SP2000-L1
REPUBLIK INDONESIA
2000 POPULATION CENSUS
BUILDING AND HOUSEHOLD LISTING
Confidential
I. LOCATION IDENTIFICATION
101. Province
102. Regency/
municipality*)
103. Sub district
104. Village
(........................................)
(........................................)
(........................................)
(........................................)
105. Urban-rural
classification
Urban
Rural
106. Block
census
Number
107. Local
Unit
Administration
-1
-2
............................................
.......
II. RECAPITULATION
(Copied from last page of block IV)
201.
Total number of household (Last serial number column 18)
202.
Total number of male household member (Column 23)
203
Total number of female household member (Column 24)
204.
Total number of household member (Column 25)
III. ENUMERATION PARTICULARS
301.
Name
302.
ID number
303.
Date of enumeration/supervision
304. Signature
*) Cross out category not used
to
to
Page ..... of ..... pages
IV. BUILDING AND HOUSEHOLD LISTING
401.
402.
403.
404.
405.
NAME/ SEGMENT SERIAL
SERIAL USAGE OF CENSUS BUILDING
NUMBER NUMBER NUMBER
NUMBER
(Yes = 1 No = blank)
OF
OF
OF
LOCAL
PHYSICAL CENSUS
NON
RESI- MIXED
UNIT
BUILDING BUILDING
RESIDENCE
ADMINIS(PB)
(CB)
DENCE
TRATION
(if
COL.5 = 1
# Q.412
(1)
(2)
(3)
A. TOTAL NUMBER OF THIS PAGE
B. TOTAL NUMBER UNTIL
THE PREVIOUS PAGE
C. TOTAL NUMBER OF CUMULATIVE
THIS PAGE
(4)
(5)
(6)
(7)
406.
407.
408.
409.
410.
411.
412.
RESIDENCE COMPONENT
CONVENTIONAL
OCCUPIED
Yes = 1
No = -
SERIAL
NUMBER
OF
HOUSEHOLD
TYPE OF
HOUSEHOLD
NAME OF THE HEAD OF
HOUSEHOLD
(If col.8 to
col.14
coded 1
write code
Yes = 1
1;
No = BED- KIT- BATH- TOILET WATER ELECif not give
ROOM CHEN ROOM
TRICITY “stripe”(-)
sign)
TOTAL
NUMBER
OF HOUSEHOLD
IN THE
CENSUS
BUILDING
(17)
(18)
PERMANENT
(8)
FACILITY OF CENSUS BUILDING
(Write code 1 if any and stripe (-) if none)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
if “-”
STOP
(16)
Ordinary=1
Special = -
(19)
(If Q. 405 col.5 coded 1
write down the
usage of the census
building # STOP)
(20)
413.
414.
415.
OWNERSHIP
IIF NOT
TOTAL NUMBER OF
STATUS
SELF-OWNED
HOUSEHOLD MEMBER
OF THE
OF CENSUS
CENSUS
BUILDING
MALE FEMALE MALE +
BUILDING
FEMALE
Yes = 1
No = if “1"
# Q.415
Rent/
Contract = 1
Other = -
(21)
(22)
(23)
(24)
(25)
REPUBLIC OF INDONESIA
2000 POPULATION CENSUS
Confidential
Prov.
Reg/Mun Sub District
Village
Cens.Block No.
SP2000-L2
PB No.
HH Ser. No.
Filled by enumeratorA
HH type
Ordinary
Special
de
de
CHARACTERISTICS OF INDIVIDUAL HOUSEHOLD MEMBERS
Incleded : 1. Baby, 2. Gueasts or visitors who have been staying for the past 6 months or
less than 6 months but intended to stay, 3. Servants who staying in this household.
Not included: 1. Persons who have been away for the past 6 months, or less than 6
months who intended to move away, 2. Servants who are not-staying in this household.
Total number of household member
....................................................
DESCRIPTION
01.
Name : ...............................
02.
Relationship to head the household
Head .........1 Spouse ...........2
Children..........3
03.
Sex
04.
Place of birth
Serial number : .........................
Male.................1
Country
01.
Name : ...............................
02.
Relationship to head the household
Head .........1 Spouse ...........2
Children..........3
Other ........4
Female...........2
03.
Sex
04.
Place of birth
: ............................................................................
05.
06.
07.
08.
Month and year of birth and age
Male.................1
Country
State/province *) : ............................................................................
*) Cross out category not used
Serial number : .........................
Other ........4
Female...........2
: ............................................................................
State/province *) : ............................................................................
*) Cross out category not used
05.
Month and year of birth and age
a. Month : ................................................. Year : ............................
a. Month : ................................................. Year : ............................
b. How old are you? (In years) : .......................................................
b. How old are you? (In years) : .......................................................
Marital Status
Single.......................1
Divorced ..................3
Religion
Moslem ....................1
Hindu.........................4
06.
Married........................2
Widowed.....................4
07.
Catholic .......2
Budhist.........5
Protestant.......3
Other ..............6
Indonensia.........1
Foreign ...........2
Citizenship/ethnic
08.
Specify : .................................................................................................
Marital Status
Single.......................1
Divorced ..................3
Religion
Moslem ....................1
Hindu.........................4
Married........................2
Widowed.....................4
Catholic .......2
Budhist.........5
Protestant.......3
Other ..............6
Indonensia.........1
Foreign ...........2
Citizenship/ethnic
Specify : .................................................................................................
HOUSEHOLD MEMBERS 5 YEARS OF AGE AND OVER
09.
Place of residence 5 years ago
Country
09.
: ............................................................................
Country
State/province *) : .....................................................................
*) Cross out category not used
10.
11.
Highest education completed
No Schooling ...........................1
Junior High School...................3
College......................................5
Undergraduate/Graduate.........7
Employed.................................1
School......................................4
12.
13.
10.
11.
Looking for work ................2
Other...................................8
IF Q11 CODED 1, Type of main industry
Food crops................1
Fishery.......................3
Other Agriculture........5
Trade..........................7
Transportation............9
Highest education completed
No Schooling ...........................1
Junior High School...................3
College......................................5
Undergraduate/Graduate.........7
12.
13.
Primary School..................2
Senior High School............4
Academy............................6
What kind of activities during the previous week ?
Employed.................................1
School......................................4
Plantation........................2
Animal husbandry..........4
Manufacturing.................6
Services..........................8
Others.............................0
Employment status
Self employed.....................................................................1
Self employed assisted by temporary employee..............2
Employer.............................................................................3
Employee............................................................................4
Unpaid worker.....................................................................5
: ............................................................................
State/province *) : .....................................................................
*) Cross out category not used
Primary School..................2
Senior High School............4
Academy............................6
What kind of activities during the previous week ?
Place of residence 5 years ago
Looking for work ................2
Other...................................8
IF Q11 CODED 1, Type of main industry
Food crops................1
Fishery.......................3
Other Agriculture........5
Trade..........................7
Transportation............9
Plantation........................2
Animal husbandry...........4
Manufacturing.................6
Services..........................8
Others.............................0
Employment status
Self employed.....................................................................1
Self employed assisted by temporary employee..............2
Employer.............................................................................3
Employee............................................................................4
Unpaid worker.....................................................................5
EVER MARRIED WOMEN 10 YEARS OF AGE AND OVER
14.
Total number of children ever born
14.
Total number of children ever born
......................................
15.
Total number of children still alive
......................................
15.
......................................
Total number of children still alive
......................................
REPUBLIK INDONESIA
SENSUS PENDUDUK 2000
Kablkod. Kecamatan Desa/Kel. No. Blok Sensus
No. BS
NO. BF
No. Urut RT
SP200O-L2
Jenis RT
Contoh pengisian:
O
~~~~~~~~~~~~
KETERANGANANGGOTA RUMAH TANGGA (ART)
~anlIna
ARR
1. hy(2.
. Tvrm yang(InggJ 8 buln .tw hbh,r&l &Mg dwl O burrn(Ibpl
mlmmtunrulrnrcl.tr9,LPrmbntuNnr)rtn#rYalgtlngOll6n~dlnnuhtnlprW
m 1. Am@@o8a -&1981
yang pagl O bulan Ibu k#h.at811
lumg d u l 6
kJntrbp(brnllundvlt~2.clcllbntuh*n3,tnoo1rvlg(#rL(hqgll61NnUhtngg.w
TldrL T
1
ARTlatauART9
lumlrh anggota rumah tangga
No.ART
Uraian KeteranganAnggota Rumah Tangga
m
mr1
I ART 4 atau ART 12
[ym I
ARTZatauART10
ART 3 atau ART ii
No.ART
No.ART
No.ART
[qq
Il.Tuliskan nama sesuai dengan nomor urut ART
~
12. Jenis kelamin
Lakr-lekr...... 1
Pemmpuan.... 2
13. Hubungan dengan kepala rumah tangga
Kepale Nmah t e m 8..... 1 Anak ......................3
Istn/Suemi..................... 2 Lainnye ................. 4
U. Di kabupatdkotamadya dan propinsi mana
dilahirkan?
Nama Kobupatenkotamadya:
7comy8ngd#IL.ou.l
Nama Propinsi:
15. Bulan dan tahun kelahiran serta umur
a. Bulan dan tahun (Masehi) berapa dilahirkan?
b. Berapa umur sekarang (dalam tahun)?
I
I
B. StatudKeadaan perkawinan saat sekarang
Belum kawin ......... 1
Cerei hidup ........... 3
Kawin ................... 2
Cera; mati ............. 4
17.Agama Islam .... 1
K8tholik .. 2
Budhe ... 5
Lainnya .. 6
Protestan3
Hindu ... 4
B. KewarganegaraadSukubangsa
Indonesre ........ 1 (Tulisken suku bangsanye)
Asrng ............... 2 (Tulisken keW8W8negW88nny8)
Tulisken
3
I
UN UK ART BERUMUR 5 TAHUN KE ATAS
B. Tempat tinggal 5 tahun yang lalu (Juni 1995)
Kamod.
Nama Kobupatenkotamadya:
~
C
O
n
Prw.
Kamod.
Pm.
Mod.')
t
~
~
~
Nama Propinsi:
I O. ljazah/STTB tertinggi yang dimiliki
D¡p/Om81/11 ............5
Bl/?l&dek punye ....... 1
AkedemiAM .......... 6
SD/setere ............... .2
PeQ. n n W m l v .... 7
SLTP/Set8r8 ...........3
SMU/setara ........... .4
I 1. Kegiatan apa saja yang dilakukan sslama 1 minggu
yang lalu (bisakbih dan satu jawaban)
Bekerja/pUny8peketjaen ... 1 Sekoleh .............4
Mencari pek./mengenggur.2 Lainnye ..............8
12.Bidang pkejaan utama (Jika P i 1 ado kode 1)
Pertanian tenaman pengen... 1
Perkebunan ........................2
Penk8ni3n .......................... .3
Petem8k8n .........................4
Industri pengokhen ........... . 5
Pedagangen ....6
Jas8 .................7
Angkutan ......... . 8
Leinnye .............9
3. StatusModudukan dalam pekejaan
Berusaha#ekerje sendiri ..................................... 1
BeruS8h8 dibentu dengan buruh tidek tetap ........ .2
Berusaha dibentu dengen buruh tetep .................3
Buruhkatyawe~pekerjedibayer .........................4
Pekerje tidek dibeyer ........................................... 5
UNTUK WAN1
cn
m
c9
CID
m
:RUMUR 10 TAHUN
I
KETERANGAN ANGGOTA RUMAHTANGGA (ARTI
__
_
-
_-
!
ART 5 atau ART 13
Lanjutan anggota Nmah tangga
No. ART
Uraian KeteranganAnggota Rumah Tangga
mrl
I
1
ART 6 atau ART 14
NO.ART
Laki-laki....... 7
No.ART
1
i
ART 8 atau ART 16
No.ART
I
O l . Tuliskan nama sesuai dengan nomor urut ART
02. Jenir kelamin
ART 7 atau ART 15
Pemmpuan...... 2
03. Hubungan dengan kopals rumah tangga
Kepala Nm8h tangga..... 1 Anak ......................3
IsttVSuarni..................... 2 Lainnya ................. 4
04. Di kabupatenntotamadyadan propinsimana
dibhirkan?
Nama Kabupatentlcotamadya:
7-)rmg-Nama Propinsi:
05. Bulan dan tahun kelahiran setta umur
I
Bulan
Tahun
7
Bian
Tahun
I
Bulan
Tahun
1
Bulan
Tahun
a. Bulan dan tahun (Masehi)berapa dilahirkan?
b. Berapa umur sekarang (dalamtahun)?
06. StatusNeadaan perkawinan saat sekarang
Behm kawin ......... I
Cerai hidup ........... 3
Kawin .................. 2
Cerai mati ............ 4
07. Agama Islam ..... i Protestan3
Katholik .. 2 Hindu .... 4
Budha ... 5
Lainnya .. 6
08. Kewarganegaraan/Sukubangsa
Indonesia ........ 1 (Tuliskan suku bangsanya)
Asing ............... 2 (Tuliskan kewarganegaraannya)
Tuliskan
9
UNTUK ART BERUMUR 5 TAHUN KE ATAS
09. Tempat tinggal 5 tahun yang lalu (Juni 1995)
Nama Kabupatenkotamadya:
7-Y-tl-d-
7
-
mod')
7
-
Nama Propinsi:
10. IjezshlSm tertinggi yang dimiliki
Diploma 1/11 ............ 5
Blm/tidak punye ....... 7
Akademr/DIII .......... 6
SD/setara ............... .2
Pew. Tinssi/DlV .... 7
SL TP/setare ............ 3
SMWsetara ............ .4
1 1. Kegiatan apa saja yang dilakukan selama 1 mingg
yang lalu (bisa lebih deri satu jewaban)
Eekerjdpunya peketjaan ... 1 Sekolah .............. 4
Mencan' pek./menganggur .2 Lainnya............... 8
12. Bidang pekeqaan utama (Jika P i 1 ada kode 1)
Pertaniant8namanpang8n 1 Perdagangan 6
Perkebunan
2 Jasa
3 Angkutan
8
Penkanan
Petemakan
4 Lamnya
9
lndustn pengolahan
5
w i c n
a
Tr)
a
m
m
7 c D m
.
13 StatusMedudukan dalam pekeqaan
BerusahdBekeqa sendin
Berusaha dibantu dengen buruh tidak tetap
Berusaha dibentu dengan buruh tetap
BuruhAcaryawadpekeqadrbayar
Pekeqa tidak dibayar
14 Jumlah andc kandung yang pornah dibhifkan
hidup
15. Jumlah snak kandung yang marih hidup
1
2
3
a
m
Ts)
m
CD
I
(P
4
QI
ch)
5
CD
FIF]
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I
1
m
m
m
m
a3
cD
a3
GD
p-lpl
m
CD
m
CD
m
!
I
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m
m I c D
m'CI3
GD
D
m
c5>
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a l C D
G D C D
m
m
m
CD
GD
CD
m
CD
[q-q