PROBNI
Popis 2012
Bosna i Hercegovina
Latin
PILOT CENSUS OF POPULATION, HOUSEHOLDS AND DWELLINGS 2012
Data will be used
for statistical purposes only.
PERSONAL QUESTIONNAIRE (P-1)
FORM
Cyrillic
MUNICIPALITY
ENTITY/BD
ENUMERATION AREA
10. Has the person lived continuously in the place of usual residence since birth?
DWELLING
HOUSEHOLD
PERSON
Question 19
Yes
No
11. The person moved to the address of the place of usual residence from:
SETTLEMENT
1
Other settlement in BiH
MUNICIPALITY
Name
Father’s or mather’s name
FOREIGN COUNTRY
Foreign country
Surname
MONTH
male
DAY
female
MONTH
YEAR
Sex:
Date of arrival:
LAST 6 DIGITS OF THE PIN
Date of birth and PIN
(personal identification number):
YEAR
12. Has the person (ever) lived/reside outside BiH continuously one year and longer?
Yes
PLACE OF USUAL RESIDENCE
1. Does the person lives in the place of Census 12 months and more?
Yes
Question 2
No
Question 3
2. Is the person present in the place of usual residence at the critical
moment of census?
Yes
Question 8
No
Question 3
Question 13
No
Question 13
Person is abroad
COUNTRY FROM WHICH THE PERSON IMMIGRATED
MONTH OF IMMIGRATION
Study
Work
Family reasons
Out of necessity
YEAR OF IMMIGRATION
Other
Reason for immigration:
3. The reason of absence/presence
(copy the code of reason from the List of persons, column 10)
13. Place of usual residence at the time of the Census 1991 (only for persons born before 31.03.1991):
The same address where the
person usually resides today
4. Duration of the absence/presence
One year or more
5. How long the person intends to be
absent / present?
One year or more
Question 6
Less than one year (number of months)
Question 14
SETTLEMENT
Question 5
Other settlement in BiH
MUNICIPALITY
Less than one year (number of months)
FOREIGN COUNTRY
6. The place where the absent person is /place of usual residence of temporarily present person
Foreign country
SETTLEMENT
14. Did the enumerated person have the status of refugee from BiH (after 1991)?
In BiH
15. Did the enumerated person return from refuge?
Yes, to the place the person
fled from
MUNICIPALITY
Yes
Yes, to some other
place in BiH
Has not returned
to BiH
Question 16
No
FOREIGN COUNTRY
16. Did the enumerated person have the status of a displaced person (after year 1991)?
Foreign country
THE SETTLEMENT FROM WHICH THE PERSON HAS BEEN DISPLACED
7. Frequency of returning to the place of usual residence:
Less than once a week
Yes
At least once a week
8. Place of birth
Place of census
MUNICIPALITY
Question 19
No
Question 9
SETTLEMENT
17. Has the enumerated person returned to the place from which he/she was displaced?
Question 19 No
Yes
Other place in BiH
MUNICIPALITY
18. Does the person still have the legal and actual status of a displaced person in BiH?
Question 18
Yes
No
19. Citizenship:
BiH
FOREIGN COUNTRY
Foreign citizen
9. Mother’s place of usual residence at the time of person’s birth:
Place of census
Without citizenship
Question 10
SETTLEMENT
Other place in BiH
FILL IN
BiH and other country
In foreign country
20. Legal marital status:
Single (never married)
Married
21. Does the person live in a consensual union?
MUNICIPALITY
In foreign country
14
Divorced
Widowed
MUNICIPALITY
Yes
11
No
22. Number of live-born children, including those who are not alive any more
(answered only by female persons aged 14 and over)
(only if this question is answered,
question 23 needs to be answered as well)
23. Years of birth of live-born children
MONTH
For more than 2 live-born children fill in the month and year of birth of the youngest child
YEAR
MONTH
First one
YEAR
MONTH
39. Main activity of your employer or business (for persons who work or have worked):
YEAR
FILL IN
Youngest one
Second one
ACCORDING TO THE ARTICLE 12. OF THE LAW ON CENSUS IN BIH, CITIZENS ARE NOT OBLIGED TO DECLARE THEMSELVES ON QUESTIONS 24 AND 25
ACTIVITY CODE
24. Ethnicity/nationality:
Bosniak
Croat
NAME OF THE EMPLOYER/BUSINESS
Not declared
Serb
Other
25. Religion:
40. Place of work/study:
Islam
Catholicism
Orthodoxy
Not declared
In the place of census
Other
26. Mother tongue:
Bosnian
Question 41
SETTLEMENT
Croatian
In other settlement in BiH
Other
Serbian
27. Whether the person can read and write (answered only by persons born before 31.08.2002)?
Yes
MUNICIPALITY
No
FOREIGN COUNTRY
28. What the person can perform on computer (answered only by persons born before 31.08.2002; multiple answers possible)?
