1960
Census: Instructions to Respondents
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The 1960 census was the first to employ a form of self-enumeration.
The Census Bureau mailed each householder an "Advance Census Report" form
that they were to fill out without the aid of census employees. Census
takers (enumerators) later collected these forms in person and transferred
the information they contained onto permanent FOSDIC census forms that
computers read to derive the official tabulations. If a household failed
to complete its advance report form, or filled it out incorrectly, the
census taker interviewed that household and copied the answers directly
to the permanent forms. (A few of the housing items were completed by the
enumerators without consulting the respondents.)
One-fourth (25 percent) of the households later received a second questionnaire
containing additional "sample" questions, and census takers transferred
the answers from these to permanent FOSDIC forms just as they did with
the basic Advanced Census Reports. The 1960 PUMS was created from the FOSDIC
forms for these sample households and the persons living in them. However,
since the respondents originally answered the Advanced Census Reports and
sample questionnaires, it is the questions from these that are reproduced
below.
The questions are presented in two sections, "Population questions"
and "Housing questions." All persons contained in the PUMS answered all
of the population questions listed below, but not all households answered
the same housing questions:
-
Households in cities with populations of 50,000 or more were asked some
additional housing questions not asked in other areas, while households
outside of those cities received a different set of additional housing
questions. Those questions asked only inside the 50,000+ population cities
are marked PH-4" below, while those asked only outside of those cities
are marked "PH-3." (The terms are derived from the names of the two FOSDIC
forms to which census takers copied the information.)
-
The FOSDIC forms used to record the 25 percent sample all contained the
same population questions, but recorded two slightly different sets of
housing questions. Most of the housing questions did appear on both of
the forms, but some appeared on only four-fifths of them, while the rest
appeared on the other one-fifth of the sample forms. The 25 percent sample
can therefore be thought of as two separate samples: a 20 percent sample
(comprising four-fifths of all sample households) and a 5 percent sample
(comprising the remaining sample households).
The following codes are used to identify which housing
questions were asked of which households:
[All] = Question asked of all households in the sample.
[PH-4] = Question asked only in cities with populations of 50,000+.
[PH-3] = Question asked only of households not contained in PH-4 universe.
[20%] = Response recorded only for 20 percent sample households (whether
inside cities or not).
[5%] = Response recorded only for 5 percent sample households (whether
inside cities or not).
For full information, see U.S. Bureau of the Census, 1960 Censuses of
Population and Housing: Procedural History, Washington D.C., 1966,
and Principle Data-Collection Forms and Procedures, Washington D.C.,
1961.]
[This is the cover page to all preliminary "Advance Census Report" forms.
Note that it mentions the possibility that the household might be issued
a "sample" form in the future.]
U.S. DEPARTMENT OF COMMERCE
BUREAU OF THE CENSUS
ADVANCE CENSUS REPORT FORM FOR THE
1960 CENSUS OF POPULATION AND HOUSING
Dear Householder:
This Government report form is for you to fill out before the Census
Taker calls to take the 1960 Census of Population and Housing. The enclosed
example will serve as a guide to help you put down the required answers
for each member of your household.
If you will have the form ready for the Census Taker by April 1, you
can help speed up the Census and reduce costs. In order to make the results
more accurate, you are asked to consult other members of your household,
if necessary, to get the dates of birth and other facts. Any visitors who
stayed overnight in your home on Thursday, March 31, 1960 should be listed
in Section C of the report.
As provided in the Constitution, the Census count will determine the
number of seats in Congress to be apportioned to each State. The information
which you give will also help Government and business in developing their
plans, which may affect all of us.
In one out of every four homes, extra questions will be asked. That
home is picked by chance, so that no one knows in advance whether it will
be yours or your neighbor's. When the Census Taker comes, he will tell
you if your household has been chosen.
The information that you are required to furnish is held confidential
by law. Your Census report cannot be used for purposes of taxation, investigation,
or regulations.
