Malaysia 2000 Enumeration Form
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.. CENSUS DAY IS 5 JULY 2000 LlYlNG QUARTERS {LQ), HaUSEHCLD (?!di AND PERSON PARTICULARS .............................................. (1) STATE .......................................................................... ( Name and Code ) (2) ADMINISTRATIVE DISTRICT I JAJAHAN ..................................... ( Name and Code ) (3) CENSUS DISTRICT NUMBER For Household 02 (4) CENSUS CIRCLE NUMBER cancel K3 and K4 DS LIVE IN THIS LIVING QUARTERS? J (5) ENUMERATION BLOCK NUMBER Household is a group ofpersons who : - Usually live together and - Make common provisions for food and other essentials of living TYPE OF LIVING QUARTERS ( OBSERVATION QUESTION) i) BUILT OR CONVERTED FOR LIVING ( OBSERVATION QUESTION) 1 0 Treated Diped water Housinq Unit 1 0 Brick House 2 0 Plank 2 0 Othersources (Spec/&/) O1 Detached 3 0 Brickand Plank O2 Semi-deiached t 03 Terrace. Row or Link, Townhouse -I ELECTRICITY SUPPLY FACILI I Y O4 Longhouse ( Sabah & Sarawak only.) I -- 7 Flat lAparfmentl Condominium / Shophouse OCCUPIED OR VACANT LIVING I QUARTERS I 05 F,,I-t I Apartment I Condominium i Occupied 1 24 hoursaday e5 [7 ~hc;hcuse I office 1 0 Occupied 1 Room (with direct access) Vacant 2 Less than 24 hours a day 07 c] In Shophouse, Office; In I Attached to House. Factory, 2 Newly completed I for Mill etc. rent or sale Not Supplied lmprovised / Temporary Hut 3 For repair I renovation 3 c] Self-owned generator 08 lmprovised I Temporary Hut, etc. Others 4 u Holiday Resort (END 4 0 None INTERVIEW O9 Others ( e.g. mobile unit ) a (Specify) ................................................................. FOR THIS 5 0 Seasonalworkers LQ 1 Collective Living Quarters Quarters TYPE OF TOILET FACILIT'I 10 0 Hotel, Lodging House, Rest House, etc. - 6 0 Dilapidated I 0 Flush System 11 0 Medical Institutuion ( e.g. Hospital, etc.) - 7 O~ers 2 Pourflush 12 0 Educatjonal Institution (e.g. Hostel) - (Specify) .................................. 3 Pit 13 fll Charitable or Social Welfare Institution - 14 0 Religious Home - OWNER OF THIS LIVING QUARTERS 4 Enclosed space over water (Specify) ....................................... u 15 u Prison, Detention Centre etc. -+ GOTO I 0 Individual Owner 5 u None PART 5 16 Labour Camp -. u (Questions 2 Government I Statutory Body BI - 56, 5f 1 --- - Private _-^- onryl 3 DOE§ THE GARSAGE COLLECTION FACILITY REACH YOUR LIVING (ii) NO1 INTENDED FOR LIVING BUT USED AS SUCH ON CENSUS DAY QUARTERS 1AREA? In a permanent building (e.g. ofice, 18 1 Yes, tc tilis living quarters u school, shop, mosque, etc.) [,I NUMBER OF BEDROOMS Ye.-D, to this area - 1I 2 1_7 8 Households - A Household consists of related and / or unrelated persons who usually live together and make common provisions for food and other essentials of living. ta Head of Household - The Head of Household is any one of the household members who USUALLY LIVES in the Living Quarters and is regarded as head by the other household members. ;ive the names of persons who usually s the names of persons j any member of this 9re the following items available ¡we together as members of this ned in Question BI, ,ousehold handicapped? or use by the members of this iousehold on CENSUS DAY. id you miss out I are unsure iousehold. f including any other ( Do not include persons who live in lerson who eats and lives separate living quarters and who return to 