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CONFIDENTIAL WHEN COMPLETED
2. |
Print your telephone number: |
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Area code |
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Telephone number |
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3. |
Complete this section if there is no printed address in the address space above or if you lived at a different address on May 16, 2006. |
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No. and street or lot and concession |
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Apt. No. |
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City, municipality, town, village, Indian reserve |
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Province / territory |
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Postal code |
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_______ _______ |
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EVERYONE WHO USUALLY LIVES HERE, AT THIS ADDRESS, including newborn babies and room-mates;
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;
CHILDREN IN JOINT CUSTODY who live here most of the time. Children who spend equal time with each parent should be included in the home of the parent where they are staying on May 16, 2006;
SPOUSES OR COMMON-LAW PARTNERS WHO LIVE ELSEWHERE while working or studying, but who return here periodically;
LANDED IMMIGRANTS who usually live at this address;
Persons claiming REFUGEE STATUS and family members living here with them;
PERSONS FROM ANOTHER COUNTRY WITH A WORK OR STUDY PERMIT and family members living here with them;
PERSONS who usually live here but are now IN AN INSTITUTION (such as a home for the aged, a hospital or a prison), IF THEY HAVE BEEN THERE LESS THAN SIX MONTHS;
PERSONS staying here on May 16, 2006, WHO HAVE NO USUAL HOME ELSEWHERE.
Persons who have their usual home at another address in Canada and who are staying here temporarily (for example, persons visiting or persons who have their secondary residence here, at this address);
Residents of another country visiting Canada (for example, on a business trip or on vacation);
Government representatives of another country and their family members.
3. |
IF THERE IS NO ONE TO INCLUDE IN STEP B |
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If all persons staying at this address on May 16, 2006, usually live elsewhere in Canada or are visitors or government representatives of another country, mark this circle. Please print your name and your usual telephone number below. Do not complete this questionnaire. Mail it in the enclosed postage-paid envelope. |
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Family Name Given Name |
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Area code |
Telephone number |
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1. |
Including yourself, how many persons usually live here, at this address, as of May 16, 2006? Include all persons who usually live here, even if they are temporarily away. |
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2. |
Including yourself, list below, using CAPITAL LETTERS, all persons who usually live here. Begin the list with an adult followed, if applicable, by that person's spouse or common-law partner and by their children who usually live here. Continue with all other persons who usually live here. |
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FAMILY NAME |
GIVEN NAME |
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Person 1 |
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Person 2 |
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Person 3 |
__________________________________________ |
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Person 4 |
__________________________________________ |
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Person 5 |
__________________________________________ |
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Person 6 |
__________________________________________ |
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Person 7 |
__________________________________________ |
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Person 8 |
__________________________________________ |
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Person 9 |
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Person 10 |
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Did you leave anyone out of Step B because you were not sure the person should be listed? |
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For example:
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No |
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Yes |
Specify the name, the relationship and the reason. |
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Name(s) |
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______________________________ |
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Relationship / Reason |
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______________________________ |
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1. |
Is anyone listed in Step B a farm operator who produces at least one agricultural product intended for sale? (crops, livestock, milk, poultry, eggs, greenhouse or nursery products, Christmas trees, sod, honey, bees, maple syrup products, furs, etc.) |
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No |
Go to Step E |
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Yes |
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2. |
Does this farm operator make the day-to-day management decisions related to the farm? |
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No |
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Yes |
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Copy the names in Step B to Question 1, on top of page 4.
Keep the same order.
