2019 Census Test: Form 2A-L

Complete online: 2019 Census Test

Secure access code

  • Prov.
  • CD
  • CU
  • VR line No.
  • CLD
  • Forms 3
  • Questionnaire No.

Message from the Chief Statistician of Canada

The census paints a portrait of Canada's population and the places where we live. It provides high-quality information for communities across the country and is used to plan services that support employment, education and health care.

Preparations for the next census have begun, and Statistics Canada is seeking your participation in this important test.

By law, your household must complete a 2019 Census Test questionnaire. Your answers are collected under the authority of theStatistics Act and will be kept strictly confidential.

Statistics Canada employs a number of mechanisms to manage the response burden on Canadians by using existing administrative data sources such as immigration records and personal income tax and benefit data. For more information, please visit 2019 Census Test.

The information that you provide will be used by Statistics Canada for statistical purposes.

Be part of this new portrait of Canada and complete your census questionnaire today.

Thank you for your co-operation.

Anil Arora
Chief Statistician of Canada

Complete your census questionnaire:

  • Online at: 2019 Census Test by using the secure access code printed above.
  • On paper: please print using capital letters.

Any questions?

  • 2019 Census Test
  • Call us free of charge at: 1-855-850-2019
  • TTY: 1-833-830-3109

Confidential when completed

This information is collected under the authority of the Statistics Act, R.S.C. 1985, c. S-19.

Step A

1. What is your telephone number?

2. What email address could we use to contact your household, if applicable?

3. What is the address of this dwelling?

  • Number (and suffix, if applicable) (e.g., 302, 151 B, 16 1/2)
  • Street name, street type (e.g., DR = Drive), direction (e.g., N = North)
  • Apartment/unit
  • City, municipality, town, village, Indian reserve
  • Province/territory
  • Postal code

4. What is the mailing address of this dwelling, if different from above?

(e.g., Rural Route, PO Box, Lot and Concession or General Delivery)

Step B

1. Including yourself, how many persons usually live at this address on May 14, 2019?

Include: all persons who have their main residence at this address, even if they are temporarily away. See the instructions on page 3 (joint custody, students, landed immigrants, secondary residence, etc.).

  • Number of persons

2. Including yourself, list all persons who usually live here on May 14, 2019.

Important: Begin the list with an adult followed, if applicable, by that person's spouse or common-law partner and by their children. Continue with all other persons who usually live at this address.

  • Person 1: Family name(s), Given name(s)
  • Person 2: Family name(s), Given name(s)
  • Person 3: Family name(s), Given name(s)
  • Person 4: Family name(s), Given name(s)
  • Person 5: Family name(s), Given name(s)
  • Person 6: Family name(s), Given name(s)
  • Person 7: Family name(s), Given name(s)
  • Person 8: Family name(s), Given name(s)
  • Person 9: Family name(s), Given name(s)
  • Person 10: Family name(s), Given name(s)

Step C

Did you leave anyone out of step B because you were not sure the person should be listed?

For example, a student, a child in joint custody, a person temporarily away, a person who lives here temporarily, a resident from another country with a work or study permit, a refugee claimant, etc.

  • No
  • Yes - Specify the name, the relationship and the reason.
    • Name(s) and relationship
    • Reason

Step D

Copy the names in step B to question 1, at the top of pages 4.

Keep the same order.

If more than five persons live here, you will need an extra questionnaire; call 1-855-850-2019.

1. Whom to include in Step B

  • All persons who have their main residence at this address on May 14, 2019, including newborn babies, room-mates and persons who are temporarily away,
  • Canadian citizens, landed immigrants (permanent residents), persons asking for refugee status (refugee claimants), persons from another country with a work or study permit and family members living here with them,
  • Persons staying at this address temporarily on May 14, 2019 who have no main residence elsewhere.

2. Where to include persons with more than one residence

  • Children in joint custody should be included in the home of the parent where they live most of the time. Children who spend equal time with each parent should be included in the home of the parent with whom they are staying on May 14, 2019.
  • Students who return to live with their parents during the year should be included at their parents' address, even if they live elsewhere while attending school or working at a summer job.
  • Spouses or common-law partners temporarily away who stay elsewhere while working or studying should be listed at the main residence of their family, if they return periodically.
  • Persons in an institution for less than six months (for example, in a home for the aged, a hospital or a prison) should be listed at their usual residence.

If this address is:

  • A secondary residence (for example, a cottage) for all persons who stayed here on May 14, 2019 (all these persons have their main residence elsewhere in canada), mark this circle. Print your name, your telephone number and your main residence address at the bottom of this page. Do not answer other questions.
  • A dwelling occupied only by residents of another country visiting canada (for example, on vacation or on a business trip), mark this circle. Print your name, your telephone number and your country of residence at the bottom of this page. Do not answer other questions.
  • The home of a government representative of another country (for example, an embassy or a high commission) and family members, mark this circle. Print your name, your telephone number and the country that you represent at the bottom of this page. Do not answer other questions.
  • Name
  • Telephone number
  • Number (and suffix, if applicable) (e.g., 302, 151 B, 16 1/2)
  • Street name, street type (e.g., DR = Drive), direction (e.g., N = North)
  • Apartment/unit
  • City, municipality, town, village, Indian reserve
  • Province/territory
  • Postal code
  • Country

Mail this questionnaire in the enclosed envelope today.

