Questionnaire Text
Questionnaire form
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Households at the selected dwelling
Household number of this household _ _
Total number of households at the selected dwelling _ _
Was this questionnaire subjected to quality control (or checks) by any Community Survey personnel other than the supervisor? Mark the appropriate box with an X.
[] 1 Yes
[] 2 No
Questionnaire instructions
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Was this questionnaire subjected to quality control (or checks) by any Community Survey personnel other than the Fieldwork Supervisor?
You are not required to answer this question.