Translated from Latvian LATVIJAS REPUBLIKAS CENTRĀLĀ STATISTIKAS PĀRVALDE Lāčplēša iela 1, Rīga, Latvija, LV-1301, fakss: 67366658, www.csb.gov.lv POPULATION AND HOUSING CENSUS 2011 PERSON QUESTIONNAIRE TS 2011-persona 06.11.2006. Ministru kabineta noteikumu Nr. 922 pielikums Nr. 193 VSPARK 10506003 C01 Household number |___|___|___|___|___|___|___|___|___| Sequence No of the household member 1st person 2nd person 3rd person 4th person ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ____________________ ____________________ ____________________ ____________________ Name, surname C03 C04 Identity No |__|__|__|__|__|__| |__|__|__|__|__|__| |__|__|__|__|__|__| |__|__|__|__|__|__| C04 C05 |__|__|__|__|__| |__|__|__|__|__| |__|__|__|__|__| |__|__|__|__|__| |__| |__| |__| |__| C06 What is your C06 country of birth? ________________ ________________ ________________ ________________ C07 Country name ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ |__| |__| |__| C09 |__| |__| |__| C10 |__| |__| |__| C11 Sex C05 1. Male 2. Female What is your country of C07 citizenship? Country name C08 What kind of citizenship do you have? 1. Citizen C08 2. Non-citizen 3. Refugee 4. Stateless |__| What is your legal marital status? 1. Single C09 2. Married 3. Divorced 4. Widowed |__| Relationship to the reference person C10 1. Reference person 2. Spouse 3. Cohabiting partner 4. Child 5. Brother or sister 6. Mother or father 7. Grandchild 8. Other relative 9. Other persons, not relative |_1_| Sequence number of the person’s spouse, cohabiting partner, father and mother in the list of household members (C03) A. Spouse C11 B. Cohabiting partner C. Father D. Mother |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |__|__| C12 Sequence No of the household member 1st person 2nd person 3rd person 4th person What is your usual place of residence? Questions C12 and C13 are asked only to the persons on the list of household members of the Housing questionnaire C12 who have answered 4 -„guest” in column „status”. 1. This dwelling 2. Other place in Latvia 3. I have no usual place of residence |__| |__| |__| 1. D01 2. C13 3. D01 |__| Address of the usual place of residence, if it differs from the residence where the interview takes place Address (name of street/house, house number, block number, flat number, county city/pagasts/parish, city under state jurisdiction/county) and CATTU code C13 1st person |__|__|__|__|__|__|__| 2nd person |__|__|__|__|__|__|__| 3 rd person D01 |__|__|__|__|__|__|__| 4th person |__|__|__|__|__|__|__| What is your current status of economic activity? (Persons aged 15 and over are answering to this question) 1. Employed 2. Unemployed 1.D03 2.D02 3. Unemployed pensioner 3. 4. D01 4. Resident earning from property or investments |__| |__| |__| |__| E01 5. Unemployed student/pupil 5. 6. Housekeeper 7. Other 6. 7. Have you ever had job or occupation? (Persons aged 15 and over are answering to this question) D02 1. Yes 2. No |__| |__| |__| |__| 1.D03 2.E01 What is/was your employment status in the main job? (Persons aged 15 and over are answering to this question) 1. Employee D03 2. Employer 3. Self-employed 4. Unpaid family worker |__| |__| |__| |__| D04 In which country your main job is/was located? (Persons aged 15 and over are answering to this question) D04 1. Latvia 2. Abroad (Country name) |__| |__| |__| |__| ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ 1.D05 2.D06 City under state jurisdiction or county where local unit of your main job is/was located and what is/was name of it? (Persons aged 15 and over are answering to this question) Location of main job local unit – city under state jurisdiction (Riga, Daugavpils, Jelgava, Jēkabpils, Jūrmala, Liepāja, Rēzekne, Valmiera, Ventspils) or county - and name D05 1st person 2nd person D06 3rd person 4th person 2 What is/was economic activity (industry) of local unit of your main job? (Persons aged 15 and over are answering to this question)Kind of economic activity and two digits of NACE Rev. 2 1st person |__|__| D06 2nd person |__|__| rd |__|__| 3 person 4th person Sequence No of the household member What is/was your occupation in the D07 main job? (Persons aged 15 and over are answering to this question) Four digit code of the occupation group D07 |__|__| st 1 person 2 nd person 3 rd person 4 th person ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__| E01 What is your highest level of education successfully completed? (Persons aged 7 and over are answering to this question) E01 1. Doctorate degree 2. Highest education 3. Professional secondary education after secondary school 4. Vocational education or professional secondary education after basic education 5. General secondary education after basic education or vocational education 6. Basic education or professional basic education 7. Primary education 8. Without formal education or less than primary education 9. Cannot read or write 1. 2. 3. 4. F01 |__| |__| |__| |__| 6. 7. 8. E02 9. Do you attend school? (Persons aged 7 to 17 years without basic education are answering to this question) E02 1. Yes 2. No 5. |__| |__| |__| |__| 1.F01 2.E03 |__| |__| F01 Specify the reasons why you are not attending school! 1. Due to heath conditions E03 2. Due to material conditions 3. Other reason |__| |__| Have you ever permanently lived abroad for more than 12 months during the time period from 1980? F01 1. Yes 1.F02 |__| |__| |__| |__| 2. No 2.F03 When did you last time returned/came to Latvia for permanent residence? F02 Year Month (should be specified only if person returned in |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__| |__|__| |__|__| |__|__| F03 2010, 2011) Did you live in the same place of residence a year ago (March 1, 2010)? 1. 1. Yes, in the same dwelling F03 2. Yes, in the same city under state jurisdiction/county 3. No G01 |__| |__| |__| |__| 2. 3.F04 3 Sequence No of the household member 1st person 2nd person 3rd person 4th person |__| |__| |__| |__| 1.F05 2.F06 ________________ ________________ ________________ ________________ G01 ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ F04 Where did you live on March 1, 2010? 1. In Latvia 2. Abroad If country of residence is Latvia, specify city under state jurisdiction or county. F05 City under state jurisdiction (Riga, Daugavpils, Jēkabpils, Jelgava, Jūrmala, Liepāja, Rēzekne, Valmiera, Ventspils) or county If person lived F06 abroad, specify country name. G01 What is your ethnicity? G01 G02 What is the main language you use at home? G02 1. Latvian 2. Russian 3. Byelorussian 4. Ukrainian 5. Polish 6. Lithuanian 7. Other language (specify which) |__| ________________ |__| ________________ |__| |__| ________________ ________________ G03 Do you use Latgalian, subtype of Latvian language, on a daily basis? H02 G03 1. Yes 2. No |__| |__| |__| Thank you for your cooperation! 4 |__| (to reference person) End of interview (to other persons)
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