Sincerely yours,
[signed]
ROBERT W. BURGESS, Director
Bureau of the Census
DO NOT MAIL - HAVE READY FOR THE CENSUS TAKER
CONFIDENTIAL - The Census is required by the United States Constitution
and further authorized by 13 U.S.C. 5, 9, 141, 221-4. The law requires
that the inquiries be answered completely and accurately, and guarantees
that the information furnished will be accorded confidential treatment.
The Census report cannot be used for purposes of taxation, investigation,
or regulation.
***************************************************************************
[The header to all sample questionnaires, whether 20% or 5%.]
U.S. DEPARTMENT OF COMMERCE
BUREAU OF THE CENSUS
ADVANCE CENSUS REPORT FORM FOR THE
1960 CENSUS OF POPULATION AND HOUSING
Dear Householder:
Thank you for your cooperation in providing the information you have
already given the Census Taker. This questionnaire covers the additional
items needed to complete the Census.
You will see that questions about your dwelling are on the next page
and that questions concerning yourself and each other person in your household
are on the following pages. Please study the enclosed example before you
start to fill in the form.
Never skip a question just because it does not seem to apply. For instance,
an answer of "No" to the question, "Did this person work at any time last
week?" is just as important as an answer of "Yes." Whenever you do not
know the exact answer (such as the cost of utilities or the amount of wages
last year) make a reasonable estimate. After you complete the form, please
check it over to make sure you have not missed anything.
Federal law states that Census employees must hold all information which
you give them in strictest confidence. The statistics published
from this Census will not reveal any individual information.
Please mail the completed questionnaire within 3 days
in the addressed envelope which the Census Taker has left with you. It
requires no postage. Your prompt attention to this request will be appreciated.
Sincerely yours,
[signed]
ROBERT W. BURGESS, Director
Bureau of the Census
This is an official document of the United States Government.
CONFIDENTIAL - The Census is required by the United States Constitution
and further authorized by 13 U.S.C. 5, 9, 141, 221-4. The law requires
that the inquiries be answered completely and accurately, and guarantees
that the information furnished will be accorded confidential treatment.
The Census report cannot be used for purposes of taxation, investigation,
or regulation.
***************************************************************************
1960
Population questions
[These were asked of persons
in all 1960 PUMS households.]
SECTION A - In this section list:
1. Everyone who usually lives here, whether related to you
or not.
2. All persons staying here who have no other home.
PLEASE BE SURE TO LIST -
All members of your family living with you, including babies.
All other relatives living here.
Lodgers and boarders living here.
Servants, hired hands, others not related to you who are living here.
Any one else staying here but who has no other home.
ALSO LIST -
Persons who usually live here but who are away temporarily on business,
on vacation, or in a general hospital.
DO NOT LIST -
College students who are away at college (or who are here only on vacation).
Persons stationed away from here in the Armed Forces.
Persons away in institutions, such as a sanitarium, nursing home, home
for the aged, mental hospital.
They will be counted there.
(P2) NAMES OF PERSONS LIVING HERE ON APRIL 1, 1960,
AND THOSE STAYING HERE WHO HAVE NO OTHER HOME
Write names in this order
Head of household on first line
Wife of head
Unmarried children, oldest first
Married children and their families
Other relatives
Others not related to head of household
IF THERE ARE MORE THAN 10 NAMES ON YOUR LIST, USE AN ADDITIONAL SHEET
Last name
First Name
Middle initial
____________________ ____________________ ____________________
(P3) What is the relationship of each person to the
head of this household?
(For example, wife, son,
daughter, grandson, mother-in-law, lodger, lodger's wife)
____________________
(P4) Male or Female (M or F)
___________________
(P5) Is this person - White, Negro, American Indian,
Japanese, Chinese, Filipino, Hawaiian, Part Hawaiian, Aleut, Eskimo, (etc.)?
____________________
(P6) When was this person born?
Month ____________________
Year ____________________
(P7) Is this person - Married, Widowed, Divorced,
Separated, Single (never married)?
(Leave blank for children
born after March 31, 1946)
____________________
P8. Where was this person born?
(If born in hospital, give residence
of mother, not location of hospital)
If born in the United States, write
name of State. If born outside the United States, write name
of country, U.S. possession, etc.
