SECTION B
-
Any Ccmur Off=
Place In Enwkps
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S500
CENSUS OF
POPULATION AND HOUSING
8 AUGUST 2006
NORFOLK ISLAND
HOUSEHOLDER'S SCHEDULE
Under the provisions of the Census and Statirtics Act 1%1 you arc rcquired to fill in this form to the best of your
knowledge and belief. However them is no liability to a penalty for omitting information on a person's religion.
The information supplied on this form is CONFIDENTIAL. The Act provides Mit cannot be seen by any
persons other than Census Staff.
I.
FILL IN A SEPARATE FORM FOR EACH HOUSEHOLD.
A household is a domestic group living and eating together. A person Living done is also a houvhdd
2.
IF THERE IS MORE THAN ONE HOUSEHOLD OBTAIN EXTRA FORMS FROM THE CENSUS COLLECTOR
WHEN HE RETURNS. Aka obtain extra fornu if there are more thsn 7 persons in this household.
3.
IF ANY PERSON m THE HOUSEHOLD, SUCH AS A V I S ~ ROR BOARDER, PREFERS M FILL IN A
SEPARATE FORM M MAINTAIN PRIVACY. ASK THE COLLECTOR FOR ANOTHER SCHEDULE. This
private schedule should be fded in by the person wnarned md x d e d in the envelope provided for delivery by
you unopened to the Census Collector with thL schedule.
4.
If you do not know the exact m e r to a question. give the best estimate you an.
S.
Aeue u.c ink or ball mint a n .
6. The completed schedule should be signed m d y to hand to the Census Collector who will call on
Wednesday 9th August or as soon as possible after that day.
I certify that 10the best of my knowledge and belief this form has been comcdy filled in.
Signature of Head of Household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Date. .................
or P m in Charge
Address of Dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
...........................................................................
PLEASECOMPLETEONE COLUMN
FOR EACH PER SO^
For each person who complcter a Personal for
schedule). write only rht m e . tu and relrtic
form md write "PS.' ahcr r h c name
PERSON 2
-
E n u hW h d d Mcw my Idol( harrehdd e
I
L
c
mI
r
.I
1.
.
a
SE(.
one box for a c h
pmon
(c;.
b.
I
3. ACE of Q& pumm
8
4.
I
ycul
LncomPktCyan
Wmt U rhL wmn't RELATIONSHIP to
I
PEWON l?
PERSON
1
5 . Yrmththkpcmn'iPREYKT
MARITAL STATUS?
Tick onc b o x for -ch
-m
1. I f NOT born on IORFOU: I S M D
-
L s h . t ~ Q i d h i . p m o a ~ ~ i . l b c T ~ r q I ~ ~ p - c
d r a w d b pcmuncnrlyatcmgar&)
Yar
....................
.
.
...............
3.
Tbcboldnofn~RhRY
4.
A TOURIST Q V I S ~ P O Rto
N d d k lxl-9
eh-rRY
m
PhRTS 3 OR 4 OF Q U E X I O H 10 PLEAS8 ANSeER
F O U O V W G QUESTION: W NOT CO TO Q W I O N 1L
LP YOU
11. ~tirqourruurlpL.crC.!rpi&na)
Upuu+&-ofncPponn-paitmmdatae.ioo.,iohc
unvl g,d I&(&a h N d d I-.
cr.-0
l m N c r ~
M
NSW.
1
l
FOR A HOUSEHOLD WITH MORE.T H A N 7 PERSONS
PLEASE COSTACT THE COLLECTOR
m (r p m t c hourehold
rionship to hrson 1 on lhir
PERSON 4
PERSON 3
.............
.............. _ ....
......
PERSON 7
...--....................................................................................
........ -
.............
"
PERSON 6
'PERSON S
...................................................
..-...,...
_.._
.......................
- ........................
t
MAC
P
Fcmdc
0
WF
2
......................................
- . Y W
.- .........
................
-- ......
0
hlak
2
0
Fc-lc
MJt
FUl
n
1
57
n
S
0
l
a
0
a
I
0
3
D3
0
4
4
o
5
6
o
5
6
.mm
"
2
IJ 3
04
I7 6
?
