Questionnaire Text

Questionnaire form view entire document:  text  image

11. What is your current marital status?
Only for those 12 years of age and older

[] 1 Married
[] 2 Consensual union
[] 3 Widowed
[] 4 Separated or divorced
[] 5 Single
Questionnaire instructions view entire document:  text  image

Question 11. What is your current marital status?

Do not forget that this question is only for persons age 12 and above.

Read each of the options and then make an X in the corresponding box.

[A depiction of question 11 to the right of the preceding text is omitted here.]

Remember that:

Married: A person who has entered into a civil and/or religious marriage bond, and currently lives in that bond.
United: A person who lives with their spouse without having entered a civil and/or religious marriage bond.
Widow: A person who, after the death of their spouse, has neither remarried nor lives in a de facto union.
Separated or divorced: A person who is legally separated from their spouse and who has neither remarried nor lives in a de facto union.
Single: A person who has never been married, nor lives in a de facto or free union. [Free union refers to category "united"].

[A drawing representing marital status is omitted here.]