship with the head of the household?

If no relationship with head of household, ask for relationship with most senior member of the household. This person will be head of the household.

[] 1 Head of the household themselves
[] 2 Spouse / partner of head
[] 3 Child / adopted child / stepchild
[] 4 Foster child
[] 5 Grandchild
[] 6 Parent / foster parent / parent-in-law
[] 7 Son-in-law / daughter-in-law / partner of child
[] 8 Grandparent / grandparent-in-law
[] 9 Other family member of the head
[] 10 Live-in household servant
[] 11 Other person, no family
[] 97 Don't know
[] 99 No response

P06b. This person is a child of (household member with identity no.):

Instruction: if this person's father or mother does not belong to this household, enter: 00 as father's and/or mother's identity number(s).

Identity no. of
_ Father
_ Mother

P06c. This person is the partner of (household member with identity no.):

Instruction: if there is no partner or if the partner of the household. If M=member does not belong to this household, enter: 00 as partner's identity number.

_ Identity no. of the partner

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P07. What is this person's religion / faith?

Christianity

[] 1 Roman Catholic
[] 2 Lutheran
[] 3 Pentecostalism
[] 4 Moravian Church
[] 5 Reformed
[] 6 Other Christian

Hinduism

[] 7 Sanatan Dharm
[] 8 Arya
[] 9 Other Hindu

Islam

[] 10 Islamic - Sunni
[] 11 Islamic - Ahmadiyya
[] 12 Other Islamic

Other religions

[] 13 Jehovah's Witnesses
[] 14 Javanism
[] 15 Judaism
[] 16 Winti
[] 17 Other, please specify ____

[] 18 No religion
[] 97 Don't know
[] 99 No response

P08. What ethnic group does this person say they are?

[] 1 Native / indigenous
[] 2 Maroon
[] 3 Creole
[] 4 Afro-Surinamese
[] 5 Hindustani
[] 6 Javanese
[] 7 Chinese
[] 8 Caucasian / white
[] 9 Mixed

If code 9, enter ethnicity of father and mother
_ _ Ethnicity of father
_ _ Ethnicity of mother

[] 10 Other
[] 97 Don't know
[] 99 No response

[If answer 1 or 2, go to question P09. Elsewise, go to P10.]

P09. To what tribe does this person belong?

[] 1 Arawak
[] 2 Caribs
[] 3 Wajana
[] 4 Trio
[] 5 Akurio
[] 6 Saramaka
[] 7 Aukan
[] 8 Matuari
[] 9 Paramaccan
[] 10 Bonis / Alukus
[] 11 Kwinti
[] 12 Other tribe
[] 13 None
[] 97 Don't know
[] 99 No response

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P10. What nationality is this person?

[] 1 Surinamese
[] 2 Dutch
[] 3 Guyanese
[] 4 French
[] 5 Brazilian
[] 6 Haitian
[] 7 Chinese
[] 8 US
[] 9 Other Caricom (Caribbean Community)
[] 10 Other, please specify ____
[] 97 Don't know
[] 99 No response

P11. Where was this person born?

[] 1 Paramaribo
[] 2 Wanica
[] 3 Nickerie
[] 4 Coronie
[] 5 Saramacca
[] 6 Commewijne
[] 7 Marowijne
[] 8 Para
[] 9 Brokopondo
[] 10 Sipaliwini
[] 11 Previous distr. Suriname
[] 12 In Suriname, district unknown
[] 13 Netherlands
[] 14 Guyana
[] 15 Brazil
[] 16 China
[] 17 Other abroad
[] 97 Don't know
[] 99 No response

[If answer 1 -12, go to question P13. If answer 13 - 17, go to P12a. If answer 97 or 99, go to P13.]

Residence and migration
[Questions P12a to P14 were asked of persons who were born outside Suriname.]

P12a. If the person is a national of Suriname and was born abroad: In what year did this person obtain Surinamese nationality?

If the person is not a national of Suriname and was not born in Suriname, proceed to question 12b.

[] Year ____
[] 9997 Don't know

P12b. For all those born outside Suriname: In what year did this person come to live in Suriname? (for 6 months or longer)

[] Year ____
[] 9997 Don't know

P13. Since what year has this person been living at this address?

[] Year ____
[] 9997 Don't know

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P14. What was this person's previous place of residence?

[] 1 This address
[] 2 Other address in this district
[] 3 Other district, please specify what district ____
[] 4 In Suriname
[] 13 Netherlands
[] 14 Guyana
[] 15 Brazil
[] 16 China
[] 17 Other. Abroad
[] 97 Don't know
[] 99 No response

[If answer 13 - 17, go to question P19.]

