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Republic of Venezuela
Census '90

Head Office of National Statistics and Census

XII General Population and Housing Census

Expanded Questionnaire

Protected under statistical secrecy

L-2

Section I -- Dwelling identification

1. ____ Federal entity
2. ____ Municipality or parish
3. ____ Locality
4. ____ Segment number
5. ____ Section number
6. ____ Subsection number
7. ____ Block number
8. ____ Sector number

9. ____ Dwelling order number

[] Continuation of another questionnaire

Section II -- Dwelling information

1. Access to the dwelling

[] Paved street
[] Gravel or dirt street
[] Route or way
[] Public Stairs or walkways
[] Others

2. Dwelling type

[] House with garden (quinta, casa-quinta )
[] House
[] Apartment in a building
[] Apartment in a house (quinta, casa-quinta )
[] Tenement (Casa de vecindad)
[] Shack or hut (Rancho)
[] Peasant hut (rural type) (Rancho campesino)
[] Other type

3. The occupancy status of the dwelling is:

[] Permanent use
[] Occasional use (End the interview here)
[] Unoccupied (End the interview here)
[] Under construction (End the interview here)

4. The predominant material in the exterior walls is:

[] Finished cement block or brick
[] Unfinished cement block or brick
[] Concrete
[] Sawed wood, Formica, fiberglass and similar
[] Finished adobe, adobe or mud wall (tapia), bamboo-and-mud (bahareque)
[] Unfinished adobe, mud wall, bamboo-and-mud

5. The predominant material in the roof is:

[] Roof slab (Platabanda)
[] Tile
[] Asbestos or similar
[] Metal sheet (zinc or similar)
[] Others (cane, palm, planks or similar)

6. The predominant material in the floor is:

[] Tile, granite or marble, ceramic, brick, terracotta, parquet, carpet and similar
[] Cement
[] Earth
[] Others (planks, tablon board, and similar)

7. How many rooms does the dwelling have in total, including living room, dining room, sleeping rooms and other rooms?

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8 or more

8. The kitchen in located in:

[] Separate room
[] Another place

9. The fuel normally used for cooking is:

[] Gas
[] Electricity
[] kerosene or gasoline
[] Others (wood, charcoal, etc.)

10. Water arrives at this dwelling via:

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

11. This dwelling has:

[] Toilet (W.C.) connected to sewer
How many?
[] 1
[] 2
[] 3 or more
[] Toilet (w.c.) connected to a septic tank
How many?
[] 1
[] 2
[] 3 or more
[] Pit toilet or latrine
[] Doesn't have a toilet or latrine

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

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

13. Does the dwelling have any of the following public services?

[] Telephone service
[] Yes
[] No

[] Public garbage collection
[] Yes
[] No

[] Street sweeping service
[] Yes
[] No

[] Public electric service
[] Yes
[] No

Section III -- Number of households

1. How many people habitually live in this dwelling?

[] One person alone
[] One family
If this/these person/people form a census household. Skip to Section IV, "Composition of the household."
[] Two or more families or groups of people

2. Do these families or groups of people keep separate budgets for food?

[] No. These people form a census household. Skip to Section IV, "Composition of the Household."
[] Yes

3. How many families or groups of people keep separate budgets for food?

____
Each family or group forms a Census Household.

Follow these instructions:
Continue the interview for the first household on this same questionnaire.
For the rest of the households do the following:

- Fill in one questionnaire per Census Household
- Copy the information from Section I, "Dwelling Identification" (Points 1 to 9)
- Leave blank Section II, "Dwelling Information," and Section III, "Number of Households"
- Begin the interview with Section IV, "Composition of the Household"

Section IV, Composition of the household

(Only for habitual residents of this household)

Mark the number of the Census Household that you are enumerating

Census Household number:

[] 1
[] 2
[] 3
[] 4
[] 5 or more

1. How many people habitually live in this dwelling, whether present or not at this moment?
Important:

- Be sure to include small children and elderly people
- Do not include people who habitually live in another place

____ Total number of people

Ask and write down the surname of each of the members of this household in the following order:

- Head of the household [explicitly male or female] (First Line)
- Spouse or partner
- Single sons or daughters without children (from oldest to youngest)
- Single, divorced, separated or widowed children, with their respective children noted after each
- Married or partnered children and their families
- Other relatives of the head (parents, in-laws, siblings, etc.) and their families
- People not related to the head (friends, etc.) and their families
- Domestic employees and their families (write "S.D." under relationship to head of household)

[There is a table with 10 rows to fill the following information]

____ Person number
____ Names and surnames
____ Relationship to head of household
Mark the sex
[] Male
[] Female

[The following line is the last row of the table]

Total
____ Male
____ Female

If there are more than 10 people, use another questionnaire for the rest of the people.

2. I have written down the following individuals: (Read their names aloud) Do any of these people not live habitually in this dwelling?

[] Yes [Check the rules of residence, and if any are non-residents, erase their information from the appropriate line]
[] No

3. Is there anyone I haven't written down who habitually lives here but who is not here at the moment due to vacation, work, illness, or any other reason?

[] Yes [Check the rules of residence, and if any are residents, add their information to this section]
[] No

Comments: [7 blank lines] ________

Section V -- Household information

1. For this household, the dwelling is:

A. Owned
[] Completed paid for
[] Paying
____ Bs./Month
[] B. Rented
____ Bs./Month
[] C. Other form

2. How many rooms do the people in this household use for sleeping?

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8 or more

3. Does the household have any of the following appliances?

Refrigerator
[] Yes
[] No

Television
[] Yes
[] No

Washing machine
[] Yes
[] No

Clothes dryer
[] Yes
[] No

Air conditioning
[] Yes
[] No

4. Does the household have a car for family use?

[] Yes: How many?
[] 1
[] 2
[] 3 or more
[] No

5. Does the household have a motorcycle/motor scooter (moto)?

[] Yes: How many?
[] 1
[] 2
[] 3 or more
[] No

Go on to fill in Section VI, "Individual Characteristics," for each of the people in this household.

Follow the same order in which you wrote them down in Section IV, "Household Composition."

Section VI - Individual characteristics

Person number ____ of ____
____ Name

For all individuals:
[Questions 1-10 -- are for all person]

1. Relationship to the head of household

[] Head of household
[] Spouse or partner
[] Son/daughter
[] Grandchild
[] Father, mother, parent-in-law
[] Brother/sister, brother/sister-in-law
[] Nephew/niece
[] Other relative
[] Non- relative
[] Domestic employees and their families

2. Sex

[] Male
[] Female

3. What is your date or birth and age?

____ Day
____ Month
____ Year
____ Age
____ Under one year (months)

4. What is your current marital status?

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

5. Born in:

[] This same state -- Go on to question 10
[] Another state
____ Which? -- Go on to question 10
[] Another country
____ Which one?

6. What is your legal nationality?

____ Venezuelan by naturalization (nationalized)
____ Born abroad to Venezuelan parents
[] Foreign

7. How long have you lived in the country?

[] Less than 1 year
[] 1 to 4 years
[] 5 to 9 years
[] 10 years or more

8. How long have you lived in this city or town?

[] Always -- Go on to question 10
[] Less than 1 year
[] 1 to 4 years
[] 5 to 9 years
[] 10 years or more

9. The city or town where you lived before is in:

[] This same state
[] Another state
____ Which?
[] Another country

10. Do you have any of the following disabilities?

[] Total blindness
[] Total deafness
[] Muteness
[] Mental retardation
[] Loss or disability of upper extremities
[] Loss or disability of lower extremities
[] None of the above

Questions 11-14 are only for those over the age of 3 years

11. Are you able to read and write?

[] Yes
[] No

12. What was the highest grade, year or semester completed and at what educational level?

____ Grade
____ Year
____ Semester

[] None -- Go on to question 14
[] Preschool -- Go on to question 14
[] Primary or Basic (1-6) -- Go on to question 14
[] Middle (1-3) or Basic (7-9) -- Go on to question 14
[] Diversified Middle -- Go on to question 14
[] Superior

13. Have you obtained any higher education title or degree?

[] Yes
____ Which?
[] No

14. Are you currently attending preschool, basic, diversified or superior schooling?

[] Yes
[] No

Questions 15-17 are only for women 12 years of age and older

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

____ Total children
[] None -- Go on to question 18

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

____ Currently alive
[] None

17. Have you given birth to any child born alive in the last 12 months?

[] Yes - How many?
[] 1
[] 2
[] 3 or more
[] No

Questions 18-26 are only for people 12 years of age and older

18. In which of these situations do you currently find yourself?

[] Working -- Go on to question 20
[] Not working but employed -- Go on to question 20
[] Looking for work having worked before -- Go on to question 19
[] Looking for work for the first time -- Go on to question 26
[] Doing household duties without also working -- Go on to question 26
[] Studying without also working -- Go on to question 26
[] Living from pension or retirement without also working -- Go on to question 26
[] Permanently disabled for purposes of work -- Go on to question 26
[] Other situation -- Go on to question 26

19. How long have you been unemployed?

[] Up to 3 months
[] 4 to 6 months
[] 7 to 12 months
[] More than 1 year

20. What is your occupation in the company, organization or business where you work (or worked)? Examples: driver, lathe operator, farmer, teacher, etc.

____
____

21. What does the company, organization or business where you work (or work) do? Examples: passenger transportation, furniture making, coffee-growing, education, etc.

____
____

22. Do 5 or more people work in this company, organization or business?

[] Yes
[] No

23. What is the name of the company, organization or business where you work (or worked)?

____

24. In this job, are (or were) you a:

[] Public sector professional employee or laborer
[] Private sector professional employee
[] Domestic servant
[] Member of a cooperative
[] Employer or owner
[] Own-account worker (who doesn't have employees or workers)
[] Unpaid family worker

25. How much did you earn total by way of salaries, wages, tips, bonuses, (primas), or commissions during the last month (or during the last month that you worked), in all of your jobs?

____ Bs/Month
____ Bs/Week
____ Bs./Day

[] Did not receive income

26. Did you receive income during the last month from any of the following sources, and approximately how much?

[] Rent/investment income
____ Bs.

[] Pension or retirement
____ Bs.

[] Public or private scholarship or aid
____ Bs.

[] Unemployment insurance
____ Bs.

[] Others
____ Bs.

[] Did not receive any of these types of income