Use international boundaries as now recognized by the U.S.
Distinguish Northern Ireland from
Ireland (Eire).
________________________________________
(State, foreign country, U.S.
possession, etc.)
P9. If this person was born outside the U.S.
-
What language was spoken in his home
before he came to the United States?
____________________
P10. What country was his father born in?
United
States...O OR
_____________________________________________
(Name of foreign country; or Puerto Rico, Guam, etc.)
P11. What country was his mother born in?
United
States...O OR
_____________________________________________
(Name of foreign country; or Puerto Rico, Guam, etc.)
P12. When did this person move into this house
(or apartment)?
(Check date of
last move)
Jan. 1954
In 1959 or 1960................
O to March 1955.................. O
In 1958.............................
O 1950 to 1953.................... O
In 1957.............................
O 1940 to 1949.................... O
April 1955
to Dec. 1956.....................
O Always lived here............. O
P13. Did he live in this house on April 1, 1955?
(Answer 1, 2, or
3)
1. Born April
1955 or later........... O
OR
2. Yes, this
house.......................... O
OR
3. No, different
house.................... O
Where did he live on April 1, 1955?
a. City or town ____________________ b. If city or town -
Did he live inside | Yes...O
the city limits? | No....O
c. County ____________________
AND State, foreign country, U.S. possession, etc. ___________________
P14. What is the highest grade (or year) of regular
school this person has ever attended?
(Check one box)
If now attending a
regular school or college, check the grade (or year) he is in. If it is
in junior
high school, check
the box that stand for that grade (or year).
Never attended school......................
O
Kindergarten.................................
O
Elementary
1 2 3 4 5 6 7 8
school (Grade)...............................
O O O O O O O O
1 2 3 4
High school (Year)...........................O
O O O
1 2 3 4 5 6 or more
College (Year)...............................
O O O O O O
P15. Did he finish the highest grade (or
year) he attended?
Finished this grade...........
O
Did not finish this grade.....
O
Never attended school.......
O
P16. Has he attended regular school or college
at any time since February 1, 1960?
If he has attended only
nursery school, business or trade school, or adult education classes, check
"No".
Yes...O No...O
P17. Is it a public school or a private school?
Public school................................. O
Private or
parochial school............................. O
P18. If this person has ever been married -
Has this person been
married more than once?
Once...O More than once...O
P19. When did he get married? When did he get
married for the first time?
Month __________ Month __________
Year __________ Year ___________
P20. If this is a woman who has ever been married
-
How many babies has she
ever had, not counting stillbirths?
Do not count her stepchildren
or adopted children.
__________ OR None...O
(Number)
P21. When was this person born?
Born before April
1946
Born April 1946 or later
O
O
Please go on with
questions P22 to Please omit
questions
P35. Answer the questions
regardless P22 to P35 and turn
of whether the person is
a housewife, the page to the next
student, or retired person,
or a part- person.
time or full-time worker.
Space for any notes about the entries for this person.
________________________________________
P22. Did this person work at any time last week?
Include part-time work
such as a Saturday job, delivering papers, or helping without pay
in a family business
or farm. Do not count own housework.
Yes...O
No...O
P23. How many hours did he work last week
(at all jobs)?
(If exact figure not know, give best estimate)
1 to 14 hours.......O 40 hours.........................O
15 to 29 hours..... O 41 to 48 hours..................O
30 to 34 hours..... O 49 to 59 hours..................O
35 to 39 hours..... O 60 hours or more..............
O
P24. Was this person looking for work, or on layoff
from a job?
Yes...O No...O
P25. Does he have a job or business from which he was temporarily
absent all last week because of illness, vacations, or other reasons?
Yes...O No...O
P26. When did he last work at all, even
for a few days?
(Check one box)
Working now...... O
1949 or earlier.... O
In 1960...............
O
In 1959...............
O Never worked..... O
1955 to 1958...... O
1950 to 1954...... O
P27. Occupation (Answer 1, 2, or 3)
1. This person last worked in 1949 or earlier..............|
This person has never worked.................................| O
OR
2. On active duty in the Armed Forces now..................
O
OR
3. Worked in 1950 or later...O
Answer a to e, below.