Filter
Instruction: Tick the relevant box in line with the answer to P11 and follow the instructions below.

N.B.: If you entered codes 97 or 99 in P11, please tick the box ''Don't know'' and go to P19

Person was born in:

Suriname [go to question P15]
Abroad [go to question P19]
Don't know [go to question P19]

Only persons born in Suriname
[Question P15 to P17 were asked of persons who were born in Suriname.]

P15. Has this person ever resided in another country? (For 6 months or longer?)

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 None answer

[If answer 1, go to question P16. Elsewise, go to P19.]

P16. What other country was this person's last country of residence?

____
Code ____

[] 9997 Don't know
[] 9999 No response

P17. In what year did this person return to Suriname to settle?

_ _ _ _

[] 9997 Don't know

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All persons (residence and migration)
[Question P18 - P20]

P18. What was the main reason why this person returned to settle in Suriname?

Please provide only answer.

[] 1 Suriname is country of origin
[] 2 Family reunification
[] 3 Deported / involuntary return
[] 4 Set up a business / job
[] 5 Retirement
[] 6 Homesick
[] 7 Completed studies
[] 8 Marriage
[] 9 Travelled with parents / family
[] 10 Other reason, please specify ____
[] 97 Don't know
[] 99 No response

P19. What was this person's place of residence 1 year ago, so in August 2011?

[] 1 This address
[] 2 Other address in this district
[] 3 Other district, please specify ____
[] 4 In Suriname, district unknown
[] 5 Abroad, please specify ____
[] 6 Wasn't yet born [go to question P21a]
[] 7 Don't know
[] 9 No response

P20. What was this person's place of residence 8 years ago, so during the previous census of August 2004?

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All persons (health)
[Questions P21a to P23 were asked of all persons about their health.]

P21a. Does this person experience difficulty / problems (with):

N.B.: The person has had (or is expected to have) the complaint(s) for at least 6 months.

Enter one of the following codes in each cell:

[] Tick this box if A to G = 1, 5, 7 or 9, and proceed to P22.

A. Seeing (even when using glasses)

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

B. Hearing (even when using a hearing aid)

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

C. Walking or going up and down stairs

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

D. Remembering and concentrating

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

E. Personal care

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

F. Lifting / reaching / carrying

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

G. Communicating / talking

[] 1 No difficulty / problems
[] 2 Some difficulty
[] 3 Much difficulty
[] 4 Not able to do this at all
[] 5 Doesn't apply, considering age
[] 7 Don't know
[] 9 No response

P21b. What causes this impairment?

Enter the relevant code for each of the impairments listed under P21a:

A. Seeing (even when using glasses)

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

B. Hearing (even when using a hearing aid)

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

C. Walking or going up and down stairs

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

D. Remembering and concentrating

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

E. Personal care

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

F. Lifting / reaching / carrying

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

G. Communicating / talking

[] 1 Congenital
[] 2 Illness
[] 3 Traffic accident
[] 4 Other accident
[] 5 Other cause
[] 7 Don't know
[] 9 No response

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P22. Does this person have any of the following chronic diseases?

Enter one of the following codes in each cell:

A. Kidney disease

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

B. Diabetes

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

C. Hypertension

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

D. Cardiovascular diseases

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

E. Cancer

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

F. Arthritis

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

G. Asthma

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

H. Sickle cell disease

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

I. Epilepsy

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

J. Mental

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

P23. How are medical expenses mainly paid for this person?

[] 1 SZF compulsory
[] 2 SZF private
[] 3 SZF voluntary insurance
[] 4 Medical Mission (Medische Zending)
[] 5 SoZaVo (insolvent)
[] 6 SoZaVo (impecunious)
[] 7 Other insurer, through employer
[] 8 Other insurer, voluntary insurance
[] 9 Direct payment (no insurance)
[] 10 Other
[] 97 Don't know
[] 99 No response

Persons aged 4 years and above (health)
[Questions P24 was asked of persons aged 4 and above about their sports activities.]

P24. Which of the following sports activities does this person practice?

Enter one of the following codes in each cell:

A. Walking / running / jogging

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

B. Cycling / roller skating / skateboarding

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

C. Fitness, gymnastics, weight-lifting

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

D. Ballet or dancing

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

E. Ball games, individual

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

F. Ball games, team

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

G. Swimming

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

H. Contact / combat sports

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

I. Other, namely ____

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

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Persons aged 4 and above (education) school year 2011 / 2012
[Questions P25 - P29 were asked of persons aged 4 and above about their education.]

P25. Is this person currently in formal education?

[] 1 Yes
[] 2 No [go to question P28]
[] 7 Don't know
[] 9 None answer

P26. What is the type of formal education this person is in?

See flash card

Type of education

[] 1 KLO
[] 2 GLO / BO
[] 3 VOJ
[] 4 IMEAO, NATIN
[] 5 Teacher training for primary education
[] 6 HAVO, VWO
[] 7 Higher vocational education
[] 8 University
[] 97 Don't know
[] 99 No response

Class / Year ____

P27a. What is the name of the school / educational institution where this person is currently registered?

Name of school / educational institution ____
[] 9997 Don't know
[] 9999 No response

P27b. What is the address of this school / educational institution?

Distr. ____
Place ____
Str. ____
Code _ _ _ _ _ _

P27c. How does this person go to this school / educational institution?

Record the two principal means of transport.

[] 1 Walking
[] 2 By bike
[] 3 By moped / scooter
[] 4 By car
[] 5 By private school bus
[] 6 By regular bus service

No. of buses ____

[] 7 By Minov [Ministry of Education and Community Development] bus
[] 8 By boat
[] 9 By school boat
[] 9 Other
[] 97 Don't know
[] 99 No response

P28. What is the highest level of formal education completed by this person?

See flash card

Type of education

[] 1 KLO
[] 2 GLO / BO
[] 3 VOJ
[] 4 IMEAO, NATIN, AMTO
[] 5 Teacher training for primary education
[] 6 HAVO, VWO
[] 7 Higher vocational education
[] 8 University
[] 9 No education (go to question P30)
[] 97 Don't know (go to question P30)
[] 99 No response (go to question P30)

Class / Year ____

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P29. What is the highest qualification obtained by this person?

[Question P29 was asked of persons age 4+ who completed some formal education, per question P28.]

N.B.: For persons under 15, enter type of certificate and proceed with next person.

See flash card ____
[] 997 Don't know
[] 999 No response

Persons 15 and above (employment)
[Questions P30 - P42 were asked of persons aged 15 and above about their employment.]

P30. Was this person active in the period 6 to 12 August 2012?

Examples of work: activities in agriculture, livestock and fisheries, selling pickles, selling newspapers, jobs, odd jobs.

N.B.: If the person carries out unpaid work in a family business, enter code 1.

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

[If answer 1, go to question P32. Elsewise, go to P31.]

P31. Was this person absent from work in the period 6 to 12 August 2012 due to, for example: leave, illness, holidays, stay abroad, training, strike, weather conditions?

[Question P31 was asked of persons age 15+ who were not active in the period 6 to 12 August 2012, per question P30.]

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

[If answer 2, 7 or 9, go to P38.]

P32. This person was active as:

[Question P32 was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

[] 1 Employer
[] 2 Self-employed person
[] 3 Unpaid worker in family business
[] 4 Civil servant
[] 5 Employee with parastatal institution
[] 6 An employee of a private business / NGO
[] 7 Employed at private household
[] 8 Trainee
[] 9 Volunteer
[] 10 Member of a worker co-operative
[] 97 Don't know
[] 99 No response

P33. What kind of work did this person do?

[Question P33 was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

N.B.: Give a clear description of this person's main activities.

Give a specific description of the activity, e.g. carpenter, typist, teacher at a GLO school, teacher of mathematics at a MULO school. If nature of activity is unclear, ask for main activities.

N.B.: 'Civil servant' is not a proper description; specify the person's actual activity, e.g. driver at Ministry of Home Affairs.

____
Code _ _ _ _

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P34a. Where did this person work?

[Question P34a was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

Enter don't know if workplace is unknown.

Record:

1) Name of the business / workplace ____
2) Activity of the business / the workplace ____
Code _ _ _ _ _ _

P34b. What is the address of the business / workplace?

[Question P34b was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

Enter don't know if address of workplace is unknown.

District ____
Place ____
Street ____
Code _ _ _ _ _ _

P35a. What is the location of this person's workplace?

[Question P35a was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

[] 1 Works at home (permanently)
[] 2 Permanent workplace elsewhere
[] 3 No permanent workplace
[] 4 Other, please specify ____
[] 7 Don't know
[] 9 No response

P35b. How does this person go to work?

