Statistics
N E W
Z E A L A N D
Dwelling Form
The Census of Population and Dwellings
For Census advice
and information:
Make sure you count
Tuesday, 5 March 1996
• Look at the Dwelling Help Notes
• Call the Census Helpline toll-free
0800 80 1996
Office use
Dist
SubDist
Who should fill in this form?
In every dwelling, one person must take responsibility for this form. An
adult who lives here would be best, but any person can be the one who
must:
• fill in this form; and
• make sure that everyone fills in an Individual Form (the blue one); and
• have all the forms ready for the Enumerator to collect.
MeshB
L
ID elsewhere
NPD
What is your dwelling?
Cont
If you live in a flat which is part of a larger building, your dwelling is your
flat – NOT the whole building.
There are examples of other types of dwellings in the Dwelling Help Notes.
Fill in this form on the night of Tuesday, 5 March 1996.
of
CE
PES
DS
Proc cont
How to fill in this form
For each question: tick one or more circles
N
T
P
M
write a number like this
print an answer in
capital letters like this
Follow the arrow coming from any
answer you tick.
For example, if you had ticked this circle
the next question to answer would be 25.
no
Go to 25
Collection Authority and Confidentiality
One of these forms must be filled in for every dwelling in NZ that
has a person in it on Census night. The information you provide is
collected under the authority of the Statistics Act (1975).
Your information remains confidential to Statistics New Zealand
and is protected by the Statistics Act (1975). Your information
will be used only for statistical purposes.
start
here
1
Len Cook
Government Statistician
Print the full address of this dwelling.
Give all of these if possible:
•
•
•
•
•
These people have to fill in a Census
Individual Form (the blue one) here at this
dwelling:
• everyone who is spending the night of
Tuesday, 5 March 1996 in this dwelling
(including children and babies); and
• anyone arriving at this dwelling before
noon on Wednesday, 6 March 1996,
who has not filled in an Individual Form
anywhere else.
2
flat number (if this is a flat)
street number
street or road name
suburb or rural locality
city, town or district
How many Census Individual Forms (the blue
forms) are being filled in, here in this dwelling?
CS/00/01
D
For Census advice • Look at the Dwelling Help Notes
and information: • Call the Census Helpline toll-free
3
0800 80 1996
In the spaces below, give the information that is asked for, about all the people you counted in question 2.
• Print YOUR name here and give your age.
Your surname
or family name
All your first
or given
name(s)
• Print the names of all the
OTHER people
you counted in
question 2.
Surname or
family name
All first or
given name(s)
2
Surname or
family name
All first or
given name(s)
3
Surname or
family name
All first or
given name(s)
4
Surname or
family name
All first or
given name(s)
5
Surname or
family name
All first or
given name(s)
6
Surname or
family name
All first or
given name(s)
7
Surname or
family name
All first or
given name(s)
8
Surname or
family name
All first or
given name(s)
9
My age on my
last birthday
was:
years
• Give their age. • For each person, tick one circle
For babies
• If you tick “other”, print, for example, my COUSIN
under 1 year
my FLATMATE
my A VISITOR or whatever they are.
old, put 0.
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
years
This
person
is –
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
Print, for example, SISTER,
MOTHER-IN-LAW, FLATMATE
my
If you have more than 9 people, use the spaces at
the bottom of the back page. Don’t forget to come
back to answer question 4 and the other questions.
Census Helpline
toll-free – 0800 80 1996
4
9
Go to 9
no
10
no
5
If nobody who lives here owns
this dwelling, who owns it?
a person or a private trust
a Local Authority or City
Council
Housing New Zealand
Go to 10
How many motor vehicles (apart
from motor bikes or scooters)
do the people who live here have
available for their use?
electricity
DON’T COUNT
• vehicles that belong to visitors
• vehicles that this household borrows
occasionally from another household
• vehicles that can be used ONLY for
work
• motor bikes, motor scooters
bottled gas
If a
microwave
or other electric
appliance is also
used for cooking,
also tick
electricity
other fuel(s)
Print fuel(s)
mains gas
15
1
2
3 or more
a business or other
organisation
11
don’t know
How many bedrooms are there
in this dwelling?
mains gas
bottled gas
wood
other fuel(s)
no
12
don’t know
open-plan
COUNT
rooms such as
• bedrooms
kitchen-lounge
• kitchens
as
• lounges or living rooms 2 rooms
• dining rooms
• rumpus rooms, family rooms, etc.
• conservatories you can sit in
• studies, studios, hobby rooms, etc.
Go to 8
no, dwelling
provided rent-free
other
arrangement
8
Count
Do you, or anyone else who lives
here, pay rent to the owner (or to
their agent) for this dwelling?
yes
Go to 9
DON’T COUNT
• bathrooms • showers
• toilets
• laundries • spa rooms • pantries
• halls
• garages
How much rent does the
household pay to the owner (or
to their agent) for this dwelling?
$
,
.
cents
per
week
Go to 10
fortnight
13
16
Go to 10
calendar month
Print the period covered
by that rent payment
Go to 10
Print fuel(s)
Is there a telephone here in this
dwelling?
COUNT a cell phone that is
here all or most of the time
DON’T COUNT disconnected
or broken phones
yes
17
no
Is there anyone living here who is
away on Census night, and who
will NOT have a Census Individual
Form (the blue one) filled in here?
COUNT
• children away at boarding school
• people in hospital for a short time
• people away on holiday, visiting
relatives, away for work, etc.
Tick as many circles as you need
to show which of the following are
ever used to heat this dwelling.
never use any form of
heating in this dwelling
electricity
DON’T COUNT
• university or other tertiary
students who live somewhere
else for most of the year
mains gas
4-week period
other
Counting those bedrooms, how
many rooms are there in this
dwelling?
If
you heat
water with a
wet-back, show
the fuel(s)
used
solar heating
yes
7
Tick as many circles as you need
to show which of the following are
used in this dwelling for
water-heating.
no water-heating ever
done in this dwelling
electricity
COUNT
• rooms furnished as bedrooms
• any sleepout or caravan which
is used as a bedroom
Is the owner of this dwelling also
the employer of anyone who lives
here?
Tick as many circles as
you need to show which
of the following are ever
used for cooking inside
this dwelling.
no cooking ever done
inside this dwelling
none
other state-owned enterprise
or government department
or corporation
or ministry
6
14
yes
Do you, or anyone who lives here,
own this dwelling (even if it is with
a mortgage, or only partly owned)?
yes
Does anyone who lives here
make mortgage payments for
this dwelling?
bottled gas
yes
no
Go to 20
wood
18
coal
solar heating system
other fuel(s)
HOW MANY people who live here
are away, and will NOT have an
Individual Form filled in here?
Print fuel(s)
Go to the back page
For Census advice • Look at the Dwelling Help Notes
and information: • Call the Census Helpline toll-free
19
0800 80 1996
Answer all the following questions for every one of the absent people you counted in question 18.
Print the names of
ALL the absent people
you counted in
question 18
Surname or family name
All first or given name(s)
How old is
this person?
If you are not
sure, please
guess.
Is this
person
male
or
female?
this person’s
age on their
last birthday,
(if under a
year old, put 0)
How long
altogether
is this
person
away for?
Is this person in
New Zealand
on Census
night (Tuesday,
5 March 1996?)
male
away for less
than 12 months
in NZ on
Census night
female
away for 12
months or more
not in NZ on
Census night
For each person, tick one circle or
print in the space to show how they
are related to you. If they are not
related to you at all, print what they
are, e.g. my
This person is –
wife or my husband or
partner or my de facto
my son or my daughter
my
my
my
OR
Surname or family name
All first or given name(s)
this person’s
age on their
last birthday,
(if under a
year old, put 0)
male
away for less
than 12 months
in NZ on
Census night
female
away for 12
months or more
not in NZ on
Census night
All first or given name(s)
this person’s
age on their
last birthday,
(if under a
year old, put 0)
male
away for less
than 12 months
in NZ on
Census night
female
away for 12
months or more
not in NZ on
Census night
wife or my husband or
partner or my de facto
my son or my daughter
my
my
my
All first or given name(s)
this person’s
age on their
last birthday,
(if under a
year old, put 0)
male
away for less
than 12 months
in NZ on
Census night
female
away for 12
months or more
not in NZ on
Census night
21
Could you please give Statistics NZ a telephone
number (at home or work) where we can contact
you. It will be used only if we need to contact you
about the forms.
(
my
my
my
my
wife or my husband or
partner or my de facto
son or my daughter
my
mother or my father
my
This person is –
OR
20
my
my
my
wife or my husband or
partner or my de facto
son or my daughter
my
mother or my father
my
cannot be
reached
by
telephone
)
area code
Please sign this declaration: I declare that the information
I have given is true and
complete as far as I know.
mother or my father
This person is –
OR
Surname or family name
my
This person is –
OR
Surname or family name
mother or my father
object to
giving
phone
number
✗
Please check that you have answered all the questions you should have answered. Thank you for your time and effort.
