Questionnaire Text

Questionnaire form view entire document:  text  image
IV. Population information


Only for those persons 5 years of age and older:

10. Where did you habitually reside in July of 1967?

If in this municipality (district), mark "here." If in another place, write the municipality where residing, (or department); or the name of the foreign country.

[] Here
____ Other municipality
____ Department
____ Country

[] [a blank box appears in corner of response area for this question]

Questionnaire instructions view entire document:  text  image
IV. Information about the Population


10. Place of habitual residency in July, 1967
This question is only for persons 5 years old and more. If in July of 1967 the person already resided in this municipality (or district), or in any of its colonies or companies, etc., mark "Here".

For all persons who are under seven years old, the interview ends here.

10. Only for persons five years old or more.
Where did you have your habitual residency in June of 1967?
If it was in this municipality (district), mark "here".
If he/she had habitual residence in another place, write the municipality where he/she resided (or department), or the foreign country.

Here [] / Other municipality ___
Department ___
Country ___