Person number (within household)

Sequence number of the nucleus inside of the family

1. Reference Number [pre-numbered] 2. Reference person's complete name (first and last name to all other persons): ____

4. Spouse/partner's reference number _ _

5. Father's reference number _ _

6. Mother's reference number _ _

Family type

3. Relationship to household's reference person [Codes to be used in the relationship description:] [] 01 Reference person [] 02 Spouse [] 03 Son/daughter not married [] 04 Son/daughter married [] 05 Foster son/daughter not married [] 06 Foster son/daughter married [] 07 Stepson/stepdaughter not married [] 08 Stepson/stepdaughter married [] 09 Father or Mother [] 10 Father-in-law or mother-in-law [] 11 Daughter-in-law or son-in-law [] 12 Brother or sister [] 13 Grandson or granddaughter/great-grandson or great-granddaughter [] 14 Grandfather or grandmother / Great-grandfather or great-grandmother [] 15 Other relative person [] 16 Domestic servant [] 17 Other

2. Sex [] 1 Male [] 3 Female

[Questions 3.1-21 were asked of persons who consider this living quarter their usual place of residence, according to question 3] 4. Date of birth: Day _ _ Month _ _ Year _ _ _ _

[Questions 3.1-21 were asked of persons who consider this living quarter their usual place of residence, according to question 3] 5. Marital Status: [] 1 Single [] 2 Married: with register [] 3 Married: without register [] 4 Widowed [] 5 Separated [] 6 Divorced Question 5 - Marital status The actual situation should always be indicated, independently of whether it coincides with the legal situation. For example: If you are divorced but at the census moment you are living with another person without legal marriage, you should tick "Married without register".

[Questions 3.1-21 were asked of persons who consider this living quarter their usual place of residence, according to question 3] 8. Do you have any disability? [] 1 No - Go to 9 [] Yes, indicate type: [] 2 Hearing [] 3 Visual [] 4 Physical [] 5 Mental [] 6 Cerebral palsy [] 7 Other Question 8 - Do have any disability? Physiological or anatomic function. This question only applies to persons with a permanent disability. If you have a temporary disability (for example, if you use crutches or a wheel chair because you broke your leg or if you suffer from a partial detachment of the retina which forces you to wear an eye patch), the answer is "No". Hearing - Complete or significant loss of hearing. This includes individuals with a complete or significant loss of the ability to hear a conversation spoken in a normal voice and who have to resort to sight to communicate; this also includes individuals who, under the above conditions, can hear with the help of a hearing aid. Visual - Complete or significant loss of sight. This includes persons who are unable to or experience extreme difficulty in performing tasks requiring distance or peripheral vision or in performing fine detail tasks such as reading, writing, distinguishing TV images at a distance of 2 meters, see the time on a wristwatch or recognize faces, even when wearing glasses or contact lenses. Not included are individuals who, wearing glasses or contact lenses, are capable of performing the above tasks. Physical - Disability characterized by the difficulty or impossibility of performing activities requiring control of movement or the ability to manipulate objects. Included in this group are individuals who find it impossible or extremely difficult to walk or handle objects without the aid of an assistant device (for example, a wheel chair, walker, crutches, prostheses and orthoses for the members or trunk). Included in this group are individuals in the conditions referred to above and who suffer from, for example, ankylosing spondylitis, spina bifida, poliomyelitis, multiple sclerosis, muscular dystrophy, paramyloidosis (Wohlvill-Corino Andrade syndrome), cranio-encephalic trauma. Mental - Intellectual and psychological disability. Included in this group are persons suffering from mild, moderate or severe mental retardation or other development problems characterized by a significantly lower-than average intellectual ability, such as autism or Down's syndrome (mongolism). It does not include psychotic or serious, degenerative diseases coming under the general classification of psychiatric disorders. Cerebral palsy - Brain damage causing paralysis and affecting movement and posture. Individuals with cerebral palsy display limited, uncoordinated and uncontrolled movements, difficulty in maintaining their balance, problems of co-ordination and speech. Individuals suffering from cerebral palsy should be mentioned in this group and not in the group for motor impairment. Other - Disabilities not included in any of those mentioned above. By way of example, persons suffering from kidney failure, hemophilia, lupus, aphasia, dyslexia, mute, speech disorders, ostomates, deaf -blind. If you have more than one disability, state the main one, that is, the one causing you the greatest degree of incapacity.

[Questions 10-24 were asked of persons born before December 31, 1999, who consider this living quarter their usual place of residence, according to questions 3 and 9] 24. What is your religion? [Question 24 was asked of persons age 15+ who ever attended school at a level higher then pre-primary, and consider this living quarter their usual place of residence, according to questions 3, 13, and 19] [] 1 Catholic [] 2 Orthodox [] 3 Protestant [] 4 Other Christian [] 5 Jewish [] 6 Muslim [] 7 Other non-Christian [] 8 Without religion

[Questions 3.1-21 were asked of persons who consider this living quarter their usual place of residence, according to question 3] 11. Literacy: If you just write numbers or your name; only read out do not write, or just read and write only memorized sentences, then indicate "Not able to read and write" [] 1 Able to read and write [] 3 Not able to read and write Question 11 - Literacy Able to read and write - you can read and write, even if it is difficult for you, if you are able to read a newspaper and write sentences. Not able to read and write - if you are unable to read and write sentences, even simple sentences, and understand their content. If you can only write your name, numbers, read but not write or read and write memorized sentences, you are not considered as being able to read and write.

[Questions 3.1-21 were asked of persons who consider this living quarter their usual place of residence, according to question 3] 12. Are you attending or have you ever attended school? [] 1 No, never attended - Go to 16 [] 3 Attending [] 5 Attended, but no more Question 12 - Are you attending or have you ever attended school? No, never attended - you have never regularly attended classes in an educational establishment. Usually, this situation refers to persons who have never enrolled in an educational establishment, although they may be able to read and write. It also applies to children who have not reached school age and who are not attending pre-school classes. Attending - to tick this box, it is not enough to be enrolled, it is necessary to regularly attend classes. You must also tick this response for children in pre-school education. Attending vocational programs will be considered here whenever the program attended is equivalent to a level of public education. Attended, but no more - whoever no longer attends classes, that is, whoever is no longer enrolled because they have finished their studies or have dropped out of school.