31 DATA COLLECTION FORMS 6OPH-7. -lIHousehold Questionnaire" used for sample outside large cities (front) * * * * U.S.DEPARTMENT O F COMMERCE Bureau of the Census HOUSEHOLD QUESTIONNAIRE FOR THE 1960 CENSUS OF POPULATION AND HOUSING Dear Householder: Thank you for your cooperation iii providing the information you have already pivcw the Census Taker. This questionnaire covers the additional items needed to coniplete the Census. You will see that questione about your dwelling are on the next page and that questions concerning yourself and each other person in your household are on the following pages. Please study the enclosed example before you start to fill in the form. Never skip a queetion just because it does not seem to apply. For instance, a n anewer of r r N ~ * ' to the question, "Did this person work at anv time last week?" is just as important as a n answer of "Yes." Whenever you do not know the exact answer (such as the cost of utilities o r the amount of wages last year) make a reasonable estimate. After you complete the form. please cherk it ober t o make sure you have not missed anything. Federal law states that Census employees must hold all information which you give them in strictest conJidence. T h e statistics published from this Census will not reveal any individual information. Please mail the completed questionnaire within 3 days in t h e addressed envelope which the Census Taker has left with you. It requires no postage. Your prompt attention to this request will be appreciated. Sincerely yours. Robert W. Burgess, Director Bureau of the Census CONFIDENTIAL-The Cmrus II required by the United States Constitution and further authorized by 13 U.S.C. 5, 9, 14 1 , 22 1-4. The law requires that the inquiries be answered completely and accu-, rately, and guarantees that the information furnished will be accorded confidential treatment. The Census report cannot be used for purposes of taxation, Investigation, or regulation F o 60PH-7 ~ Budget Bureou No 4 1-5953 Approval expirer 12-3 1-60 32 1960 CENSUSES OF POPULATION AND HOUSING 6OPH-7.--"Household Questionnaire" used for sample outside large cities (housing section, left) PUASE NOTE: These housing questions begin with number H17 because the Census Taker has already obtained the answers to questions H1 to H16. The term '*house" or "apartment" covers your house or part of the houw you occupy, or the apartment, flat, or rooms in which you live. M o s t of these questions refer to your own house or oportment but note that quertions H20, H32, and H33 are about the whole building in which you live. Questions H17 and H18 refer to the whole place on which you live; if your house i s on land which i s only part of a larger property, answer questions H 17 and H 1 8 about the whole place. H22. Here is a list of fuels. In the first column, check which one i s used most for heating. In the second column, check the one used most for cooking. In the third column, check the fuel used most for hoatlng water. O n a city lot (or is this an apartmont building)? - - ----__ --0 O n a placo of loss than 10 acros? (Check one i n eoch column) A B C _ _ _ _ _ _ _ Ol)last yoar (1959), did saIr of craps, livostock, and a t b r farm produds from th& place amount to $250 or moro? Cool or coke $250 ar more - - - -- 0 Less than $250 or none - - - OR O n a placo of 10 or more a c m ? _ _ _ _ _ _ _ _ O'Last 0 yaar (1959),did saim of crops, livostock, and othor farm products from this placo amount to $50 or more? $50 or more - - Less than $50 or --- 0 none - - - -0 H19. How many bedrooms are in your house or apartment? If you live in a one-room apartment without a separate bedroom, check "No bedroom." -0 1 bedroom - -0 - --- --- --- 2 bedrooms3 bedrooms; __-______0 hol - o-----o------o o- - - - - u - - - - - - o -u - - - - - - - - - - - - - - - - - 0 - - - - - o- - - - - _u _ _ _ _ _ - -u_ _ _ _ _ o------o - - - - - - - - - - - - - - --.u - - - - - u - - - - - -0 -- ---- Fuel oil, kerosene, -0 ----- _ _ _ _ -0_ _ _ _ _ Bottled, tank, or LP gas- etc- -0 n Other fuel n------o No fuel used _ _ _ _ _ _ _ _ _ _ _ - _ - -_- -_ H23. Do you have a clothes washing machine? Do not count machines shared with any other household in this building. ----- --unit) - - - - - - Automatic or semi-automatic machineWasher-dryer combination (single No washing machine- u ___________________ 0 H24. Do you hove an electric or gas dothes dryer? Do not count dryers shared with any other Electrically heated dryer- __-___ __-- Gas heated dryer- household i n N o dryer - ---- _________ 0 _ _ -_- - _ - - - _ -- _ _0 H25. Do you have any television sets? H20. About when was this house originally built? Count floor, table, and Count only sets in working order. portable television sets as well a3 combinations. ___ 1958 _ _ _ _ _ _ _ - 0 In 1 9 5 9 or 1 9 6 0 - 1 set _______ -0 1949 _ _ _ _ _ _ _ - 0 _ _ _ _ _ _ _ _ _ _ _ _ - _ -O --__ 1 9 5 0 to 1954 2 sets or more- 1 9 4 0 to NO 0 1 9 3 0 to 1939 _ _ - - - _ _ 1 9 2 9 or earlier- hurting this building. 4 bedrooms or more - 1955 to - - -- - Electricity fu01 __-__-___-_-_-- -- wood -- -- - - - - - -- Utility gas from underground pipes serving the neighborhood- - - - - - - - --- - Wator Cooking hosting fu01 Machine with wringer ar separote spinner- Count rooms whose moln use i s as bedrooms even if they are occasionally used for other purposes. No bedroom- - - - - - - - Hou*. List of b l s -- - --- --- -- television sets O __________ O H26. Do you have any radios? ______ Count only sets in working ordar. Count floor, table, and portable radios as well as radio combinations. Do not count automobile radios H21. How is your h o u e or opartment heated? Check ONLY the kind of heat you use the most _______________-0 _ _ _ - - - _ _ - -0 No radios- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 1 radio-- Heated by: 2 radios or more- Steam or hot water- __-___ _____-___ ---__-__0 Worm air furnace with individual room registers- - 0 __-__----_____ Built-in electric units- - _ _ - _ _ - _ -- _ _ _ - _ - _ _ _ _ _ Room heater(s) connected to chimney or flue- - - - Room heater(s) not connected to chimney or flue - - I I] Floor, woll, or pipelesr furnace- 0 0 H27. Do you have any air conditioning? Count only equipment which cools the air b y refrigeration. Room unit-1 only- Room units-2 _________0 or more- ______0 Central air conditioning systemOther method- Write in. No air conditioning- _ ________ H28. Do you have a home food freezer which is separate from your refrigerator? Yes- ___ No---- O 33 DATA COLLECTION FORMS 6OPH-7. --"Household Questionnaire'' used for sample outside large cities (housing section, right) I YOUR HOUSE, APARTMENT, OR FLAT A complete bothroom has both nush toilet and battling focilitier !bathtub or shower) A partial bathroom has a flush tottet or bathing facilities, but not both. - ..- . -- ~ - -. - . -. -- - some other source?. - - - ._ _ .- ---- -__------ __ . . . - - - .- .- - - ~ ~ ~ ~ 0 0 Yes, connected to o public sewer- No, has septic tank or cesspool- No, hos other Yes. 0 - - --- - y w r , ek.) -O No- - 0 +What Yes ir ths g~~-e-m%t!!t!& ol.micity? CO81 for s .o0 s .o0 s .o0 (See ~nstructionsbelow) Gas? (Check one box) ~ - 0 Yes O W h a t - O No - o n a concrete slab? - -. -. fr tho ovecolt for gar? a H35. Is there a telephone on which people who live here can be called? Y e s - - O ' L w Yes 0 No a Yes Count company cars kept at home ------ __ -_____ 2 outomobiles-. - 0 (See instructions below) +About how much do you pay for such fuel per voor? No s .o0 (See instrudions below HOW TO FIGURE COST OF UTILITIES AND FUEL - - +What Ir h o v e r o a e msnth! cost for woter? u Enter the cost to the neorerf ___ ___- 3 outomobiles or more- - - (See instructions below) H45 and H46. In addition to rent, do you also pay for oil, coal, kerosene, or wood? by people who live here? No outomobile. - - - monthly Water? (Check one box) t i s th. t o g h o n e number? H36. How mony possenger automobiles ore owned or regularly used ~ iWeek, No with a barement? . . 1 outornobile- per Electricity? (Check.ooe box) ________- H33. Is this house built: I .o0 H43 and H44. In addition to rent, do you also poy for: means of sewage disposal - - . in onother way? dollar) 442. Does your rent include any land used for farming (or ranching)? O H32. I s this house connecte¿ to a public sewer? .o0 What is your rent ond what period does it cover? 0 (Nearest a public syskm (or private company)? (Neanitdollor) If you pay your rent b y the week or some other period of time- H31. Do you get water from: an individud well?- - S OR sl 1 complete bothroom, plus portiol bothroom(s) - .- . 2 or more complete bothrooms rent by the month- What i s your monthly rent? -u No bathroom, or only o partial bothroom . 1 complete bothroom.. H41. I f you pay yoiir dollor 0 H37. If you live in a trailer, i s it. mobile (on wheels, p r can easily be put on wheels)' - _ _ - - - _ _ - - - - __ ~ 0 on ca permanent foundation? - ANSWER H40 IF YOU OWN OR ARE BUYING THIS HOME H40. About how much do you think this property would sell for on cool Multiply number o f tons used per year b y the cost per ton. Oil Multiply number of gallons used per year b y the cost per gallon; OR multiply number of deliveries by overage cost per delivery or kerosene todoy's market? ______$7,400-- _ _ _ _ _ $9,900. -__- Less than $5,000- $5,000 to $7,500 to $ 1 0,000 to $1 2,400- $ 1 2,500 to $1 4,900- - .~ Wood 0 not OnSWer - of $15,000 to $17,400. ocres $17,500 to $19,900 1 1 1 2 $20,000 to $24,400 . $25,000 to $34,900 - - - 435,000 or more- - - --- ~ ' (such as kerosene by the can or coal by the kg), It m y be easier to figure o b u t how much you s p n d for fuel per week, and multiply by the number of 0 - 0 :f ~ ~ h p q ~ ~ e 10 - - 0 __ 0 --- 0 .- Multiply number of cords (or loads) used per year b y cost per ' U AFTER YOU FINISH THE HOUSING QUESTIONS0 FILL THE F O L L O W I N G PA-GES . F O R PEPSONS WHOSE NAMES HAVE BEEN WRITTEN IN BY THE CENSUS TAKER 0 MAKE SURE THAT EACH "EXTRA PERSON" QUESTIONNAIRE LEFT BY THE CENSUS TAKER IS FILLED O INCLUDE THE COMPLETED "EXTRA PERSON" QUESTIONNAIRES IN THE FAMILY'S ENVELOPE WHEN THIS F O R M IS MAILED TO THE CENSUS OFFICE Sheefs filled by houne- or more hold members nof related to fhe heod may first be enclosed in the special smaller envelopes left for these persons 34 1960 CENSUSES OF POPULATION AND HOUSING 6OPH-7. -“Household Questionnaire” used for sample outside large cities (population section, left) (The population questions were repeated on succeeding pages of this form, for two more persons) ...................... ..................................................................... .................................................................... + .......................................................... QUESTIONS F O R .......................................................... ....... ....... .......................................................... ....... *.*,-. P2. N a m of this person P3. (Enter lort mme first) What is the relationship of this person to tho hood of this hauw hold? Haod - - - - - - ------ ------0 Wife of head-. ___________ Son or daughter of heod - I P14. --- 0 0 Other-Wrife in (For example Son-in-law, mother, uncle, cousin, etc. P8. What ir tho highost grade (or yeor) af ropulor school this person has over attonded? (Check one box) If now attending a regular school or college, check the grade If it i s in lunior high school, check the (or year) he i s in. box that stands for that grode (or yeor) Never ottended school - .a Kindergarten - - - - -0 -- ~ W h e n wos this person bom? (If born in hospitol, give residence o f mother, not location 0 hospital) If born in the United Stotes, write name of Stote. I f born outside the United Stotes, write name of country, U S possession, etc. Use international boundaries as now recognized by the U S. Distinguish Northern Ireland from lrelonc (Eire). V S . Did he f& (Stols, brctgn counhy, U S possess~on, etc ) I P9. If this person wos born outside the U S Finis hed this grode- - - What language wos spoken in his home boforc he came to thi United States? -0 P10. P1 1. Yes- - OR (Nomeof foreign cowtry, or Puerto RICO, Guam, 0% P17. What county was his mother born in? United Stoter- P12. O O In 1958 lon 1954 to March 1955 - - _ _ _ _ _ _ _ _ _ _0 P18. If thu --0 ------0 -- person has cver been morried- P csl When did ho got married? When did he get momod for the first time? Month Ytor P20. If this Yeor is a woman who hos ever beon morried- How many babies has she ovor had, not counting stillbirths? ou Do not count her stepchildren or adopted childen 3. No, different house - - Where did he live on April school- Month 1, 1955? 0 2. Yes, this house-- _ _ _ _ _ _ _ _ _ _ -0 - - -0 Has this person bron married more than onte? More thon Once once 1. Born April 1955 or later - - - - - OR No- Private or parochial school - - lpso1 9 5 3 - - - n Did he live in this house on April (Answer 1 , 2, or 3) . 1, 1955? OR None--m ( W A ) P21. a. City or toyh When was this person born? Born before April 1946 o the city limits? - .- c. County Stote, foreign country, U.S ---0 Is it a public school or a private school? P19. P13. -0 1 (Nameof foreign counky, or Puerto Rico, Guom, dc When did this person move into this house (or opartment)? (Check dote o f last move) In 1959 or 1 9 6 0 . school 1, 19601 Public OR Never attended - If he has attended only nursery school, business ar hode school, or d u l t education classes, check “No”. What country was his father born in? United Stotes- Did not finish this grade. ’16. Hos he ottended regular school ar collogo at any time s i n o Februory I the highest grode (or yeor) ho attended? + on with questions P22 to P35 Answer the questions regardless of whether the person is a housewife, student, or retired person, or o parftime or full-time worker. Please go Born April 1946 or later 9 Please omit quest i o n s P22 to P35 ond turn the page to the next person. Pog. DATA COLLECTION FORMS 35 6OPH-7 -'"Household Questionnaire11 used for sample outside large cities (population section, right) (The population questions were repeated on succeeding pages of this form, for two more persons) , .....:....:... -... . . . . . . . ............................................................................. ...................................................................................................................................................................... ................................................................................................................................................................. ........................................................................................................................................................................... THIS PERSON 0 ..................................................................... ..................................................................................... ....... ......................................................................................... ...... ..... ......................................................................................... ....................................................................... .................. ... . . . . . ........................................................ ................ ..................................................................... l -.a. 22. Did this person work at any time last week? - If this person worked lost week, onswer questions P28 and P29 Include part-time work such as a Saturday lob, delivertng'papers, Do not or helping without pay in a family busmess or farm. couirt own housework ___ Yes. B P28.' What city and county did he work in last week? If he workcd in more than one city or county, give place where he worked mort last week .... No a. City or town P23. How many hours did he work last week (at all jobs)? b. If (If exoct figure not known, give best estimateJ 1 to 14 hours ~. 1 5 to 29 hours-. 30 to 34 hours-. 35 to 39 hours 24. Was this 0 - - - - - - -0 40 hours - 41 to 48 hours- - -. 0 0 49 to 59 hours. - -..a __.o 60 hours or more - - -0 person looking for work, or on layoff from a lob? --- 0 No- Yes---.O 25. Does he have a job or business from which he was temporarily absent all last week because of illnoss, vacation, or other reasons? Yes- ---CI '26. When did he No----O 1955 _- 1949 or earlier - - -0 Never worked-. 0 Bus or straetcor - -0 --_ _ _ _ _ _ _ -- - Jo 3. Worked in 1950 or later - _ _ -0 __ >O 0 7 N o - - D known, give bert estimate) 48 ta 49 weeks- - - 0 0 50 to 52 weeks - - - 39 weeks - - all jobs? s [Dollari only) .o0 None--O OR PU.H o w much did he earn in 1959 in profits or fees from working in his own business, professional practice, paflnorship, or farm? Net income after business expenses (Enter omount or check "None " If exact figure not known, give best estimate II business or farm lort money, write "loss" after amount ) t (Dollorr (For example County lunior high school, outo ossembly plonf, TV o n d radio service, retoil supermarket. rood construction, form) (Check one box - -- ---- - ---- -0 Wholesale trode - - - - - - - - - - - - - - - - 0 Retoil trade-- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - 0 ~ Other (services, agriculture, government, construction, etc 40 to 47 weeks- - - only) .o0 None..O OR P U . last year (1959), did this person receive any income from: Describe octivity at location where employed. ~ 0 0 Before deductions for taxes, bonds, duer, or other itoms. (Enter amount or check "None ' * If exact figure not known, give best estimate ) (Nome of compony, businew, orgonizotion, or other employer) Manufacturing - - to missions, or tips from he work? c. Is this primarily: Write in P32. How much did this person earn in 1959 in wages, salary, com- Answer a to e, blow. b. What kind of business or industry was this? ci. - (If exact fylure not -'--- Describe this person's lob or business last week, if ony, ond write i n name of employer If this persan had no job or business last weok, give informotion for last lob or business since 1950. a. For whom did 0 Other means- 0 - -0 -- port-time? Count paid vacation, patd sick leave, and military service as weeks worked 27 2, or 3 ) 1. This person last worked in 1949 or earlier ~ Worked at home- - - - - - P31. How many weeks did he work in 1959, either full-time or P27. Occupation (Answer 1, OR -0 - - ~0 14 to 26 weeks - This persan hos never worked- Walk only- - private auta or car pool- - 13 weeks or less - 2. On active duty in the Armed Forces n o w - - .----a Taxicab Subway or elevated- - - 1 9 5 0 to 1 9 5 4 - - OR 0 No--[13 Stote Railroad- - Yes- to 1958-- Yes- P29.' How did he get to work last week? (Check one box for principal means used lost week) In 1 9 6 0 . - - - - - 0 In 1 9 5 9 - - _ ~ "30. last year (1959), did this person work at all, oven for a few days? (Check one box) 0 { __- __ .c. County work at all, even far a few days? Working now - - city or town-Did he work inside the city limits?. - - --- O Social security Pensions Veteran's poyments Rent (minus expenses) Interest ar dividends Unemployment insuronce Welfare payments Any other source not olreody entered y e s - - % h a î is h e z o u t e received from these sources in 1959? (If exact figure not known, give bert ertimok) What kind of work wos he doing? (For exomple 8th grade English teacher, paint rproyer, repoiri TV sets, grocery checker, civil engineer, farmer, form hond) (Check one boa e. Was this person: Employee of private company, business. or individual, for woges, salary, or commissions - - Government employee (Federal, Stote, county, or local)-- - - - .- - .- - - - - - - - Self-employed in own business, proferslonal practice, or farm - - - - - - - - - Working without p a y in a family business or form .. - - . - - - - - - - - -. ~ 3 ----~O --O Korean War (June l'ì50 to Jon 1955) - World War II(Sept 1940 fo July 1947) - - --0 ----0 - .o World War I (April 1917 io Nov 1918) . - . 0 0 0 1960 CENSUSES O F POPULATION AND HOUSING 36 60PH-7.-“Household Questionnaire” used for sample outside large cities (back) PLEASE ANSWER THESE TWO OUESTIONS ~~~ If it is neces-ry for the Censur Taker to get in touch with you, the best time usually ir: Name of person($) who filled this form. (Chock om b o x ) 8 ta 1 2 a.m o .