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Population and Housing Census 2010 Country SAO You Have Moved From

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Population and Housing Census 2010 Country SAO You Have Moved From -4- (ภาษาอังกฤษ) Sheet no. ………..of……………for this household Birth province How long have Where did you If you have lived If you have Do you have a disability? Confidential or country you lived in this previously live? somewhere else, moved from municipality/SAO? Specify specify the somewhere else Amphoe/Province/ municipality or specify reasons. If yes, specify the disability Country SAO you have Population and Housing Census 2010 moved from. e.g. e.g. National Statistical Office ๑๐๐ th 100 Anniversary Population Census in Thailand If you have never Looking for work - Blind in both eyes National Statistical Office moved, write PHC 2/1 “NEVER MOVED.” Work-related - Unable to speak/mute/or unable to speak intelligibly (Special Enumeration Form) (For manual or online completion or Telephone Interview) Then skip (22) and Study-related (23), and go to (24). - Loss of at least one foot at Attention: Household owner Accompanying a the ankle or above or one family member arm at the wrist or Instruction: - Please provide information about every member in your household (Official listing in above/Paralyzed Back to hometown the census registration is not necessary.), including permanent members, visitors staying - Mentally ill/ Move house Violent/Withdrawn/Autistic over 3 months, and temporary absentees (who have no other permanent address). - Intellectually challenged - Your information will be treated in strict confidence and will be used by NSO solely for the purpose of national development, not for revenue collection. - In case of more than one disability, list all. Completion Methods: 1) For manual completion, please put the completed form in the envelope provided and return it in person to the NSO agent as previously arranged or by prepaid post (by July 2010). - Write “no disability” if you have no disability, and go or 2) For online completion, please access our website: www.nso.go.th Enter 20-digit reference to the question concerning or 3) For completion by phone, please call our hotline number : 1111 number in the brown household at the bottom Province/Country of this page. box for access. (19) (20) (21) (22) (23) (24) Thank you for your cooperation in filling out this form. Household address 20-digit reference number to be used as user name to a. Street address, Alley, Stream, Neighborhood (Specify access online completion website : www.nso.go.th or completion via hotline at 1111 name if any) …………………………...... Tel: ...………… Region .….………………………………………………… Region 1 Province ….….…….…………………………………….… Province 2-3 Amphoe/District ...………………………………………… Amphoe/District 4-5 Tambon/Sub-district …… ...……………………………… Tambon/Sub-district 6-7 b. Administrative district Within municipality ....... 1. Without municipality ........ 2 Administrative district 8 Name of municipality............ Name of SAO........................ Municipality/SAO 9-11 c. Enumeration Area ................................................................. Enumeration Area 12-14 d. Moo ........... Village ............................................................. Moo 15-16 e. Type of household (from PHC1 Form. C17-18) Private household............ 1 Collective household .......... 2 Type of household 17 f. Household serial number (from PHC1 Form. C17-18) Household serial number 18-20 g. Household language(s) (9) “Main source of water used or (10) As of 1 July 2010, which of the following (11) As of 1 July 2010, which of drunk in the house” items does your household have? the following items does your Thai only..... 1 Thai mixed with other languages .... 2 Others .... 3 Language spoken 21 (Put a check √ for both drinking Check all that apply. house have? and non-drinking water”) Check all that apply. Other languages used (specify) ………………. Other languages 22-23 Drinking Non-drinking 1. Tap water c c c 1. Television c 7. Washing machine c 1. Cable TV h. Number of household members (Recorded after enumeration) …… Total number of members 24-27 2. Treated tap water c c 2. VCD/DVD player Air-conditioner 2. Satellite dish (boiled/filtered) c c 8. c c c 3. Underground c 3. Mobile phone c 9. Car/pick-up truck/van c 3. Internet For official use only c c 4. Well water c 4. Computer c 10. Motorcycle c c 5. River/Steam/Canal/ waterfall/ mountain c 5. Fridge/cold box c 11. 