Describe this person's job or business last week, if any, and write in
name of employer.
If this person had no job or business last week, give information for last
job or business
since 1950.
a. For whom did he work?
_______________________________________________
(Name of company, business, organization, or other employer)
b. What kind of business or industry was this?
Describe activity at location where employed.
__________________________________________________
(For example: County junior high school, auto assembly plant, TV
and radio service, retail supermarket, road construction, farm)
c. Is this primarily:
Manufacturing..............................................O
Wholesale trade............................................O
Retail trade.................................................O
Other (services, agriculture,
government, construction, etc.)..........................O
d. What kind of work was he doing?
__________________________________________________
(For example: 8th grade English teacher, paint sprayer, repairs TV
sets, grocery checker, civil engineer, farmer, farm hand)
e. Was this person: (Check one box)
Employee of private company, business, or
individual, for wages, salary, or commissions.........O
Government employee (Federal, State,
county, or local............................................O
Self-employed in own business,
professional practice, or farm...........................O
Working without pay in a family business or farm... O
If this person worked last week, answer questions P28 and P29.
P28. What city and county did he work in last week?
If he worked in
more than one city or county, give place where he worked most last week.
a. City or town
____________________
b. If city or town
- Did he work inside the city limits?
Yes...O No...O
c. County ____________________
State ____________________
P29. How did he get to work last week?
(Check one box for
principal means used last week)
Railroad.............
O Taxicab.............. O Walk only........... O
Subway or
Private auto
Worked at
elevated..............
O or car pool.......... O home.................. O
Bus or
Other means - Write in:
streetcar..............
O ____________________
P30. Last year (1959), did this person work at
all, even for a few days?
Yes...O No...O
P31. How many weeks did he work in 1959, either
full-time or
part-time? Count paid
vacation, paid sick leave, and military
service as weeks worked.
(If exact figure not
known, give best estimate)
13 weeks or less...............
O 40 to 47 weeks................. O
14 to 26 weeks.................
O 48 to 49 weeks................. O
27 to 39 weeks.................
O 50 to 52 weeks................. O
P32. How much did this person earn in 1959
in wages, salary, commissions, or tips from all jobs?
Before deductions for
taxes, bonds, dues, or other items.
(Enter amount or check
"None." If exact figure not known, give best estimate.)
$_________________.00
OR None...O
(Dollars only)
P33. How much did he earn in 1959 in profits or
fees from working in his own business, professional practice, partnership,
or farm?
Net income after
business expenses. (Enter amount or check "None."
If exact figure
not known, give lest estimate. If business or farm lost money,
write "Loss"
after amount.)
$_________________.00
OR None...O
(Dollars
only)
P34. Last year (1959), did this person receive
any income from:
Social security
Pensions
Veteran's payments
Rent (minus expenses)
Interest or dividends
Unemployment insurance
Welfare payments
Any other source not
already entered
Yes...O
No...O
What is the amount he
received from these sources in 1959?
(If exact figurenot
known, give best estimate.)
$_________________.00
(Dollars
only)
P35. If this is a man -
Has he ever served in
the Army, Navy, or other Armed Forces of the United States?
Yes...O No...O
(Check one box on each line)
Was it during:
Yes No
Korean War (June 1950
to Jan. 1955).......... O O
World War II (Sept. 1940
to July 1947)....... O O
World War I (April 1917
to Nov. 1918)....... O O
Any other time, including
present service........ O O
PLEASE ANSWER THESE TWO QUESTIONS
Name of person(s) who filled this form:
____________________
____________________
Date filled: ____________________
If it is necessary for the Census Taker to get in touch with you,
the best time usually is:
(Check one box)
8 to 12 a.m..................................... O
12 to 6 p.m.................................... O
6 to 9 p.m...................................... O
[Section B and C contain questions designed to ensure a complete
count.]
SECTION B - NEXT: Please answer the questions
in this section to help the Census Taker count your household correctly.
1. Does more than one family live in this home?
Yes...O No...O
If "Yes," do they live and eat with your
family?