___________ Dah filled: PLEASE BE SURE THATthe housing questions have been filled, the population pages have been filled for all’persons whose names have been written in by the Census Taker, e each ‘*extraperson” questionnaire hae been filled. Include the “extra person’’ questionnaires in the family’s envelope when you mail this form back to the Census Ofice. I T O BE FILLED BY CENSUS TAKER I Page No from PH-1 or PH-2 ~ H29. Number of units in structurr 1, detochod--- 0 1, attached - - - c] 0 --- - _ _ _ _0 _ - _ _ - _ _ _0 _ 2 -------_--- 3-4 5-9 ~ _______ 10-19 ~ _______ 0 50 or more - - 0 20-49 If 5 or rnoreFill items H20, H21, H22A, and H22C in Questionnaire H39. If PH-1Drstr. prop. (for owner wc.) 1 nb ________0 .o 1 wb _ _ - _ _ - 2 FORM 6OW-7 0 _ _ _ _ _ _ . _ _ _ _ I 37 DATA COLLECTION FORMS 6OPH-8. -"Household Questionnaire" u s e d for sample in large cities (housing section, left) (The front page and population section of this form were the s a m e as 6OPH-7) -- 7 - I 1 PLEASE NO7E: ! Thete housing que\"ons ths eorlier questtons The term "house ar begin with numbr. H 1 9 because the Census Toker hos already obtained the onswers to apartment ' coveri your house or part of the house you occupy, or the apartment, flat, or rooms J n which you live i Most o f these questions refer to your own.house or oportment but noto that questions H20, H33, ond H 3 4 ore about the whole building in which you live H23. Do you have a dottles washing mothine? H l 9 How mcny bedrooms are in your house or apartment? Count rooms whose main use i s o s bedrooms even i f they ore this building. bedroom, check "No bedroom Automatic or 5emi.outomoiic mochtne . - Machine with wringer or seporote spinner. - - . - o o o o N o bedroom. l Do not count mochines shored with any other household i n occosionolly used for other purposes If you live in o one-room oportment without o separote 1 bedroom 2 bedr clo mI 3 bedrooms No woshino machine building Electricolly heoted dryer . . -- 0 0 Count floor, table, ond portable television sets os well as combinations 0 1 set-- __ .--____---o U 0 2 sets or more - - - - -- Count only 5et5 in working order. -- n .u 0 --.u u 2 radios or more - - - -0 No rodios - - - - - - H27. Do you have any air conditiodng? Count only equipment which cools the air b y refrigeration. -. Room heoter(s) no? connected to chimney or flue - - 0 1 only - - Room unit- Write in Room units-2 -- --- or m o r e - - -- -- --- N o air conditioning - - - - - - - - - - - - n22. _____ __ refrigerator? Here is o list of fuels. In the first column, check which one i s used most for heating. In the second column, check the one used most for cooking. In the third column, check the fuel used most for heating water. Yes---O No--~~ H30. How many bathrooms ore in your house or apartment? A complete bothroom has bufi flush toilet ond bathing focilities (bothtub or shower) (Check one in each column) Lirt of fuels [II H28. Do you hove a home food freezer which i s separate from your 0 _ _ _ . _ _ _ . . ._ _.. ~ 0 ______- Central air conditioning system No( h e u i - Do not count automobile radios ----------- .- - - - - - - - - - Room heoter(s) connected to chimney or flue Count floor, table, and portable rodios 0 5 well as radio combinations. Worm oir furnoce with individual room registers - - - .- -- H26. Do you have any rodiOs? - - Floor, woll, or pipeless furnace television sets NO h a r e d by: Other method- . -- -- Count only sets in working order. Check ONLY the kind o f heot you use fhe most Built-in electric units. - . H25. Do you have any television sets? H21. How i s your house or opartment heated? -. - No dryer. 1 9 3 0 t o 1939.. - - ~ - - - .- - - Gas heoted dryer 0 1 9 4 0 to 1 9 4 9 . Steam or hot woter. 0 -0 Do not count dryers shared with ony other household in this 1 9 5 0 t o 1954 II .. . . - H24. Do you hove an electric or gas clothes dryer? In 1 9 5 9 or 1 9 6 0 . - - 1 9 2 9 or earlier . ~~~ H20 About when was this house originally built? 1 9 5 5 to 1958 . 0 - Wosher-dryer combinotion (single unit) . - - - 0 4 bedrooms or more . A II C Mouse heating fuel Cooking fuel Woter heating fuel A partial bothroom hos o flush toilet but not both er bothing facilities, No bothroom, or only o portiol bothroom - - r- - - -C - _ _ - - - - - - - _ -- - - - - - - 1 complete bothroom, plus portiol bathroom(s)- - 2 or more complete bothrooms- - - - - - - - - _ _ - - 1 complete bothroom . -u H33. Is this house built: with on Q boument? . a concrete slab? -. in onother way?. - ~ ... U O -~ H34. Does this building have: 3 stories or ~ e s r ? . . -- 4 stories oc morewith olevotw? wolk-up? . -. . n 0 0 fl 38 1960 CENSUSES OF POPULATION AND HOUSING Questionnaire" used for sample in large cities (housing section, right) 6OPH-8. -"Household H35. I s there a telephone on which people who live here con be called' 00 Yes No What is the telephone number' ~ .. - - - H36. How many passenger automobiles are owned o i regularly used by people who live here' Count compony cor5 kept at home N o autornobile 1 automobile 2 automobiles u . El . CI .. . 3 automobiler or more - H37. If you live in a trailer, is . - - . . it: mobile (on wheels, or con eorily be put on wheels)? o on a permanent foundation? 0 ANSWER QUESTIONS H43 TO H46 IF YOU PAY RENT FOR YOUR HOUSE, APARTMENT, OR FLAT ~~ ~ H43 and H44. In addition to rent, do you also pay for: (Check one box) Electricity? G+What is the overoge monthly cost for electricity? No GOS? (Check one is the overoge monthly cost for gos? s .O( s .O( (Sœ inrtructims belon 0 (Check one box) Water? Yes o + W h o t is the averoae monthly cost for woter? Na (Sac instructions below 0 H45 and H46. In addition to rent, kerosene, or wood? Yes n + A b o u t do you also pay how much do you poy for such fuel No .O( box) Ye, O+Whot Na s (See instructions below 0 perxor? 