Questionnaire Text

Questionnaire form view entire document: text image

To be filled out by the census agent
___1 Dwelling number*
___2 Location in the building** (stairs, floor, situation on the stairway platform, apartment or bedroom number, etc.)
___3 Name of the occupant
___4 Dwelling category (1 to 7) see FL
___5 Number of number 2 forms (list A only) ****