1. |
NAME |
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In the spaces provided, copy the names in the same order as in Step B. Then answer the following questions for each person. |
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PERSON 1 |
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Family Name |
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______________________________ |
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Given Name |
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______________________________ |
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2. |
SEX |
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Male |
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Female |
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3. |
DATE OF BIRTH |
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Day |
Month |
Year |
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Example : |
1 3 |
0 2 |
1 9 5 0 |
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If exact date is not known, enter best estimate. |
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Date of birth |
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Day |
Month |
Year |
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_____ ______ |
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4. |
MARITAL STATUS |
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Mark one circle only. |
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Never legally married (single) |
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Legally married (and not separated) |
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Separated, but still legally married |
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Divorced |
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Widowed |
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5. |
Is this person living with a common-law partner? Common-law refers to two people of the opposite sex or of the same sex who live together as a couple but who are not legally married to each other. |
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Yes |
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No |
For each person usually living here, describe his/her relationship to Person 1. |
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Mark or specify one response only. |
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Stepchildren, adopted children and children of a common-law partner should be considered sons and daughters. |
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If none of the choices apply, use the "Other" box to indicate this person's relationship to Person 1. |
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Examples of "Other" relationships to Person 1: |
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PERSON 1 |
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PERSON 1 |
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PERSON 2 |
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Husband or wife of Person 1 |
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Opposite-sex common-law partner of Person 1 |
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Same-sex common-law partner of Person 1 |
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Son or daughter of Person 1 |
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Son-in-law or daughter-in-law of Person 1 |
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Grandchild of Person 1 |
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Father or mother of Person 1 |
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Father-in-law or mother-in-law of Person 1 |
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Grandparent of Person 1 |
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Brother or sister of Person 1 |
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Brother-in-law or sister-in-law of Person 1 |
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Lodger or boarder |
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Room-mate |
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Other— Specify |
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______________________________ |
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______________________________ |
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ACTIVITIES OF DAILY LIVING
7. |
Does this person have any difficulty hearing, seeing, communicating, walking, climbing stairs, bending, learning or doing any similar activities? |
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Yes, sometimes |
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Yes, often |
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No |
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8. |
Does a physical condition or mental condition or health problem reduce the amount or the kind of activity this person can do: |
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(a) |
at home? |
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Yes, sometimes |
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Yes, often |
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No |
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(b) |
at work or at school? |
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Yes, sometimes |
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Yes, often |
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No |
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Not applicable |
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(c) |
in other activities, for example, transportation or leisure? |
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Yes, sometimes |
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Yes, often |
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No |
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SOCIOCULTURAL INFORMATION
9. |
Where was this person born? |
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Born in Canada |
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Nfld.Lab. |
Manitoba |
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P.E.I. |
Sask. |
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N.S. |
Alberta |
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N.B. |
B.C. |
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Quebec |
Yukon |
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Ontario |
N.W.T. |
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Nunavut |
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Born outside Canada |
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10. |
Of what country is this person a citizen? |
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Canada, by birth |
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Canada, by naturalization |
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Other country — Specify |
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______________________________ |
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11. |
Is this person now, or has this person ever been, a landed immigrant? A "landed immigrant" (permanent resident) is a person who has been granted the right to live in Canada permanently by immigration authorities. |
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No |
Go to Question 13 |
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Yes |
