2016 Census of Population questions, short form

For Information only This is an electronic survey example for information purposes only. This is not a working questionnaire.

To reduce the burden on Canadians and to improve the quality of the data, Statistics Canada will not ask questions on income but rather use information already available from the Canada Revenue Agency.

Step A

  1. Step A - Question identifier 1: What is your telephone number?

    • 1: Area Code, Telephone Number
  2. Step A - Question identifier 2: What email address could we use to contact your household, if applicable?

    • 1: Email address
  3. Step A- Question identifier 3: What is the address of this dwelling?

    • 1: Number (and suffix, if applicable) (e.g., 302, 151 B, 16 1/2)
    • 2: Street name, street type (e.g., DR = Drive), direction (e.g., N = North)
    • 3: Apartment/unit
    • 4: City, municipality, town, village, Indian reserve
    • 5: Province/territory
    • 6: Postal code
  4. Step A - Question identifier 4: What is the mailing address of this dwelling, if different from above?

    • 1: Mailing address (e.g., Rural Route, PO Box, Lot and Concession or General Delivery)

Step B

Whom to include in step B

  • All persons who have their main residence at this address on May 10, 2016, including newborn babies, room-mates and persons who are temporarily away;
  • Canadian citizens, landed immigrants (permanent residents), persons asking for refugee status (refugee claimants), persons from another country with a work or study permit and family members living here with them;
  • Persons staying at this address temporarily on May 10, 2016 who have no main residence elsewhere.

Where to include persons with more than one residence

  • Children in joint custody should be included in the home of the parent where they live most of the time. Children who spend equal time with each parent should be included in the home of the parent with whom they are staying on May 10, 2016.
  • Students who return to live with their parents during the year should be included at their parents' address, even if they live elsewhere while attending school or working at a summer job.
  • Spouses or common-law partners temporarily away who stay elsewhere while working or studying should be listed at the main residence of their family, if they return periodically.
  • Persons in an institution for less than six months (for example, in a home for the aged, a hospital or a prison) should be listed at their usual residence.

If this address is:

  • a secondary residence (for example, a cottage) for all persons who stayed here on May 10, 2016 (all these persons have their main residence elsewhere in Canada), mark this circle. Print your name, your telephone number and your main residence address. Do not answer other questions.
  • a dwelling occupied only by residents of another country visiting Canada (for example, on vacation or on a business trip), mark this circle. Print your name, your telephone number and your country of residence. Do not answer other questions.
  • the home of a government representative of another country (for example, an embassy or a high commission) and family members, mark this circle. Print our name, your telephone number and the country that you represent. Do not answer other questions.
  1. STEP B - Question identifier 1: Including yourself, how many persons usually live at this address on May 10, 2016?

    Include: all persons who have their main residence at this address, even if they are temporarily away. See the instructions (joint custody, students, landed immigrants, secondary residence, etc.).
    • 1: Number of Persons
  2. STEP B - Question identifier 2: Including yourself, list all persons who usually live here on May 10, 2016.

    Important: Begin the list with an adult followed, if applicable, by that person's spouse or common-law partner and by their children. Continue with all other persons who usually live at this address.
    • 1: Family Name(s); Given Name(s)

Step C

  1. STEP C - Question identifier 1: Did you leave anyone out of step B because you were not sure the person should be listed? For example, a student, a child in joint custody, a person temporarily away, a person who lives here temporarily, a resident from another country with a work or study permit, a refugee claimant, etc.

    • 1: No
    • 2: Yes. Specify the name, the relationship and the reason.

Step D

  1. STEP D - Question identifier 1: Is anyone listed in step B a farm operator who produces at least one agricultural product intended for sale? For example, crops, livestock, milk, poultry, eggs, greenhouse or nursery products, Christmas trees, sod, honey, bees, maple syrup products, furs, etc.