[Question P35b was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

Record the two principal means of transport

[] 1 Walking
[] 2 By bike
[] 3 By moped / scooter
[] 4 By car
[] 5 By public bus service

No. of buses ____

[] 6 By employer-provided transport / bus
[] 7 By boat
[] 8 Other
[] 9 Doesn't apply
[] 97 Don't know
[] 99 No response

P36. How many hours did this person work in the week from 6 to 12 August 2012?

[Question P36 was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

____ [hours]
[] 97 Don't know
[] 99 No response

P37. How is this person paid for their work?

[Question P37 was asked of persons age 15+ who were active in the period 6 to 12 August 2012, per question P30 or who were not active in that period but absent from work due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

[] 1 Daily
[] 2 Weekly
[] 3 Every two weeks
[] 4 Every month
[] 5 Other
[] 6 Unpaid
[] 7 Don't know
[] 9 No response

(Go to question P41)

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P38. Was this person looking for work in the period 12 July 2012 to 12 August 2012?

[Question P38 was asked of persons age 15+ who were not active in the period 6 to 12 August 2012, per question P30 and who were absent from work not due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31.]

[] 1 Yes [go to question P40]
[] 2 No [go question P39]
[] 7 Don't know [go question P41]
[] 9 No response [go question P41]

P39. What is the reason this person wasn't looking for work?

[Question P39 was asked of persons age 15+ who were not active in the period 6 to 12 August 2012 per question P30, who were absent from work not due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31, and who were not looking for work in the period 12 July 2012 to 12 August 2012 per question P38.]

Once you have completed P39, proceed to P41

[] 1 Retired / elderly
[] 2 Student (regardless of level of education)
[] 3 Family career
[] 4 Incapacitated for work
[] 5 Thinks they won't find work
[] 6 Looking for work but unable to find
[] 7 Waiting for application outcome
[] 8 Other, please specify ____
[] 97 Don't know
[] 99 No response

P40. What was this person's main approach to finding work during this period?

[Question P40 was asked of persons age 15+ who were not active in the period 6 to 12 August 2012 per question P30, who were absent from work not due to, for example: leave, illness, holidays, stay abroad, training, strike, or weather conditions, per question P31, and who were looking for work in the period 12 July 2012 to 12 August 2012 per question P38.]

[] 1 Registered with public entity
[] 2 Contacted employer
[] 3 Contacted friend / acquaintance
[] 4 Trying to start up own business
[] 5 Did nothing
[] 6 Other, please specify ____
[] 7 Don't know
[] 9 No response

P41. What did this person do most of the time during the past 12 months?

A job / an odd job is also regarded as work

[] 1 Was working
[] 2 Had a job but didn't work
[] 3 Was looking for work for the first time
[] 4 Looked for work having worked previously
[] 5 Didn't look for work but wanted to work and was available for work
[] 6 Went to school (any level)
[] 7 Was a family career
[] 8 Retired, without work
[] 9 Was impaired / incapacitated for work
[] 10 Other, please specify ____
[] 97 Don't know
[] 99 No response

[If answer 1 or 2, go to question P42. Elsewise, go to P43.]

P42. How many of past 12 months did this person spend working?

[Question P42 was asked of persons age 15+ who spent most of the time during the past 12 months working or had a job but did not work, per question P41.]

No. of months _ _
[] 97 Don't know
[] 99 None answer

[next page]

Persons 15 and above
[Questions P43 - P45 were asked of persons aged 15 and above.]

P43. What is this person's main income and second income?

N.B.: Enter the gross monthly incomes for income group: see map

Main income

Type

[] 1 Wages / salary
[] 2 Profit
[] 3 Interest
[] 4 From property
[] 5 Pension
[] 6 Alimony
[] 7 Disability benefit
[] 8 Other, social benefit
[] 9 Support in the form of funds transfers and/or gift packages
[] 10 No income
[] 11 Other than listed
[] 97 Don't know
[] 99 No response

Group ____

Second most important income

Type

Group ____

P44. What is this person's civil status?

Instruction: Read out the answer options

[] 1 Single
[] 2 Legally married
[] 3 Divorced
[] 4 Widow(er)
[] 7 Don't know
[] 9 No response

P45. What is the current status of this person's cohabitation?

[] 1 Cohabiting with spouse
[] 2 Cohabiting with partner (non-marital)
[] 3 No cohabitation
[] 7 Don't know
[] 9 No response

Women aged 15 to 64
[Questions P46 - P49 were asked of women aged 15 to 64.]

P46. How many children has this woman given birth to that were born alive? How many sons and how many daughters?

If none, enter a zero (0) in each box and proceed with next person

____ Total
____ Daughters
____ Sons
[] 97 Don't know
[] 99 No response

P47. How many of this woman's children are currently alive?

____ Total
____ Daughters
____ Sons
[] 97 Don't know
[] 99 No response

[next page]

P48. When was the first time this woman gave birth (to a live-born child)?

If the day or the month is unknown, enter 97; if there is no response, enter 99.
If the year is unknown, enter 9997; if there is no response, enter 9999.

First child's date of birth

Day _ _
Month _ _
Year _ _ _ _

P49. When was the last time this woman gave birth (to a live-born child born)?

If the day or the month is unknown, enter 97; if there is no response, enter 99.
If the year is unknown, enter 9997; if there is no response, enter 9999.

Last child's date of birth

Day _ _
Month _ _
Year _ _ _ _

Women aged 15 to 49
[Questions P50 - P52 were asked of women aged 15 to 49.]

P50. How many live-born children did this woman give birth to in the period from 13 Aug 2011 to 12 Aug 2012?

N.B.: If the answer is 0 children, proceed with next person.

Enter the number: ____
[] 97 Don't know
[] 99 No response

P51. How many of this woman's children born alive in the period 13 Aug 2011 to 12 Aug 2012 have died since?

N.B.: If the answer is 0 children, proceed with next person.

Enter the number: ____
[] 97 Don't know
[] 99 No response

P52. What age and sex was the child (were the children) that died in the past 12 months?

Child 1

Sex

[] 1 Male
[] 2 Female
[] 7 Don't know
[] 9 No response

Age in months ____

Child 2

Sex

[] 1 Male
[] 2 Female
[] 7 Don't know
[] 9 No response

Age in months ____

[next page]

Household module

Part 1: Characteristics of the inhabited building
[Applies to questions 1 - 4]

1. What kind of building is it:

[] 1 Self-contained dwelling
[] 2 Dwelling with business premises
[] 3 Semi-detached / duplex
[] 4 Apartment building / multi-dwelling unit
[] 5 Other, namely ____
[] 7 Don't know
[] 9 No response

2. What are the outer walls of the building mainly made of?

N.B.: Please provide only one answer.

[] 1 Wood
[] 2 Wood and building blocks / bricks
[] 3 Wood and concrete (slabs) / cement panels
[] 4 Wood and galvanized / zinc plates
[] 5 Building blocks
[] 6 Concrete / concrete slabs
[] 7 PVC paneling
[] 8 Zinc / galvanized plates
[] 9 Other, namely ____
[] 97 Don't know
[] 99 No response

3. What material is the roof of the building mainly made of?

N.B.: Please provide only one answer.

[] 1 Metal roof sheets / roof tiles (zinc, galvanized, aluminum)
[] 2 Wooden roof tiles (shingles)
[] 3 Concrete
[] 4 Tiles
[] 5 Asbestos roofing sheets
[] 6 Palm leaves (pina, tasi, etc.)
[] 7 Other, namely ____
[] 97 Don't know
[] 99 No response

4. In what year / period was this building erected?

[] 1 Before 1980
[] 2 1980-1989
[] 3 1990-1999
[] 4 2000-2004
[] 5 2005
[] 6 2006
[] 7 2007
[] 8 2008
[] 9 2009
[] 10 2010
[] 11 2011
[] 12 2012
[] 97 Don't know
[] 99 No response

Part 2: Characteristics of the inhabited living quarter
[Applies to questions 5 - 9]

5. This living quarter is:

[] 1 Permanently inhabited
[] 2 Occupied irregularly
[] 7 Don't know
[] 9 No response

6. How would you describe the living quarter where your household lives?

[] 1 Self-contained living quarter, an entire private dwelling
[] 2 Upstairs living quarter
[] 3 Downstairs living quarter
[] 4 Room-unit living quarter
[] 5 Part of a semi-detached / duplex
[] 6 Part of an apartment building / part of a multi-dwelling unit
[] 7 Dwelling with business premises
[] 8 Shack
[] 9 Hut
[] 10 Other, namely ____
[] 97 Don't know
[] 99 No response

7. What arrangement is in place for the household's occupancy of this living quarter?

[] 1 Property of one of the household members
[] 2 Rented from a public entity
[] 3 Rented from a private person or firm
[] 4 Hire-purchase
[] 5 No rent; free occupancy of a government residence [Geen huur, gratis verblijf in een overheidswoning]
[] 6 No rent; free occupancy of a private or business dwelling
[] 7 Squat
[] 8 Other, namely ____
[] 97 Don't know
[] 99 No response