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12. |
In what year did this person first become a landed immigrant? |
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Year |
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If exact year is not known, enter best estimate. |
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13. |
Can this person speak English or French well enough to conduct a conversation? |
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Mark one circle only. |
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English only |
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French only |
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Both English and French |
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Neither English nor French |
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14. |
What language(s), other than English or French, can this person speak well enough to conduct a conversation? |
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None |
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OR |
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Specify other language(s) |
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______________________________ |
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______________________________ |
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15. |
(a) |
What language does this person speak most often at home? |
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English |
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French |
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Other — Specify |
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______________________________ |
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(b) |
Does this person speak any other languages on a regular basis at home? |
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No |
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Yes, English |
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Yes, French |
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Yes, Other — Specify |
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______________________________ |
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16. |
What is the language that this person first learned at home in childhood and still understands? |
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If this person no longer understands the first language learned, indicate the second language learned. |
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English |
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French |
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Other — Specify |
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______________________________ |
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The census has collected information on the ancestral origins of the population for over 100 years to capture the composition of Canada's diverse population. |
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17. |
What were the ethnic or cultural origins of this person's ancestors? |
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An ancestor is usually more distant than a grandparent. |
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For example, Canadian, English, French, Chinese, Italian, German, Scottish, East Indian, Irish, Cree, Mi'kmaq (Micmac), Métis, Inuit (Eskimo), Ukrainian, Dutch, Filipino, Polish, Portuguese, Jewish, Greek, Jamaican, Vietnamese, Lebanese, Chilean, Salvadorean, Somali, etc. |
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Specify as many origins as applicable using capital letters. |
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______________________________ |
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______________________________ |
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______________________________ |
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______________________________ |
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18. |
Is this person an Aboriginal person, that is, North American Indian, Métis or Inuit (Eskimo)? |
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If "Yes", mark the circle(s) that best describe(s) this person now. |
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No |
Continue with the next question |
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Yes, North American Indian |
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Yes, Métis |
Go to Question 20 |
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Yes, Inuit (Eskimo) |
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19. |
Is this person: |
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Mark more than one or specify, if applicable. |
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This information is collected to support programs that promote equal opportunity for everyone to share in the social, cultural and economic life of Canada. |
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White |
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Chinese |
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South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.) |
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Black |
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Filipino |
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Latin American |
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Southeast Asian (e.g., Vietnamese, Cambodian, Malaysian, Laotian, etc.) |
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Arab |
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West Asian (e.g., Iranian, Afghan, etc.) |
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Korean |
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Japanese |
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Other — Specify |
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______________________________ |
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20. |
Is this person a member of an Indian band/First Nation? |
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No |
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Yes, member of an Indian band/First Nation |
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Specify Indian band/First Nation (for example, Musqueam) |
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21. |
Is this person a Treaty Indian or a Registered Indian as defined by the Indian Act of Canada? |
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No |
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Yes, Treaty Indian or Registered Indian |
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MOBILITY
23. |
Where did this person live 1 year ago, that is, on May 16, 2005? |
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Mark one circle only. |
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Note: |
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For those who mark the third circle: |
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Please give the name of the city or town rather than the metropolitan area of which it is a part. |
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For example: |
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Lived at the same address as now |
