Census 2A-L - 2016

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

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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

Ce questionnaire est disponible en français (1-855-700-2016)

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, your household 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:

- ONLINE: at www.census.gc.ca by using the secure access code printed above.

or

- ON PAPER: please print using CAPITAL LETTERS.

STEP A

STEP A - Question identifier:1.

What is your telephone number?

  • 1: Telephone Number

STEP A - Question identifier:2.

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

  • 1: Email address

STEP A - Question identifier:3.

What is the address of this dwelling?

  • 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
  • 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

STEP B - Question identifier:1.

Including yourself, how many persons usually live at this address on May 10, 2016?

  • 1: Number of persons

STEP B - Question identifier:2.

Including yourself, list all persons who usually live here on May 10, 2016.

  • 1: FAMILY NAME(S), GIVEN NAME(S)

STEP C

STEP C - Question identifier:1.

Did you leave anyone out of step B because you were not sure the person should be listed? For example, a student, a child in joint custody, a person temporarily away, a person who lives here temporarily, a resident from another country with a work or study permit, a refugee claimant, etc.

  • 1: No
  • 2: Yes. Specify the name, the relationship and the reason.
    - Name(s) and Relationship
    - Reason

STEP D

STEP D - Question identifier:1.

Is anyone listed in step B a farm operator who produces at least one agricultural product intended for sale?
For example, crops, livestock, milk, poultry, eggs, greenhouse or nursery products, Christmas trees, sod, honey, bees, maple syrup products, furs, etc.

  • 1: No. Go to step E.
  • 2: Yes

STEP D - Question identifier:2.

Does this farm operator make the day-to-day management decisions related to the farm?

  • 1: No
  • 2: Yes

STEP E

Copy the names in step B to question 1.
Keep the same order.
If more than five persons live here, you will need an extra questionnaire; call 1-855-700-2016.

STEP E - Question identifier:1.

NAME

  • 1: Family Name, Given Name

STEP E - Question identifier:2.

What is this person's sex?

  • 1: Male
  • 2: Female

STEP E - Question identifier:3.

What are this person's date of birth and age?

  • 1: Day, Month, Year
  • 2: Age

STEP E - Question identifier:4.

What is this person's marital status?

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

STEP E - Question identifier:5.

Is this person living with a common-law partner?

  • 1: Yes
  • 2: No

STEP E - Question identifier:6.

What is the relationship of this person to Person 1?

  • 1: Person 1

    Person 2
    1: Opposite-sex husband or wife of Person 1
    2: Opposite-sex common-law partner of Person 1
    3: Same-sex married spouse of Person 1
    4: Same-sex common-law partner of Person 1
    5: Son or daughter of Person 1 only
    6: Grandchild of Person 1
    7: Son-in-law or daughter-in-law of Person 1
    8: Father or mother of Person 1
    9: Father-in-law or mother-in-law of Person 1
    10: Brother or sister of Person 1
    11: Foster child
    12: Room-mate, lodger or boarder
    13: Other relationship - specify:

    Person 3-6
    1: Son or daughter of both Persons 1 and 2
    2: Son or daughter of Person 1 only
    3: Son or daughter of Person 2 only
    4: Grandchild of Person 1
    5: Son-in-law or daughter-in-law of Person 1
    6: Father or mother of Person 1
    7: Father-in-law or mother-in-law of Person 1
    8: Brother or sister of Person 1
    9: Foster child
    10: Room-mate, lodger or boarder
    11: Other relationship - specify:

STEP E - Question identifier:7.

Can this person 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 E - Question identifier:8. a)

What language does this person speak most often at home?

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

STEP E - Question identifier:8 b)

Does this person speak any other languages on a regular basis at home?

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

STEP E - Question identifier:9.

What is the language that this person first learned at home in childhood and still understands?

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

STEP E - Question identifier:10.

This question is for all persons listed on the questionnaire. If you are answering on behalf of other people, please consult each person.

Does this person agree to make his or her 2016 Census information available in 2108 (92 years after the census)?

  • 1: Yes
  • 2: No

ACTIVITIES OF DAILY LIVING

ACTIVITIES OF DAILY LIVING - Question identifier:11. a)

Does this person have any:
difficulty seeing (even when wearing glasses or contact lenses)?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

ACTIVITIES OF DAILY LIVING - Question identifier:b)

Does this person have any:
difficulty hearing (even when using a hearing aid)?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

ACTIVITIES OF DAILY LIVING - Question identifier:c)

Does this person have any:
difficulty walking, using stairs, using his/her hands or fingers or doing other physical activities?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

ACTIVITIES OF DAILY LIVING - Question identifier:d)

Does this person have any:
difficulty learning, remembering or concentrating?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

ACTIVITIES OF DAILY LIVING - Question identifier:e)

Does this person have any:
emotional, psychological or mental health conditions (e.g., anxiety, depression, bipolar disorder, substance abuse, anorexia, etc.)?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

ACTIVITIES OF DAILY LIVING - Question identifier:f)

Does this person have any:
other health problem or long-term condition that has lasted or is expected to last for six months or more?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

SOCIOCULTURAL INFORMATION

SOCIOCULTURAL INFORMATION - Question identifier:12.

Where was this person born?

  • : Born in Canada
  • 1: Nfld.Lab.
  • 2: P.E.I.
  • 3: N.S.
  • 4: N.B.
  • 5: Quebec
  • 6: Ontario
  • 7: Manitoba
  • 8: Sask.
  • 9: Alberta
  • 10: B.C.
  • 11: Yukon
  • 12: N.W.T.
  • 13: Nunavut
  • 14: Born outside Canada - specify country:

SOCIOCULTURAL INFORMATION - Question identifier:13.

Of what country is this person a citizen?

  • 1: Canada, by birth
  • 2: Canada, by naturalization
  • 3: Other country - specify:

SOCIOCULTURAL INFORMATION - Question identifier:14.

Is this person now, or has this person ever been, a landed immigrant?

  • 1: No. Go to question 16.
  • 2: Yes

SOCIOCULTURAL INFORMATION - Question identifier:15.

In what year did this person first become a landed immigrant?

  • 1: Year

SOCIOCULTURAL INFORMATION - Question identifier:16.

What language(s), other than English or French, can this person speak well enough to conduct a conversation?

  • 1: None; OR
  • 2: Other language(s) - specify:

SOCIOCULTURAL INFORMATION - Question identifier:17.

What were the ethnic or cultural origins of this person's ancestors?

  • 1: Specify as many origins as applicable using capital letters.

SOCIOCULTURAL INFORMATION - Question identifier:18.

Is this person an Aboriginal person, that is, First Nations (North American Indian), Métis or Inuk (Inuit)?

  • 1: No, not an Aboriginal person. Continue with the next question.
  • 2: Yes, First Nations (North American Indian). Go to question 20.
  • 3: Yes, Métis. Go to question 20.
  • 4: Yes, Inuk (Inuit). Go to question 20.

SOCIOCULTURAL INFORMATION - Question identifier:19.

Is this person:

  • 1: White
  • 2: South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)
  • 3: Chinese
  • 4: Black
  • 5: Filipino
  • 6: Latin American
  • 7: Arab
  • 8: Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai, etc.)
  • 9: West Asian (e.g., Iranian, Afghan, etc.)
  • 10: Korean
  • 11: Japanese
  • 12: Other - specify:

SOCIOCULTURAL INFORMATION - Question identifier:20.

Is this person a Status Indian (Registered or Treaty Indian as defined by the Indian Act of Canada)?

  • 1: No
  • 2: Yes, Status Indian (Registered or Treaty)

SOCIOCULTURAL INFORMATION - Question identifier:21.

Is this person a member of a First Nation/Indian band?

  • 1: No
  • 2: Yes, member of a First Nation/Indian band.
    Specify name of First Nation/Indian band.

MOBILITY

MOBILITY - Question identifier:22.

Where did this person live 1 year ago, that is, on May 10, 2015?

  • 1: Born after May 10, 2015
  • 2: Lived at the same address as now
  • 3: Lived at a different address in the same city, town, village, township, municipality or Indian reserve
  • 4: Lived in a different city, town, village, township, municipality or Indian reserve in Canada.
    Specify the name of the city, town, village, township, municipality or Indian reserve of residence 1 year ago.
    - Province/territory
    - Postal code
  • 5: Lived outside Canada.
    Specify the country of residence 1 year ago.

MOBILITY - Question identifier:23.

Where did this person live 5 years ago, that is, on May 10, 2011?

  • 1: Born after May 10, 2011
  • 2: Lived at the same address as now
  • 3: Lived at a different address in the same city, town, village, township, municipality or Indian reserve
  • 4: Lived in a different city, town, village, township, municipality or Indian reserve in Canada.
    Specify the name of the city, town, village, township, municipality or Indian reserve of residence 5 years ago.
    - Province/territory
    - Postal code
  • 5: Lived outside Canada.
    Specify the country of residence 5 years ago.

PLACE OF BIRTH OF PARENTS

PLACE OF BIRTH OF PARENTS - Question identifier:24.

Where was each of this person's parents born?

  • a): Father
  • 1: Born in Canada
  • 2: Born outside Canada - specify country:
  • b): Mother
  • 1: Born in Canada
  • 2: Born outside Canada - specify country:

EDUCATION

EDUCATION - Question identifier:25.

Has this person completed a high school (secondary school) diploma or equivalent?

  • 1: Yes, high school diploma
  • 2: Yes, high school equivalency certificate
  • 3: No

EDUCATION - Question identifier:26. a)

Has this person completed a Registered Apprenticeship or other trades certificate or diploma?

  • 1: Yes, Certificate of Apprenticeship or Certificate of Qualification (Journeyperson's designation)
  • 2: Yes, other trades certificate or diploma
  • 3: No

EDUCATION - Question identifier:26. b)

Has this person completed a college, CEGEP or other non-university certificate or diploma?

  • 1: Yes, certificate or diploma from a program of less than 3 months
  • 2: Yes, certificate or diploma from a program of 3 months to less than 1 year
  • 3: Yes, certificate or diploma from a program of 1 year to 2 years
  • 4: Yes, certificate or diploma from a program of more than 2 years
  • 5: No

EDUCATION - Question identifier:26. c)

Has this person completed a university certificate, diploma or degree?

  • 1: Yes, university certificate or diploma below bachelor level
  • 2: Yes, bachelor's degree (e.g., B.A., B.A.(Hons.), B.Sc., B.Ed., LL.B.)
  • 3: Yes, university certificate or diploma above bachelor level
  • 4: Yes, degree in medicine, dentistry, veterinary medicine or optometry (M.D., D.D.S., D.M.D., D.V.M., O.D.)
  • 5: Yes, master's degree (e.g., M.A., M.Sc., M.Ed., M.B.A.)
  • 6: Yes, earned doctorate (e.g., Ph.D.)
  • 7: No

EDUCATION - Question identifier:27.

What was the major field of study of the highest certificate, diploma or degree that this person completed?

  • 1: Major field of study of highest certificate, diploma or degree: OR
  • 2: No certificate, diploma or degree higher than high school. Go to question 29.

EDUCATION - Question identifier:28.

In what province, territory or country did this person complete his or her highest certificate, diploma or degree?

  • 1: In Canada — specify province or territory: OR
  • 2: Outside Canada — specify country:

EDUCATION - Question identifier:29.

At any time since September 2015, has this person attended a school, college, CEGEP or university?

  • 1: Yes, attended elementary, junior high school or high school
  • 2: Yes, attended trade school, business school, community college, technical institute, CEGEP or other non-university institution
  • 3: Yes, attended university
  • 4: No, did not attend school at any time since September 2015

LABOUR MARKET ACTIVITIES

LABOUR MARKET ACTIVITIES - Question identifier:30.

During the week of Sunday, May 1 to Saturday, May 7, 2016, how many hours did this person spend working for pay or in self-employment?

  • 1: Number of hours (to the nearest hour). Go to question 36
  • 2: None. Continue with the next question.

LABOUR MARKET ACTIVITIES - Question identifier:31.

During the week of May 1 to May 7, 2016, was this person on temporary lay-off or absent from his/her job or business?

  • 1: No
  • 2: Yes, on temporary lay-off from a job to which this person expects to return
  • 3: Yes, on vacation, ill, on strike or locked out, or absent for other reasons

LABOUR MARKET ACTIVITIES - Question identifier:32.

During the week of May 1 to May 7, 2016, did this person have definite arrangements to start a new job within the next four weeks?

  • 1: No
  • 2: Yes

LABOUR MARKET ACTIVITIES - Question identifier:33.

Did this person look for paid work during the four weeks from April 10 to May 7, 2016?

  • 1: No. Go to question 35.
  • 2: Yes, looked for full-time work
  • 3: Yes, looked for part-time work (less than 30 hours per week)

LABOUR MARKET ACTIVITIES - Question identifier:34.

Could this person have started a job during the week of Sunday, May 1 to Saturday, May 7, 2016 had one been available?

  • 1: Yes, could have started a job
  • 2: No, already had a job
  • 3: No, because of temporary illness or disability
  • 4: No, because of personal or family responsibilities
  • 5: No, going to school
  • 6: No, other reasons

LABOUR MARKET ACTIVITIES - Question identifier:35.

When did this person last work for pay or in self-employment, even for a few days?

  • 1: In 2016. Continue with the next question.
  • 2: In 2015. Continue with the next question.
  • 3: Before 2015. Go to question 49.
  • 4: Never. Go to question 49.

LABOUR MARKET ACTIVITIES - Question identifier:36.

For whom did this person work?

  • 1: Name of firm, government agency, etc.
  • 2: Section, plant, department, etc. (if applicable)

LABOUR MARKET ACTIVITIES - Question identifier:37.

What kind of business, industry or service was this?

  • 1: Kind of business, industry or service

LABOUR MARKET ACTIVITIES - Question identifier:38.

What was this person's work or occupation?

  • 1: Occupation

LABOUR MARKET ACTIVITIES - Question identifier:39.

In this work, what were this person's main activities?

  • 1: Main activities

LABOUR MARKET ACTIVITIES - Question identifier:40.

In this job or business, was this person mainly:

  • 1: working for wages, salary, tips or commission? Go to question 42.
  • 2: working without pay for his/her spouse or another relative in a family farm or business? Go to question 42.
  • 3: self-employed without paid help (alone or in partnership)?
  • 4: self-employed with paid help (alone or in partnership)?

LABOUR MARKET ACTIVITIES - Question identifier:41.

If self-employed, was this person's farm or business incorporated?

  • 1: No
  • 2: Yes

LABOUR MARKET ACTIVITIES - Question identifier:42.

At what address did this person usually work most of the time?

  • 1: Worked at home (including farms). Go to question 45.
  • 2: Worked outside Canada. Go to question 45.
  • 3: No fixed workplace address. Continue with the next question.
  • 4: Worked at the address specified below:
    Street address (see example)
    City, town, village, township, municipality or Indian reserve
    Province/territory
    Postal code

LABOUR MARKET ACTIVITIES - Question identifier:43. a)

How did this person usually get to work?

  • 1: Car, truck or van - as a driver. Go to question 43 b)
  • 2: Car, truck or van - as a passenger. Go to question 43 b)
  • 3: Bus. Go to question 44 a)
  • 4: Subway or elevated rail. Go to question 44 a)
  • 5: Light rail, streetcar or commuter train. Go to question 44 a)
  • 6: Passenger ferry. Go to question 44 a)
  • 7: Walked to work. Go to question 44 a)
  • 8: Bicycle. Go to question 44 a)
  • 9: Motorcycle, scooter or moped. Go to question 44 a)
  • 10: Other method. Go to question 44 a)

LABOUR MARKET ACTIVITIES - Question identifier:43. b)

How many people, including this person, usually shared the ride to work in this car, truck or van?

  • 1: Drove alone
  • 2: 2 people
  • 3: 3 or more people

LABOUR MARKET ACTIVITIES - Question identifier:44. a)

What time did this person usually leave home to go to work?

  • 1: Time in hour and minutes.
    - hour : min
  • 2: Mark circle a.m. OR p.m.
    - a.m. OR p.m.

LABOUR MARKET ACTIVITIES - Question identifier:44. b)

How many minutes did it usually take this person to get from home to work?

  • 1: Number of minutes

LABOUR MARKET ACTIVITIES - Question identifier:45. a)

In this job, what language did this person use most often?

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

LABOUR MARKET ACTIVITIES - Question identifier:45. b)

Did this person use any other languages on a regular basis in this job?

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

LABOUR MARKET ACTIVITIES - Question identifier:46.

How many weeks did this person work in 2015?

  • 1: None. Go to question 49; OR
  • 2: Number of weeks

LABOUR MARKET ACTIVITIES - Question identifier:47.

During most of those weeks, did this person work full time or part time?

  • 1: Full time (30 hours or more per week)
  • 2: Part time (less than 30 hours per week)

LABOUR MARKET ACTIVITIES - Question identifier:48.

In 2015, did this person pay for child care, such as day care or babysitting, so that this person could work at his or her paid job(s)?

  • 1: Yes. Enter the total amount for 2015.
  • 2: No

LABOUR MARKET ACTIVITIES - Question identifier:49.

In 2015, did this person pay child or spousal support payments to a former spouse or partner?

  • 1: Yes. Enter the total amount for 2015.
  • 2: No

STEP F

STEP F - Question identifier:F1

Who pays the rent or mortgage, taxes, electricity, etc., for this dwelling?

  • 1: Person 1
  • 2: Person 2
  • 3: Person 3
  • 4: Person 4
  • 5: Person 5
  • 6: A person who is listed on another questionnaire for this dwelling
  • 7: A person who does not live here

STEP F - Question identifier:F2

Is this dwelling:

  • 1: owned by you or a member of this household (even if it is still being paid for)?
  • 2: rented (even if no cash rent is paid)?

STEP F - Question identifier:F3

Is this dwelling part of a condominium development?

  • 1: Yes
  • 2: No

STEP F - Question identifier:F4 a)

How many rooms are there in this dwelling?

  • 1: Number of rooms

STEP F - Question identifier:F4 b)

How many of these rooms are bedrooms?

  • 1: Number of bedrooms

STEP F - Question identifier:F5

When was this dwelling originally built?

  • 1: 1920 or before
  • 2: 1921-1945
  • 3: 1946-1960
  • 4: 1961-1970
  • 5: 1971-1980
  • 6: 1981-1990
  • 7: 1991-1995
  • 8: 1996-2000
  • 9: 2001-2005
  • 10: 2006-2010
  • 11: 2011-2016

STEP F - Question identifier:F6

Is this dwelling in need of any repairs?

  • 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.)

STEP F - Question identifier:F7

Is this dwelling located on an agricultural operation that is operated by a member of this household?

  • 1: Yes. Go to step G.
  • 2: No. Continue this section.

STEP F - Question identifier:F8

For this dwelling, what are the YEARLY payments (last 12 months) for:

STEP F - Question identifier:a)

Electricity?

  • 1: None
  • 2: Included in rent or other payments; OR Enter the amount per year

STEP F - Question identifier:b)

Oil, gas, coal, wood or other fuels?

  • 1: None
  • 2: Included in rent or other payments; OR Enter the amount per year

STEP F - Question identifier:c)

Water and other municipal services?

  • 1: None
  • 2: Included in rent or other payments; OR Enter the amount per year

STEP F - Question identifier:F9

For RENTERS only, answer parts a) and b):

STEP F - Question identifier:a)

What is the monthly rent paid for this dwelling?

  • 1: Rented without payment of cash rent; OR
  • 2: Enter the amount per month

STEP F - Question identifier:b)

Is this dwelling subsidized?

  • 1: Yes
  • 2: No

STEP F - Question identifier:F10

For OWNERS only, answer parts a) through e):

STEP F - Question identifier:a)

What are the total regular monthly mortgage or loan payments for this dwelling?

  • 1: None. Go to part c); OR
  • 2: Enter the amount per month

STEP F - Question identifier:b)

Are the property taxes (municipal and school) included in the amount shown in part a)?

  • 1: Yes. Go to part d).
  • 2.: No

STEP F - Question identifier:c)

What are the estimated yearly property taxes (municipal and school) for this dwelling?

  • 1: None; OR
  • 2: Enter the amount per year

STEP F - Question identifier:d)

If you were to sell this dwelling now, for how much would you expect to sell it?

  • 1: Enter the amount

STEP F - Question identifier:e)

What are the monthly condominium fees?

  • 1: None; OR
  • 2: Enter the amount per month

STEP G

Does this person agree to make his or her 2016 National Household Survey information available in 2108 (92 years after the National Household Survey)?

  • 1: Yes
  • 2: No

STEP H

If more than five persons live here, you will need an extra questionnaire; call 1-855-700-2016.
You have now completed your questionnaire. Please mail it today. If you have lost the return envelope,
please mail the questionnaire to:
Statistics Canada
PO BOX 99997 STN FED-GOVT
Ottawa, ON K1A 9Z7
Thank you for your cooperation.

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