Questionnaire Text

Questionnaire form view entire document:  text  image
[Question 13- 17 were asked of all persons.]

15. b) Where did this person live 1 year ago?

Address (Development or condominium name, number and street name) ____
Name of city, town, or post office ____
Name or U.S. county or municipio in Puerto Rico ____
Name of U.S. state or Puerto Rico ____
Zip Code _ _ _ _ _
Questionnaire instructions view entire document:  text  image
15a. If the person did not live in Puerto Rico or the United States one year ago, mark the "No, outside Puerto Rico and the United States" box and print the name of the foreign country, or U.S. Virgin Islands, Guam, etc., where the person lived. Be specific when printing the name of foreign country, for example, specify whether Northern Ireland or the Republic of Ireland (Eire); North or South Korea; England, Scotland or Wales (not Great Britain or United Kingdom). Specify the particular country or island in the Caribbean (not, for example, West Indies). Then skip to question 16.

If the person lived somewhere else in the United States one year ago, mark the "No, different house in the United States" box.

15b. Include the house or structure number; street name; street type (for example, St., Road, Ave.); and the street direction (if a direction such as "North" is part of the address). For example, print 1239 N. Main St. or 1239 Main St., N.W., not just 1239 Main. If the person lived in Puerto Rico, the address should also include the name of the development or condominium.

If the only known address is a post office box, give a description of the residence location. For example, print the name of the building where the person lived, the nearest intersection, the name of a military base or installation, or the nearest street where the residence was located, etc. Do not give a post office box number.

Print the name of municipio (municipality) in Puerto Rico or U.S. county. If the person lived in Louisiana, print the parish name in the "Name of municipio in Puerto Rico or U.S. county" space. If the person lived in Alaska, print the borough or census area name, if known. If the person lived in New York City and the county name is not known, print the borough name. If the person lived in an independent city (not in any county) or in Washington, D.C., leave the "Name of municipio in Puerto Rico or U.S. county" space blank.