I
REPUBLIC OF LIBERIA
a.
MINISTRY
OF
City,
Town or other place name
I
PLANNING AND
ECONOMIC AFFAIRS
FORM PH-3
LONG FORM 1974
CENSUS OF POPULATION
b.,
C.
Street address if available
Structure number
d.
Household Serial number
r
CONFIDENTIAL:
This questionnaire is required by the Government of Liberia for the purposes of planning for 'the future as well as appraising
needs of the Country. All infdrmation herein is accorded confidential treatment and can not be used for purposes of taxation,
or regulation. No person on this form w i l l be mentioned by name, only totals will be shown.
//
Ask all persons over age
'
5
Ask
Ask all women over age
all persons over
age
the present
investigation
10 rears
IO years
years
1
NAME
RELATIONSHIP
HEAD
Whot is the name of the head of this
household ?
Nr '(!of persons who usually live here.
At.,- Babies or old people you did not list?
Name of persons temporily away but who
will return within 2 months.
Name of persons staying here with no usual place of residence elsewhere.
Name of persons not usual residents but
who have been staying here more than
2 months.
How many persons staying here
less than 2 months have a usual
piace of residence elsewhere p.....
(List all persons in order shown in
relationship to head column.)
(-
TO
List persons in following
order.
HEAD. Ist. wife with unmarried children. Other wives
and their children ( number
each wife 1
Married children o f head.
Grandchildren of head.
Other related persons.
Other nonrelated persons.
MARITAL
STATUS
n
w
œ
ntsr "00"
a
What was person
doing most during
past 12 months ?
If person reported
as anything but
working, skip
columns on occupation, industry
and work status.)
If person working
uhat type of work
did they do ?
Example:
Rice Farmer
Auto Mechanic
BUSINESS
OR INDUSTRY
What kind of
business or
industry did
person work
in ?
Example:
Iron mine
Rice farm
WORK
STATUS
Was person paid
employee ?
Was person employer ?
Was person selfemployed ?
Was person unpaid family worker!
I
D
W
a
2
s o a
-
Pp
zgg
O
w
>
t
O
W
.-I
n
O
o
u >
œ
w 3
z
2 x 5
(2)
'00"
USUAL
O CCUPATI ON
ECONOMIC
ACTIVITY
I
œ
-LL
CHILDREN
BORN IN
PAST YEAR
Ask all women w e i
age 14 years regardless of mantal
status.
Ask all
Last
Country if
Number of
persons
birth dab
outside Libaria years person
lived in this
over 10 year!
country.
If always,
enter '25"
If less than
1yr, enter"
~
#
I have listed (-7 persons. Are there
any other persons who are usually
here that have not been mentioned?
If yes, list them.
AGE
I
1
1
1NUMBER O F
LENGTH
CITIZEN
COUNTY O F
OF
OF
BIRTH
ATTENDGRADE
CHILDREN BORN
RESIDENCE LIBERIA
ANCE
COMPLETED
a
E
w
u)
(ln
(5)
1 2 ' 3
3
I
2
3
2
3
4
I
2
3
2
3
4
I
0 I. Owned
0 Rented
or being bought.
for
cash
Rent free or other arrangment.
If rented, what is monthly rent ?
(enter amount)
I-[
ASK
" X" /7
(H-2)
IS HOUSING UNIT OWNED BY SOMEONE
LIVING IN IT OR IS IT BEING RENTED 7
Other
4
-
2
2
a 3 Temporary
J
W
io
3
2
(H-3)
CONSTRUCTION' MATERIALS OF
OUTERWALLS.
/7 Stone, concrete cement block
U Wood boards
D Mud and mat
/7 Reed, bamboo, grass
E3 Galvanized iron
LI
2
-.
( H-I)
'TYPE OF HOUSING UNIT
17 I Conventional- permanent.
D 2 Conventional- semi- permanent
\
I
!
IF LISTING IS CONTINUED ON A
CONTINUATION SHEET, ENTER
a
3
2 (18) 3
2
IO
GJ
ALL
(H-4)
Number of households in this structure
UNumber of rooms in this household
Number of persons in household
( Enter number of persons in household)
lZ7 Number of persons in household
under age 14 years (count children in
column I.)
UTILITIES
Yls
I
D
a
3
4
4
3- 4
3
-
2
3
2
3
4
-
2
3
4
-
HOUSEHOLDS
( H-5 1
AVAILABLE IN HOUSING
UNIT
No
2
17 Inside pipe water
UElsctricity
7
( H-6)
Number of persons who
died in this household in
past
year.
(H-7)
AVAILABILITY
OF
RADIO IN
HOUSING
UNIT
Ye s
I
EZ7
7 /7 Inside flush toilet
C3 I Is kitchen shared with other units ?
7 /7 Is toiiet shared with other units ?
I l . Under S 5
U Z .S 50 to Sl00 Ger
Z73. S l o to $150 per
/4#sl50 to S Z ~
D s . 5200 to S250per
to $300 per month
month
u 7 . $300 to $350 per month
month
U 8 . $350 to $400 per month
~P ~ ~t f ' Dl 9 . Over $400 per month
month
4
-
4
I
REPUBLIC OF LIBERIA
a.
uture as well as appraising
purposes of taxatiorl,
ONFIDENTIAL:
City, Town or other place name
/TT7
Ministry Of Planning
And Economic Affairs
C.
Street address if available
Structure number
Form PH-4 Short Form
1974 Census of Population
d.
Household Serial number
b.
//
persons
RELATIONSHIP
HEAD
NAME
TO
AGE
SEX
MARITAL
STATUS
COUNTY OF
BIRTH
\
place o f residence elsewhere ?.....
(List all persons in order shown in
relationship to head column.)-
z
Ask all
Last
persons
i r t h dat
over IO yea1
List persons in following
order.
HEAD. Ist. wife with unmarried children. Other wives
and their children, ( number
each wife 1
Married children o f head.
Grandchildren of head.
Other related persons.
Other nonrelated persons.
IF LISTING IS CONTINUED ON A
CONTINUATION SHEET, ENTER ' I X "
/7
IO years
LITERACY SCHOOL HIGHEST
ATTENDGRADE
ANCE
COMPLETED
Write
i a m of
tribe.
if notribc
nter "OO"
h n person
read and
write English ?
k person What wasthc
presently highest grodc
attending completed ?
school ? If none enter
ECONGMlC
ACTIVITY
Ask all women ove1
age 14 years regardless of marital
status.
What was person
doing most during
past "12 months ?
[If person reported
as
working,
anything
skipbut
columns on occupation, industry
and work status.)
USUAL
OCCUPATION
If person working,
h a t type of wo&
did they do ?
Example:
Rice Farmer
Auto Mechanic
BUSINESS
OR INDUSTRY
WORK
STATUS
What kind of
business or
industry did
person work
in ?
Example:
Iron mine
Rice farm
Was person paid
employee ?
Was person employer ?
Was person selfemployed ?
Was person unpaid family worker:
1
-
r
-
7
o
w
O
o
I (312
10
TRIBE
t
1
9
CITIZEN
LENGTH
OF
OF
RESIDENCE LIBERIA
Country if
Uumber of
outside Liberia (ears persor
ived in this
country.
f always,
bnter "25"
f less han
yr, enternd
here that have not been mentioned?
If yes, list them.
3 1
age
5 years
-
What is the name of the head of this
household ?
Name of persons who usually live here.
Any babies or old people you did not list?
Name of persons temporily away but who
will return within 2 months.
Name of persons staying here with no us
ual place of residence elsewhere.
Name of persons not usual residents but
who have been staying here more than
2 months.
How many persons staying here
over
the present
investigation
(41
-4
(6)
W
o
O
o
P l 2
-4
-4
1
2
1
2
2
-4
1
2
2
-4
1
2
1
2
1
2
1
1
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
112 -3
2.
2 . 2
9)
~
3
4
4
REPUBLIC OF LISERIA
I
I
a, Place Name on original questionnaire
Ministry Of Planning
And Economic Affairs
CONFIDENTIAL:
// //
/
/ / / I
b. Original Structure Number
Form PH-5 Continuation
c. Origina\ Household Serial Number
L~~~ F~~,,,,1 9 7census
~
of -Population
I
//
This questionnaire is required by the Government of Liberia for the purposes o f planning for the future as well as appraising
needs o f the Country. All information herein is accorded confidential treatment and can not be used for purposes of taxation,
or regulation. No person on this
1
form will be mentioned by
the present
investigation
name, only totals will be shown.
Ask all persons over uge
Ask all women c ver age
5 years
IO year
Ask
all
persons
over
age
IO
years
b
-~
RELATIONSHIP
HEAD
NAME
What is the name of the head o f this
household ?
Name of persons who usually live here.
Any babies or old people you did not list?
Name of persons temporily away but who
will
'urn within 2 months.
Nar,
,f persons staying here with no u s
ual place of residence elsewhere.