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Lived at a different address in the same city, town, village, township, municipality or Indian reserve |
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Lived in a different city, town, village, township, municipality or Indian reserve in Canada |
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Specify name of: |
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City, town, village, township, municipality or Indian reserve |
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______________________________ |
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______________________________ |
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Province / territory |
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______________________________ |
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Postal code |
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______ ______ |
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Lived outside Canada |
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Specify name of country |
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______________________________ |
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24. |
Where did this person live 5 years ago, that is, on May 16, 2001? |
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Mark one circle only. |
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Note: |
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For those who mark the third circle: |
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Please give the name of the city or town rather than the metropolitan area of which it is a part. |
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For example: |
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Lived at the same address as now |
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Lived at a different address in the same city, town, village, township, municipality or Indian reserve |
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Lived in a different city, town, village, township, municipality or Indian reserve in Canada |
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Specify name of: |
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City, town, village, township, municipality or Indian reserve |
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______________________________ |
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______________________________ |
|||
|
|
|
|
|
|
Province / territory |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
Postal code |
|||
|
|
|
|
|
|
______ ______ |
|||
|
|
|
|
|
|
Lived outside Canada |
|||
|
|
|
|
|
|
Specify name of country |
|||
|
|
|||
|
______________________________ |
|||
|
|
|
|
|
25. |
Where was each of this person's parents born? |
|||
|
|
|
|
|
|
(a) |
Father |
||
|
|
|
|
|
|
Mark or specify country according to present boundaries. |
|||
|
|
|
|
|
Father |
||||
|
|
|
|
|
Born in Canada |
||||
|
|
|
|
|
|
Born outside Canada |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
(b) |
Mother |
|
|
|
|
|
|
|
|
Mark or specify country according to present boundaries. |
|||
|
|
|
|
|
Mother |
||||
|
|
|
|
|
Born in Canada |
|
|
||
|
|
|
|
|
|
Born outside Canada |
|
|
|
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
26. |
Has this person completed a secondary (high) school diploma or equivalent? |
|||
|
|
|
|
|
|
Examples of secondary (high) school equivalency certificates are General Educational Development (GED) and Adult Basic Education (ABE). |
|||
|
|
|
|
|
|
Secondary (high) school diploma or certificate |
|||
|
|
|
|
|
|
Yes, secondary (high) school diploma |
|||
|
|
|
|
|
|
Yes, secondary (high) school equivalency certificate |
|||
|
|
|
|
|
|
No |
|||
|
|
|
|
|
27. |
Has this person completed a Registered Apprenticeship or other trades certificate or diploma? |
|||
|
|
|
|
|
|
Mark as many circles as applicable. |
|||
|
|
|
|
|
|
For example: |
|||
|
|
|
|
|
|
Registered Apprenticeship or trades certificate or diploma |
|||
|
|
|
||
|
Yes, Registered Apprenticeship certificate |
|||
|
|
|
|
|
|
Yes, other trades certificate or diploma |
|||
|
|
|
|
|
|
No |
|||
|
|
|
|
|
Has this person completed a college, CEGEP, or other non-university certificate or diploma? |
||||
|
|
|
|
|
|
Mark as many circles as applicable. |
|||
|
|
|
|
|
|
For example: |
|||
|
|
|
|
|
|
College, CEGEP and other non-university certificate or diploma |
|||
|
|
|
||
|
Yes, certificate or diploma from a program of less than 3 months |
|||
|
|
|
|
|
|
Yes, certificate or diploma from a program of 3 months to less than 1 year |
|||
|
|
|
|
|
|
Yes, certificate or diploma from a program of 1 to 2 years |
|||
|
|
|
||
|
Yes, certificate or diploma from a program of more than 2 years |
|||
|
|
|
||
|
No |
|||
|
|
|
|
|
29. |
Has this person completed a university degree, certificate or diploma? |
|||
|
|
|
|
|
|
Mark as many circles as applicable. |
|||
|
|
|
|
|
|
University degree, certificate or diploma |
|||
|
|
|
||
|
Yes, certificate or diploma below bachelor level |
|||
|
|
|
|
|
|
Yes, bachelor's degree (including LL.B.) |
|||
|
|
|
|
|
|
Yes, certificate or diploma above bachelor level |
|||
|
|
|
||
|
Yes, master's degree |
|||
|
|
|
||
|
Yes, degree in medicine, dentistry, veterinary medicine or optometry |
|||
|
|
|
||
|
Yes, earned doctorate |
|||
|
|
|
||
|
No |
|||
|
|
|
|
30. |
What was the major field of study of the highest degree, certificate or diploma that this person completed? |
|||
|
|
|
|
|
|
Please be specific. For example: • automobile mechanics |
|||
|
|
|
|
|
|
Major field of study of highest degree, certificate or diploma |
|||
|
|
|
||
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
OR |
|
|
|
|
|
No certificate or diploma (higher than high school) |
Go to Question 32 |
|
|
|
|
|
|
31. |
In what province, territory or country did this person complete his/her highest degree, certificate or diploma? |
|||
|
|
|
|
|
|
In Canada |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
OR |
|
||
|
Outside Canada |
|||
|
|
|
||
|
______________________________ |
|||
|
|
|
|
32. |
Has this person attended a school, college, CEGEP or university at any time since September 2005? |
|||
|
|
|
|
|
|
Mark as many circles as applicable. |
|||
|
|
|
|
|
|
Yes, attended elementary, junior high school or high school |
|||
|
|
|
|
|
|
Yes, attended trade school, college, CEGEP or other non-university institution |
|||
|
|
|
|
|
|
Yes, attended university |
|||
|
|
|
||
|
No, did not attend school at any time since September 2005 |
|||
|
|
|
|
|
Note: |
||||
|
|
|||
33. |
Last week, how many hours did this person spend doing the following activities: |
|||
|
|
|
||
|
(a) |
doing unpaid housework, yard work or home maintenance for members of this household, or others? |
||
|
|
|
|
|
|
|
Some examples include: preparing meals, washing the car, doing laundry, cutting the grass, shopping, household planning, etc. |
||
|
|
|
|
|
|
|
None |
||
|
|
|
|
|
|
|
Less than 5 hours |
||
|
|
|
|
|
|
|
5 to 14 hours |
||
|
|
|
|
|
|
|
15 to 29 hours |
||
|
|
|
|
|
|
|
30 to 59 hours |
||
|
|
|
|
|
|
|
60 hours or more |
||
|
|
|
|
|
|
(b) |
looking after one or more of this person's own children, or the children of others, without pay? |
||
|
|
|
|
|
|
|
Some examples include: bathing or playing with young children, driving children to sports activities or helping them with homework, talking with teens about their problems, etc. |
||
|
|
|
|
|
|
|
None |
||
|
|
|
|
|
|
|
Less than 5 hours |
||
|
|
|
|
|
|
|
5 to 14 hours |
||
|
|
|
|
|
|
|
15 to 29 hours |
||
|
|
|
|
|
|
|
30 to 59 hours |
||
|
|
|
|
|
|
|
60 hours or more |
||
|
|
|
|
|
|
(c) |
providing unpaid care or assistance to one or more seniors? |
||
|
|
|
|
|
|
|
Some examples include: providing personal care to a senior family member, visiting seniors, talking with them on the telephone, helping them with shopping, banking or with taking medication, etc. |
||
|
|
|
|
|
|
|
None |
||
|
|
|
|
|
|
|
Less than 5 hours |
||
|
|
|
|
|
|
|
5 to 9 hours |
||
|
|
|
|
|
|
|
10 to 19 hours |
||
|
|
|
|
|
|
|
20 hours or more |
||
|
|
|
|
|
34. |
Last week, how many hours did this person spend working for pay or in self-employment? |
|||
|
|
|
|
|
|
Please enter the total number of hours worked for pay or in self-employment at all jobs held last week. |
|||
|
|
|
|
|
|
Include: |
|||
|
• |
working for wages, salary, tips or commission; |
||
|
• |
working in his / her own business, farm or professional practice, alone or in partnership; |
||
|
• |
working directly towards the operation of a family farm or business without formal pay arrangements (e.g., assisting in seeding, doing accounts). |
||
|
|
|
|
|
|
Number of hours (to the nearest hour) |
|||
|
|
|
|
|
|
__________ |
Go to Question 40 |
||
|
|
|
|
|
|
OR |
|
|
|
|
|
|
|
|
|
None |
Continue with the next question |
||
35. |
Last week, was this person on temporary lay-off or absent from his / her job or business? |
|||
|
|
|
|
|
|
Mark one circle only. |
|||
|
|
|
|
|
|
No |
|||
|
|
|
||
|
Yes, on temporary lay-off from a job to which this person expects to return |
|||
|
|
|
||
|
Yes, on vacation, ill, on strike or locked out, or absent for other reasons |
|||
|
|
|
36. |
Last week, did this person have definite arrangements to start a new job within the next four weeks? |
|||
|
|
|
|
|
|
No |
|||
|
|
|
||
|
Yes |
|||
|
|
|
37. |
Did this person look for paid work during the past four weeks? |
|||
|
|
|
|
|
|
For example, did this person contact an employment centre, check with employers, place or answer newspaper ads, etc.? |
|||
|
|
|
|
|
|
Mark one circle only. |
|||
|
|
|
|
|
|
No |
Go to Question 39 |
||
|
|
|
||
|
Yes, looked for full-time work |
|||
|
|
|
||
|
Yes, looked for part-time work (less than 30 hours per week) |
|||
38. |
Could this person have started a job last week had one been available? |
|||
|
|
|
|
|
|
Mark one circle only. |
|||
|
|
|
|
|
|
Yes, could have started a job |
|||
|
|
|
||
|
No, already had a job |
|||
|
|
|
||
|
No, because of temporary illness or disability |
|||
|
|
|
||
|
No, because of personal or family responsibilities |
|||
|
|
|
||
|
No, going to school |
|||
|
|
|
||
|
No, other reasons |
|||
|
|
|
Note: Questions
40 to 48 refer to this person's job or business last week. |
||||
|
||||
40. |
For whom did this person work? |
|||
|
|
|
|
|
|
For self-employed persons, enter the name of their business. If the business does not have a name, enter the person's name. |
|||
|
|
|
|
|
|
Print in capital letters as follows: |
|||
|
|
|
|
|
|
Name of firm, government agency, etc. |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
Section, plant, department, etc. (if applicable) |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
41. |
What kind of business, industry or service was this? |
|
|
|
Please give details. For example: |
|
• new home construction |
|
|
|
Kind of business, industry or service |
|
|
|
______________________________ |
|
|
|
______________________________ |
|
|
|
______________________________ |
|
42. |
What was this person's work or occupation? |
|||
|
|
|
|
|
|
Please be specific. For example: |
|||
|
• legal secretary |
|||
|
|
|
|
|
|
(If in the Armed Forces, give rank.) |
|||
|
|
|||
|
Occupation |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
43. |
In this work, what were this person's main activities? |
|||
|
|
|
|
|
|
Please give details. For example: |
|||
|
• prepared legal documents |
|||
|
|
|
|
|
|
Main activities |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
|
______________________________ |
|||
|
|
|
|
|
45. |
If self-employed, was this person's farm or business incorporated? |
|||
|
|
|
|
|
|
No |
|||
|
|
|
|
|
|
Yes |
|||
|
|
|
|
|
46. |
At what address did this person usually work most of the time? |
||||
|
|
|
|
|
|
|
Example: |
365 Laurier Ave. West |
|
|
|
|
|
|
|
|
|
|
Number |
|
|
|
|
|
Name |
|
|
|
|
|
Type |
|
|
|
|
|
Direction |
|
|
|
|
|
|
|
|||
|
If direction (e.g., North, South, East or West) is a part of the street address, please include it. |
||||
|
|
|
|||
|
If street address is unknown or if the address is a post office box, specify the building or nearest street intersection. Do not give a post office box number. |
||||
|
|
|
|
|
|
|
Please give the name of the city or town rather than the metropolitan area of which it is a part. |
||||
|
|
|
|
|
|
|
For example: |
||||
|
|
|
|
|
|
|
If the address of work is different than the address of the employer, please provide the address where this person actually works (e.g., school teachers should provide the address of their school, not the address of the school board). |
|
|
|
|
|
|
Worked at home (including farms) |
|||
|
|
|
|
|
|
Worked outside Canada |
|||
|
|
|
|
|
|
No fixed workplace address |
|||
|
|
|
|
|
|
Worked at the address specified below: |
|||
|
|
|
|
|
|
Specify complete address |
|||
|
|
|||
|
Street address (see example) |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
City, town, village, township, municipality or Indian reserve |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
Province / territory |
|||
|
|
|||
|
______________________________ |
|||
|
|
|||
|
Postal code |
|||
|
|
|||
|
______ ______ |
|||
|
|
47. |
How did this person usually get to work? |
|||
|
|
|
|
|
|
If this person used more than one method of transportation, mark the one used for most of the travel distance. |
|||
|
|
|
|
|
|
Car, truck or van — as driver |
|||
|
|
|
||
|
Car, truck or van — as passenger |
|||
|
|
|
||
|
Public transit (e.g., bus, streetcar, subway, light-rail transit, commuter train, ferry) |
|||
|
|
|
||
|
Walked to work |
|||
|
|
|
||
|
Bicycle |
|||
|
|
|
||
|
Motorcycle |
|||
|
|
|
||
|
Taxicab |
|||
|
|
|
||
|
Other method |
|||
|
|
|
48. |
(a) |
In this job, what language did this person use most often? |
||
|
|
|
|
|
|
|
English |
||
|
|
|
|
|
|
|
French |
||
|
|
|
|
|
|
|
|
Other — Specify |
|
|
|
|
|
|
|
|
|
______________________________ |
|
|
|
|
|
|
|
(b) |
Did this person use any other languages on a regular basis in this job? |
||
|
|
|
|
|
|
|
No |
|
|
|
|
|
|
|
|
|
Yes, English |
|
|
|
|
|
|
|
|
|
Yes, French |
|
|
|
|
|
|
|
|
|
|
Yes, Other — Specify |
|
|
|
|
|
|
|
|
|
______________________________ |
|
|
|
|
|
|
49. |
In how many weeks did this person work in 2005? |
|||
|
|
|
|
|
|
Please enter the total number of weeks worked for pay or in self-employment at all jobs held in 2005. |
|||
|
|
|||
|
Include those weeks in which this person: |
|||
|
• |
was on vacation or sick leave with pay; |
||
|
• |
worked full time or part time; |
||
|
• |
worked for wages, salary, tips or commission; |
||
|
• |
was self-employed; |
||
|
• |
worked directly towards the operation of a family farm or business without formal pay arrangements. |
||
|
|
|||
|
None |
|||
|