....................................V
.............
................................
"
a
0
F-c
1
.............................................. ..............
l
a
Y
l
.............................m1
W1
.
0
03
o
Far&
I
...m l h .................................
mmUu ...................
..............monlhr .........................
...........................
rnenLh1
0
l
2
3
4
S
J
0
6
6
............................................................................................................
Y-...
Ye"
....
Yeu
non
D
0
D
0
1
l
3
I
5
2
0
1
0
1
D
3
5
0
0
[3
ya
c l 1
0
0
1
"
"
NOD
v-0
0
(7
0
m01
v a n
---
... .........--..u...---..--.-.-
...........-......u...-.-"
......
Y W
NO
0
0
0
0
0
4
5
1
....
Ytu
............u...-.........-..u.............
0
NOO
0
1
2
1
3
O
x
4
0 .
5
5
................................. ,.........................................................................................
.......
.
"
.................
"
PLEASE COMPLETE ONE COLUMN
Fbr cach pcnon who completes a Personal (on
phcdult). w i t e only the nune. sex and rclau'c
Tom and wnte "PS." after the name.
FOR EACH PERSOh'
.
nthhngtzmcawhdriLcvhac
-
Record h r k of rtl m,.&l& a d
{iarnt
vimon) rho appn k n!tk d T n d r y IA o m XXj6 ~n
.......................
.
.
.
.............
C k n Nme
m85
1
..............................
- ................
Surarme
EnnrhehoppholdMarxtyukkhm&&dmtmt*r
<. FmW" l
.k--bau.full-ooro
pnrm3 a =d=~
Uudmu. tick
1
F-@=
I 14
irperr0n.s
USUAL MAJOR .4ClTVTTY?
m t t
wocHqIn]atr~oa,agrm
1.
E ~ h v p a i O ~ 6 J E m
2.
...................
mrac6*ly.wDd
15. Is hwFUNMCAPPED
01m
e
n
u&ifion?
m
by
X
SERIOUS Iorcpram &u.
W ant b x
U 'Yu-.hurd(P@-.
g u o n hndiElppd?
G-f p
h W
YU. hu&=4ppd
1.
0
No. no1 b t d l o ~
1.
a y
how U Ihc
or holdiry a job
I.
In . c u a I W Inins. ea. d r e e
5.
h oche.
6.
In
"xfl
--
[F THLS CERV)N rS Uh'DER
16.
I5 Y E A M 01: AGE. R
NO YORE Q m O N S ABOUT THIS E R S O N
Hu hir pxmn obPard IIROFEILSIONAL. TEafMChL. TRADE or
OTHER QUAUnCAllON?
NO.
Fat euh m n . dck oar box
r b p l s nfe - o d e d
NuCuti6y.t~.BA..
i
.
etc.
N u n d lrutitutiDn
1.
1
f b n
FOR A HOUSEHOLD WITH MORE TWAH 7 PERSONS
PLEASE COKTACT THE COUUTTOR
(a p i n t c hourhold
alionship to Penan 1 m (his
PERSON
PERSON 3
'PERSON S
4
.........._........
........_..... ....
PERSON 6
PERSON 7
.............................
........
.
................................. ...............
...
"
.
-
P U A S E COMPETE ONE COLCUN
FOR EACH PERSON
For cach pcrmn who complctcr a Pnronrl ion
rchcdulc), v i l e only the name, ux and rcbt~c
form and write "PS." dlcr che nanc
H~dcrh-~(~~0(1hCM~DttAu~u~M06~nlhilhouwhold
l
PERSON 2
lnJudcmy-whawamNor(oll:onCurru.ntt*nd
rCNrWd 10 nY hOIYhOId m W n t d a y 9 A o ~ 2M6
r
w t M h l r !ban
~ counted elRcmnl &,Is
d .L1d s k a . c h b a d
(~ncludmg
wnrm) who r p m Ibr n q k bT-y
8 Awgm ZDM fa
h%b M d
C i nSme
-e
-Erm1kharrc)sldkdormysdulbho3dmmba
UPcnal
18. In r h . t M D U m Y . B U W W or SERVICE ruUn p m n r o r k h W
~
r
asaQ U h& u pmbk.ndq,ho
plblr W .
hovr talldin(. t r c
or mare rordr.c& r c u l uoccry.
~ l . l n t h c o a r p ~ ~ a Iborc.brrnmyHOUXSdid
lal
WORK IASTIWC?
I
22. Did t b p
~ LOOK
s FOR WO-
'K& one box.
t k -1u
fN~pmm
NXL.UY
LAST-?
'M&for rok- muru pl.-
p-hc
T WEEK?
emplo-.
of r a r n l npplrcrtiom
ar
4- Icrka of xp-fim
&.Cnkmm4
or r-
......
FOR A HOUSEHOLD WITH MORE THAN 7 PERSONS
PLEASE CONTACT THE COLUCTOR
orm (a plivrtt haurrhold
cionrhip to P e r m I on this
PERSON 3
.....--
PERSON P
-
'PERSON S
.....................
....................... -........"......"...............-
...........
-.-
PERSON 6
PERSON 7
...
.
......... -........
....... ...........................
-. ......................................
.......
"
...........................
"
-
Yes
0
Xo
0
0
0
No
0
So
Ye,
0
0
0
0
0
No
I
.............................................
..........................................
-
.....
No
0
0
M
O
y-
.....
."
"
.........................
.........
y-
0
NO
@
C)
U-
No
O
U-
C3
Y-
v-
.............................................
"
y-
(3
No
0
unm
- .
.................
0
......................................
"
hmrl
0
0
0
...,.-
"
0
NO
0
horm
hMuY
hwn
Ye,
........................
Yo
0
y-
0
l
N.3
0
No
0
•
PLEASECOMPLETE ONE COLUMN
F08 EACH PERWF) .
1
NAMEoImrh paron I& m
N g k o f 5 AUpsl2006 In this houxhofd
I-a~pncavhDwsmNdoILonCwntgkyd
mvndto~hDnctaldaWedntsdiy9Au~uu2OOd
t a n commd c l w k w .
'
--
.
m
m
-
U&
wcbrc p.pmQ0 babe lhra
AmtnlL U N d d k I d d .
For each petron who cornp1etcs r Pemnd fc
rrhcdule). w i l e only the name. x x md rclU
( o n and write '?PS." after the name.
PERSON 2
I form (a printe howhold
.htionrhip to Person I on chis
FOR A
PERSON 3
....
.
I
PERSON
HOUSEHOID W I T H MORE THAN 7 PERSONS
PLEASE CONTACT THE COLLECTOR
PERSON S
4
0
m-
....
S per rack
0
S ~ r a c k
Spnvoct
OR
OR
OR
S pr m u m
sprmrn
Sp a m k
---
...
Swwuk
OR
Swanmm
........-....-.....-....
---......................................
SF&
SW-
% p 4
.....................................
............... "
-
OR
OR
OR
Sprmnum
Sp
. mnum
Sprrumum
OR
OR
"
I pcr utmm
pzr annum
..... ..............................................................................
.
.
.
.
.
L
.
.
.
.
SW-
............... ...................
....u..,."
....................
OR
Ipcrlnrmrn
.-.......................................
...............".
OT
IF~W
"
"
.....-.......m.
...........
*-
0
Cd
S pcr wrum
.-
Nolmmm
.....................................
.............
..)....(.._...............................
......
Q
.. .-...........................
.....
..
.................. -.,,...
M-
U
4
PERSON 7
_
............. -
.........-..............-........................... _. .........-.............- .......
m-
PERSON 6
.......
L
....
.-...........................................
I
Iprva*
....
......................
OR
l p rm
1prr-
-.-.....
SF-&
spr-
spnvar*
"
..
"
on
OR
OR
I pr wtiwn~
m
-.. --........
Spa.nmvn
OR
S pruumm
S ~ u m u m
.
.................................
"
1
v=
0
NO
N"
0
0
v=
No
D
0
v.
ye,
wa
H0
U
0
1
0
1
0
1
0
I
0
2
0
2
0
2
0
2
0
3
0
3
a
3
0
3
0
3
0
4
0
4
a
4
0
4
0
4
0
5
U
3
a
5
D
5
a
5
D
6
0
6
0
6
6
0
6
0
1
2
........-.