0 for ail, coal, s .O( (See instructions belov HOW TO FIGURE COST OF UTiLlTlES AND FUEL Enter the c o s t to the nearest dollar Utilities If you don't know exactly how much you have spent and i f you don't have records, put down the approximate carts Fuels If you don't know how much fuels cost per year, one o f the. following methods moy help you figure the approximate costs: Fuel usod Coal Oil or kerosene Wood 2 hthod Multiply number af tons used per year by the cost per ton Multiply number of gallons used per year by the cost per gallon, OR multiply number of deliveries by overoge cost per delivery Multiply number of cords (or loads) used per year by cost per cord (or lood) NOTE: If you buy fuel in small quantities (such as kerosene by the can or coal by the bag), it may be easier to figure about how much you spend for fuel per week, and multiply by the number of weeks during which it is used AFTER YOU FINISH THE HOUSING QUESTIONS- - o FILL THE F O L L O W I N G P A G E S F O R PERSONS WHOSE NAMES HAVE BEEN WRITTEN IN BY THE CENSUS JAKER o MAKE SURE THAT EACH ' EXTRA PERSON" QUESTIONNAIRE LEFT BY THE CENSUS JAKER IS FILLED INCLUDE THE COMPLETED "EXTRA PERSON" QUESTIONNAIRES I N THE F A M I L Y ' S ENVELOPE WHEN THIS F O R M IS MAILED TO THE CENSUS O F F I C E Sheets filled by house- hold members n o l reloted to the head may first be enclosed in the special smaller envelopes left for these persons 39 DATA COLLECTION FORMS 6OpH-8. --"Household Questionnaire'' used for sample in large cities (back) PLEASE ANSWER THESE TWO QUESTIONS the Census Toker to get in touch wlth you, the beit time usually is Name of person(s) who filled this form (Check Dote filled. PLEASE BE SIJRE THAT- TO BE FILLED BY CENSUS TAKER Page No from PH-2 ED No H29. Number of units in structure 0 1, detoched l 2 0 1,ottoched I cl 5-9 10-19 . 50 or more20-49 FORM~OPH-a 0 i If 5 or moreF i l l i k m s H20, H2 1,H22A, ond H22C in Questionnoire one h o r ) 8to l 2 0 m D 1 2 to 6 p m . O 6to9pm O ,I f i ,:;':' i', i !'I . .... ' ?. /I .-- .\ I :.- I ,- -. -', . s. fi UNITED STATES OF AMERICA 1360 Census of Population I 0 \ OVERSEAS CENSUS REPORT This fonn is for Americans living outoido the Unitcd States, Puerto Rico, American Samoa, Canal Zone, Guam, and the Virgin Islands on Census Day April 1, 1960. 1 j -- I I I I I 1 1 i I Dear Fellow American: Please fill this official 1910 Population Census report forn on April 1,1960 ] a s possible thereafter. Our Nation has raken a Popola- I tion Census cvcry ten years-sincc'l790. Facts about thc numbers of Americans, I their location, ages, education, occupation, etc. a t t v¿ry important to all o f us. j . (Census Day) oras soon I 1 if any members of your family are living with you overcic3s, plcnsc be sure If thcrc ore more than four persons in y o u family I to include thcm on t h i s form. list them on nn additiond form or shcct of papcr. Fold the extra lorm or I group, sheet inside this form before scaling. 1 Flense fill out this farm completely and corrcccly. IC will trkc only li few I minutes of your time. First, fill out the identification infom;rtion cn the k c k of form. Then, cnswer t h r qucstions on thc inside for yourself and cach n c n b t r I ofthisyour fornily Group. answcrs to chest I confidcntial, as providedYour by law. I I I I I I 1 I I I I I qucstions will bc tcpt strictly hfcrnbcraof the Anncd Forces should mum the conplcrcd form to the npproprinte pcrson an thc pott, in a c c o r d a c c with locs1 crrmgcmtnts. Civilinns should t c t u n the complctcd form (in person or by m i l ) to the nearest U.S. Embassy or Consular Of€ice in the country ín which they nxc living, Thank you far your cooperation. I I 1 I I 1 1 1 1 I I I Sincerely yours, R o b m V. B W ~ C S O Dircccor , Burcau of the Census Ø NOTE: I 1 ' 1 @ I I II This form is being distributcd through scvcrnl sourccs t o ennblc the grcntcst number possible of Amcricnns O V C K S C ~ to S b c counted in the 1960 Ccnsus. If you rcccivc more thnn onc copy, pleasc do not fi11 the duplicatcs. 1. What ic tbc nnmc of the hcnd ofthisfaqi1yE"upl. ................................... 2. If the hczd is in thc Anncd Forces: 8. .................................... 