3 (continued)
Surname or
family name
All first or
given name(s)
10
Surname or
family name
All first or
given name(s)
11
The spaces below are for you to use if you ran out of space in question 3.
This person’s
age on their
last birthday:
This
person
is –
years
This person’s
age on their
last birthday:
years
This
person
is –
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
my
my
my
my
wife or
husband or
partner or
de facto
my
my
mother or
father
Don’t forget to answer question 4
and the other questions.
my
son or my daughter
other
Print, for example,SISTER,
MOTHER-IN-LAW, FLATMATE
my
my
son or my daughter
other
my
Print, for example,SISTER,
MOTHER-IN-LAW, FLATMATE
Individual Form
Statistics
N E W
Z E A L A N D
The Census of Population and Dwellings
For Census advice
and information:
• Look at the Individual Help Notes
• Call the Census Helpline toll-free
For each question:
write a number like this
print an answer in
capital letters like this
Follow the arrow coming from any
answer you tick. For instance, if you
1
no
Go to 55
Surname or family name
On the night of Tuesday,
5 March 1996, are you at the
address you gave in question 2?
yes
All first and middle name(s), or all given name(s)
2
no
Where do you live – give the full address,
including, if possible, all of these:
•
•
•
•
•
0800 80 1996
9
Go to 6
Give the address where
you are on Census night.
Include, if possible,
all of these:
• flat number (if a flat)
• street number & name
• suburb or rural locality
• city, town or district
4
10
ID elsewhere
CE
PES
DS
year
NZ European or Pakeha
other
European
How long have you lived at the address
you gave in question 2?
Are you:
7
not born 5 years ago
at the address you gave in question 2
Give that address
as fully as you can
Samoan
English
Cook Island
Maori
Dutch
Tongan
Australian
Niuean
Scottish
Chinese
day
month year you were
(e.g. 29) (e.g. 11) born (e.g. 1963)
Indian
8
What country were you born in?
New Zealand
other
Go to 10
Australia
11
England
Tick as many circles as you
need to answer this question.
Are you:
The Netherlands
living in
New Zealand
Western Samoa
working in
New Zealand
Cook Islands
NOT living in NZ
and NOT working
in NZ
Fiji
other
Irish
Print your
ethnic
group(s)
Scotland
Print the country
you were living in
Which of these
groups?
When were you born?
number
of years
Where did you live 5 years ago, on
5 March 1991?
not living in NZ
P
Tick as many circles as you
need to show which ethnic
group(s) you belong to.
female
living in NZ at
another address
L
NZ Maori
country
OR
MeshB
month
(if known)
male
less than
a year
SubDist
If you live in New Zealand,
answer this question.
When did you first arrive to
live in New Zealand?
flat number (if it is a flat)
street number and street name
suburb or rural locality
city, town or district
country
6
3
Office use
Dist
Len Cook
Government Statistician
5
What is your name?
Make sure you count
One of these blue forms must be filled in for
every person in New Zealand on the night of
Tuesday, 5 March 1996, including babies.
The information you provide is collected under
the authority of the Statistics Act (1975).
Your information will be used only for statistical
purposes. Census responses will be used to select
people for a disability survey (see Help Notes).
Your information remains confidential to
Statistics New Zealand and is protected by the
tick one or more circles
had ticked this circle,
the next question to
answer would be 55.
Tuesday, 5 March 1996
Print the present
name of the country
Go to 54
at the end
CS/00/02
Go to 12
Census Helpline
toll-free – 0800 80 1996
12
16
your legal
husband
or wife
Tick as many circles as you need
to answer this question.
In which language(s) could you
have a conversation about a lot of
everyday things?
English
24
Go to 19
your partner or de facto,
girlfriend or boyfriend
none of these
17
Maori
Which of these people live in
the same household as you?
everyday activities that people
your age can usually do
Have you ever been legally married?
yes
no
communicating, mixing with
others or socialising
Go to 20
Samoan
18
NZ Sign Language
other language(s)
(such as GUJARATI,
CANTONESE, GREEK)
Name the
language(s)
Which one of these are you? If you
have been married more than
once, answer for your most recent
marriage.
Go to 20
widowed
none (for example, too
young to talk)
13
Are you descended from a NZ
Maori (that is, did you have a NZ
Maori birth parent, grandparent,
or great-grandparent, etc.)?
yes
Go to 20
permanently
separated from your
legal husband or wife
Go to 20
19
Go to 15
OR
no difficulty with any of these
25
20
no
26
Do you know the name(s) of
your iwi (tribe or tribes)?
Print the
• name and
• region
of your iwi
yes
no
Iwi (tribe)
27
Which of these people live in the
same household as you?
Which of these people live in the
same household as you?
none of these
28
29
Which of these people live in the
same household as you?
your brother(s)
no religion
Christian
no
If you are female, answer this
question.
(If you are male, go to 30.)
How many babies have you given
birth to?
COUNT ONLY any who were
born alive
none
Which of these,
if any, are you?
Hindu
Anglican
Muslim
Presbyterian
Buddhist
Catholic
Jewish
Methodist
other religion
other
Print what it is
OR
Have you ever been a regular
smoker of one or more cigarettes
per day?
yes
your sister(s)
What is your religion?
Go to 29
no
your daughter(s)
15
Do you smoke cigarettes regularly
(that is, one or more per day)?
COUNT ONLY tobacco cigarettes
DON’T COUNT pipes, cigars or
yes
your son(s)
22
Go to 54 at the
end of the form
cigarillos
neither of these
Region
Which of these age-groups
are you in?
15 years or older
your father
21
no
under 15
years old
your mother
14
Do you have any disability or
handicap that is long-term (lasting
6 months or more)?
yes
Is this your first legal marriage?
yes
no
any other activity that people
your age can usually do
not separated but living in a
different household from your
husband or wife
Go to 14
don’t know
divorced or
marriage dissolved
Tick as many circles as
you need to answer this
question.
Does a health problem, or a
condition, you have (lasting
6 months or more) cause you
difficulty with, or stop you
doing:
none of these
23
Apart from the people already
asked about, does anyone else live
in the same household as you?
yes
no
Print who they ALL
are, for example:
MY FLATMATES,
MY AUNTY &
MY COUSINS,
MY SON-IN-LAW,
MY MOTHER’S
PARTNER
OR
number born alive
OR
30
object to answering this question
Tick as many circles as you need
to answer this question.
In the 7 days that ended on
Sunday 3 March, did you:
attend or study for a full-time
course at school or anywhere else
attend or study for a part-time
course at school or anywhere else
object to answering this question
OR
neither of
these things
Census Helpline
toll-free – 0800 80 1996
31
Do you have a secondary school
qualification?
yes
32
35
no
Go to 33
Tick as many circles as you
need to show ALL the ways you
yourself got income in the 12
months ending today.
DON’T COUNT loans, because
they are not income
37
wages, salary, commissions,
bonuses, etc., paid by employer
What is your highest secondary
school qualification?
household work, cooking, repairs,
gardening, etc., for yourself or your
household
self-employment, or business
you own and work in
NZ School Certificate in one or more
subjects
interest, dividends, rent,
other investments
NZ Sixth Form Certificate in one or
more subjects
NZ University Entrance before 1986
in one or more subjects
caring for or looking after any child,
including your own, who lives in the
same household as you
ACC regular payments
caring for or looking after a person
living in the same household as you,
who is aged, ill or has a disability
New Zealand Superannuation
(National Super)
NZ Higher School Certificate or
Higher Leaving Certificate
superannuation, pensions,
annuities (other than NZ Super
or Veterans Pension)
NZ University Bursary or Entrance,
or Scholarship
other NZ secondary
Print the
qualification
school qualification
Unemployment Benefit
OR
38
Domestic Purposes Benefit
overseas secondary
school qualification
Sickness Benefit
Print the qualification, and
the country where you got it
Invalids Benefit
DON’T COUNT
• secondary school qualifications
• part of an unfinished qualification
(e.g. credits towards a degree)
yes
34
no
Go to 35
Give details for each of those
qualifications. If you have more
than 2, give the 2 highest.
Name of
qualification
Main
subject(s)
if any
36
other sources of income,
COUNTING support payments
from people who do not live in
your household
unpaid household work, cooking,
repairs, gardening, or looking after
a person who is aged, ill or has a
disability (DON’T COUNT work for
your own household or
people living there)
no source of income during
that time
unpaid training, coaching,
teaching, giving advice or
counselling, helping at school, etc.
From ALL the sources of income
you ticked in question 35, what
will the TOTAL income be
• that you yourself got
• before tax or anything else was
taken out of it
• in the 12 months that will end on
31 March 1996?
unpaid fund-raising work, selling,
etc., for group, church or marae
other unpaid work
• for people who do NOT live in
the same household as you, or
• for a group, church or marae
Print the type(s) of work you did,
for example:
FIXING NEIGHBOUR’S CAR;
DELIVERING MEALS ON WHEELS.
zero income
$1– $5,000
$5,001– $10,000
1 9
Name of
qualification
$10,001– $15,000
OR
$15,001– $20,000
39
$20,001– $25,000
Main
subject(s)
if any
$25,001– $30,000
$30,001– $40,000
Name of
institution
and country
Year you received it
(had it conferred)
attending committee meeting, or
organisation, administration, policy
work, etc., unpaid, for group, church
or marae
loss
Name of
institution
and country
Year you received it
(had it conferred)
OR
Tick as many circles as you need
to answer this question.
