Questionnaire Text

Questionnaire form view entire document:  text  image
4. Place of your birth ____

Specify the name of the foreign state at the time of birth (including former Soviet Union republics); for those born in the Russian Federation specify republic, region, autonomous region or district, Moscow, St. Petersburg for Russia (RSFSR)
Questionnaire instructions view entire document:  text  image
Question 4. Your place of birth
For person born in the territory of Russian Federation (including RSFSR) only the name of region or territory, or republic, or autonomous district, city of Moscow or city of Saint-Petersburg (for example, "Saratov Region", "Republic of Dagestan", "Chukotka Autonomous District) shall be written.
For person born outside Russian Federation, in foreign country or one of the united republics of the former USSR name of the foreign country or united republic of the former USSR, where he/she was born (for example, Kazakhstan, Latvia, Poland, Canada) shall be written. For example, for person born in Vitebsk in 1981 written Belorussian USR shall be written, and not Vitebsk Region or town of Vitebsk.
If a respondent names only a settlement, he/ she shall be asked to specify in which subject of the Russian Federation or in which foreign country this settlement is.
Subjects of the Russian Federation include republics, territories, regions, autonomous districts, Moscow, Saint-Petersburg, Jewish Autonomous District.
Administrative and territorial changes that were made after the respondent's birth shall not be taken into account. Name is written in the way it was as of the moment of birth of the respondent. In case if a respondent remembers (knows) only the contemporary name of place of birth, a census taker shall write the name he is provided.
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The box for numbers after writing place of birth in words is left blank.