Census 3A - 2016

Census 3A - 2016
Other versions of the questionnaire
Related Survey(s)

Archived Content

Information identified as archived is provided for reference, research or record keeping purposes. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please contact us to request a format other than those available.

Archived

Archived Content

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

Show all instructions

Table of Contents

Introduction

Purpose

The census provides a detailed statistical portrait of Canada and its people by their demographic, social and economic characteristics. This information is important for communities and is vital for planning services such as child care, schooling, family services, and skills training for employment.

Authority

This information is collected under the authority of the Statistics Act, R.S.C. 1985, c. S-19.
Confidential when completed.

Confidentiality

THE LAW PROTECTS WHAT YOU TELL US

The confidentiality of your responses is protected by law. All Statistics Canada employees have taken an oath of secrecy. Your personal information cannot be given to anyone outside Statistics Canada without your consent. This is your right.

Assistance

ANY QUESTIONS?

- www.census.gc.ca
- Call us free of charge at 1-855-700-2016
- TTY: 1-866-753-7083

REASONS WHY WE ASK THE QUESTIONS
Steps A to D and question 1 are asked to determine who should complete this questionnaire.

Questions 2 to 6 provide information about the living arrangements of people in Canada, the family size, the number of children living with one parent or two parents, and the number of people who live alone. This information is used for planning social programs, such as Old Age Security and the Canada Child Tax Benefit. It is also used by communities to plan a variety of services such as day care centres, schools, police, fire protection and residences for senior citizens.

Questions 7 to 9 are used to provide a profile of the linguistic diversity of Canada's population. This information is used to estimate the need for services in English and French, and to better understand the current status and the evolution of Canada's various language groups.

Question 10 provides each person with the opportunity to make an informed decision about what happens to his or her personal census information in 92 years. Consenting to the release of census information in 92 years will help future generations better understand the Canada of today, and will benefit historical, academic and genealogical research.

Introduction statement

Message from the Chief Statistician of Canada

The census provides a portrait of our people and the places in which we live. Census information is important for your community and is vital for planning its public services. Be part of this new portrait of Canada and complete your census questionnaire.

In order to reduce the number of questions in this questionnaire, Statistics Canada will obtain your income information from personal income tax and benefits records.

By law, every person must complete a census questionnaire. Your answers are collected under the authority of the Statistics Act and will be kept strictly confidential.

The information that you provide may be used by Statistics Canada for other statistical and research purposes or may be combined with other survey or administrative data sources.

Thank you for your cooperation.

Wayne R. Smith
Chief Statistician of Canada

Reporting instructions

Complete your census questionnaire:
• Please print using CAPITAL LETTERS.
• Mark circles with " X ".

STEP A

STEP A - Question identifier:1.

What is your telephone number?

  • 1: Telephone Number, Ext.

STEP A - Question identifier:2.

What email address could we use to contact you, if applicable?

  • 1: Email address

STEP A - Question identifier:3.

What is the address where you received this questionnaire?

  • 1: Number (and suffix, if applicable) (e.g., 302, 151 B, 16 1/2)
  • 2: Street name, street type (e.g., DR = Drive), direction (e.g., N = North)
  • 3: Apartment/unit/room
  • 4: City, municipality, town, village, Indian reserve
  • 5: Province/territory
  • 6: Postal code

STEP A - Question identifier:4.

What is the mailing address of this dwelling, if different from above?

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

STEP B

What is your name?

  • 1: Family name(s), Given name(s)

STEP C

If you are:
• a Canadian citizen, continue with step D.
• a landed immigrant (permanent resident), continue with step D.
• in Canada asking for refugee status (refugee claimant), continue with step D.
• a person from another country with a work or study permit, continue with step D.

OR

If you are:
• a resident of another country visiting Canada, for example, on vacation or on a business trip; mark the circle, STOP HERE and see instructions in step E.
• a government representative of another country; mark the circle, STOP HERE and see instructions in step E.

STEP D

Is this your main residence?

  • 1: Yes. Continue with question 1 a).
  • 2: No, but I have no other residence in Canada. Continue with question 1 a).
  • 3: No, it is somewhere else in Canada. Specify complete address.

    Number and street or lot and concession
    Apartment/unit
    City, municipality, town, village, Indian reserve
    Province/territory
    Postal code
    Telephone number

    STOP HERE.
    You should be included on the household questionnaire for the above address.
    See instructions in step E.

STEP D - Question identifier:1. a)

Is there any other address in Canada where someone may include you on the census form for that household?

  • 1: No. Go to question 2.
  • 2: Yes. Specify complete address.

    Number and street or lot and concession
    Apartment/unit
    City, municipality, town, village, Indian reserve
    Province/territory
    Postal code
    Telephone number

STEP D - Question identifier:1. b)

Please give the name of another adult (if any) living at this other address.

  • 1: Family name(s), Given name(s)
  • 2: No other adult

STEP D - Question identifier:2.

What is your sex?

  • 1: Male
  • 2: Female

STEP D - Question identifier:3.

What are your date of birth and age?

  • 1: Day, Month, Year
  • 2: Age

STEP D - Question identifier:4.

What is your marital status?

  • 1: Never legally married
  • 2: Legally married (and not separated)
  • 3: Separated, but still legally married
  • 4: Divorced
  • 5: Widowed

STEP D - Question identifier:5.

Are you living with a common-law partner?

  • 1: Yes
  • 2: No

STEP D - Question identifier:6.

What is your status here (at the address you entered in you entered on the front cover)?

  • 1: Resident under care or custody (e.g., patient, inmate)
  • 2: Room-mate, lodger or boarder
  • 3: Employee
  • 4: Employee's family member
  • 5: Other status — specify:

STEP D - Question identifier:7.

Can you speak English or French well enough to conduct a conversation?

  • 1: English only
  • 2: French only
  • 3: Both English and French
  • 4: Neither English nor French

STEP D - Question identifier:8. a)

What language do you speak most often at home?

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

STEP D - Question identifier:8. b)

Do you speak any other languages on a regular basis at home?

  • 1: No
  • 2: Yes, English
  • 3: Yes, French
  • 4: Yes, other language - specify:

STEP D - Question identifier:9.

What is the language that you first learned at home in childhood and still understand?

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

STEP D - Question identifier:10.

Do you agree to make your 2016 Census information available in 2108 (92 years after the census)?

  • 1: Yes
  • 2: No

STEP E

You have now completed your questionnaire.
Please see instructions on the envelope.
Thank you for your cooperation.

Date modified: