STATISTICS BUREAU OF THE SLOVAK REPUBLIC RÚ 4-12 SB SR registration No. Vk 1/06 IKF dated 29 June 2005 4 0 0 1 Act No. 540/2001 Coll., on government statistics regulates the protection of confidential information. Act No. 428/2002 Coll., on the protection of personal information regulates the protection of personal information. The Statistics Bureau of the Slovak Republic is responsible for the protection of confidential and personal infor- mation. Reporting unit Line District code Sample number Month Year 01 REPORTING HOUSEHOLD JOURNAL Name of contact person: Tel.: SB SR office address: Accepted by: Date: Signature: Dear Household, The Statistics Bureau of the Slovak Republic has regularly conducted statistical sur- veys of household accounts in the Slovak Republic since 1957. Household income and ex- penditure data constitute part of social statistical data collected for the purposes of acquiring current information on the standard of living of Slovak population. In addition to correct methodology and thorough preparation, the quality of the survey results depends on the se- lected respondents’ willingness to take a responsible approach to the survey and cooperate with the Statistics Bureau. The household accounts are aimed at acquiring information on household income, expenditure and consumption as an important source of information to evaluate the current economic situation in the Slovak Republic and to trace its development. The results are also used for international comparisons. In the interests of ensuring the objectivity of the survey results, we ask that you com- plete this statistical form fully and truthfully according to the methodological notes and the directions provided by the competent SB SR staff. The data for each individual reporting unit are confidential data that will not be dis- closed and will only serve for statistical and analytical purposes. Pursuant to Act No. 540/2001 Coll., on government statistics, the Statistics Bureau of the Slovak Republic is re- sponsible for the protection of personal information. Please fill out this form in as much detail as possible using the appropriate tables in order to allow for correct categorization and subsequent analysis. In case the space provid- ed in the tables is not sufficient, please use the reverse side of the form to provide any addi- tional information. In order to provide correct and complete data, income and expenditures have to be recorded in the Reporting Household Journal on a regular basis. Certain tables include nu- merical codes of purchased goods or services to facilitate the entries. The form has to be delivered to the competent SB SR staff by 10th day of the subse- quent month. For true data provided in a timely manner, the reporting unit will be evaluated in compliance with the agreed terms. We thank you for returning the form in a timely manner and look forward to our future cooperation. Ing. Milan Olexa, CSc., v. r. CEO Demography and Social Statistic Section Statistics Bureau of the Slovak Republic TABLE OF CONTENT Page I. Household monetary expenditures in the given month in Sk 3 1301. PERSONAL CONSUMPTION EXPENDITURES 3 1. Foodstuffs and non-alcoholic beverages 3 2. Alcoholic beverages and tobacco 19 3. Clothing and footwear 20 4. Housing, water, electricity, gas and other fuel 21 5. Home furnishing, household goods and services 23 6. Health care 23 7. Transport 24 8. Post and telecommunications 24 9. Recreation and culture 24 10. Education 25 11. Hotels, coffee-bars, restaurants 25 12. Sundry goods and services 27 13. Other expenditures 28 II. Household monetary income for the given month in Sk 30 1308. HOUSEHOLD MEMBERS' MONETARY INCOME 30 1. Gross monetary income from employment 30 2. Monetary income from self-employment 30 3. Household social income 31 1309. HOUSEHOLD MONETARY INCOME 31 1. Household social income 31 2. Investment income 32 3. Other monetary income of the household 32 III. Household in-kind income for the given month in Sk 33 1310. FOODSTUFFS 33 1311. CATERING 34 1312. OTHER IN-KIND INCOME 34 Surveying officer´s notes regarding review and data entry from the statement 34 Household notes regarding data recorded in the statement 35 I. Household monetary expenditures in the given month in Sk 1301. PERSONAL CONSUMPTION EXPENDITURES 1. FOODSTUFFS AND NON-ALCOHOLIC BEV- ERAGES 002. PASTA 001. RICE 12 Egg pasta 01 Milled (white) rice 99 Other pasta types (flavored, eggless, rice, etc.) 02 Boil-in-bag white rice Type kg Sk 99 Other rice types (flavored, brown, etc.) Type kg Sk 003. BREAD - continued 003. BREAD Type kg Sk 03 Dark bread 04 Light bread 99 Other bread types (graham, soya, potato, sesame, oatmeal, etc.) Type kg Sk 3 004. REGULAR PASTRY 005. LONG-LIFE PASTRY 05 Regular white roll 06 Long-life sliced