3gether in this Household? Mark X in the relevant boxes this living quarters during weekends I - baby, young children holidays only. ) - old People Pyes - student@)in pnmary I Type of handicap PLEASE REFER TO NOTE PROVIDED secondav school hostel 1 - Sight BELOW ON THIS PAGE. - servant 2 - Hearing ( Mulfiple answers accepfed) - tenant, boarder 3 - Speech Start with Head of Household followed - usual household member 4 - Limbs by : who is ternporanly away 5 - Mental - Spme of Head 6 - Others Motorcar - Unmarried children yes (Please Iist their names u I unit - Married children and their families /n 81 and complete ' Fill in the respective handicap - Father I mother of Head or spouse of Head columns 83 until 86) :ode for tbe relevant member 02 units - Brother I sisters of Head or srnuse of Head mlv; transfer the codehl to - Other relatives 2uestion C30 for the 03 units or more - Others ( e g. servant, tenant, boarder ) [7 No {Ask Question 83 and .especfive person } thereafter) Motorcycle I Scooter ( Multiple answers 0I unit accepted ) 2 units or more HEAD Bicycle aBicycle Others I-0Ar-Conditioner L0 Washing Machine Refrigerator 0Microwave 0Radio I Hi-fi Television Video I VCD I OVO Fixed Telephone Line 0Mobile phone 0Personal Computer (PC) Internet Subscription None of the items mentioned above I l 0 a) Does any member of this HOUSEHOLD Is this household paying rent for this low much is the current SUMMARY own this living quarters? 1 living quarters? nonthly rental payment? II ( No. of usual household members ) 1 u Yes4 (GotoEll) 20No 10Yes, furnished Less than RM 100 ( From Question El and E4) 'g u RM 100-249 b) Does any member of this household own any 2 0Yes, not furnished u RM 250-499 Male Female Total other living quarters in Malaysia? 0RM 500-749 mmm 1UYeS 30None --+ (Go-toB11) c] RM 750-999 20No 0RM 1000 and more -- -- NOTE FOR QUESTION BI Q Do not forget to include : (i) Babies bom on or before Census Day and still living on Census Day. (ii) Boarders, lodgers, visitors, maids, elderly persons, relatives who usually live in this household. (iii) Usual rnernben who are temporarity away because of work, study, on leave, on vacation ( in and outside Malaysia) etc. (iv) Students ( primary and secondary schools ) not living with parents but in hostels ( in Malaysia ) afthouah for more than 6 months in the year 2000. (v) Any person staying I will be staying in hospital for less than 6 months in the year 2000. (vi) Those who passed away erCensus Day. 0 Do not include : (i) Babies bom after Census Day. (ii) Those who passed awaybefore Census Day. (iii) Malaysian students who have been I will be living overseas for 6 months or more in the year 2000. (Iv) Students ( college I university ) in Malaysia who donot live with parents for a period of 6 months or more in the year 2000. (v) Malaysians working overseas for a nsriod of 6 mnnthu nr mArp in +ha *I-*- ~nn member from a total of -housshold memben PERSON NUMBER LECT FOR NON-MALAYSIAN CITIZEN, PLEASE ( Obtain from column 85 SPECIFY COUNTRY ( Refer to code card - Document 4 1 n .............................................................................. w ...................... ........