Yes...O No...O
Be sure they are listed in Section 1, above.
2. Is there anyone left out of Section A because you were not sure
whether he should be listed - for example, a new baby still in the hospital,
or a lodger who also has another home?
Yes...O No...O
If "Yes," write name(s) here: ____________________
3. Is there anyone listed in Section A who is away from home now?
Yes...O No...O
If "Yes," write name(s) here: ____________________
SECTION C - List below all persons who were
staying here overnight on Thursday, March 31, 1960, except those you have
already listed in Section A. Give their home addresses so that the Census
Bureau can make sure it counts these people.
(1) Name of visitor (If there are more than 2 names use an additional
sheet)
____________________
(2) What is the relationship of this person to the head of the household
where he usually lives?
____________________
(3) Male or Female (M or F)
____________________
(4) Is this person - White, Negro, (etc.)?
____________________
(5) When was this person born?
Month ____________________
Year ____________________
(6) Is this person - Married, Widowed, Divorced, Separated, Single
(never married)?
(Leave blank for children born after
March 31, 1946)
____________________
(7) Home house number and street
____________________
(8) Home city or town and postal zone
____________________
(9) Home State
____________________
(10) If visitor's home is in a rural area - Box No., Rural Route
No., and full description of location
____________________
(11) Is there anyone there to report this person?
Yes...O No...O
1960
Housing questions:
[All] = Question asked of all sample households.
[PH-4] = Question asked only in cities with populations of 50,000+.
[PH-3] = Question asked only of households not contained in PH-4
universe.
[20%] = Response recorded only for 20% sample households (whether
inside cities or not).
[5%] = Response recorded only for 5% sample households (whether
inside cities or not).
[See section introduction for a full explanation
of notes in brackets.]
SECTION D - These questions are about the place where you and the people
you listed in Section A live. They refer to your house or the part of the
house which you occupy, or to the apartment, flat, or rooms in which you
live.
[H1, H3, H4, H6, and H7 appeared only on FOSDIC forms, not on the
questionnaires. They were filled in by the enumerator, not the respondent.]
[All. Determines whether housing unit was group
quarters.]
H1. Sample key
O A
O GQ
(If GQ, fill H17-H18 and omit remaining "H" items)
[All. Only on FOSDIC form; filled in by enumerator, not respondent]
H3. Type
O House, apt., flat
O Trailer
[All. Only on FOSDIC form; filled in by enumerator, not respondent]
H4. Access
O Direct from outside or common hall
O Through another unit
[All] H5. Do you have a kitchen or cooking equipment:
(Check
one)
For use of the people in your household only (those you listed
in Section A)?.. O
Shared with another household or no cooking equipment?............................
O
[All. Only on FOSDIC form; filled in by enumerator, not respondent]
H6. Condition [of housing]
O Sound
O Deteriorating
O Dilapidated
[All. Only on FOSDIC form; filled in by enumerator, not respondent]
H7. Occupancy
O Occupied
Vacant:
O Year-round
O Migratory wkr
O Seasonal
[All]
H8. How many rooms are in your house or apartment? (Count a kitchen
as a room but do not count bathrooms)
Number of rooms ____________________
[All]
H9. Is there hot and cold running water in this house or building?(Check
one)
Hot and cold running water
inside the house or building......................... O
Only cold running water inside..............................................................
O
Running water on property but
not inside building.................................. O
No running water.................................................................................
O
[All]
H10. Is there a flush toilet in this house or building? (Check
one)
Yes, for the use
of this household only..................................................
O
Yes, but shared
with another household................................................
O
No flush toilet
for the use of this household............................................
O
[All]
H11. Is there a bathtub or shower in this house or building?(Check
one)
Yes, for the use of this
household only.................................................. O
Yes, but shared with
another household................................................ O
No bathtub or shower
for the use of this household............................... O
[PH-3]
H12. Is the house, part of the house, or apartment
in which you live: (Check one)
Owned or being
bought by you or someone else in your household? O
Rented for cash?.......................................................................