Name of persons not usua! residents but
who have been staying here more than
2 months.
How many persons staying here
AGE
TO
MARITAL
STATUS
Ask all
Last
sirth dat
persons
over IO year
List persons in following
order.
HEAD Ist wife with unmarried children. Other Wives
and their children ( number
each wife 1
Married children o f head.
Grandchildren o f head.
Other related persons.
Other nonrelated persons.
COUNTY OF
BIRTH
TRIBE
LENGTH
OF
RESIDENCE
~
Write
name qf
tribe.,
If no tribe
Number of
Country if
outside Liberia years persor
livsd in this
country.
If always,
enter "25"
If less than
I yr, enter"@
1 CHILDREN
NUMBER O F
LITERACY SCHOOL HIGHEST
CHILDREN BORN BORN IN
4TTENDGRADE
PAST YEAfi
COMPLETED
ANCE
Can person Is person
read a n d presently
write Eng- attending
school 1
lish ?
What wasthc Ask all women over
highest grodc age 14 years regcompleted 7 ardless of marital
If none entei status.
"00"
USUAL
O CCUPATION
ECONOMIC
ACTIVITY
What was person
doing most during
past 12 months ?
:If person reported
as anything but
working, skip
columns on occupation, industry
and work status.)
If person working
what type of work
did they do ?
Example:
Rice Farmer
Auto Mechanic
BUSINESS
WORK
STATUS
3R INDUSTRY
What kind o f
business or
industry did
person work
in ?
Example :
Iron mine
Rice farm
Was person pc
em
Was
ploperson
yee ? er
ployer ?
Was person st
employed ?
Was person UI
paid family wor
n
w
relationship
to head column.)-,
a
I have listed
persons. Are there
my-e#w persms who are usually
here that have not been mentioned?
If yes, list them.
a
z
w
a
o
m
O
LL
W
a =
a
z
$2
$E
J
E
w
W
O
k
a
c
(2)
(41
1
(!
2
(6)
(7)
1-12
4
4
3
4
3 4
1
2
1
2
1
2
3 1
1
2
1
2
1
2
4
1
2
1
2
1
2
5
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
4
-
1
2
1
2
1
2
4
-
-
,&KG
IF
IS CONTINUED ON A
CONTINUATION SHEET, ENTER
" X" 0
Enter housing information on original questionnaire
I"
J
& I a
-
n
w
SC3
&
œ
: E
A
'
$ 5
0
0
2
3
2
3
2
3
4
2
I
-
3
4
I
-
2
3
4
-
I
-
2
3
I
2
3
I
2
3
I
-
2
3
1
c
c
4
L
I
I
-
REPUBLIC OF LIBERIA
a.
Ministry Of Planning
CONFIDENTIAL:
City, Town or other place name
/TT7
And Economic Affairs
b.
c.
Form PH-6 Continua-
Street address if available
Structure number
///
tion; Short Form.1974
d.
Census o f Population
Household Serial number
This questionnaire is required by the Government of Liberia for the purposes of planning for the future as well as appraising
needs of the Country. All information herein is accorded confidential treatment and can not be used for purposes of taxation,
or regulation. No person on this form w i l l be mentioned by name, only totals will be shown.
I
//
Ask all persons over age
5 years
RELATIONSHIP
HEAD
NAME
What is the name of the head of this
household ?
Name of persons who usually live here.
Any babies or old people you did not list?
Name of persons temporily away but who
will return within 2 months.
Name of persons staying here with no usual place of residence elsewhere.
Name of persons not usual residents but
who have been staying here more than
2 months.
How many persons staying here
(List all persons in order shown in
relationship to head column.) ,-
TO
AGE
STATUS
List persons in following
order.
HEAD. Ist. wife with unmarried children. Other wives
and their children (number
each wife 1
Married children o f head.
Grandchildren of head.
Other related persons.
Other nonrelated persons.
La st
>kth datc
over IO yea
BIRTH
LENGTH
CITIZEN
OF
OF
RESIDENCE LIBERIA
/D
(7)
I
+
d8)2
1
2
1
2
X"
/7
What was person
doing most during
past 12 months ?
:If person reported
as anything but
working, skip
columns on occupation, industry
and work status.)
USUAL
OCCUPATION
BUSINESS
OR INDUSTFn
If person workiq What kind of
what type. of wad business or
did they do ?
industry did
Example:
person work
Rice Farmer
in ?
Auto Mechanic
Iron
Example:
mine
'
Rice farm
WORK
STATUS
Was person paid
8mplOYUe ?
Was person employer ?
Was person selfemployed 7
Was person unpaid family worker:
I
w
ID
s
4
I
2.
3
4
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
2 ; 3
4
1
'I
ECONOMIC
ACTIVITY
4
7
ENTER
Is person What wasthc Ask all women w e i
presently highest grodc age 14 years regattending completed? ardless of mantal
school? If none entei status.
"00'
CHILDREN
BORN IN
PAST YEAR
3
2
CONTINUATION SHEET,
years
3
1
IF LISTING IS CONTINUED ON A
IO
2
6
IO
age
2
2
9
over
1
2
1
8 1
all persons
1
1
5 1
Ask
IO years
NUMBER OF
ATERACY SCHOOL HIGHEST
CHILDREN BORN
ATTENDGRADE
ANCE
COMPLETEC
k n person
of read and
write Engtribe.
f no trib lish ?
nter "00"
iame
Ask all women over age
1
a
i
TRIBE
lurite
Number of
years persoi
lived in this
country.
If always,
enter "25"
If less than
I yr, enter%
w
here that have not been mentioned?
If yes, list them.
the present
investigation
-
I
I
REPUBLIC
OF LIBERIA
CONFIDENTIAL:
a. City, town o r place n a m e
T;TT7
Ministry of Planning
And
Economic
Form P H - 7
Affairs
b. Street address if
This questionnaire is required by the Government of Liberia for the purposes of planning for the future as weH as appraising
needs of the Country. All information herein is accorded confidential treatment and can not be used for purposes of taxation,
or regulation. No person on this form will be mentioned by name, only totals will be shown.
available
GROUP QUARTERS
Ask all persons over age
1974 Census of Popuc . Name o f
I
lation
Group Quartets
R E L ATIONSHIP
NAME
Type
-I
AGE
SEX
MARITAL
STATUS
Inmate
Guest
Lodger
Wor ke r
Worker's
X
son
Soldier
K
a
z o a
uww
2 x 3
I
Ask all w o r n w e i
age I4 years regardless of marital
status.
What was person
doing most during
:If
pastperson
12 months
reported
?
as anything but
working, skip
columns on occupation, industry
and work status.)
CI
-
w
o
a
w
IO years
WORK
STATUS
Was person paid
omploy.. ?
Was person em-
If person workiq
what type of wort
did they do ?
Example:
Rice Farmer
Auto Mechanic
ployer ?
Was person selfemployed ?
Was person unpaid family worker:
(5)
2
3 4
(6)
(9l
(7)
I-
n
œ
! En
u
7
w
W
n
O
o
ES Yi V
l æ-, lUa -Ix0-
O
o
x
z
Z
P w
x
~
n
o
O
3
O
c3
w
n
1
n
v
-
\
1
2
( IS
3
4
5
I
2
3 4
1
2
1
2
1
2
1
2
3
4
5
1
2
I
2
3 4
1
2
1
2
1
2
1
2
3
4
5
1
2
I
2
3 4
1
2
1
2
1
2
1
2
3
4
5
1
2
1
2
? 4
1
2
1
2
1
2
1
2
3
4
5
1
2
I
2
3 4
1
2
1
2
1
2
1
2
3
4
5
2
3
4
5
1
2
I
2
3 4
1
2
I
2
1
2
1
2
1
2
2 4
1
2
1
2
1
2
1
2
3
4
5
9
1
2
I
2
3 4
1
2
1
2
1
2
1
2
3
4
5
IO
1
2
I
2
3 4
1
2
1
2
1
2
I
2 , 3
4
5
/7
age
1
I
IF L!STING IS CONTINUED ON A
CONTINUATION SHEET, ENTER ' I X "
persons over
USUAL
OCCUPATION
ECONOMIC
ACTIVITY
2
1
7 1
What was the
ighast gmdc
:ompleted 3
f none enter
'00'
w
eg O
Z a Q
(4l
all
w
UJ
'
2
Can persa
read and
write English 7
wU
p
I (312
3 1
Number of
Country if
outside Liberia years person
lived in this
country.
If always,
enter "25"
If less than
I yr, enter"&
2HILDREN
30RN IN
'AST YEAR
n
ELL
(Il
NUMBER O F
HIGHEST
CHILDREN BORN
GRADE
;OMPLETED
1
a
z
w
i
LITERACY
OF
Ask
Ask all women over age
IO years
5 years
LENGTH
OF
RESIDENCE
COUNTY
BIRTH
Last
Ask all
persons
)irth dat
over IO yea
Patient
I
the present
investigatkw
(16)
(17)