1I Nx13:: of i n s t a l h t i m Et which stztioncd b . C O ~ ~ . . t . . . . * . . m . * . . . o . . * * * I 3. If the hczd is a civilim: I I N ~ ofCcountry in which now l i v i n g . . ..................... I ................................... l QUESTIONS INSIDE G I I I I I ô I E I I I I I I I The C a c r r Is teqdz?d by the United S t a t e s C o n s i i t u t i o a and further authorized by 13 U.S.C. 5 , 9, 141,221-4. Tbc law g u a r a n t e e s that t h e infornation f u t n i s h e d will be accorded C O N F I D E N T I a t!eatmc3t. The Ceerus r C p R connot be u s e d for p u r p o s e s of taxation, invcsrigation, or regulatios. A 19& C n t u i K t p D r t P U L l b e filed by members of the Armed F o r c e s and by civilian h c r i c a n c i t i z e n s mploycdby the U.S. Government who are livine abroad; filing i s d i s c r e t i o n a r y for othtr A n e t i c m c livin6 abroad. Y 1 1 .I I I I I I f f I 1 1 I ! Flll e oeparato c o J m for the hoad und for each mcmbermf hJo f r n f l y &roup Jlvfnp w l f h hfm hor. (fncludfng babfao). Exclude forofgn notfonela worklnp for Iho fanlfy First ............................. ............................. .................. '2. \IHAT IS THIS PERSON'S RELATIONStIIP TO THE I/ HEAD OF THIS FALIILY GROUP? (For example, hoad, wlfs, eon, mother-In-law, a t c ) 3. SEX 4. COLOR OR RACE Check ons box or write In japanoss, ChJnese, Flflpfno, etc. 5. WHEH WAS THIS PERSON BORN? I/ 6. MARITAL STATUS -- IS THIS PERSON NOWCheck one box. 7. WHERE WAS THIS PERSON BORN? (Check U . S. or wrlte In name of foreign country, U. S. poscerafon, etc.) ß. If Ihfe perecn waa b o r n o u t s l d e the Unlted Statea I S HE A UNITED STATES CITIZEN? -- ' No, he is cot a U. S. citizen - - - - - - ---- * Fnther's birthplace: No, he is cot a U. S citizen Fsthet'a binhglacc: --------- -- 0 B U. S. c i t i z e n F3thc:'t D h h p l æ c e : No, hc Is not ------ lAOTHER80RNl U*S-Oor. ......................... Neme o l IorzJCr, corntry, etc. ........ OR Left before 1940--- Lelt the U.% in (vear). , - -- - ----- c ,oll !c.!e:5!E?i=E2 Expects ro be abroad 3 months or more J Kindergmm ...................... ........ OR bdore 1940 - - O t:.!2z7e of f3rel.'n c c x t r y . etc. Left the U . S in ( y e a r ) . -u- - - -- - - ----- 0 - -- 0 -0 Erpecta to be abroad l e i s thon 3 a o n t h r None-n 0 u s - o01.. e--- E r p c c t s to be nbroad Left - - - ----- - OR Never lived in U.?, 3 oronchi or more Ergecta to bt abroad lera t h t a 3 m o a t h s None - c] ------- 4 --_--------------- - 7 / Yes, ...... ........... . cnrollrd in school, cbllcge, or m j v e r s i t y bcgrcc: ---.. Major field: . . * - . . - . - * - . - . . - . - - - o - - - Techaicnl institute work (rithour detree) No. Of yearc (3 Field of study i Technicnl institute m l k (without dccrcc) Field of study INo. of ycarr I NO--E ------------------ ---------- - - - - - - - - - - - - - ..- - a Q - ---------------- - - - - - .-- E J syr” (citbor: ~ Field oí study! I now in U. S h e d Forces No, be is a civilian Yes, Techiccl insritutc INo. of years /II 81 I -- - - - - - - - - NO-- - - - - - - - - -- - in U. S. h r n e d Fo:ccs Yes, No, IR is n civilian worked full t i n e or part- time No, but hac: a job or business from which he WES rmporarily absent Yes, No. and has no job or b u s i n e s s . D.FOR CIVILIANS ONLY-- OCCUPATI Ott Dcocrfbe fhe poram’r j a b o r bunlnocr leaf wee??. err lort woet, dooeriba bla la:? j o b or b u z t ~ o c satnce 1950. Ir Kind of work t h i s person bid No, and has no job or business.-- -- Kind o f work this pctson did: N e v e r work [n 1950-54 0 Kind o f =.ork this person did: GIvo exact f i r f a or dsscrlpllon, clvll en:fncer, d,trrfsf, off welf ahoorer, d m t d rochrfcim, p n l o s s o r of BnClfoh Ilfamiuro, r e ~ l e i o r e d n u r r e ,oic. ao - - - - - - - . - - . - - - - - - - I hed job or htclneua Q KIHD OF WORK W A S HE DOING? na. KHAT @ L\O porz-n l 8 Z t c-Jrkcd In 191’9 or osdler, or h a s never tvor::&, rc3t-o fNJ fem bfcrk. Corked for: GOVERNMENT ngency Qaat 3R PRIVATE company or orgnnizntion e Name of company or ---- - e Kind of - ap- * - - - - I P30. Last year (1959), did you work at all, evan for 7 -I o faw days? No-- P31. How many weeks ¿id you work In 1959, either purt-timel f u l l 4 i n o O? Count rnllltary rorvico, paid vacotion, and paid sick laove o s weeks worked. (If exact Figure not known, givu bert estimolu) 0 13 weeks or lest-,14 to 26 weeks 27 i o 39 weeks ___-0 ____ (Dollora only) OR None-, [7 P33. How muth did you earn i n 1959 i n profits or fees from working i n your own business, p r o h i o n o l practice, partnership, or farm? N e t income afler business oxpenser. (Enfer omouof or chock "None." If exact figure no! known, give best estimate. If business or form lost money, write "Lors" offer amount.) f.................00 OR None-- (Dollora onyl I U.S. DEPARTAiEM OF COI,WERCE BUREAU OF THE CENSUS I ............................ I I Location of installation: I State (or U.S. poxsassion, etc.) I .............................. ...............o0 I%lIon OnM P35. t!m YOU crcr rcrvad In Ihr Army, Now, or ofhtt Armad Tams (Check ono box o n aach linn) Vlos i t hik;: Yes No Koruon War (Junu IPSO to Jon. 1955)------- 0 W o r l d W a r II (Sept. 1940 to July 1947).-,,,0 World Wat I (April 1917 to Nov. 1910),,,,,, 0 Any cther timo, including prescnt renice-,,,,[7 0 0 Fill Informutim c n I;r:bn on rAxl ia------). 1 I I l i I I 1 I I 1 I I the 1960 Ccnrur report for: I PII- +It vrite you nam OR hom+ ............................................... (Last n a m ) you ara on a VESSIL0 Nome of verrol (Mid&. in;t,oll (;in, mama) L ................................ Nome of aparator (if U.S. Government, specify Navy, Coost Guard, etc.): I I Dear Fellow American: I This report form must be filled for you to be counted in the 1960 Census of the United Stoter. A s you know, our Nation hos token o Population Census every tcn years since 1790. I of vessel ........................................ a O n A p r i l 1 , 1960, wos thir vessel berthod In o U.S. port (including Alaska, Hawaii, Puorto Rico, Amorican Semoa, Canal Zone, Guam, and Iho Virgin Islands)? i I No-, Foch about the numbers of Amcricons, their locotion, ogcs, cducation, occupations, c k . , are vcry impotfcnt to oll of us, Plcatc fill out this form conplctcly and :orrcctly. It will taka c d y CI fc:r minst:; af your tino. ïho f i r n ccn bo :csl:d with the gu;;lr;.,:d flsp ta k t yzur cz~;.-xsc : ~cznf,dx:iol. I 0 1960 POPULATION CENSUS REFORT FOR MILITARY AND I;lARiTII;1E FE2SOìu"EL ................................ I County .................................... Cify or fawn I Y h t 1s the cnûunt Y C salvtd ~ fron thsre mms LI 19597 (rf exocf figuro not bom,aivo bozt crfimcfe) Page 5 I 1 I Social security Pensions Velaran's payments Rmt (minus expenrei) Interest or dividends Unemployment insurance Wdfcre poyrnenh Any cther m u r t e not already entered No,, Yes-- J I I 1 0 P34. Lart year (I959), did' you rcceiua cny income from: $.. I I I 1 I Il\IIITARY l ~ ~ S T A l l A T l O ~ - Namo of insfallation @ 1 OF THE TWO SECTlOIiS DELOW you ar# en a +If I Before deductions for taxes, bonds, dues, o r other items. (Eftor ornount or check "None." If exact figuro not known, give b e s t srfimoto.) .................O 0 PLEASE FILL &O ____ 0 I 0 40 to 47 weeks---4 8 to 49 weeks 50 t o 52 weeks,--- P32. tlow muth did you earn i n 1959 in wagis,sola~,cornmissions,or tips from oll jobs (including mitifay servico)? $ I I I I I ~ or othor derigncted anchoragi ............................... b. Nanr af pori . ............................ c Ciry form .............................. CI d. S M o (or U.S. pc:rtrrim, ctc.) ............................ I 1 I I 1 W u r n ih3 cornpfctcd form to the p r : m vdì0 gava i t to you, i n cc:ordznco vliIh fh:: crranCmcnts on your po;t CI ship. Thnk you f i r your csopcration. A Sinccraly yours, I 1 I hon ond lurthrr outhorIrrd by 13 U.S.C. 5 . 9, 141. 121-4. The law rqqwirar that tho Inquirltr b . cnlrcrrd ccm:I~I~lycnd occuratoty, and fiucranlrac tho! the infornotlon fdrnlbod riil t.1 o:rwc!ad conCdt*iol h o t r n c n t . l h e C l n r u r r n p d caract ho c u J far purpûrrs of taral+-~n, Ferm CPII-13 , c.2;rt &;rarcl t b . 11-591 13. u,wa 1 2 4 t - S . LkCSU m - 1 1 1 I ? ...................................." F b V;?.:n w:a y t . ~ttn? Month.. .........Year.. .....;. . y a rz.7- (Ch::k c ? . b o x ) PI. .....D M:nicd Widowcd.-n Otvcrtcd .-.a Singla ( n w w mcrrlrd)..C) Separated.. ....................................................... [M; cm-; u.: plu:.'.--.c,) knCL&J F7, If FJ %:ra f.5 U&- .......................... '........................ I f you htvr cf:n&d only bwsln:ri or trada rchocl, or odult rducdlen claiioi, cheek "No." If you cro takInO conespend:n:s courios (giron by USAFI, a unlraralty, c k . ) for high rchtsl or collet:, aodit, chock "YOS." I Stoter..D OR ...................................... - Momo ol b m c n P12. Y k n &id you /Ch& m i r s onto this d a h of hit mow) r bh . b . otc.1 . uh c o m t m pos! or ih¡?? l I ....-..a 1 In 1 9 5 7 .__._..____..__.o ._.__.._ a I Apri! 1955 1 Dec. I 9 5 6 ..__.___._ a --.. I PIJ. Old ycu lim on !his (Anmvzr 1 or 2) I 1. Yes, this p c l rhlp,,o z No, r o n o w h ~ r 2elzc,.,o I In 1 9 5 9 or 1 9 6 0 In IO56 YO$ Jan. 1 9 5 4 ro March 1955 IPSO to 1953 .........0 1 9 4 0 ?o I 9 4 9 1939 or eorlier ..____._ Alwoys lived here post cr s!S? ca April 1, 19557 .......... P11. Is it o p b h rQo:! ....a Privoto or parochial schho01 C Y y a Iira ca k:r!! 1, IrSS? If on bocd r.ip cn Apil 1 , 1955, &cck+ a. City or t i w n . . ............................... b. I! civ cr tsm-Cid y c i GY: ksi?a I a 1 I I ........o P18. If p u hovo ercr bttn morrid- I I thea mrsl ; l ~ Mom than Onco onca ? ? c I J I Yd?% c3 you c:! I X n t t d fcr tha h t tima?' P19. Y k n ¿id y03 F t cd:3 I I I 113 St:!:, fcrFiCn cavz!ry U.S. possession. ctc. . . .: ...................... Pcga 2 I I I I i Yeor.. .......:. .... Papi Year 3 as an cmployao of a prlvcto company-, a i a gorarnntnt ernp!ayee (Fedarcl, .. .......... I 1 .$. I I i 0 O Stato, county, or local) _ _ l _ _ _ _ . _ _ _ _ . _ , _ __ __ __ en a ship which you own o _,____ civilian work, If you worked lort w e k af military onnror qutrfions P28 ond P29. P23. Whit dty cnd county did you vro& in lpst weak? If you worked in more thon one city or county, give place where you worked most last week. Worked on this Answer a, b, ond c, below OR check+ board ship.- c] I I I I ~~ Hlva ycr been ~rrrl:d p I I I I 1 .........-.o CI l'.%:a ...........o o priU=!l s&::r? CT Public school -.-.-.-.-.--.--0 to No I a. Cityortown ................................ b. i t c i v OC bwn- Did you work insids ths city linits? f c' County.. ......... .... ..................Siate.. ........ P29. t ï o a Cid ycu s:t to vish 1 s t weck? Chaac ono box f i r principol mecns u ~ f lort d wcek OR check+ Railroad ____ 0 stroetcor 0 Taxicab ____ II] Other means- Worked on this post or on boord ship-- 0 Wolk only--- 0 Write in: ........................... Pago 4 Continued on other size+