.......... O
Occupied without
payment of cash rent?.................................. ......... O
[PH-4]
H12. Is the house, part of the house, or apartment in which you
live: (Check one)
Owned or being
bought by you or someone else in your household? O
Answer question H15 and fill Section E
Rented for cash?.................................................................................
O
Answer question H16 and fill Section E
Occupied without
payment of cash rent?........................................... O
Skip to Section E
[All. Only on FOSDIC form; filled in by enumerator, not respondent.]
H13. Vacancy status
O For rent
O For sale only
O Rented or sold not occupied
O For occasional use
O Other vacant
[PH-4. Filled in by enumerator, not respondent. This is the FOSDIC
version;
see also H39.]
If "OWNED OR BEING BOUGHT" OR "VACANT--FOR SALE ONLY"
H14. Description of property
O 1 unit, no business
O 1 unit, with business
O 2 or more units
HOME OWNERS AND BUYERS PLEASE ANSWER THIS QUESTION
[PH-4; see also H40.]
H15. About how much do you think this property would sell for on
today's market? (Check one)
Under $5,000...................
O $15,000 to $17,400.......... O
$5,000 to $7,400..............
O $17,500 to $19,900.......... O
$7,500 to $9,900..............
O $20,000 to $24,900.......... O
$10,000 to $12,400..........
O $25,000 to $34,000.......... O
$12,500 to $14,900..........
O $35,000 or more............... O
RENTERS PLEASE ANSWER THIS QUESTION
[PH-4; see also H41.]
H16. If you pay your rent by the month-
What is your monthly
rent? $_________________.00
(Nearest dollar)
OR
If you pay rent by the week or some other period of time-
What is your
rent and what period does it cover?
$_________________.00
per ____________________
(Nearest dollar)
(Week, year, etc.)
[Sections E and F omitted]
Fill Inside Page for Population Census
HOLD THIS REPORT FOR THE CENSUS TAKER - DO NOT MAIL
[PH-4]
The term "house" or "apartment" covers your house or part of the
house you occupy, or the apartment, flat, or rooms in which you live. Most
of these questions refer to your own house or apartment but note that questions
H20, H33, and H34 are about the whole building in which you live.
[PH-3]
The term "house" or "apartment" covers your house or part of the
house you occupy, or the apartment, flat, or rooms in which you live. Most
of these questions refer to your own house or apartment but note that questions
H20, H32, and H33 are about the whole building in which you live. Questions
H17 and H18 refer to the whole place on which you live; if your house is
on land which is only part of a larger property, answer questions about
the whole place.
[PH-3]
H17 and H18. Is this house:
On a city lot (or is this an apartment building)?.... O
OR
On a place of less than 10 acres?............................ O
Last year (1959),
did sales of crops, livestock, and other
farm products from
this place amount to $250 or more?
$250 or more.................... O
Less than $250 or none..... O
OR
On a place of 10 or more acres?.............................
O
Last year (1959),
did sales of crops, livestock, and other
farm products from
this place amount to $50 or more?
$50 or more.................... O
Less than $50 or none..... O
[5%]
H19. How many bedrooms are in your house or apartment?
Count rooms whose
main use is as bedrooms even if they are occasionally
used for other
purposes. If you live in a one-room apartment without a separate bedroom,
check "No bedroom."
No bedroom.....................
O
1 bedroom........................
O
2 bedrooms.......................
O
3 bedrooms.......................
O
4 bedrooms or more..........
O
[All]
H20. About when was this house originally built?
In 1959 or
1960................ O
1955 to 1958....................
O
1950 to 1954....................
O
1940 to 1949....................
O
1930 to 1939....................
O
1929 or earlier..................
O
[All]
H21. How is your house or apartment heated?
Check ONLY the
kind of heat you use the most.
Heated by:
Steam or hot water.....................................................
O
Warm air furnace with individual room registers........... O
Floor, wall, or pipeless furnace...................................
O
Built-in electric units...................................................
O
Room heater(s) connected to chimney or flue............. O
Room heater(s) not connected to chimney or flue....... O
Other method - Write in:
____________________
Not heated..................................................
