Document 6529070

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.
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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.
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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.
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Sincerely yours,
R o b m V. B W ~ C S O
Dircccor
,
Burcau of the Census
Ø
NOTE:
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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:
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N
~
ofCcountry in
which now l i v i n g . .
..................... I
...................................
l
QUESTIONS
INSIDE
G
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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
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f
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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------).
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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
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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
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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--
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P34. Lart year (I959), did' you rcceiua cny income from:
$..
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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
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or othor
derigncted
anchoragi
...............................
b. Nanr af pori . ............................
c Ciry form ..............................
CI
d. S M o (or U.S.
pc:rtrrim, ctc.)
............................
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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
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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
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...................................."
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
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........o
P18. If p u hovo ercr bttn morrid-
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thea mrsl
; l ~
Mom than
Onco
onca
?
?
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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
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113
St:!:, fcrFiCn cavz!ry
U.S. possession. ctc. . .
.: ......................
Pcga 2
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Yeor..
.......:. ....
Papi
Year
3
as an cmployao of a prlvcto company-,
a i a gorarnntnt ernp!ayee (Fedarcl,
.. ..........
I
1
.$.
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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]
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Hlva ycr been ~rrrl:d p
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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+