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Republic of Venezuela
Ministry of Development

Head Office of National Statistics and Census
Protected Under Statistical Secrecy

XI General Population and Housing Census
General Enumeration Questionnaire

Section I - Dwelling identification
1. ____ Municipality
2. ____ District
3. ____ Federal entity
4. ____ Sector number

A. Urban area

[] 1 Urbanized
[] 2 Shantytown

____ Segment number
____ Block number
____ City or town
____ Suburb / Neighborhood (UrbanizaciĆ³n)
B. [] 3 Rural area

____ Name of populated area

5. ____ Dwelling order number

Very important warning:
Before going on to Section II ask the following questions:

I. How many families live in this dwelling?

[] Just one (one census household) -- Fill in one questionnaire
[] Two or more [arrow points to question II]
[] Collective dwelling -- Fill in one questionnaire

II. Do these families make their lives together, or with separate arrangements?

[] Living together -- Fill in one questionnaire.
[] With separate arrangements (various census households)
How many? ____ Fill in one questionnaire for each census household.

For office use only:
[Table with fill-in ovals numbered 0 - 9 below each of the following headings:]

Structure registry
Number [7 digits] _ _ _ _ _ _ _
Municipality [2 digits] _ _
Entity [2 digits] _ _
Region [1 digit] _
Sub-region [2 digits] _ _
Sector
Number [3 digits] _ _ _
Area [1 digit] _
Segment [1 digit] _
Block [2digits] _ _
Locality [3 digits] _ _ _
Dwelling order number [3 digits] _ _ _
Section II - Dwelling information

General aspects

1. Dwelling type

A. Family dwelling

[] House or house with garden (quinta)
[] Apartment in a building, house or quinta
[] Room in a house, quinta, or apartment
[] Room in a townhouse (Casa de vecindad)
[] Peasant hut (rural type) (Rancho campesino)
[] Urban hut/improvised dwelling (Rancho urbano improvisado)
[] Other type

B) Collective dwelling

____ Class
____ Name

2. Occupancy

A. Occupied

[] Permanently -- Go on to question 3
[] Occasional use -- Go on to question 3

B. Unoccupied

[] For rent -- End the interview here
[] For sale -- End the interview here
[] Rent or sale -- End the interview here
[] Occasional use -- End the interview here
[] Other -- End the interview here

C. [] Under construction -- End the interview here

3. Number of rooms

(Do not include bathrooms, laundry areas, hallways or separate kitchens)

____ Total number of rooms
____ How many are used for sleeping?
[Fill-in numbered ovals appear here.]

4. Tenure of the dwelling

A. Owned

[] Completely paid for
[] Still in payment
____ Bs./month

B. Rented

____ Bs./month

C. [] Other form

Predominant materials

5. In the exterior walls

[] Finished cement block or brick (frisado)
[] Unfinished cement block or brick
[] Concrete
[] Sawed wood
[] Finished adobe, adobe or mud wall (tapia) or bamboo-and-mud wall (bahareque)
[] Unfinished adobe, mud wall or bamboo-and-mud wall
[] Others (cane, palm leaves, planks, tin, straw, cardboard, or similar)

6. In the roof

[] Roof slab (Platabanda)
[] Tile
[] Asbestos and similar
[] Metal sheet (zinc and similar)
[] Others (cane, palm leaves, planks, tin, straw, cardboard, or similar)

7. In the floor

[] Tile, granite or marble, ceramic, brick, terracotta, parquet, carpet and similar
[] Cement
[] Earth

Facilities and equipment

8. Where is the piped running water supply?

[] Inside the dwelling
[] Outside the dwelling
[] Doesn't have

9. How is water normally obtained?

[] Aqueduct (piped)
[] Public cistern (pila)
[] Tanker truck
[] Other means

10. How many bathrooms with shower or tub does this dwelling have?

[] One
[] Two
[] Three or more
[] None

11. Does this dwelling have?

[] Toilet (w.c.) connected to sewer
[] Toilet (w.c.) connected to a septic tank
[] Pit toilet or latrine
[] Doesn't have a toilet

12. What type of lighting is used?

[] Public electric system
[] Own electric generator
[] Other type

13. What fuel is used for cooking?

[] Natural gas
[] Kerosene or gasoline
[] Electricity
[] Other type (wood, charcoal, etc.)
[] No cooking

14. Household equipment (mark all that apply)

Vehicle (car) for family use. How many?
[] One
[] Two
[] Three
[] Four or more
[] Refrigerator or freezer
[] Washing machine
[] Clothes dryer
[] Hot water heater
[] Television
[] Telephone
[] Air conditioning
[] Doesn't have any of the above
Section III - Household composition

Only for habitual residents, members of this household

Important: Include all the members of this household who habitually live in this dwelling, whether present or not present at the moment of the census. Be sure to include children, newborns, and elderly persons. Do not include on this questionnaire any person who habitually resides elsewhere and is part of another census household, even when present here at the moment of the census.

Begin the interview by filling in columns 1 through 4 for each person, and proceed with the control question.

Column 1

Write the surname and name of each person who habitually resides in this dwelling in the following order:

1. Head of the household (first line)
2. Spouse or companion
3. Single children from oldest to youngest
4. Married children and their families
5. Other relatives of the head (parents, grandparents, grandchildren, siblings, nephews or nieces, parents-in-law, etc.)
6. Other people not related to the head of the household (guests, employees, etc.) who habitually sleep in the dwelling.

____ Last name
____ First name

Column 2

Write the relationship to the head of the household (for members of collective dwellings write "C").

____ Relationship

Column 3

Mark the sex

[] Male
[] Female

Column 4

Mark whether the resident is present or absent

[] Present
[] Absent

Column 5

Person number

____ Number

[Lines for responses of up to 16 people]
____ Total [applies to columns 3 and 4]

Control questions

(Only for census household)

1. Apart from the members of this household, is there any person residing here temporarily and who forms part of another household located outside of this locality?

[] Yes
Fill in a blue Individual Questionnaire for each of these people. If you have written any of them down in column 1, erase their information from the corresponding lines and go on to question 2.
[] No

2. In addition to the following people (read aloud the names of the people noted in column 1), is there any other person who habitually lives here, but who is temporarily absent (for reasons of vacation, work or business, illness, etc.)?

[] Yes
Write the data of this person in columns 1 to 4, and then go on to question 3
[] No

3. I have listed ____ people who habitually live here as members of this household. Has any member of this household been left out?

[] Yes
Consult the rules of residence and, if a resident, write the data of this person in columns 1 to 4
[] No

Now, in column 5, assign a number in consecutive order to all of the people listed as members of this household. Then go on to question 4.

4. Number of people listed in this household.

____ Total
____ Males
____ Females

Only for zones pre-determined by the office:

5. Does any person among those listed speak from childhood (or used to speak from childhood) an indigenous language?

[] Yes
[] No

Comments: [4 blank lines] ________

Section IV - Individual characteristics

____ Name

[] Present
[] Absent

____ Person number
____ of

[The following questions are translated as 2nd person, but it is understood that they really refer to the person whose name was given above.]

A. General characteristics

1. What is the relationship to the head of the household?

[] Head of household
[] Spouse or partner
[] Son or daughter
[] Father, mother, parent-in-law
[] Grandchild
[] Son- or daughter-in-law
[] Brother or sister
[] Other relative
[] Domestic servant
[] Not related
[] Person in a collective dwelling


2. Sex

[] Male
[] Female

3. What is your date of birth (or age attained?)

____ Day
____ Month
____ Year

____ Years (one year or more)
____ Months (under one year)

4. What is your current marital status?

[] Consensual union
[] Married
[] Separated
[] Widowed
[] Single
[] Divorced

5. Where were you born?

In Venezuela
____ State
____ Municipality -- Go on to question 8
Abroad
____ Country

6. What is your current legal nationality?

[] Naturalized Venezuelan
[] Born abroad to Venezuelan parents
[] Foreigner

7. How long have you lived in this country?

[] Less than a year
A year or more. How many? ____

8. How long have you lived in this populated area?

[] Always lived here [Go on to question 10]
[] Less than a year
[] 1 Year
[] 2 to 4 years
[] 5 to 9 years
[] 10 to 14 years
[] 15 to 19 years
[] 20 years or more

9. Where did you live before residing in this locality?

In Venezuela:
____ State
____ Populated area
[] Abroad

B. Educational characteristics

(Only for those 5 years of age or older)

10. Are you able to read and write?

[] Yes
[] No

11. What was the highest grade, year or semester completed, and at what level of schooling?

[] None
[] Primary
____ Grade
[] Middle (secondary)
____ Year
____ Semester
[] Superior
____ Year
____ Semester

12. Are you currently studying in preschool, primary, middle or superior schooling?

[] Yes -- Go on to question 14
[] No

13. If between 5 and 24 years old, why are you not currently studying?

[] There are no higher grades
[] There is no school, high school, etc.
[] School is very far away
[] There are no places open in the school(s)
[] Without economic resources
[] Working
[] Finished studies
[] Other reason

14. If studying at the superior level, have you obtained any higher education degree or title?

[] Yes
____ Which?
[] No

C. Fertility characteristics

(Only for women 12 years of age and older.)

15. How many children born alive have you had in total?

____ Total children (born alive)
[] None

16. Of the total children born alive, how many are currently alive?

____ Currently alive
[] None

17. Between October 1st, 1980 and September 30th, 1981, did you give birth to any child born alive?

____ Yes
How many?
[] One
[] Two
[] Three or more
[] No

D. Economic characteristics

(Only for people 12 years of age and older.)

18. In which of the following situations did you find yourself last week? (Mark only one response)

[] Working -- Go on to question 24
[] Not working but employed -- Go on to question 24
[] Looking for work
[] Household duties
[] Studying
[] Living from investment income
[] As a pensioner or retiree
[] In another situation
[] Permanently disabled for purposes of work

19. Did you receive or will you receive payment in money for any work done in or outside of your home during the last week (such as selling or making a product, sewing, washing and ironing for someone outside of your household, washing cars)?

[] Yes (skip to 24)
[] No

20. During the last week, did you work without receiving payment in money, in your house or in any business, industry, workshop, farm activity, etc., that belongs to a member of your family?

[] Yes (skip to 24)
[] No

21. Did you engage in any diligence during the last 30 days to find work?

[] Yes
[] No

22. Have you previously done any work, part-time or full-time, for payment in money?

[] Yes
[] No (End of interview)

23. How long have you been without full-time or part-time employment for payment in money?

[] Up to 6 months
[] More than 6 up to 12 months
[] More than 1 year (End of interview)

24. How many hours did you work last week (or regularly work per week) in all of your jobs (or how many hours did you regularly work per week in your last job)?

____ Total hours

25. What does the organization, company, establishment or business where you work (or worked) produce or do, or what service does it render?

____

26. What is the occupation, position or class of work you perform in the organization, company, establishment or business for which you work (or worked)?

____

27. In this job, are (or were) you a?

[] Public sector professional employee -- Go on to question 28
[] Private sector professional employee -- Go on to question 28
[] Public sector manual laborer (obrero) -- Go on to question 28
[] Private sector manual laborer (obrero) -- Go on to question 28
[] Domestic servant -- Go on to question 29
[] Owner -- Go on to question 29
[] Own-account worker -- Go on to question 29
[] Member of a cooperative -- Go on to question 29
[] Unpaid family worker -- Go on to question 30

Did you look for work? [Unpaid family worker]
[] Yes
[] No

28. What is the name of the organization, institution, company or business for which you work (or worked in your last job)?

____

29. How much did you earn total by way of salaries, wages, commissions, tips, or bonuses, during the last month (or during the last month that you worked)?

____ Bs/Month (if paid monthly or every fifteen days)
____ Bs/Week (if paid weekly)
____ Bs/Day (if paid daily)

30. How many weeks did you work, full-time or part-time, between October 1980 and September 1981? (Include weeks of vacation and leave.)

____ Weeks
[] Did not work