Questionnaire Text

Questionnaire form view entire document:  text  image

For all individuals:
[Questions 1-10 -- are for all person]


5. Born in:

[] This same state -- Go on to question 10
[] Another state

____ Which? -- Go on to question 10


[] Another country

____ Which one?

Questionnaire instructions view entire document:  text  image

Questions 1-10 -- are for all persons

Every person in the household should be asked these questions.

-- In the case of people who are absent or of small children, ask the Head of Household or the person who can give the most reliable information.


Question No.5

[Place of birth]
[The instructions refer to a graphic of section VI, question 5 on the census form.]

-- Read the question and the possible answers and fill in the cell corresponding to the answer:

-- If the answer is this same state, go to Question No.8.

-- If the answer is another state

Ask which state and write down the answer in the space provided.
Go to Question No.8.


-- If the answer is another country

Ask which country and write down the answer in the space provided.
Go to the next question.