8. Is this living quarter in need of repair?

[] 1 No, not in need of repair
[] 2 Yes, minor repair
[] 3 Yes, major repair
[] 4 No, is beyond repair
[] 7 Don't know
[] 9 No response

9. What arrangement is in place for the household's use of the land this living quarter is built on?

[] 1 Property of a household member
[] 2 Property of family / estate
[] 3 Public land
[] 4 Rented from a private person
[] 5 Land use with permission
[] 6 Land use without permission
[] 7 Other, namely ____
[] 97 Don't know
[] 99 No response

[next page]

Part 3: Facilities available to the household
[Applies to questions 10 - 18]

10. How many rooms does the living quarter of this household comprise?

(Do not include bath/toilet, shed, hallway and balcony)

Number of rooms _ _

11. How many bedrooms does the living quarter of this household comprise?

Number of rooms _ _

12. What is the main fuel this household uses for cooking?

N.B.: Please provide only one answer.

[] 1 Wood / charcoal
[] 2 Kerosene
[] 3 Electricity
[] 4 Gas (propane)
[] 5 Solar energy
[] 6 Biogas
[] 7 None (doesn't cook)
[] 8 Other, namely ____
[] 97 Don't know
[] 99 No response

13. What is this household's main manner of disposing of its rubbish?

N.B.: Please provide only one answer.

[] 1 Collected once a week
[] 2 Collected twice a week
[] 3 Collected more than twice a week
[] 4 Put in a waste container
[] 5 Burn it
[] 6 Bury it
[] 7 Take it to a disposal site
[] 8 Throw it into a river / gutter / ditch
[] 9 Dump it elsewhere
[] 10 Other, namely ____
[] 97 Don't know
[] 99 No response

14. What is the main type of water supply for this household?

N.B.: Please provide only one answer.

[] 1 Tap water, indoor

Supplied by:

[] 1 SWM (Surinaamsche Waterleiding Maatschappij)
[] 2 Natural resources
[] 3 other

[] 2 Tap water, outdoor 200m and under

Supplied by:

[] 1 SWM (Surinaamsche Waterleiding Maatschappij)
[] 2 Natural resources
[] 3 other

[] 3 Tap water, outdoor over 200m

Supplied by:

[] 1 SWM (Surinaamsche Waterleiding Maatschappij)
[] 2 Natural resources
[] 3 other

[] 4 Rain water in barrel / basin or tank

Is it protected?

[] 1 Yes
[] 2 No

[] 5 Well

Is it protected?

[] 1 Yes
[] 2 No

[] 6 Creek or river
[] 7 Supply by water tank / water truck
[] 8 Other, namely
[] 97 Don't know
[] 99 No response

15. What is the main type of drinking water supply for this household?

N.B.: Please provide only one answer.

[] 1 Tap water, indoor

Supplied by:

[] 1 SWM (Surinaamsche Waterleiding Maatschappij)
[] 2 Natural resources
[] 3 other

[] 2 Tap water, outdoor 200m and under

Supplied by:

[] 1 SWM (Surinaamsche Waterleiding Maatschappij)
[] 2 Natural resources
[] 3 other

[] 3 Tap water, outdoor over 200m

Supplied by:

[] 1 SWM (Surinaamsche Waterleiding Maatschappij)
[] 2 Natural resources
[] 3 other

[] 4 Rain water in barrel / basin or tank

Is it protected?

[] 1 Yes
[] 2 No

[] 5 Well

Is it protected?

[] 1 Yes
[] 2 No

[] 6 Creek or river
[] 7 Supply by water tank / water truck
[] 8 Bottled water
[] 9 Other, namely ____
[] 97 Don't know
[] 99 No response

16. What type of toilet facility does the household have?

N.B.: Please provide only one answer.

[] 1 Flush toilet and septic tank
[] 2 Outhouse (private)
[] 3 Open pit or hole in the ground
[] 4 River or creek
[] 5 Woods, field
[] 6 Other, namely ____
[] 7 Don't know
[] 9 No response

[If answer 1 or 2, go to question 17. Elsewise, go to question 18.]

17. Is the toilet facility shared with other households?

[Question 17 was asked of households whose toilet facility is flush toilet and septic tank or private toilet, per question 16.]

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

18. What is the main source of lighting used by this household?

N.B.: Please provide only one answer.

