Canadian Income Survey - 2013
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Activity (Labour force) (ACT1)
- Activity (Labour force) (ACT2)
- Activity (School attendance) (ACT3)
- Support payments received (SCC1)
- Support payments paid (SCC2)
- Childcare expenses (SCC3)
- Inter-household transfers - amounts received (IHT1)
- Inter-household transfers - amounts paid (IHT2)
- Total personal income (INC1)
- Introduction to the disability screening questions (PDSQ)
- Disability screening questions (DSQ)
- Financial difficulty due to disability (FDD)
- Owners and renters (DWL)
- Owners (OWN)
Activity (Labour force) (ACT1)
Activity (Labour force) (ACT1) - Question identifier:ACT1_Q01
Did you work at a job or business in ^DV_REFYEAR?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Activity (Labour force) (ACT1) - Question identifier:ACT1_Q05
During ^DV_REFYEAR, how many weeks did you work at a job or business? [Include vacation, maternity or parental leave, illness, strikes and lock-outs./(Include vacation, maternity or parental leave, illness, strikes and lock-outs.)]
Min = 00; Max = 52
Activity (Labour force) (ACT1) - Question identifier:ACT1_Q10
During [that week/those weeks], how many hours did you [work/usually work per week] at all jobs?
Min = 1.0; Max = 168.0
Activity (Labour force) (ACT1) - Question identifier:ACT1_Q15
Considering all the jobs you have held in ^DV_REFYEAR, did you work...
- 1: as an employee?
- 2: as self-employed?
- 3: in a family business without pay?
- 8: RF
- 9: DK
Activity (Labour force) (ACT2)
Activity (Labour force) (ACT2) - Question identifier:ACT2_Q05
[During ^DV_REFYEAR,/(During ^DV_REFYEAR,)] how many weeks were you without work AND looking for work? [Include temporary lay-offs./(Include temporary lay-offs.)]
Min = 00; Max = 52
Activity (Labour force) (ACT2) - Question identifier:ACT2_Q10
What was your main activity during the [week/weeks] when you were neither working nor looking for work?
- 1: Ill, or disabled and unable to work
- 2: Took care of home or family
- 3: Went to school
- 4: Retired
- 5: Other - Specify
- 8: RF
- 9: DK
Activity (School attendance) (ACT3)
Activity (School attendance) (ACT3) - Question identifier:ACT3_Q05
Did you attend a school, college, CEGEP or university [at any time between January and December ^DV_REFYEAR/(at any time between January and December ^DV_REFYEAR)]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Activity (School attendance) (ACT3) - Question identifier:ACT3_Q10
Were you enrolled as...?
- 1: A full-time student
- 2: A part-time student
- 3: Both full-time and part-time student
- 8: RF
- 9: DK
Activity (School attendance) (ACT3) - Question identifier:ACT3_Q15
Did you receive any money from a scholarship, bursary or fellowship in ^DV_REFYEAR?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Activity (School attendance) (ACT3) - Question identifier:ACT3_Q20
What was the total amount you received in ^DV_REYEAR?
Min = 1; Max = 999995
Support payments received (SCC1)
Support payments received (SCC1) - Question identifier:SCC1_Q05
Between January and December ^DV_REFYEAR, did you receive support payments from a former spouse or partner? [By support payments I mean a formal agreement for spousal support, alimony, separation allowance, or child support./(By support payments I mean a formal agreement for spousal support, alimony, separation allowance, or child support.)]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Support payments received (SCC1) - Question identifier:SCC1_Q10
What is your best estimate of the amount of support payments you received in ^DV_REFYEAR?
Min = 1; Max = 99999995
Support payments paid (SCC2)
Support payments paid (SCC2) - Question identifier:SCC2_Q05
Between January and December ^DV_REFYEAR, did you make support payments to a former spouse or partner? (By support payments I mean a formal agreement for spousal support, alimony, separation allowance, or child support.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Support payments paid (SCC2) - Question identifier:SCC2_Q10
What is your best estimate of the total amount you paid in support payments in ^DV_REFYEAR?
Min = 1; Max = 99999995
Childcare expenses (SCC3)
Childcare expenses (SCC3) - Question identifier:SCC3_Q05
Between January and December ^DV_REFYEAR, did you pay for child care, so that you could work at your paid job(s)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Childcare expenses (SCC3) - Question identifier:SCC3_Q10
What is your best estimate of the total amount you paid for child care between January and December ^DV_REFYEAR? [blank/Please exclude any amount previously reported.]
Min = 0; Max = 99999995
Inter-household transfers - amounts received (IHT1)
Inter-household transfers - amounts received (IHT1) - Question identifier:IHT1_Q05
Excluding spousal and child support payments from a formal agreement, did anyone not living with you help to pay for your annual living expenses by giving you money or paying bills, [between January and December ^DV_REFYEAR/(between January and December ^DV_REFYEAR)]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Inter-household transfers - amounts received (IHT1) - Question identifier:IHT1_Q10
[Between January and December ^DV_REFYEAR,/(Between January and December ^DV_REFYEAR,)] did anyone not living with you help to pay for your annual living expenses by giving you money or paying bills?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Inter-household transfers - amounts received (IHT1) - Question identifier:IHT1_Q15
In total, how much did you receive from anyone not living with you between January and December ^DV_REFYEAR?
Min = 0; Max = 9999995
Inter-household transfers - amounts paid (IHT2)
Inter-household transfers - amounts paid (IHT2) - Question identifier:IHT2_Q05
Excluding spousal and child support payments from a formal agreement, did you help anyone not living with you pay for their annual living expenses by giving them money or paying their bills, [between January and December ^DV_REFYEAR/(between January and December ^DV_REFYEAR)]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Inter-household transfers - amounts paid (IHT2) - Question identifier:IHT2_Q10
[Between January and December ^DV_REFYEAR,/(Between January and December ^DV_REFYEAR,)] did you help anyone not living with you pay for their annual living expenses by giving them money or paying their bills?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Inter-household transfers - amounts paid (IHT2) - Question identifier:IHT2_Q15
In total, how much did you give to anyone not living with you between January and December ^DV_REFYEAR?
Min = 0; Max = 99999995
Total personal income (INC1)
Total personal income (INC1) - Question identifier:INC1_Q05
What is your best estimate of your total personal income, before taxes and deductions, from all sources during the year ending December 31, ^DV_REFYEAR?
[Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income./(Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.)]
Min = -9000000; Max = 90000000
Total personal income (INC1) - Question identifier:INC1_Q10
Can you estimate in which of the following groups your personal income falls? Was your total personal income during the year ending December 31, ^DV_REFYEAR... ?
- 1: Less than $30,000, including income loss
- 2: $30,000 and more
- 8: RF
- 9: DK
Total personal income (INC1) - Question identifier:INC1_Q15
Please stop me when I have read the category which applies to you.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $25,000
- 6: $25,000 to less than $30,000
- 8: RF
- 9: DK
Total personal income (INC1) - Question identifier:INC1_Q20
Please stop me when I have read the category which applies to you.
Was it... ?
- 01: $30,000 to less than $40,000
- 02: $40,000 to less than $50,000
- 03: $50,000 to less than $60,000
- 04: $60,000 to less than $70,000
- 05: $70,000 to less than $80,000
- 06: $80,000 to less than $90,000
- 07: $90,000 to less than $100,000
- 08: $100,000 and over
- 98: RF
- 99: DK
Total personal income (INC1) - Question identifier:INC1_Q25
Does this amount include any Social Assistance payments?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Introduction to the disability screening questions (PDSQ)
Introduction to the disability screening questions (PDSQ) - Question identifier:PDSQ_R05
In order to reduce the length of the interview and to obtain additional information about the relationship between income and persons with and without a disability, one person has been randomly selected in your household for the next set of questions. In your household, you have been selected.
Disability screening questions (DSQ)
Disability screening questions (DSQ) - Question identifier:DSQ_R01
The following questions are about difficulties you may have doing certain activities. Please tell me only about difficulties or long-term conditions that have lasted or are expected to last for six months or more.
Disability screening questions (DSQ) - Question identifier:DSQ_Q01
Do you have any difficulty seeing?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q02
Do you wear glasses or contact lenses to improve your vision?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q03
[With your glasses or contact lenses, which/Which] of the following best describes your ability to see? [You/He/She]... ?
- 1: Have no difficulty seeing
- 2: Have some difficulty (seeing)
- 3: Have a lot of difficulty (seeing)
- 4: Are legally blind
- 5: Are blind
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q04
How often does this [difficulty/condition] limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q05
Do you have any difficulty hearing?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q06
Do you use a hearing aid or cochlear implant?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q07
[With your hearing aid or cochlear implant, which/Which] of the following best describes your ability to hear? [You/He/She]... ?
- 1: Have no difficulty hearing
- 2: Have some difficulty (hearing)
- 3: Have a lot of difficulty (hearing)
- 4: Cannot hear at all
- 5: Are Deaf
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q08
How often does this [difficulty/condition] limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q09
Do you have any difficulty walking, using stairs, using your hands or fingers or doing other physical activities?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_R10
The following questions are about your ability to move around, even when using an aid such as a cane.
Disability screening questions (DSQ) - Question identifier:DSQ_Q10
How much difficulty do you have walking on a flat surface for 15 minutes without resting?
- 1: No difficulty
- 2: Some (difficulty)
- 3: A lot (of difficulty)
- 4: [You/He/She] cannot do at all
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q11
How much difficulty do you have walking up or down a flight of stairs, about 12 steps without resting?
- 1: No difficulty
- 2: Some (difficulty)
- 3: A lot (of difficulty)
- 4: [You/He/She] cannot do at all
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q12
How often [does this difficulty walking limit/does this difficulty using stairs limit/do these difficulties limit] your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q13
How much difficulty do you have bending down and picking up an object from the floor?
- 1: No difficulty
- 2: Some (difficulty)
- 3: A lot (of difficulty)
- 4: [You/He/She] cannot do at all
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q14
How much difficulty do you have reaching in any direction, for example, above your head?
- 1: No difficulty
- 2: Some (difficulty)
- 3: A lot (of difficulty)
- 4: [You/He/She] cannot do at all
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q15
How often [does this difficulty bending down and picking up an object limit/does this difficulty reaching limit/do these difficulties limit] your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q16
How much difficulty do you have using your fingers to grasp small objects like a pencil or scissors?
- 1: No difficulty
- 2: Some (difficulty)
- 3: A lot (of difficulty)
- 4: [You/He/She] cannot do at all
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q17
How often does this difficulty using your fingers limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_R18
Please answer for difficulties or long-term conditions that have lasted or are expected to last for six months or more.
Disability screening questions (DSQ) - Question identifier:DSQ_Q18
Do you have any difficulty learning, remembering or concentrating?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q19
Do you think you have a condition that makes it difficult in general for you to learn? This may include learning disabilities such as dyslexia, hyperactivity, attention problems, etc..
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q20
Has a teacher, doctor or other health care professional ever said that you had a learning disability?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q21
How often are your daily activities limited by this condition?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q22
Has a doctor, psychologist or other health care professional ever said that you had a developmental disability or disorder? This may include Down syndrome, autism, Asperger syndrome, mental impairment due to lack of oxygen at birth, etc..
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q23
Do you have any ongoing memory problems or periods of confusion? Please exclude occasional forgetfulness such as not remembering where you put your keys.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q24
How often are your daily activities limited by this problem?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q25
Please remember that your answers will be kept strictly confidential.
Do you have any emotional, psychological or mental health conditions? These may include anxiety, depression, bipolar disorder, substance abuse, anorexia, etc..
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q26
How often are your daily activities limited by this condition?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_R27
The following questions are about pain due to a long-term condition that has lasted or is expected to last for six months or more.