O
[5%]
H22. Here is a list of fuels. In the first column,
check which one is used most for heating. In the second column, check the
one used most for cooking. In the third column, check the fuel used most
for heating water. (
Check one in each column)
A
B
C
House heating Cooking Water
heating
fuel
fuel
fuel
Coal or coke................................... O........................
O........................ O
Wood........................................... O........................
O........................ O
Utility gas from underground
pipes serving the neighborhood.............. O........................ O.........................
O
Bottled, tank, or LP gas...................... O........................
O......................... O
Electricity...................................... O........................
O......................... O
Fuel oil, kerosene, etc....................... O........................
O......................... O
Other fuel..................................... O........................
O......................... O
No fuel used................................... O........................
O........................ O
[5%]
H23. Do you have a clothes washing machine?
Do not count machines
shared with any other household in this building.
Machine with wringer
or separate spinner................. O
Automatic or semi-automatic
machine..................... O
Washer-dryer combination
(single unit).................... O
No washing machine.......................................... O
[5%]
H24. Do you have an electric or gas clothes dryer?
Do not count dryers
shared with any other household in this building.
Electrically heated
dryer............................................ O
Gas heated dryer.....................................................
O
No dryer...............................................................
O
[5%]
H25. Do you have any television sets?
Count only sets
in working order. Count floor, table, and portable television
sets as well as
combinations.
1 set.....................................................................
O
2 sets or more..........................................................
O
No television sets......................................................
O
[5%]
H26. Do you have any radios?
Count only sets
in working order. Count floor, table, and portable radios as
well as radio combinations.
Do not count automobile radios.
1 radio...................................................................
O
2 radios or more........................................................
O
No radios................................................................
O
[5%]
H27. Do you have any air conditioning?
Count only equipment
which cools the air by refrigeration.
Room unit - 1 only....................................................
O
Room units - 2
or more.............................................. O
Central air conditioning
system..................................... O
No air conditioning...................................................
O
[5%]
H28. Do you have a home food freezer which is separate from your
refrigerator?
Yes...O No...O
[20% -- filled in by enumerator, not respondent]
H29. Number of units in structure
1, detached............ O
1, attached............ O
2........................ O
3-4..................... O
5-9..................... O | If 5 or more -
10-19.................. O | Fill items H20,
20-49.................. O | H21, H22A, and
50 or more........... O | H22C in Questionnaire
[20%]
H30. How many bathrooms are in your house or apartment?
A complete bathroom
has both flush toilet and bathing facilities (bathtub or shower).
A partial bathroom
has a flush toilet or bathing facilities, but not bath.
No bathroom, or
only a partial bathroom.......................... O
1 complete bathroom.................................................
O
1 complete bathroom,
plus partial bathroom(s)................... O
2 or more complete
bathrooms...................................... O
[PH-3, 20%]
H31. Do you get water from:
a public system
(or private company)?.......................... O
an individual well?..................................................
O
some other source?..................................................
O
[PH-3, 20%]
H32. Is this house connected to a public sewer?
Yes, connected
to a public sewer............................... O
No, has septic
tank or cesspool.................................. O
No, has other means
of sewage of disposal.................... O
[20%]
H33. Is this house built:
with a basement?..........................
O
on a concrete slab?.......................
O
in another way?............................
O
[PH-4, 20%]
H34. Does this building have:
3 stories or less?..............
O
4 stories or more
-
with elevator?.. O
walk-up?........... O
[All]
H35. Is there a telephone on which people
who live here can be called?
Yes........O What is
the telephone number?____________________
No........ O
[PH-3, 5%, or PH-4, 20%]
H36. How many passenger automobiles are owned or regularly used
by people who live here?
Count company cars
kept at home
No automobile...............................
O
1 automobile..................................
O
2 automobiles.................................
O
3 automobiles
or more....................... O
[All]
H37. If you live in a trailer, is it:
mobile (on wheels,
or can easily be put on wheels)?............................. O
on a permanent
foundation?..............................................................
O
[All. Only on FOSDIC form; filled in by enumerator, not respondent.]
H38. How many months has this unit been
vacant?
O Up to 1 month
O 1 up to 2
O 2 up to 4
O 4 up to 6
O 6 or more
[PH-3 -- Filled in by enumerator, not respondent. This is the FOSDIC
version.]
If "OWNED OR BEING BOUGHT" OR "VACANT--FOR SALE ONLY" (Omit if
10 acres or more)
H39. (H14) Description of property (from back
page of questionnaire)
O 1 unit, no business
O 1 unit, with
business
O 2 or more units
[PH-3]
ANSWER H40 IF YOU OWN OR ARE BUYING THIS HOME
[PH-3; see also H15]
H40. About how much do you think this property would sell for on
today's market?
Do not answer if your home is on a place of 10 or more acres.
Less than $5,000............................ O
$5,000 to $7,400............................ O
$7,500 to $9,900............................ O
$10,000 to $12,400........................ O
$12,500 to $14,900........................ O
$15,000 to $17,400........................ O
$17,500 to $19,900........................ O
$20,000 to $24,400........................ O
$25,000 to $34,900........................ O
$35,000 or more............................ O
ANSWER QUESTIONS H41 TO H46 IF YOU PAY RENT FOR YOUR HOUSE, APARTMENT,
OR FLAT
[PH-3; see also H16]
H41. If you pay your rent by the month -
What is your monthly
rent? $_________________.00
(Nearest dollar)
OR
If you pay your
rent by the week or some other period of time -
What is your rent
and what period does it cover?
$_________________.00
per ____________________
(Nearest
dollar)
(Week, year, etc.)
[PH-3]
H42. Does you rent include any land used for farming (or ranching)?
Yes...O No...O
[All]
H43 and H44. In addition to rent, do you also pay for:
Electricity? (Check one box)
Yes...O What is the average monthly
cost for electricity? $_________________.00
(See instructions below)
No...O
Gas? (Check one box)
Yes.O What is the average monthly
cost for gas? $_________________.00
(See instructions below)
No...O
Water? (Check one box)
Yes...O What is the average monthly
cost for water? $_________________.00
(See instructions below)
No...O
[All]
H45 and H46. In addition to rent, do you also pay for oil, coal,
kerosene, or wood?
Yes...O About how much do you pay
for such fuel per year? $_________________.00
(See instructions below)
No...O
HOW TO FIGURE COST OF UTILITIES AND FUEL
Enter the cost to the nearest dollar
-
Utilities
-
If you don't know exactly how much you have spent and if you don't have
records, put down the approximate costs.
-
Fuels
-
If you don't know how fuels cost per year, one of the following methods
may help you figure the approximate costs:
Fuel used
Method
NOTE: If you buy fuel in small
Coal
Multiply number of tons used per |
quantities (such
year by the cost per ton.
|
as kerosene by
|
the can or coal
Oil
Multiply number of gallons used |
by the bag), it
or
per year by the cost per gallon; |
may be easier to
kerosene
OR multiply number of deliveries |
-- figure about how
by average cost per delivery.
|
much you spend
|
for fuel per week,
Wood
Multiply number of cords (or
|
and multiply by
loads) used per year by cost per |
the number of
cord (or load).
|
weeks during
|
which it is used.
Space for any notes about the housing entries.
____________________
AFTER YOU FINISH THE HOUSING QUESTIONS -
-
FILL THE FOLLOWING PAGES FOR PERSONS WHOSE NAMES HAVE BEEN WRITTEN IN
BY THE CENSUS TAKER. [Note: We recorded person (or population) questions
in the above section.]
-
MAKE SURE THAT EACH "EXTRA PERSON" QUESTIONNAIRE LEFT BY THE CENSUS
TAKER IS FILLED.
-
INCLUDE THE COMPLETED "EXTRA PERSON" QUESTIONNAIRES IN THE FAMILY'S
ENVELOPE WHEN THIS FORM IS MAILED TO THE CENSUS OFFICE. Sheets filled by
household members not related to the head may first be enclosed in the
special smaller envelopes left for these persons.
Go Back to Census Questions Index
Go Back to Enumeration Forms Index
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|