For e x h pcoon who complctcs I Personal fon
schedule), write only *e m e . X* and relrtio
form and wire "PS."after the name.
PLEASE COMPLETE ONE COLUMN
FOR EACH PERSON
lnclude~~vhow~tnNd&aoCnmamf)dd
m d ~ o h t h a u t h o l d r n PAuxuu?LW5
~ y
-
thirdrnll~bIkptr+Osrru.~m..)mvhich
Writ4 W numbu d each l y p or room in thh dwetlhu h
the boxt.ktor (ca.a bedroomb)).
l7ck r)r bor -ir
& dcxriprca w h ~ tru
h
h b a mn d-cflmg
ToURlST A e M M O D A l T O S
(k
~ i
m D c d J n t J y ~ - )
Nnmbcr d
0-
PI-
~GfR.vnn
&lw)
..............................................
Brdroom(r)
..
CombinoaLou&
Wung Room
Lwrrsc Roam
J%hu Room
&-m(<)
drhu R o m i
- piu
.abdlkDelFg
.-.-...L.-.
...........
-.........-.,..
B M . Bfkk Vemr. Sbnc
BbcL
GmUslc. O n -
r
Fbm. w
r
B u m c-ch m m onec only
a A mam lhud riU wckr W h o l d e r should be
ccunccd only by (be pm&
hourholdo.
h mtuu
l d c d e lmmz?rcn*cndord
~
" r.
bedroom.
1
-4aJibc
----.
LtroacrooralpmmnnbadittaDONOT~c
t #how u 'other roam" ud deui'be.
....--..- .......-...
u B bedmom b
m
I
or a o p go-.
vrbnd or podw f.mrhy)?
M o n t box
U 7 s - r h r t f r U r - o I k ~
C%'b?.cn ( 0 . 4 ~ s ) o r I e n
IX) NWT carat t
o
mpurtciu bwdr*t. rfcmmem.
Uor m d o m .
FOR A HOiiSEHOW WITH MORE THAN 7 PERSONS
P LEASE CONTACTTHE COLUCTOR
orm (a prinft howchdd
tronship to Person 1 on this
PERSON 3
PERSON A
PERSON 6
'PERSON 5
PERSON 7
.-.............................................................
....................................................
........................................... ........................................................................................................................................
'Ihcw questions should preferably bc -red
by the Hcad of the Household.
O Y ~~ ~ o & u r o ~ r u m o n b )
U "Yes'.
b:ht E Lbe W m1 p y . M e ?
B . W b l h Ihe rruin mutar of W A T E R SUPPLY rilhle
lhh dwelling?
bar only
~ u ~n. m n p .
D
OmCroud-ter
C3 2
1
9. ~ ~ P U e L w ~ & ~ u u f o I b c l ~ o r i o . b o u w h d d
,mpo.n) (If. c'm,bhdm U u d hu1,
plcuc inmalt
SECTION A
Attach to Envbkpe
Pmvkbd
Do NOT put In Envelop
CENSUS OF
POPULATION AND HOUSING
8 AUGUST 2006
NORFOLK ISLAND
HOUSEHOLDER'S SCHEDULE
This Census is king ccmduccul c d r authority of Ihc
&mu and S u r i r s Acr. 1 % l .
-SE
RehD THE FOLLOWING INSTRUCTIONSA M 2
THOSE IN SECIlON B.
Barb Scdlw A nod &c scald eavclopc coolaining Sstlon B should bc handed to rhc
bourcbol&or
rn c l w g c by Wodntsday hb August 2006.
Cf you havc difieulties in cornplcting this f a Mr Pcla F m h or Mr %c Malbws.
m assis1 at h e AdminisuaJion OF6cu. Kingston or Telephone 22001.
-
will be avaikblc
SEE S E n I O N A OVERLEAF
l
OFFICE USE
Section A
N m :Pm m-aPmcd Baby &cc
E
.
"Bnby" md s u m ~ m c .
................................................D ~ K.................... 2006
CfHaZdq-w
Mdmn
......................................................................