[] 1 Direct supply of electricity through EBS
[] 2 Direct supply of electricity through public scheme (Min. Natural Resources / Min. Regional Development)
[] 3 Electricity through neighbors
[] 4 Own generator (genset)
[] 5 Kerosene lamp / candle / diya
[] 6 Solar energy
[] 7 Other, namely ____
[] 8 No lighting facilities
[] 97 Don't know
[] 99 No response

[next page]

Part 4: Household appliances and other facilities
[Applies to questions 19 - 20]

19. Which of the following products and facilities are at the household's disposal, and in working condition?

N.B.: Read out the products one by one and enter the corresponding code.

1. Cooking appliance (gas, electric or solar-powered)

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

2. Radio / stereo set

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

3. TV set

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

4. Fridge

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

5. Washing machine

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

6. Telephone landline

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

7. Mobile / cell phone

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

8. Water pump / hydrophore

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

9. DVD / MP3 / MP4 / Blu-ray player

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

10. Computer / Laptop / Netbook / Tablet

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

11. Internet access

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

12. Microwave

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

13. Freezer

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

14. Digital video camera / digital photo camera

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

15. Air conditioner

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

16. Genset / generator

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

17. Connection to satellite TV / dish / subscription-based TV

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

18. Boiler / gas-operated water heater

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

19. (Tumble) dryer

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

20. Dishwasher

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

20. Which of the following means of transport are at the disposal of at least 1 household member and in working condition?

N.B.: Read out the means of transport one by one and enter the corresponding code.

1. Bicycle

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

2. Moped / scooter

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

3. Motorcycle

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

4. Passenger car / minibus

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

5. Bus, more than 8 passengers

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

6. Pickup / truck

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

7. ATV (All-Terrain Vehicle)

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

8. Boat with outboard motor

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

9. Dugout canoe

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

10. Other, namely ____

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

[next page]

Part 5: International migration (emigration)
[Applies to questions 21 - 29]

21. Have any persons that in the period 2004 to 12 Augusts 2012 were members of this household gone to another country and stayed there?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

[If answer 1, go to question 22. Elsewise, go to part 6.]

22. How many persons are involved?

[Question 22 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

_ _ Total number of persons
_ _ Males
_ _ Females

23. What sex is this person?

[Question 23 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

[] 1 Male
[] 2 Female

24. What age was this person on leaving? _ _

[Question 24 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

For any emigrants aged 96 or above, enter 96.

25. Where did this person emigrate to?

[Question 25 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

[] 1 Netherlands
[] 2 USA
[] 3 Guyana
[] 4 French-Guyana
[] 5 Curaçao
[] 6 Island of St Martin
[] 7 Other Caribbean
[] 8 Other Europe
[] 9 Other Countries
[] 97 Don't know
[] 99 No response

26. In what year did this person emigrate? _ _ _ _

[Question 26 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

9997 Don't know
9999 No response

27. What was the main reason for emigrating?

[Question 27 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

[] 1 Family (reunification)
[] 2 Work
[] 3 Studies
[] 4 Sense of insecurity
[] 5 Medical reason
[] 6 Marriage
[] 7 Travelled with parents / family
[] 8 Other
[] 97 Don't know
[] 99 No response

28. What was the highest educational level completed by this person prior to emigrating?

[Question 28 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21.]

[] 1 No education / preschool
[] 2 GLO / BO
[] 3 VOJ
[] 4 VOS
[] 5 HBO / University
[] 6 Other
[] 7 Don't know
[] 9 No response

29. What was this person's profession prior to emigrating?

[Question 29 was asked of households whose members that in the period 2004 to 12 Augusts 2012 were gone to another country and stayed there, per question 21, and were aged 15 and above.]

Record the profession ____
Code _ _ _ _
[] 8888 Had no profession
[] 9997 Don't know
[] 9999 No response

[next page]

Part 6: Environment
[Applies to questions 30A - 30B]

30A. Is this household affected by any of the following phenomena in its immediate surroundings?

Enter the relevant code.

1 Soil pollution

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

2 Water pollution

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

3 Flooding / drainage

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

4 Air pollution (particles, smoke, etc.)

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

5 Use of pesticides

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

6 Asbestos

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

7 Soil erosion

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

8 Vermin

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

9 Noise pollution

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

10 Other, namely ____

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

30B. Which of the following activities are carried out in the area immediately surrounding this household:

Enter the relevant code.

