Survey Text

1980
1979
top
1980
Survey form view entire document:  text  image
Complete 1a and b from household composition items, if not clear, ask:
1a. Is -- related to any persons now living in this household?
[] 1 Y
[] 2 N (2)

b. Is -- now living with --'s:

Mark all that apply:

1 [] Brother/sister
3 [] Parent
4 [] Spouse
7 [] Son/daughter
0 [] None of the above

2. How long has -- lived at this address? Enter number, then mark box

[] 1 Days
[] 2 Weeks
[] 3 Months
[] 4Years
Number ____ [Used for all responses]
If "3" years, ask:
Was it less than 3 years or more than 3 years?
RM2
1 [] 3+ years in 2 (RM3)
2 [] Less than 3 years in 2

c. How many people was -- living with at that time, not counting -- ?

[] 00 Lived alone (5)
Number ____

d. Were any of these people related to -- ?

[] 1 Y
[] 2 N (5)

e. Was -- living with -- 's:

Mark all that apply

1 [] Brother/sister
3 [] Parent
4 [] Spouse
7 [] Son/daughter
0 [] None of the above

top
1979
Survey form view entire document:  text  image
Complete 1a and b from household composition items, if not clear, ask:

1 a. Is -- related to any persons now living in this household?

1 [] Y
2 [] N (2)

b. Is -- now living with --'s:

(1) Brother or sister?
(3) Father or mother?
(5) (Husband/wife)?
(7) Son or daughter?
Mark all that apply
1 [] Sibling
3 [] Parent
5 [] Spouse
7 [] Child
0 [] None of the above

2. How long has -- lived at this address? Enter number, then mark box
If "3" years, ask:
Was it less than 3 years or more than 3 years?

Number ____
1 [] Days
2 [] Weeks
3 [] Months
4 [] Years

c. How many people was -- living with at that time, not counting --?

00 [] Live alone (5)
Number ____

d. Were any of these people related to --?

1 [] Y
2 [] N (5)

e. Was -- living with --'s:

(1) Brother or sister?
(3) Father or mother?
(5) (Husband/wife)?
(7) Son or daughter?
Mark all that apply
1 [] Sibling
3 [] Parent
5 [] Spouse
7 [] Child
0 [] None of the above