crisp bread (“Vláran”, “Knäckenbrot”, Other regular types of pastry (buns, plaited buns, etc.) “bosniaky” (small-sized bread), graham pastry, sprout 07 Plain biscuits bread, non-filled sandwich - whole or sliced, bread- 08 Filled biscuits crumbs, etc.) 09 Filled wafers, non-dipped 10 Baby sponge biscuits, light Type kg Sk 11 Salty sticks 79 Other types of long-life pastry (crackers, gingerbread, regular/diet digestive biscuits, tea biscuits, “Fidorka”, “3-bit” etc.) Type kg Sk 4 006. FANCY PASTRY 007. SANDWICHES, FILLED BAGUETTES AND PAS- TRY 13 Plaited leavened Christmas cake 14 Sweet pastry, no filling (coffee cakes, croissants, etc.) 15 Sweet pastry with filling (turnovers, Moravian tartlets, shortcakes, strudel, fancy bread, sweet fornetti, Type kg Sk stuffed leavened cake, etc.) 16 Steam-boiled dumpling 17 Frozen pizza, with filling 99 Other types of fancy pastry (salty pastry, pizza-corpus, potato pancakes, etc.) Type kg Sk 008. OTHER CEREALS AND CEREAL PRODUCTS 18 Wheat flour, medium ground 19 Semolina 20 Puff pastry 21 Oat flakes 22 Peeled barley 23 Instant blended cereal products 24 Corn semolina and corn flour products (corn-flakes, popcorn, etc.) 25 Other types of grain flour 99 Other cereals and cereal products (“Peppies”, puffed rice, müsli bars, powders - pancakes, pizza, cakes, coffee cakes, meat/vegetable-stuffed pasta, etc.) Type kg Sk 5 009. BEEF 011. MUTTON, LAMB AND GOAT KID MEAT 01 Forequarter beef, boned 02 Forequarter beef, boneless Type kg Sk 03 Round beef, boneless 04 Short loin, boneless 89 Veal 99 Other types of beef (incl. bones) Type kg Sk 012. POULTRY, POULTRY PRODUCTS AND SEMI- FINISHED PRODUCTS 10 Fresh drawn chicken, chilled 11 Chicken frozen 12 Chicken pieces (fresh/frozen legs, wings, breasts, etc.) 13 Poultry products and semi-finished products (cans, salami, etc.) 14 Poultry giblets and mixed offal (fresh/frozen poultry body, etc.) 010. PORK 99 Other poultry (duck, goose, turkey, ostrich meat etc.) 05 Loin, boned Type kg Sk 06 Boston butt, boned 07 Side 08 Ham, boneless 09 Shoulder, boneless 99 Other pork types (incl. bones) Type kg Sk 6 013. PROCESSED MEAT, SEMI-FINISHED MEAT PRODUCTS, READY-MADE MEALS AND CANS 014. SAUSAGES AND SMOKED MEAT PRODUCTS 24 Pork Luncheon meat 15 Sausage (all types) 25 Pate (all types except poultry) 16 Wieners (fine, regular, student, Spiš-style, etc.) 99 Other processed meat, semi-finished meat products 17 Ham sausage (Piešťanská, Nova, Šunkáčik etc.) and ready-made meals, cans other than canned poul- 18 Salami (Nitran, Hornád, Hungarian, etc.) try (porkpie, hash-and-crumbs sausage, pork greaves, 19 Long-life sausage (Sliačska, Turistická, etc.) red pepper (cooked) bacon, mincemeat, intestines, 20 Smoked pork Boston butt, boneless beef olives, kebab, liver cheese, etc.) 21 Ham (toast, Prague, beef, etc.) 22 Smoked bacon (with or without skin, incl. English-style Type kg Sk and Oravská) 23 Smoked and unsmoked bratwurst (all types) 99 Other smoked meat products (short speck sausage, smoked shoulder, loin, knee, ribs, etc.) Type kg Sk 7 015. OFFAL 018. OTHER TYPES OF MEAT 26 Pork liver (wild boar, nutria, horse, rabbit meat, etc.) 89 Other offal apart from poultry (pork, beef, veal, etc.) Type kg Sk Type kg Sk 019. OTHER SEA PRODUCTS (fresh or frozen seafood - crab, mussels, shark, octopus, shrimps, cuttlefish, squid etc.) (apart from seaweed – table 040) Type kg Sk 016. FISH – LIVE, CHILLED, FROZEN 01 Fish fillets, frozen, natural 02 Carp - live, chilled, frozen 99 Other fish – live, fresh, chilled, frozen Type kg Sk 020. PROCESSED FISH, FISH PRODUCTS AND SEMI- FINISHED PRODUCTS (apart from seaweed – ta- ble 040) 04 Fish in oil (canned) 05 Fish salad in mayonnaise (pre-packed or sold by weight) 06 Sour fish (pre-packed or sold by weight) 99 Other processed fish, fish products and semi-finished products (canned fish in own juice, tomato, vegeta- bles, cod liver, caviar, anchovy paste, etc.) Type kg Sk 017. SMOKED AND DRIED FISH AND SEAFOOD 03 Smoked fish and seafood 99 Dried fish and seafood Type kg Sk 8 021. MARKET MILK (non-condensed) 022. PROCESSED MILK 01 Semi-skimmed milk (expiration 5-7 days) 07 Condensed milk, unsweetened - “Tatra” 02 Semi-skimmed milk with extended shelf life 08 Dried milk used as infant formula (3 months) 09 Dried milk, semi-skimmed 89 Other milk with lower fat 99 Other processed milk (“Bikava”, “Piknik”, “Pikao”, dried 99 Unskimmed milk (all types, including raw milk fresh skimmed, unskimmed, dried cream, etc..) from the cow) Type g Sk Type l Sk 023. YOGURT 10 Cream yogurt with fruit 99 Other types of yogurt and a yogurt creams Type g Sk 9 024. CHEESE AND CURDS 025. OTHER DAIRY PRODUCTS AND NON-DAIRY MILK SUBSTITUTES (soya, etc.) 11 Hard cheese (“Eidam”, “Primátor”, “Gouda”, “Emmen- thal”, “Allgäutaler”, sold by weight or