(Wnte .,..... Country) ....................................... I NAME ( Corresponding to CI ) I WHAT IS YOUR RELIGION? ...................................................................................................... WHERE WAS YOUR USUAL PLACE OF Islam RESIDENCE 5 YEARS AGO ( ¡.e IN 1995)? I For children aaed less than 5 Years (i.e. bom Christianity affer 1995) record mother's usual residence at time of hislher birth RELATIONSHIP TO HEAD OF HOUSEHOLD Hinduism I Obtain from column 83 1 L 1 This house as in Question K1 Buddhism u 2 Different house ( Give fuil address 1 O1 0 Head of Household Confucionism / Taoism, Other Traditional Chinese Religion 02 SpouseofHead (a) Name Of Street / Housing Estate Tnbal / Folk Religion i 03 0 Unmarned child of Head ahers (StWfvJ ............................................... 04 0 MarnedchildofHead (b) Name of Town / Villaqe No Religion 05 0 Dauqhter-in-law / Son-in-law of Head 06 0 Grandchild of Head (c) Mukim / District ( Kelantan ) I SubDistrict ( Sarawak) BIRTHPLACE 07 Father / Mother of Head or spouse of Head 0 (a) Where were you bom? 08 Brother / sister of Head or spouse of Head (d) Administrative District / Jaiahan ( Kelantan ) 0 I Malaysia [GotoClO(b)] O9 Other relatives af Head ar spouse of Head 2 0 Outside Malaysia I Go to CfO (cJ 1 10 Others who are not related to Head or spouse (e) State /Country of Head (b) State of bitth? ( Refer to code card - Document 4 ) (Goto SEX ( Obtain from column E4 1 GI ....................................................... C12) (Specify State) 1 0 Male ' (c) Country of birth? 2 0 Female (Refer to code card - Document 4 ) HAVE YOU EVER E~EENTO SCHOOL COLLEGE / n POLYTECHNIC I UNIVERSITY? w ....................................................... ( Including Preschool ) (Specify Country) I 0 Yes, currently schooling ( full time ) 2 0 Yes, currently schooling ( part time ) 1 IIIII YEAR OF FIRST ARRIVAL IN MALAYSIA 3 0 Completed schooling (For those born outside Malaysia ) Date Month Year I -(If no information for C5,ask C6 ) 5 0 Neverattendedschool * (Go foCi7) & HOW OLD ARE YOU? CITIZENSHIP I RESIDENCE STATUS WHAT IS THE HIGHEST LEVEL OF EDUCATION (In comDleted vears) ATTAINED 1CURRENTLY STUDYING? ( If age is less than 1 year wnfe "00" Malaysian Citizen If age is 99 years or more write "99" ) 1 Pre-school 1 0 Malaysian Citizen . 4 (Go to Cf4) n 2 0 Primary School ( Standard I Year 1 till 6 ) Non-Malaysian Citizen IW 3 a Lower Secondary ( Remove / Form 1 till 3 ) 2 u Permanent Resident 4 0 Upper Secondary ( Form 4 till 5, GCE O Level WHAT IS YOUR MARITAL STATUS? 3 0 Expatriate (For person aged 10 years and above 1 5 0 Vocational I Technical ( Form 4 till 5 ) 4 Foreign Visitor 1 0 Never Married 6 0 Trade & Technical Skills Institution 5 Foreign Student 2 u Married 7 0 Post Secondary ( Form 6, GCE A Level, 6 Foreign Worker Matriculation ) 3 Widowed 7 u .Others (specify) ............................................... 8 Tz] Tertiary. ( Polytechnic / College / University 4 0 Divorced / Permanently separated .. , .. .., . ............... .. ......... -......... .. ^..,".,- ..... .,..*..Y ,.,:;~ WHAT 1s THE HIGHEST CERTIFICATE I DIPLOMA I DO YOU HAVE ANY WORK TO RETURN TO? DEGREE YOU HAVE ATTAINED? (a) What are the Activities I Services I Products O1 None of your place of work? ( Describe in a few words 1 02 h-^] PMRiSRPlLCi 03 SPMIMCEISCI (GotoC20) GCE O level DID YOU LOOK FOR WORK DURING THE O4 17 STPM / ttSC i STA / LAST 7 DAYS? (b) What is the Namo and Address of the your 4 Thanawi / GCE A Level * Company I Employer? I Yes (END INTERVIEW ( If relevant only) 05 SPVM/SPM(V)IMCVE - (Go to Cl9) - FOR THlS PERSON) 2 u No (i) Name of Company I Employer : ...........