1. Geographical information Municipality ____ Parish ____ Section/Subsection _ _ _ - _ _ Building number _ _ _ 2. Address Street __________ Number _ _ _ _ Locality ____ Postcode _ _ _ _ - _ _ _

2. Type of living quarter Housing unit [] 1 Conventional dwelling [] 2 Shack [] 3 Rudimentary wooden house [] 4 Mobile housing unit [] 5 In a permanent building not designed for habitation [] 6 Other inhabited Collective living quarter - end questionnaire here [] 7 Hotel or similar Camps or Institutions: [] 8 Social support [] 9 Education [] 10 Health [] 11 Religious [] 12 Military [] 13 Prison [] 14 Work [] 15 Other type Reserved for NSI: [] 16 On board population [] 17 Diplomatic personnel Questions no. 1 to 3, inclusive, are completed by the Census Enumerator.

2. Type of living quarter Housing unit [] 1 Conventional dwelling [] 2 Shack [] 3 Rudimentary wooden house [] 4 Mobile housing unit [] 5 In a permanent building not designed for habitation [] 6 Other inhabited Collective living quarter - end questionnaire here [] 7 Hotel or similar Camps or Institutions: [] 8 Social support [] 9 Education [] 10 Health [] 11 Religious [] 12 Military [] 13 Prison [] 14 Work [] 15 Other type Reserved for NSI: [] 16 On board population [] 17 Diplomatic personnel 3. Type of building [] 1 Conventional building (apartments, houses) [] 2 Other type of inhabited construction - end questionnaire here [] 3 On board population - reserved to INE officers [] 4 Diplomatic personnel - reserved to INE officers Questions no. 1 to 3, inclusive, are completed by the Census Enumerator.

3. Occupation status [Question 3 was asked of persons living in housing units, according to question 2] [] 1 Usual residence [] 2 Seasonal or secondary use - end questionnaire here [] Vacant: end questionnaire here [] 3 For sale [] 4 For rent [] 5 For demolition [] 6 Other cases Questions no. 1 to 3, inclusive, are completed by the Census Enumerator.

3. Occupation status [Question 3 was asked of persons living in housing units, according to question 2] [] 1 Usual residence [] 2 Seasonal or secondary use - end questionnaire here [] Vacant: end questionnaire here [] 3 For sale [] 4 For rent [] 5 For demolition [] 6 Other cases Questions no. 1 to 3, inclusive, are completed by the Census Enumerator.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] [Questions 11-18 were asked of persons living in a conventional dwelling as the place of their usual residence, according to questions 2, 3] 15. If you are a tenant, please indicate the form lease: [Question 15 was asked of persons living in a conventional dwelling as the place of their usual residence, but not owning it, according to questions 2, 3.] Rented dwelling with a: [] 1 Contract for 3 or 5 years [] 2 Contract without term [] 3 Social rent contract [] 4 Sub-rented dwelling - go to 17 [] 5 Other situation (granted, etc) - go to 18 Question 15 - If you are a tenant, please indicate the form of lease: This question is only for occupants who are not owners or co-owners of the respective dwellings. 3- or 5-year fixed-term contract - a contract in which at the end of the term (3 or 5 years), the amount of the rent may be renegotiated by the parties. If the parties fail to come to an agreement, the contract lapses and the tenant is required to leave the dwelling. Renewable contract of indefinite duration - a contract which is automatically renewed and only terminates if the tenant wishes to leave the dwelling. Council or subsidized rent contract - a contract in which the tenant is a public body and in which the amount of the rent was reduced in view of the need for social aid by the household. If the dwelling is let to an individual who, in turn, lets it to a third person through payment of a rent, the dwelling is said to be sublet. Cases involving the voluntary conveyance of the dwelling, (for example: a father owns a dwelling and transfers it free of charge to his son), as well as cases in which the occupancy of the dwelling is usually associated with a contract in which consideration is either directly or indirectly assigned to it, subject to the performance of a task (for example: doormen, watchmen, etc.), should be included under other situations.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] [Questions 11-18 were asked of persons living in a conventional dwelling as the place of their usual residence, according to questions 2, 3] 18. Dwelling ownership: [Question 18 was asked of persons living in a conventional dwelling as the place of their usual residence, but not owning it, according to questions 2, 3.] [] 1 Ascendants or descendants [] 2 Private owner or private company [] 3 State, public corporations, social security or other non-profit institutions [] 4 Public company [] 5 Local authority [] 6 Housing association Question 18 - Dwelling ownership: If the occupant is the owner or co- owner of the dwelling, do not answer this question. First or second-generation ascendants or descendants - parents, children, grandparents or grandchildren.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] [Questions 11-18 were asked of persons living in a conventional dwelling as the place of their usual residence, according to questions 2, 3] Questions 13 and 14 are only for owner-occupied dwellings. If no household member is owner of the dwelling go to question 15. 13. Do you have a mortgage or loan resulting from the purchase of this dwelling: [Question 13 was asked of persons living in a conventional dwelling as the place of their usual residence and owning it, according to questions 2, 3.] [] 1 Yes [] 3 No - end questionnaire here Question 13 - Do you have mortgage or loan resulting from the purchase of this dwelling ? The owner-occupier of the dwelling pays financial charges resulting from the purchase of the dwelling, when: The dwelling is built for purchase and is acquired through a welfare fund or other institution, a situation whereby individuals have the right to occupy the dwelling by virtue of a sum paid over a certain period of time, usually fifteen to twenty years, at the end of which they become the owners of the dwelling; The dwelling is the property of people who occupy it and purchased it through a bank loan or other financial arrangements not completely paid; here the individual immediately becomes the owner of the dwelling, although the dwelling is generally mortgaged as collateral for the loan, with the financial charges consisting of the payment of principal and interest due. Thus, the monthly payment will include the repayment of principal and interest due. Any other type of housing charges, such as charges on home improvement loans should Not be considered. Tick "No" if the dwelling is free from encumbrance or charges, regardless of how the owner acquired it (purchase, inheritance or other). This charge must refer to the month immediately preceding the census moment.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] 5. Does the housing unit have electricity? [] 1 Yes [] 3 No Question 5 - Does the dwelling have electricity? Tick Yes if you have electrical power installed in your dwelling, whatever the source.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] 6. Water supply system: Piped water available in the housing unit: [] 1 From a community scheme [] 2 From a private source [] 3 Piped water available within the building but outside the housing unit No piped water available but providing from: [] 4 Public drinking fountain [] 5 Well, private hole [] 6 Other Question 6 - Water supply system: When the kitchen and/or bathroom are located in a building separate from the dwelling (in the yard, etc.), which has piped water, the dwelling is considered as having inside water. When the dwelling has piped running water outside (yard, etc.) but not in any of the rooms comprising it (kitchen, water closet or bathroom), it will be considered as having running water in the building, but outside the dwelling. When there is no piped water in the dwelling or in the building and the household resorts to other supply sources, various alternative sources may be used. In this case, the source which is most frequently used to obtain water for cooking and hygiene should be considered.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] 7. Toilet facilities: With toilet within the housing unit for exclusive use: [] 1 Flush toilet [] 2 No flush toilet With toilet within the building but outside of the housing unit for shared use [] 3 Flush toilet [] 4 No flush toilet [] 5 No toilet available Question 7 - Toilet facilities: By flush toilet, we mean the flushing mechanism, flow meter, etc., in other words, the mechanical system for discharging water inside the lavatory cistern.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] 8. Bathing facilities: [] 1 Housing unit with fixed bath or shower [] 3 Housing unit without fixed bath or shower Question 8 - Bathing facilities: Bath or shower means any installation permanently connected to a water supply system and to a drainage system enabling the evacuation of used bath water to the exterior of the dwelling. Do not consider the mere existence of a washbasin as constituting a bath or shower (whether connected to a drainage system or not), even when located in a room separate from the dwelling, or a makeshift installation in suspended recipients, which, filled manually, are used as a shower

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] 9. Sewage disposal system: [] Housing unit with sewage disposal system: [] 1 Connected to a public sewage disposal plant [] 2 Connected to a private sewage disposal plant (septic tank, etc.) [] 3 Other arrangements [] 4 Housing unit without sewage disposal system Question 9 - Sewage disposal system: Sewage disposal system means the entire permanent installation permitting the evacuation of wastewater from the dwelling to the exterior. Public sewage system means the drainage system (for example in a city), which collects all the waste and channels it along a specific path. Septic tank is a specially structured receptacle enabling certain processes of disinfection, which, by means of a suitable pipeline, receives wastewater from one or a small number of dwellings.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] [Questions 11-18 were asked of persons living in a conventional dwelling as the place of their usual residence, according to questions 2, 3] 11. Availability of kitchen: Kitchen with: [] 1 Less than 4 square meters [] 2 4 square meters or more [] 3 Kitchenette [] 4 Without kitchen or kitchenette Question 11 - Availability of kitchen: Kitchen means the place designed and equipped for making meals, and which is in fact used for this purpose, even if it is also used as a dining room, bedroom or living room. The kitchen may be separated from the dwelling (in the yard for example). Kitchenette means a small space within a room, separated usually by a small counter or similar, designed for preparing food. This situation is found mainly in urban zones and in smaller flats. In dwellings with a kitchen, it is necessary to consider the size of the kitchen since it is classified according to whether it has an area of more than 4 m2 or less than 4 m2.

[Questions 4-18 were asked of persons living in housing units as the place of their usual residence, according to question 3] 10. Type of heating: [] 1 Central heating No central heating: [] 2 Fireplace [] 3 Fixed equipment (in the wall, stove, etc.) [] 4 Mobile equipment (electric heater, gas, etc.) [] 5 Without heating Question 10 - Type of heating: If there is more than one heating system, indicate the one used most frequently whenever it becomes necessary.