1 Gold / lead smelting

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

2 Mercury use

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

3 Sand quarries

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

4 Deforestation

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

5 Cell tower / TV or radio mast

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

6 Waste dumping

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

7 Other, namely ____

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

Part 7: Access to the Internet
[Applies to questions 31 - 33]

31. Has any member of this household made use of the internet in the past 3 months?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

[If answer 1, go to question 32. Elsewise, go to part 8.]

32. Where was made use of the internet in the past 3 months?

[Question 32 was asked of households whose member has made use of the Internet in the past 3 months.]

You may provide more than one answer.

[] 1 At home
[] 2 At work
[] 3 At school / educational institute
[] 4 Internet cafe
[] 5 In family's or friends' home
[] 6 No particular location / Hotspots / open wireless
[] 7 Don't know
[] 9 No response

33. What type(s) of Internet connection does this household have?

[Question 33 was asked of households whose member has made use of the Internet in the past 3 months.]

You may provide more than one answer.

[] 1 None
[] 2 ADSL over telephone network
[] 3 ADSL wireless / WIFI
[] 4 Dial-up
[] 5 Cellular wireless internet or mobile broadband
[] 6 3G modem or EDGE modem
[] 7 Don't know
[] 9 No response

Part 8: Language used by the household
[Applies to questions 34 - 35]

34. What is the most commonly used language in this household?

N.B.: Please provide only one answer.

[] 1 Dutch
[] 2 Sranang Tongo
[] 3 Sarnami
[] 4 Javanese
[] 5 Arawak
[] 6 Carib
[] 7 Saramaccan
[] 8 Aukan
[] 9 Paramaccan
[] 10 Chinese
[] 11 Portuguese
[] 12 English
[] 13 French
[] 14 Other, namely ____
[] 97 Don't know
[] 99 No response

35. What is the second most commonly used language in this household?

[next page]

Part 9: Criminality
[Applies to heading A - I and questions 36 - 41 for each heading.]

A. Murder

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

[Question 38a was asked households whose member has fallen victim in the past 12 months and the offence / crime was not reported to the police.]

[] 1 No confidence in judicial process
[] 2 Fear of offender
[] 3 Offence not serious enough
[] 4 Offender is a relative
[] 5 Other, please specify ____
[] 7 Don't know
[] 9 No response

Proceed with question 39.

38b. What was the outcome?

[Question 38b was asked households whose member has fallen victim in the past 12 months and the offence / crime was reported to the police.]

[] 1 Process underway
[] 2 Tried / sentenced
[] 3 Case dismissed
[] 4 Other, please specify ____
[] 7 Don't know
[] 9 No response

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

[] 1 Bureau slachtofferzorg (Victim Support Agency)
[] 2 PCS
[] 3 Other public authority, namely ____
[] 4 Vereniging verkeersslachtoffers (Traffic Accident Victims' Association)
[] 5 Stop geweld tegen vrouwen (Stop Violence against Women)
[] 6 Other non-public body, namely ____
[] 7 Don't know
[] 9 No response

B. Shooting

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

C. Abuse / assault / rape

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

D. Theft / Robbery

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

E. Injury

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

F. House / Car break-in

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

[Question 38b was asked households whose member has fallen victim in the past 12 months and the offence / crime was reported to the police.]

[] 1 Process underway
[] 2 Tried / Sentenced
[] 3 Case dismissed
[] 4 Other, please specify ____
[] 7 Don't know
[] 9 No response

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

[] 1 Bureau slachtofferzorg (Victim Support Agency)
[] 2 PCS
[] 3 Other public authority, namely ____
[] 4 Vereniging verkeersslachtoffers (Traffic Accident Victims' Association)
[] 5 Stop geweld tegen vrouwen (Stop Violence against Women)
[] 6 Other Non-public body, namely ____
[] 7 Don't know
[] 9 No response

G. Traffic criminality

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

H. Fraud

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

I. Other namely ____

36. Has any member of the household fallen victim to any of the following in the past 12 months...?

[] 1 Yes (go to question 37)
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

37. Was the offence / crime reported to the police?

[] 1 Yes (go to question 38b)
[] 2 No (go to question 38a)
[] 7 Don't know (proceed with question 39)
[] 9 No response (proceed with question 39)

38a. Why wasn't the offence / crime reported?

38b. What was the outcome?

39. Was victim support applied for?

[] 1 Yes
[] 2 No
[] 7 Don't know
[] 9 No response

40. Was victim support provided?

[] 1 Yes
[] 2 No (proceed with next offence / crime)
[] 7 Don't know (proceed with next offence / crime)
[] 9 No response (proceed with next offence / crime)

41. Who provided victim support?

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