Text processing
Using e-mail
Drafting tables
Using internet
29. Highest level of completed education (answered only by persons born before 31.08.1997)?
1 years or
2 year
Secondary school
4 or 5 years
3 years
Grammar school
Specialist
Secondary
technical school
Master of Science
Secondary vocational
school
Doctor of Science
Post-secondary school and first grade of the faculty
Bus
Tram
Trolley
Train
Motorcycle
Bicycle
By foot
Other
Does not travel
Salary or other allowance based on work except in agriculture
Social welfare
Income from agriculture
Other benefits or income
(scholarships, student loans, alimony etc)
Income from renting dwelling, land, shop, or other property,
or income from royalties
Loans or savings
Doctoral degree (third cycle)
Other sources
Sick leave or maternity leave pay
Dependant
Question 43
Financial compensation for persons who have lost their jobs
(due to bankruptcy, redundancy etc)
31. School attendance:
Not attending
school
Primary school
Specialization after
secondary school
Pre-school
education
Secondary
school
Post-secondary
school
Basic academic studies –
old program
Master academic
studies – old program
First cycle
(Bologna process)
Specialist studies –
old program
Doctoral academic
studies – old program
Second cycle
(Bologna process)
Third cycle
(Bologna process)
43. The supporter of the enumerated dependant is a person who:
Performs non-agricultural work
Has other income sources
Performs agricultural work
Works abroad
Pensioner
Legal entity
ECONOMIC ACTIVITY (32-39 ANSWERED ONLY BY PERSONS BORN BEFORE 31.08.1997)
32. Did the person work in the week from 25-31 August, even if only for one hour, for either pay or profit, or unpaid family member?
Yes
Question 44
Question 44
Pension
Master’s degree (second cycle and integrated study)
Teacher-training
school
Higher education/faculty/academy/university
Car
42. The main source of livelihood throughout the year:
BOLOGNA-COMPLIANT PROGRAM
Bachelor’s degree and undergraduate
(first cycle of studies)
Secondary religious
school
Secondary art school
(ballet, music, etc.)
Specialization after secondary school
41. Means of travelling to work/studies (not more than two answers):
Graduate
TYPE OF SECONDARY SCHOOL
Primary school
None of the listed
30. Qualifications obtained (only if answer “higher education/
faculty/academy/university” is marked at question 29)
OLD PROGRAM
5 years
4 years
6 years
No formal schooling
Incomplete basic education (Fill in the highest completed class
of primary school)
eight-year program or
nine- year program
old program
In another country
No, but has a job to return to
(sick leave, vacation etc)
Question 37
33. Did the person look for a work, in the period between
the 4-31 August?
Question 37
44. Does the person have limitations in performing day-to-day activities at home, work or school? (possible multiple answers)
No, waiting to start a job
already obtained
Yes
Yes
36. Has the person ever worked?
35. Status of an inactive person:
Question 40
Yes
No
Retired
Person with income from property or
investments, interests, rents or royalties
Homemaker
a) Type of limitation
Question 35
No
b) Grade of limitation
No
34. Could the person start working in the period 1-15 September if a job is offered?
Pupil/student (aged 15 and over)
No
Question 42
Question 42
Question 36
No
Yes, some
Yes, a lot
c) Cause of disability (the answer is given for each difficulty the person has)
Yes, completely
prevented
Congenital
Injury during
Illness
delivery
Injury at
work
Traffic Consequence
Other
accident
of war
Seeing, even when wearing glasses
Hearing, even when using hearing aid
37. Status in employment:
Employee (work for an employer)
Walking or climbing up the stairs
Employee (work for an employer)
Remembering or concentrating
Self-employed (without employees)
Bathing or dressing
Farmer working on his/her own farm
Communicating (with other people)
Incapable of work
Farmer working on his/her own farm
without employees
Other inactive person
Unpaid family member
45. Does the person with mentioned limitations use the assistance of
another person?
Yes
46. The person who provided the data is:
The enumerated person
No
Member of the household
SIGNATURE
Other person
38. Ocupation (for persons who work or have worked):
TO BE FILLED IN BY THE MUNICIPAL INSTRUCTOR
SN
12
13
Relation to the household
reference person
Ordinal number of
the family
The position of the person
as a family member