The 1999 Population Census in the Republic of Kazakhstan CENSUS QUESTIONNAIRE 3C

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1111111111 samples of letters and numbers 1111111111111 Approved by the Committee Of Statistics and Analysis No 20 of 29.06.98 The 1999 Population Census in the Republic of Kazakhstan Enumerators and other census personnel are forbidden to disclose the content of responses to the census questionnaire CENSUS QUESTIONNAIRE 3C census division instructor enumeration the list of residents in the dwelling persons within the dwelling form within the portfolio Tick off an appropriate answer Name No 1. Relationship to person No 1 person no 1 in the household 1 wife, husband 1 daughter, son 1 mother, father 1 sister, brother 1 mother-in-law, father-in-law 1 daughter-in-law, son-in-law 1 grandmother, grandfather 1 granddaughter, grandson 1 other relation degree 1 non-relative 1 mother (father) 11 2. Sex male 1 female 1 3. Temporarily resident 1 absent 1 4. Date of birth day 11 month 11 year 111 completed years 1 5. Place of birth (specify region, country) 6. Citizenship Republic of Kazakhstan 1 without citizenship 1 111111111111111111 7. Nationality Kazakh 1 Russian 1 111111111111111111 8. National language fluent 1 not fluent 1 do not speak 1 study 1 Specify languages you speak fluently (other than the national language) 111111111111111111 111111111111111111 9. Marital status (15 years of age and over) never married 1 married 1 widowed 1 divorced, separated 1 no of spouse 11 10. Education (for persons aged 6 and over) primary general 1 basic general 1 secondary general 1 primary vocational 1 secondary specialized 1 incomplete higher 1 higher 1 holder of master s degree 1 for those having academic degree: candidate of science 1 doctor of science 1 If you do not have primary education, specify whether you can read and write: yes 1 no 1 11. Type of educational establishment you attend (for persons aged 6 and over) general educational institution 1

secondary specialized educational establishment 1 higher educational establishment 1 primary vocational educational institution 1 other school (course) 1 do not study 1 For children of preschool age specify whether they attend preschool establishment: yes 1 no 1 12. Sources of livelihood Paid employment: for enterprises, organizations and institutions 1 for peasant (farming) holding 1 for individuals 1 scholarship 1 pension 1 benefit (other than unemployment benefit) 1 unemployment benefit 1 other government support 1 property income 1 dependent 1 other source 1 13. Place of main activity a) name of enterprise, economic activity b) location of place of work: in the territory of this region 1 in other territory (region, country) 1 14. Main activity (duties and responsibilities) (occupation, post) Second activity: yes 1 no 1 Self-employment: for own peasant (farming) holding 1 for own enterprise 1 own account worker 1 for family enterprise, farm (without payment) 1 for personal subsidiary plot 1 15. Status in employment employee 1 member of producer s cooperative 1 employer 1 own-account-worker 1 unpaid family worker 1 16. For those aged 15 and over who do not have job or profitable activity specify whether they look for a job: yes 1 could you start working in the next 2 weeks? yes 1 no 1 17. Have you lived in this region since birth? yes 1 no 1 If no, specify for the period from 1989 through 1998: a) the year since you have permanently lived here 11 b) previous place of residence (region, country) c) which type of settlement did you come from: urban 1 rural 1 d) are you a refugee or a forced migrant? yes 1 no 1 no 1 specify the reason: have got a job and will start working in the next 2 weeks 1 have found a job and am waiting for a response 1 run the house (housekeeper, look after children, etc) 1 other reason 1

18. For women specify: a) children ever born 11 b) children surviving 11 3 CC

1111111111 samples of letters and numbers 1111111111111 Approved by the Committee Of Statistics and Analysis No 20 of 29.06.98 The 1999 Population Census in the Republic of Kazakhstan Enumerators and other census personnel are forbidden to disclose the content of responses to the census questionnaire CENSUS QUESTIONNAIRE 4И FOR A PERSON TEMPORARILY PRESENT IN THE TERRITORY OF KAZAKHSTAN census division instructor enumeration form within the portfolio Tick off an appropriate answer Address at the moment of census Region District Rural administration Settlement Avenue, street, by-street house No apt. No Avenue, street, by-street house No apt. No Name 1. Sex male 1 female 1 male 1 female 1 2. Date of birth day 11 month 11 year 111 day 11 month 11 year 111 3. Country of birth 11111111111111111 11111111111111111 4. Citizenship Republic of Kazakhstan 1 without citizenship 1 other countries 11111111111111 (specify) 5. Country of permanent residence Republic of Kazakhstan 1 without citizenship 1 other countries 11111111111111 (specify) 11111111111111111 11111111111111111 6. Nationality 11111111111111111 11111111111111111 7. Purpose of visit to Kazakhstan work for diplomatic, trade or other state organizations of own country 1 other work 1 business or other trip 1 training in educational institution 1 seeking asylum 1 transit migrant 1 other purposes 1 work for diplomatic, trade or other state organizations of own country 1 other work 1 business or other trip 1 training in educational institution 1 seeking asylum 1 transit migrant 1 other purposes 1 4ИИ

1111111111 samples of letters and numbers 1111111111111 Approved by the Committee The 1999 Population Census in the Republic of Kazakhstan Enumerators and other census Of Statistics and Analysis 2П personnel are forbidden to disclose No 20 of 29.06.98 the content of responses to the census questionnaire LIST OF RESIDENTS IN THE DWELLING AND THEIR HOUSING CONDITIONS No census division instructor enumeration the list of residents in the dwelling form within the portfolio Tick off an appropriate answer Region 11 Settlement 111111111111111111111111111111 District 11 Avenue, street, by-street 111111111111111111111111 Institution 11 house No 111 1 apt. No 111 I. List of residents in the dwelling No within the No within the Name dwelling household 11 11 11 11 11 11 11 II. Housing conditions Questions 1п 2п to be completed for the dwelling 1п. Type of dwelling detached house 1 boarding house for aged and invalids, children s part of detached house 1 home, etc. 1 separate flat 1 other institutions 1 shared communal flat 1 hotel 1 hostel 1 other living accommodation 1 homeless 1 2п. Availability of essential facilities in the dwelling the reference person (no 1) of the household within the dwelling 3п. Who is the owner of the dwelling electricity 1 central hot water supply 1 floor electric cooker 1 hot water from individual boiler 1 piped gas 1 piped water. 1 bottled condensed gas 1 flush toilet 1 central or heating 1 bath or shower 1 heating from individual installation 1 no specified facilities 1 Questions 3п 5п to be completed for the household 11 11 11 persons in the household 1 state 1 other ownership 1 rented from individuals 1 4п. Number of occupied living rooms 5п. Floor space (m 2 ) a) usable 111 b) living 111 persons in the household 1 state 1 other ownership 1 rented from individuals 1 persons in the household 1 state 1 other ownership 1 rented from individuals 1 11 part of room 1 11 part of room 1 11 part of room 1 a) usable 111 b) living 111 a) usable 111 b) living 111 2ПП University of Minnesota Population Center, IPUMS-International, National Science Foundation Grant SBR-9908380. Translation by Inna Popova, Minsk, Belarus. December, 2002