In the last 4 weeks, which of the
following have you done, without
pay, for people who do NOT live
in the same household as you?
looking after a child who does
NOT live in the same household
as you, unpaid
other government benefits,
government income support
payments, or war pensions
Do you have any other qualification,
such as a trade certificate, a diploma
or a degree, that you had to pass a
course lasting at least 3 months
full-time (or the equivalent) to get?
none of these things
DON’T COUNT any you did for pay
Student Allowance
33
Tick as many circles as
you need to answer this
question.
In the 7 days that ended on
Sunday 3 March, which of the
following did you do for yourself, or
for people living in the same
household as you?
DON’T COUNT any you did for pay
$40,001– $50,000
1 9
none of this sort of work
If you have done any of the things
asked about in question 38, answer
this question.
In the last 4 weeks how many hours
did you spend in total, doing all those
things asked about in question 38?
1– 4
5 –14
$50,001– $70,000
15 – 29
$70,001– $100,000
30 – 59
$100,001 or more
60 or more
Go to
the
back
page
Census Helpline
toll-free – 0800 80 1996
40
Tick as many circles as you need
to answer this question.
In the 7 days that ended on
Sunday 3 March, which of these
did you do?
you worked for pay,
profit or income
for an hour or more
Go to 41
you worked in a
family business
or family farm
without pay
Go to 41
you work in a job,
business or farm,
but you were
absent for some
reason last week
OR
41
none of
these
45
46
47
Go to 41
Did you look for paid work
in the last 4 weeks?
In that job, did you mostly:
looked at job advertisements in
the newspapers
work away from home
wrote, phoned or applied in
person to an employer
Give the full address of the place
you mostly worked at. Include, if
possible, all of these:
• name of building
• street number & street name,
or name of shopping centre
• suburb or rural locality
• city, town or district
48
contacted the Department of
Labour’s NZ Employment Service
to look for a job
contacted friends or relatives for
help in finding a job
contacted career advisers or
vocational guidance officers
other method(s), for instance:
• contacted other employment
agency
• placed an ad about a job
• took steps to set up own
business
working in a family business or
family farm without pay
In that job, what was your
occupation, for example:
SHOE SHOP MANAGER,
SHEEP FARMER, BUILDER’S LABOURER,
PRIMARY SCHOOL TEACHER?
How many hours, to the nearest
hour, do you usually work each
week:
SERVICING AND REPAIRING CARS;
ANSWERING PHONES AND TYPING?
If a paid job had been available,
would you have started last week?
yes
about in questions 42 – 47?
no
• in all OTHER jobs you
counted in question 41?
54
49
On Tuesday 5 March, what was
the ONE main way you travelled
TO your work – that is, the one you
used for the greatest distance.
worked at home
did not go to work on
Tuesday, 5 March 1996
Please sign this declaration.
If the person whose details are on
this form is unable to sign, then the
person who filled in the form should
sign.
I declare that the information
I have given is true and
complete as far as I know.
✗
public bus
train
drove a private car, truck or van
In that job, what tasks or duties did
you spend the most time on,
for example: RUNNING MOTEL;
53
• in the job you gave details
In that job which ONE of these
were you?
an employer of other person(s) in
your own business
Go to 53
Tick as many circles as you need
to show all the ways you looked
for paid work in the last 4 weeks.
Go to 42
Answer 42 – 47
about the
ONE you
usually work
most hours in
no
yes
OR
Go to 51
self-employed and not employing
any other person(s)
44
51
work at home
a paid employee
43
What is the main activity of that
business or employer, for example:
SHEEP FARMING, SELLING SHOES,
52
• any job(s) for pay, profit or income
• any job(s) in a family business or
family farm, without pay
42
questions about your
job, go to 54.
MAKING CLOTHES?
COUNT ONLY
more
than
one
50 If you have answered
Otherwise, go to 51.
In those 7 days, did you have one
job or more than one job?
one job
Give the full name of the business
or employer that you worked for in
that job.
drove a company car, truck or van
passenger in a car, truck, van
or company bus
Please check that you have
answered all the questions
you should have answered.
Thank you for your time
and effort.
motor bike or power cycle
bicycle
Office Use
walked or jogged
other (such as taxi,
ferry, aeroplane)
Print the
main way
you
travelled
Proc control
N
T
P
M
D