[p.1]
Form A
This Book contains household questionnaires
Enumeration area serial no. _ _ _ _ _
If this is a special enumeration area put an "X" mark. _
[Instructions to the Enumerator about how to prepare for taking the census in the original document is not presented here.]
[Legal notice concerning the census in the original document is not presented here.]
The enumerated population's
____ Province name
____ District name
____ Sub-district name
____ Village name
____ Quarter name
____ If exists sub-municipality name
Code
Province _ _
District _ _
Sub-district _
Village _ _ _
Quarter _ _ _ _
If exists sub-municipality _ _
Statement by the enumerator
I visited, one by one, all the places assigned to me in the enumeration area. I entered all the population present in those places in accordance with the handbook. After completing the enumeration, I added up the population I entered in this book, and I found
In words ____
Subtracting from this figure the number of household heads not at home (total number of "No" answers to the question, "Is the household head at home now?" (Section III Question No. 2)), I state that the remaining total population in persons
In words ____
Enumerator's name ________
Enumerator's surname ________
Signature ____
I checked the enumerator's statement. I found
In words ____
Subtracting from this figure the number of household heads not at home (Total number of "No" answers to the question, "Is the household head at home now?" (Section III, Question No. 2)) I state that the remaining total population in person
In words ____
Supervisor's name ________
Supervisor's surname ________
Signature ____
2000 population census questionnaire
Attention to enumerator
For the places constituting household, fill in the Section I, Section II, and Section III in this form.
For the places not constituting household, fill in only Sections I and II. Leave section III unfilled.
Road, building, group name or number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Condominium name ________
Block name or number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Building number _ _ _ _ _ _ _
Flat number _ _ _ _
Section II: Nature of location where the census was carried out
[] 2 Apartment flat
[] 3 Prefabricated house
[] 4 Tent, hut, etc.
[] 5 Hotel, motel, pension
[] 6 Train, ferry, bus, terminal, etc.
[] 7 Hospital, health center
[] 8 Military quarters, barracks, garrison, etc.
[] 9 Boarding school, hostel, etc.
[] 10 Kindergarten, orphanage, nursing home
[] 11 Prison, reformatory
[] 12 Others (factory, government office, embassies, etc.)
[Note: Answers 5-12 do not constitute households (housing units) by the census definition]
Section III: Questions related to households and dwellings
(For the places constituting a household, ask the questions between 1-12 in this section to the household head or to anyone who can answer instead.)
[Questions 1-12 were asked of housing units, per Section II.]
1. What is the name and surname of the household head?
Name ________
Surname ________
2. Is the household head at home now?
[] 2 No
3. How many persons are there in this household now including visitors?
[] None
4. How many visitors are there in this household now regardless of whether they are relatives or not?
[] None
5. How many members of this household who are not in the house now are:
[] None
[] None
6. What is the ownership status of this house?
[] 2 Tenant
[] 3 Lodgment [employer]
[] 4 Not owner, but not paying rent
[] 5 Other
7. How many rooms are there in your house including the living room?
8. Which of the following are in your household?
[] 2 Outside
[] 3 Doesn't exist
[] 2 Outside
[] 3 Doesn't exist
[] 2 Outside
[] 3 Doesn't exist
[] 2 Outside
[] 3 Doesn't exist
9. Was there a member of this household who died in the last year (from 22th October 1999 until now)?
[] 2 No (Go to question 12)
_
11. What is the sex, completed age, and the date of death of the(se) person(s)?
Sex
[] 2 Female
Month _ _
Year _ _ _ _
12. Please give the names and surnames of all persons who are in this household now, starting with the household head.
Individual rank number
2 ________
3 ________
4 ________
5 ________
6 ________
7 ________
8 ________
9 ________
10 ________
11 ________
12 ________
13 ________
14 ________
15 ________
16 ________
17 ________
18 ________
19 ________
20 ________
21 ________
22 ________
23 ________
24 ________
25 ________
26 ____
27 ____
28 ____
[p. 4]
Section IV: Questions regarding individual characteristics
13. Write individual's rank number in the house.
_ _
14. What is your name and surname?
Name ________
Surname ________
15. What is your sex?
[] 2 Female
16. What is your current age in completed years?
_ _ _
17. What is your relationship to the household head?
[] 1 Household head
[] 2 Wife/husband
[] 3 Son
[] 4 Daughter
[] 5 Father
[] 6 Mother
[] 7 Brother or sister
[] 8 Father in-law
[] 9 Mother in-law
[] 10 Daughter in-law
[] 11 Son in-law
[] 12 Grandchild
[] 13 Other
[] 14 Visitor
18. What is the present name of the province and the district in which you were born?
(For those who were born abroad write only the name of the country.)
District name ____
Country name ____
19. What is your nationality?
[] 1 T.R. [Turkey]
[] 2 Does not have any nationality
Country name ____
20. Do you have any physical or mental disability?
[] 2 No (Go to question 22)
21. What kind of disability do you have?
(More than one choice may be marked.)
[] 1 Disability of seeing
[] 2 Disability of hearing
[] 3 Disability of speaking
[] 4 Physical/orthopedic disability
[] 5 Mental disability
[] 6 Other
22. Do you live (settle) in this place of residence where you are enumerated for the census?
[] 2 No
23. What is the present name of the province, district, sub-district, or village where you live (settle) in?
(For those who live abroad write only the name of the country.)
Province name ____
District name ____
Sub-district name ____
Country name ____
Ask persons age 5 or older
[Questions 24 - 27 were asked of persons age 5 and older.]
24. Five years ago, that is on October 22, 1995, were you living in the same place of residence where you are living now?
[] 2 No
25. What is the present name of the province and district where you were living five years ago, that is on October 22, 1995?
(For those whose place of residence five years ago was abroad, write only the name of the country.)
Province name ____
District name ____
Country name ____
26. Is the place of residence where you were living five years ago (on October 22, 1995) a province center, a district center, or a sub-district, village?
(Do not ask to those whose place of residence five years before was abroad.)
[] 1 Province center
[] 2 District center
[] 3 Sub-district, village
27. What was the main reason for leaving from the place of residence where you lived five years ago?
(Mark only one choice.)
[] 1 To seek/to find a job
[] 2 Designation/appointment
[] 3 Migration related to any members of the household
[] 4 Education
[] 5 Marriage
[] 6 Earthquake
[] 7 Security
[] 8 Other
Ask persons age 6 or older
[Questions 28 - 29 were asked of persons age 6 and older.]
28. Are you literate?
[] 2 No (Go to question 30)
29. What is the last school you have completed?
(The school where the final degree was received.)
[] 1 No school completed
[] 2 Primary school
[] 3 Primary education
[] 4 Junior high school
[] 5 Vocational school at junior high school level
[] 6 High school
[] 7 Vocational school at high school level
[] 8 Higher education
[] 9 Faculty
[] 10 Master/doctorate
Ask persons age 12 or older
[Question 30 was asked of persons age 12 or older]
30. What is your marital status?
[] 2 Married
[] 3 Divorced
[] 4 Widowed
Ask women age 12 or older who are married, widowed or divorced.
[Questions 31 - 33 were asked of women age 12 or older who are married, widowed, or divorced.]
31. Have you ever given birth?
[] 1 Yes
[] 2 No (Go to question 35)
32. How many children (female or male) have you ever given birth?
Female _ _
Male _ _
33. How many of these children are still alive?
Female _ _
Male _ _
[Question 34 was asked of women age 12 to 50 who are married, widowed, or divorced.]
34. When did you last give birth?
Day _ _
Month _ _
Year _ _ _ _
[Questions 35 - 43 were asked of persons age 12 or older.]
35. Did you work at any job during the last week?
[] 1 Worked
[] 2 Did not work but has a job attachment
[] 3 Did not work (Go to question 40)
[Questions 36-39 were asked of persons age 12 or older who had worked during last week or had a job attachment to, as per question 35.]
36. What was your main task or duty at the job that you worked or had a job attachment to in the last week?
________
37. What is the name of the work place or organization where you worked or had a job attachment in the last week?
________
38. What is the main activity of the work place (firm/organization) where you worked or had a job attachment in the last week?
________
39. What is your employment status in the job where you worked or had a job attachment in the last week?
[] 2 Employer (Go to question 43)
[] 3 Self-employed (Go to question 43)
[] 4 Unpaid family worker (Go to question 43)
40. Are you seeking a job?
[] 1 Yes
[] 2 No (Go to question 42)
41. When did you last take any steps to look for work?
[] 1 One month ago (Go to question 43)
[] 2 Two - three months ago (Go to question 43)
[] 3 Four - six months ago (Go to question 43)
[] 4 Seven months or more (Go to question 43)
[] 5 Have done nothing
42. Why are you not seeking a job or not working?
[] 1 Found a job but waiting to start
[] 2 Student
[] 3 Housewife
[] 4 Retired
[] 5 Income recipients
[] 6 Other
43. What is your main profession?
________
[] None