    • 1: No. Go to Step E.
    • 2: Yes
  2. STEP D - Question identifier 2: Does this farm operator make the day-to-day management decisions related to the farm?

    • 1: No
    • 2: Yes

Step E

Copy the names in step B to question 1. Keep the same order.

If more than six persons live here, you will need an extra questionnaire.
  1. STEP E - Question identifier 1: Name.

    In the spaces provided, copy the names in the same order as in Step B. Then answer the following questions for each person.
    • 1: Family Name, Given Name

The following questions refer to each person's situation on May 10, 2016, unless otherwise specified.

  1. STEP E - Question identifier 2: What is this person's sex?

    • 1: Male
    • 2: Female
  2. STEP E - Question identifier 3: What are this person's date of birth and age?

    Example: Day 23 Month 02 Year 1974 Age 42

    If exact date is not known, enter best estimate.

    For children under the age of 1, enter 0.

    • 1: Day, Month, Year
    • 2: Age
  3. STEP E - Question identifier 4: What is this person's marital status?

    Mark one circle only.
    • 1: Never legally married
    • 2: Legally married (and not separated)
    • 3: Separated, but still legally married
    • 4: Divorced
    • 5: Widowed
  4. STEP E - Question identifier 5: Is this person living with a common-law partner?

    Common-law refers to two people who live together as a couple but who are not legally married to each other.
    • 1: Yes
    • 2: No
  5. STEP E - Question identifier 6: What is the relationship of this person to Person 1?

    If none of the responses in the list describes this person's relationship to Person 1, then specify a response under "Other relationship".
    • Person 1
      • 1: Person 1
    • Person 2
      • 1: Opposite-sex husband or wife of Person 1
      • 2: Opposite-sex common-law partner of Person 1
      • 3: Same-sex married spouse of Person 1
      • 4: Same-sex common-law partner of Person 1
      • 5: Son or daughter of Person 1 only
      • 6: Grandchild of Person 1
      • 7: Son-in-law or daughter-in-law of Person 1
      • 8: Father or mother of Person 1
      • 9: Father-in-law or mother-in-law of Person 1
      • 10: Brother or sister of Person 1
      • 11: Foster child
      • 12: Room-mate, lodger or boarder
      • 13: Other relationship — specify
    • Person 3-6
      • 1: Son or daughter of both Persons 1 and 2
      • 2: Son or daughter of Person 1 only
      • 3: Son or daughter of Person 2 only
      • 4: Grandchild of Person 1
      • 5: Son-in-law or daughter-in-law of Person 1
      • 6: Father or mother of Person 1
      • 7: Father-in-law or mother-in-law of Person 1
      • 8: Brother or sister of Person 1
      • 9: Foster child
      • 10: Room-mate, lodger or boarder
      • 11: Other relationship — specify
  6. STEP E - Question identifier 7: Can this person speak English or French well enough to conduct a conversation?

    Mark one circle only.
    • 1: English only
    • 2: French only
    • 3: Both English and French
    • 4: Neither English nor French
  7. STEP E - Question identifier 8: a) What language does this person speak most often at home?

    • 1: English
    • 2: French
    • 3: Other language — specify

    b) Does this person speak any other languages on a regular basis at home?

    • 1: No
    • 2: Yes, English
    • 3: Yes, French
    • 4: Yes, Other language — specify
  8. STEP E - Question identifier 9: What is the language that this person first learned at home in childhood and still understands?

    If this person no longer understands the first language learned, indicate the second language learned.
    • 1: English
    • 2: French
    • 3: Other language — specify

This question is for all persons listed on the questionnaire. If you are answering on behalf of other people, please consult each person.

  1. STEP E - Question identifier 10: Does this person agree to make his or her 2016 Census information available in 2108 (92 years after the census)?

    Only if you answer "Yes" will your responses be available to future generations and historical researchers, 92 years after the 2016 Census, in 2108.
    • 1: Yes
    • 2: No
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