|
|||
|
OR |
|||
|
|
|||
|
______ |
|||
|
|
|
|
|
50. |
During most of those weeks, did this person work full time or part time? |
|||
|
|
|
|
|
|
Mark one circle only. |
|||
|
|
|
|
|
|
Full time (30 hours or more per week) |
|||
|
|
|
|
|
|
Part time (less than 30 hours per week) |
|||
|
|
|
|
|
INCOME IN 2005
51. |
To save time, each person can give Statistics Canada permission to use the income information already available in his / her income tax files instead of answering Question 52. |
|||
|
|
|
|
|
|
• |
This option is only available for persons who filed a tax return for the year ending December 31, 2005. |
||
|
• |
Please note that your income tax information will be used for statistical purposes only. |
||
|
|
|||
|
Does this person give Statistics Canada permission to use the income information already available in his / her income tax files for the year ending December 31, 2005? |
|||
|
|
|||
|
Yes |
|||
|
|
|
|
|
|
No |
|||
|
|
|
|
|
52. |
During the year ending December 31, 2005, did this person receive any income from the sources listed below? |
|||||
|
|
|
|
|||
|
Answer "Yes" or "No" for all sources. If "Yes", also enter the amount; in case of a loss, also mark "Loss". |
|||||
|
|
|
|
|||
PAID EMPLOYMENT: |
||||||
|
|
|||||
(a) |
Total wages and salaries, including commissions, bonuses, tips, taxable benefits, research grants, royalties, etc., before any deductions |
|||||
|
|
|
|
|||
|
Yes |
|||||
|
|
|
||||
|
No |
|||||
|
|
|
|
|||
SELF EMPLOYMENT: |
||||||
|
|
|
|
|||
(b) |
Net farm income (gross receipts minus expenses), including grants and subsidies under farm-support programs, marketing board payments, gross insurance proceeds |
|||||
|
|
|
|
|||
|
Yes |
|
|
|
|
|
|
No |
|
|
|
|
|
|
|
|
|
Loss |
|
|
|
||
|
|
|
||||
|
||||||
|
|
|
||||
(c) |
Net non-farm income from unincorporated business, professional practice, etc. (gross receipts minus expenses) |
|||||
|
|
|
||||
|
Yes |
|||||
|
|
|
|
|||
|
No | |||||
|
|
|
||||
|
Loss |
|||||
|
|
|
INCOME FROM GOVERNMENT: |
|||
|
|
||
(d) |
Child benefits, such as child tax benefits, family allowances (federal, provincial and territorial) |
||
|
|
|
|
|
Yes |
||
|
|
|
|
|
No |
||
|
|
|
|
(e) |
Old Age Security Pension, Guaranteed Income Supplement, Allowance and Allowance for the Survivor from federal government only (provincial income supplements should be reported in (h)) |
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Yes |
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No |
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(f) |
Benefits from Canada or Quebec Pension Plan |
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Yes |
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No |
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(g) |
Benefits from Employment Insurance (total benefits before tax deductions) |
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Yes |
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No |
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(h) |
Other income from government sources, such as provincial income supplements and grants, the GST/QST/HST credit, provincial tax credits, workers' compensation, veterans' pensions, welfare payments |
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Yes |
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No |
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OTHER INCOME: |
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(i) |
Dividends, interest on bonds, deposits and savings certificates, and other investment income, such as net rents from real estate, interest from mortgages. Do not include capital gains/losses. |
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Yes |
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No   | |||
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Loss |
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(j) |
Retirement pensions, superannuation and annuities,
including those from RRSPs and RRIFs. |
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Yes |
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No |
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(k) |
Other money income, such as alimony, child support, scholarships |
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Yes |
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No |
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TOTAL INCOME in 2005 from all sources |
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Yes |
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No |
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Loss |
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INCOME TAX PAID on 2005 income (federal, provincial and territorial) |
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The following question is for all persons who usually live here including those less than 15 years old. If you are answering on behalf of other people, please consult each person. |
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53. |
The Statistics Act guarantees the confidentiality of your census information. Only if you mark "YES" to this question will your personal information be made public, 92 years after the 2006 Census. If you mark "NO" or leave the answer blank, your personal information will never be made publicly available. |
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Does this person agree to make his / her 2006 Census information available for public release in 2098 (92 years after the census)? |
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Yes |
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No |
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STEP F
Answer Questions H1 to H8 about this dwelling. |
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A dwelling is a separate set of living quarters with a private entrance from the outside or from a common hallway or stairway inside the building. This entrance should not be through someone else's living quarters. |
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H1. |
Who pays the rent or mortgage, taxes, electricity, etc., for this dwelling? |
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If more than one person contributes to such payments, mark as many circles as apply. |
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Person 1 |
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Person 2 |
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Person 3 |
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Person 4 |
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Person 5 |
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A person who is listed on another questionnaire for this dwelling |
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A person who does not live here |
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H2. |
Is this dwelling: |
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Mark one circle only. |
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owned by you or a member of this household (even if it is still being paid for)? |
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rented (even if no cash rent is paid)? |
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H3. |
(a) |
How many rooms are there in this dwelling? |
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Include kitchen, bedrooms, finished rooms in attic or basement, etc. |