Disability screening questions (DSQ) - Question identifier:DSQ_Q27
Do you have pain that is always present?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q28
Do you [also/null/blank] have periods of pain that reoccur from time to time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q29
How often does this pain limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q30
Do you have any other health problem or long-term condition that has lasted or is expected to last for six months or more?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Disability screening questions (DSQ) - Question identifier:DSQ_Q31
How often does this health problem or long-term condition limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 8: RF
- 9: DK
Financial difficulty due to disability (FDD)
Financial difficulty due to disability (FDD) - Question identifier:FDD_Q05
In ^DV_REFYEAR, have [you/you and your household] experienced significant financial difficulty because of a long term disability or health problem[(blank)/ of a member of your household]?
- 1: Yes, sometimes
- 2: Yes, often
- 3: No
- 8: RF
- 9: DK
Owners and renters (DWL)
Owners and renters (DWL) - Question identifier:DWL_R05
The next series of questions will be about your dwelling.
Owners and renters (DWL) - Question identifier:DWL_Q05
Is this dwelling part of a condominium development?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners and renters (DWL) - Question identifier:DWL_Q10
Is this dwelling in need of any repairs? Do not include remodelling or additions.
- 1: No, only regular maintenance is needed (painting, furnace cleaning, etc.)
- 2: Yes, minor repairs are needed (missing or loose floor tiles, bricks or shingles, defective steps, railing or siding, etc.)
- 3: Yes, major repairs are needed (defective plumbing or electrical wiring, structural repairs to walls, floors or ceilings, etc.)
- 8: RF
- 9: DK
Owners (OWN)
Owners (OWN) - Question identifier:OWN_Q05
Does anyone in your household operate a farm on this property?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q10
Does anyone in your household operate a business from this dwelling or property?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q15
How many bedrooms are there in this dwelling?
Min = 0; Max = 95
Owners (OWN) - Question identifier:OWN_Q20
Is there a mortgage on this dwelling?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q25
Are property taxes included in your mortgage payments?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q30
Do you have more than one mortgage on your dwelling?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q35
How often do you make regular mortgage payments?
- 01: Weekly
- 02: Every two weeks
- 03: Twice a month
- 04: Biweekly
- 05: Monthly
- 06: Quarterly
- 07: Annually
- 08: Twice a year
- 09: Other - Specify
- 98: RF
- 99: DK
Owners (OWN) - Question identifier:OWN_Q40
Is that...?
- 1: Every two weeks
- 2: Twice a month
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q45
How much do you pay [for your mortgage ^OWN_Q35/for each of these regular mortgage payments], including your property taxes? Exclude irregular and lump sum payments.
Min = 1; Max = 99999995
Owners (OWN) - Question identifier:OWN_Q50
How much do you pay [for your mortgage ^OWN_Q35/for each of these regular mortgage payments]? Exclude irregular and lump sum payments.
Min = 1; Max = 99999995
Owners (OWN) - Question identifier:OWN_Q55
How much do you pay monthly for all these mortgages, including your property taxes? Exclude irregular and lump sum payments.
Min = 1; Max = 99999995
Owners (OWN) - Question identifier:OWN_Q60
How much do you pay monthly for all these mortgages? Exclude irregular and lump sum payments.
Min = 1; Max = 99999995
Owners (OWN) - Question identifier:OWN_Q65
What is the total annual property tax bill for this dwelling? Include school taxes, special service charges and local improvements.
Min = 0; Max = 99999995
Owners (OWN) - Question identifier:OWN_Q70
Is water included in the payments just mentioned?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Owners (OWN) - Question identifier:OWN_Q75
What is the regular monthly condominium fee for this dwelling?
Min = 0; Max = 99999995
Owners (OWN) - Question identifier:OWN_Q80
Are any of the following items included in the payments just mentioned?
- 1: Electricity
- 2: Heating fuel
- 3: Water
- 4: None of the above
- 8: RF
- 9: DK
- Date modified: