Questionnaire Text

Questionnaire form view entire document:  text  image
15.

a. Did this person live in this house or apartment 1 year ago?
[] Person is under 1 year old - skip to question 16
[] Yes, this house - skip to question 16
[] No, outside Puerto Rico and the United States - print name of foreign country, or US Virgin Islands, Guam, etc, below, then skip to question 16 ______
[] No, different house in Puerto Rico or the United States
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 of municipio in Puerto Rico or US county
_______
Enter Puerto Rico or name of US state
______
ZIP code
_ _ _ _ _
Questionnaire instructions view entire document:  text  image
Answer person questions 7 through 17 for all persons on pages 2, 3, and 4.

Questions 7-48 are a continuation of the questions for each person. Questions 7-48 are a continuation of the questions for each person. (Questions 1-6 appear on pages 2, 3, and 4 of the questionnaire.)

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 the municipio 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.