4-wheel tractor Date of enumeration …………………….. 2010 Date of editing and coding ……………………… 2010 c 6. Microwave c 12. 2-wheel steamroller c c 6. Rainwater First/Last Name ………………………………………. First/Last Name ………………………………………. c c 7. Bottled water/water from vending machine Enumeration Officer Editing and Coding Officer c c 8. Others (specify) .............. -2- -3- In the row below, provide information for each person residing in this house. (Official listing in the census registration not necessary) First/Last Name Relationship Sex Age Religion Nationality Is he or she Current If still in Highest Literacy Females only Marital Current Description Status at work Province or (everyone actually with head of (in years) listed in education school, level of status Occupation of country of your living in this house.) household census level specify education Number of biological (as of 1 workplace workplace registration? province achieved children born - If employed, specify July 2010) responsibilities or country (both still alive and and position (if any) where deceased) e.g. studying. e.g. e.g. e.g. e.g. Official listing in If no If never went Children who Deceased census registration longer in to school, Wife or are still alive. children Single, - Bank manager - Commercial Employer not necessary. school, husband, son- write (either living in married/ - Electrical engineer bank, specify so Self-employed in-law, “NEVER or outside this Partnership and go to - Primary school - Carbonated (with no daughter-in- ATTENDED house) (either (10) teacher drink factory, employees) law, SCHOOL.” registered - Owner of grandchildren, or not), - Secondary Help with family dressmaking shop mother, Widowed, school, business with no - Dishwasher father, Divorced, Dressmaker’s compensation mother-in- Separated. - In case of more than - Noodle shop Government/ law, father-in- Can you Can you Write “0” if there are none. one job, specify the State enterprise/ law. read read or one that takes up the Private sector or write write other Living Living largest amount of time. worker in this else- Thai? languages? - If unemployed, write house Where “UNEMPLOYED” and go to (19) Province/ (Y/N) (Y/N) (Y/N) Country (Specify) (persons) (persons) (persons) Province/Country Rank (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) 1 Head of household 2 3 4 5 6 7 Type of residence (For use by head of household only). Choose only one response in each box. Put a check √ in the c or write in the blank. ……… (1) “type of residence” (2) “Materials used” (3) “Type of occupancy” (Excluding land) (4) “Type of occupancy (5) “Number of (6) “Main source (7) “Main type of (8) Which of the following (In case of more than one house, (For those who checked items 1,2, 3, 4 of land where the bedrooms of lighting in cooking fuel used most characterizes check the one where the head or 5 in (1)). house is located” and other rooms this house.” in this house.” the toilets in the house? of household resides.) used as bedrooms (For those who checked in the house” c 1. Detached house c 1. Concrete c 1. Own house –under mortgage item 1, 2, or 3 in (3). c 2. Town house/Duplex/Town Home c 2. Wood c 2. Own house – own outright c 1. Gas c 1. Flush c 3. Condominium c 1. Owner c 1. MEA/PEA c 3. Half concrete half wood c 3. Lease purchase 1. Number of bedrooms c 2. Squat c 4. Flat/Apartment/Dormitory c 2. Solar power c 2. Charcoal/wood/ c 4. Locally found temporary materials e.g. c 4. Rental c 2. Lease Purchase c 5. Row house/shop house .................. rooms scrap wood c 3. Both flush and squat bamboo, thatch c 3. Rental (solar cells) c 6. Room in a house c 5. Rental (covered by salary) c 3. Electricity c 4. Pit/bucket/discharge c 5. Used/surplus materials e.g. boxes and crates (Go to (5)) c 4. Occupying rent free c 3. In-house generator c 7. Room in an office (Go to (3)) c 6. Allowed to live in free of rent 2. Number of rooms used c 4. Kerosene/other types into water c 8. Boat/raft/motor vehicle c 6. Others (specify) …………….. c 5. Others (specify) ….. as bedrooms c 4. Others (specify) c 7. Others (specify) …………….. of oil …………. c 5. No toilet c 0. Others (specify) …………….. .................. rooms .................. c 5. Others (specify) ....…...
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