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Do not count bathrooms, halls, vestibules and rooms used solely for business purposes. |
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______ |
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(b) |
How many of these rooms are bedrooms? |
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______ |
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H4. |
When was this dwelling originally built? |
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Mark the period in which the building was completed, not the time of any later remodelling, additions or conversions. If year is not known, give best estimate. |
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1920 or before |
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1921-1945 |
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1946-1960 |
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1961-1970 |
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1971-1980 |
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1981-1985 |
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1986-1990 |
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1991-1995 |
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1996-2000 |
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2001-2006 |
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H5. |
Is this dwelling in need of any repairs? |
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Do not include desirable remodelling or additions. |
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No, only regular maintenance is needed (painting, furnace cleaning, etc.) |
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Yes, minor repairs are needed (missing or loose floor tiles, bricks or shingles, defective steps, railing or siding, etc.) |
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Yes, major repairs are needed (defective plumbing or electrical wiring, structural repairs to walls, floors or ceilings, etc.) |
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Answer Questions H6 to H8 for only the dwelling that you now occupy, even if you own or rent more than one dwelling. If the exact amount is not known, please give best estimate. |
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Note: |
If you or anyone in this dwelling is a farm operator living
on the farm you or they operate, mark here |
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H6. |
For this dwelling, what are the YEARLY payments (last 12 months) for: |
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(a) |
electricity? |
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None |
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Included in rent or other payments |
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OR |
$ ___ ______ .00 per year |
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(b) |
oil, gas, coal, wood or other fuels? |
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None |
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Included in rent or other payments |
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OR |
$ ___ ______ .00 per year |
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c) |
water and other municipal services? |
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None |
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Included in rent or other payments |
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OR |
$ ___ ______ .00 per year |
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H7. |
For RENTERS only: |
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What is the monthly rent paid for this dwelling? |
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Rented without payment of cash rent |
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OR |
$ ___ ______ .00 per month |
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H8. |
For OWNERS only, answer parts (a) through (f): |
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(a) |
What are the total regular monthly mortgage or loan payments for this dwelling? |
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None |
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OR $ ___ ______ .00 per month |
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(b) |
Are the property taxes (municipal and school) included in the amount shown in part (a)? |
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Yes |
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No |
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(c) |
What are the estimated yearly property taxes (municipal and school) for this dwelling? |
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None |
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OR $ ___ ______ .00 per year |
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(d) |
If you were to sell this dwelling now, for how much would you expect to sell it? |
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$ ___ ______ ______ .00 |
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(e) |
Is this dwelling part of a registered condominium? |
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Yes |
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No |
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(f) |
What are the monthly condominium fees? |
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None |
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OR $ ___ ______ .00 per month |
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You have now completed your questionnaire.
(only those that differ from the paper questionnaire)
Telephone interview questions
Step A
Could you provide me with a phone number, including the area code, in case we need to contact you regarding your census questionnaire?
Step A
Could you please give me your address, starting with your civic number, street
name or lot and concession?
Do you have an apartment or unit number?
What is your city, municipality, town, village or Indian reserve?
In which province or territory do you live?
What is your postal code?
Step B
I need to make a list of all persons who usually live here, at this address, as of May 16, 2006, even if they are/were temporarily away. Including yourself, how many persons usually live here, at this address, as of May 16, 2006?
Step B
We will begin with your name then followed by another adult who lives here. If applicable, this should be your spouse or common-law partner, followed by your children who usually live here. Then continue with all other persons who usually live here. Please start by giving your family name.
Step B
As of May 16, 2006, the persons living at your address are:
As of May 16th, 2006, does or did any of the following situations apply to anyone in the household?
Is there anyone in the household who has his or her usual home at another address in Canada and who is staying here temporarily (for example, a person visiting or a person who has his or her secondary residence here, at this address)?
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Is there anyone in the household who is a resident of another country visiting Canada (for example, on a business trip or on vacation)?
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Is there anyone in the household who is a government representative of another country or a member of his or her family?
