Fuel Consumption Survey
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
A Introduction
Purpose
The purpose of this survey is to measure road use by light motor vehicles, their fuel consumption and their impact on the environment.
Additional information
Although your participation in this survey is voluntary, your cooperation is important so that the information collected will be as accurate and complete as possible.
Authority
Collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S19.
Confidentiality
The Statistics Act protects the confidentiality of information collected by Statistics Canada.
Your information may also be used by Statistics Canada for other statistical and research purposes.
More information on confidentiality, information sharing and record linkage can be found in the Reporting Guide.
Data-sharing agreements
With your authorization, the information collected during this survey will be shared with Transport Canada, Environment Canada and Natural Resources Canada. Names, addresses and telephone numbers will not be shared. These organizations have agreed to keep the data confidential and use them only for statistical purposes.
Reporting instructions
Please complete this questionnaire for the period and vehicle appearing on the label above. Refer to the Reporting Guide for help in completing the questionnaire.
B When you begin the survey
B When you begin the survey - Question identifier:1.
Please report the date that you began the survey. (YYYY-MM-DD)
B When you begin the survey - Question identifier:2.
Please report the odometer reading on this date.
B When you begin the survey - Question identifier:3.
Please report the fuel gauge reading on this date. Your best estimate is acceptable.
- 1: Full
- 2: 7/8 full
- 3: 3/4 full
- 4: 5/8 full
- 5: 1/2 full
- 6: 3/8 full
- 7: 1/4 full
- 8: 1/8 full
- 9: Empty
C During the survey period
C During the survey period - Question identifier:4.
Did you purchase any fuel during the survey period? If yes, please record the date and quantity purchased. (Litres/U.S. gallons)
D When you finish the survey
D When you finish the survey - Question identifier:5.
Please report the date that you finished the survey. (YYYY-MM-DD)
D When you finish the survey - Question identifier:6.
Please report the odometer reading on this date.
D When you finish the survey - Question identifier:7.
Please report the fuel gauge reading on this date. Your best estimate is acceptable.
- 1: Full
- 2: 7/8 full
- 3: 3/4 full
- 4: 5/8 full
- 5: 1/2 full
- 6: 3/8 full
- 7: 1/4 full
- 8: 1/8 full
- 9: Empty
D When you finish the survey - Question identifier:8.
During the survey period, was this vehicle used for commercial purposes?
Refer to the Reporting Guide for a definition of "commercial purposes".
- 1: Yes
- 2: No
D When you finish the survey - Question identifier:9.
If yes, what percentage of the total distance driven during the survey period was for commercial purposes? Your best estimate is acceptable.
E Information about the main driver
E Information about the main driver - Question identifier:10.
What is the sex of the main driver?
- 1: Male
- 2: Female
E Information about the main driver - Question identifier:11.
What is the age of the main driver?
F Information Sharing
F Information Sharing - Question identifier:12.
With your authorization, the information collected during this survey will be shared with Transport Canada, Environment Canada and Natural Resources Canada. Names, addresses and telephone numbers will not be shared. These organizations have agreed to keep the data confidential and use them only for statistical purposes.
Do you authorize Statistics Canada to share the information provided?
- 1: Yes
- 2: No
G Comments
G Comments - Question identifier:13.
Do you have any comments?
- Date modified: