Questionnaire Text

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Fill a number 2 individual form for each person in list A
___1 Last name (for a woman, add the maiden name)
___2 First name
___3 Relationship with the person recorded on the first line (for example, write: wife (or husband), son, daughter, grandson, mother, daughter-in-law, nephew, etc., or, friend, boarder, subletter, salaried employee, etc.

Record on the first line one of the spouses of the couple (and, on the second line, the other spouse) or, as the case may be, one of the adults living in the dwelling.
___1
___2
___3
___4
___5
___6
___7
___8
___9
___10
___11
___12
___13
___14


If there are more than 14 people to record, use an additional dwelling form.