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Step B
Could you please give me the name of the person or persons who are staying here temporarily and have their usual home at another address in Canada; or are residents of another country visiting Canada; or are government representatives of another country and their family members?
Step B
You have indicated that all persons staying at this address on May 16, 2006 are staying here temporarily and have their usual home at another address in Canada; or are residents of another country visiting Canada; or are government representatives of another country or a member of their family. Could you please give me again your name and telephone number at your permanent address?
Step B
As of May 16, 2006, the persons living at your address are:
Did you leave anyone out because you were not sure the person should be included?
For example:
• a person living at this address who has another home;
• a person temporarily away.
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Step C
What is this person's name, relationship to you and the reason why you
are not sure if this person should be included?
Name
Relationship / Reason
Age confirmation
I would like to confirm the age of everyone in your household.
On May 16, 2006:
• you were (age calculation) years old
• Person name was (age calculation) years old
Farm dwelling
H5(a). Are you or is anyone in this dwelling, a farm operator living on the farm you or they operate?
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Total income
The TOTAL INCOME in 2005 for Person name, from all sources, as calculated
by the system is $X.
If you disagree with the total amount, please provide the correct amount.
Internet questions
Step A
1. |
Enter your telephone number. |
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Area code Telephone number |
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Step A
2. |
Enter your address as of May 16, 2006. |
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No. and street or lot and concession |
Apartment number |
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_____________________________________ |
______________ |
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City, municipality, town, village, Indian reserve |
Province/territory |
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_____________________________________ |
______________ |
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Postal code |
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Step A
2. |
Please verify that the address below is your current address as of May 16, 2006. You can change your address information in the fields below. |
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No. and street or lot and concession |
Apartment number |
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_____________________________________ |
______________ |
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City, municipality, town, village, Indian reserve |
Province/territory |
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_____________________________________ |
______________ |
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Postal code |
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Step B |
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1. |
Including yourself, how many persons are staying here, at this address, as of May 16, 2006? |
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Include all persons, even if they are temporarily away. |
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![]() |
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Number of persons: |
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Step B |
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2. |
Including yourself, list below all persons who are staying here, at this address, as of May 16, 2006. |
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Begin the list with an adult followed, if applicable, by that person's spouse or common-law partner and by their children who stay here. Continue with all other persons who stay here. |
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Family name |
Given name |
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Person 1: |
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Step B |
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3. |
As of May 16, 2006, the persons staying at this address are: |
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(a) |
Is there anyone above who has his or her usual home at another address in Canada and who is staying here temporarily (for example, a person visiting or a person who has his or her secondary residence here, at this address)? |
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(b) |
Is there anyone above who is a resident of another country visiting Canada (for example, on a business trip or on vacation)? |
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(c) |
Is there anyone above who is a government representative of another country? |
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Step B |
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4. |
Please indicate which persons below are: |
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• |
staying here temporarily and have their usual home at another address in Canada; or |
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• |
residents of another country visiting Canada; or |
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• |
government representatives of another country and their family members. |
Step B |
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5. |
You have indicated that all persons staying at this address on May 16, 2006 are: |
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• |
staying here temporarily and have their usual home at another address in Canada; or |
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• |
residents of another country visiting Canada; or |
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• |
government representatives of another country and their family members. |
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Please specify your name and usual telephone number below. |
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Family name |
______________________ |
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Given name |
______________________ |
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Telephone number including area code |
______________________ |
Step C
As of May 16, 2006, the persons living at your address are:
Did you leave anyone out because you were not sure the person should
be included?
For example:
• a person living at this address who has another home;
• a person temporarily away.
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Step C
Specify the name, the relationship and the reason why you are not sure if that (those) person(s) should be included in this questionnaire.
Name(s) |
______________________ |
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Relationship / Reason |
______________________ |
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Age confirmation
On May 16, 2006:
Person name is (age calculation) years old
Farm dwelling |
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H5 |
(a). |
Are you or is anyone in this dwelling, a farm operator living on the farm you or they operate? |
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Total income |
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|||
TOTAL INCOME in 2005 from all sources |
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$ |
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$ |
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Summary of income in 2005
This is a summary of the income amounts reported for all household members aged 15 and over.
Please review to make sure that the amounts are correct.
Name of person
(a) |
Wages and salaries |
$ X |
(b) |
Net farm self-employment income |
$ X |
(c) |
Net non-farm self-employment income |
$ X |
(d) |
Child benefits |
$ X |
(e) |
OAS/GIS benefits |
$ X |
(f) |
CPP/QPP benefits |
$ X |
(g) |
Employment Insurance (EI) benefits |
$ X |
(h) |
Other income from government sources |
$ X |
(i) |
Investment income |
$ X |
(j) |
Pension income |
$ X |
(k) |
Other money income |
$ X |
Total income in 2005 for all sources |
$ X |
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Income tax paid on 2005 income |
$ X |