In the spaces provided, copy the names in the same order as in Step B. Then answer the following questions for each person.

The following questions refer to each person's situation on May 14, 2019, unless otherwise specified.

1. Name

  • Family name
  • Given name

2. What is this person's sex?

  • Male
  • Female

3. What are this person's date of birth and age?

Example: 23/02/1974
If exact date is not known, enter best estimate.

Age: For children under the age of 1, enter 0.

  • Day/Month/Year
  • Age

4. What is this person's marital status?

Mark " X " one circle only.

  • Never legally married
  • Legally married (and not separated)
  • Separated, but still legally married
  • Divorced
  • Widowed

5. Is this person living with a common-law partner?

Common-law refers to two people who live together as a couple but who are not legally married to each other.

  • Yes
  • No

6. What is the relationship of this person to Person 1?

If none of the responses in the list describes this person's relationship to Person 1, then specify a response under "Other relationship".

Person 1

  • Person 1

Person 2

  • Opposite-sex husband or wife of Person 1
  • Opposite-sex common-law partner of Person 1
  • Same-sex married spouse of Person 1
  • Same-sex common-law partner of Person 1
  • Son or daughter of Person 1 only
  • Grandchild of Person 1
  • Son-in-law or daughter-in-law of Person 1
  • Father or mother of Person 1
  • Father-in-law or mother-in-law of Person 1
  • Brother or sister of Person 1
  • Foster child
  • Room-mate, lodger or boarder
  • Other relationship - specify:

Person 3-5

  • Son or daughter of both Persons 1 and 2
  • Son or daughter of Person 1 only
  • Son or daughter of Person 2 only
  • Grandchild of Person 1
  • Son-in-law or daughter-in-law of Person 1
  • Father or mother of Person 1
  • Father-in-law or mother-in-law of Person 1
  • Brother or sister of Person 1
  • Foster child
  • Room-mate, lodger or boarder
  • Other relationship - specify:

7. Can this person speak English or French well enough to conduct a conversation?

Mark " X " one circle only.

  • English only
  • French only
  • Both English and French
  • Neither English nor French

8. a) What language does this person speak most often at home?

  • English
  • French
  • Other language - specify:

8. b) Does this person speak any other languages on a regular basis at home?

  • No
  • Yes, English
  • Yes, French
  • Yes, other language - specify:

9. What is the language that this person first learned at home in childhood and still understands?

If this person no longer understands the first language learned, indicate the second language learned.

  • English
  • French
  • Other language - specify:

Activities of Daily Living

The following question is about difficulties a person may have doing certain activities. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered.

10. a) Does this person have any difficulty seeing (even when wearing glasses or contact lenses)?

  • No
  • Sometimes
  • Often
  • Always

10. b) Does this person have any difficulty hearing (even when using a hearing aid)?

  • No
  • Sometimes
  • Often
  • Always

10. c) Does this person have any difficulty walking, using stairs, using his/her hands or fingers or doing other physical activities?

  • No
  • Sometimes
  • Often
  • Always

10. d) Does this person have any difficulty learning, remembering or concentrating?

  • No
  • Sometimes
  • Often
  • Always

10. e) Does this person have any emotional, psychological or mental health conditions (e.g., anxiety, depression, bipolar disorder, substance abuse, anorexia, etc.)?

  • No
  • Sometimes
  • Often
  • Always

10. f) Does this person have any other health problem or long-term condition that has lasted or is expected to last for six months or more?

Exclude: any health problems previously reported above.

  • No
  • Sometimes
  • Often
  • Always

Sociocultural Information

11. Where was this person born?

Specify one response only, according to present boundaries.

Born in Canada

  • Nfld.Lab.
  • P.E.I.
  • N.S.
  • N.B.
  • Quebec
  • Ontario
  • Manitoba
  • Sask.
  • Alberta
  • B.C.
  • Yukon
  • N.W.T.
  • Nunavut

Born outside Canada — specify country:

12. Of what country is this person a citizen?

Indicate more than one citizenship, if applicable.

"Canada, by naturalization" refers to the process by which an immigrant is granted citizenship of Canada, under the Citizenship Act.

  • Canada, by birth
  • Canada, by naturalization
  • Other country — specify:

13. Is this person now, or has this person ever been, a landed immigrant?

A "landed immigrant" (permanent resident) is a person who has been granted the right to live in Canada permanently by immigration authorities.

  • No
    • Go to question 15
  • Yes

14. In what year did this person first become a landed immigrant?

Example: Year - 1974

  • Year
    • If exact year is not known, enter best estimate.

15. What language(s), other than English or French, can this person speak well enough to conduct a conversation?

  • None
  • OR
    Other language(s) — specify:

This question collects information on the ancestral origins of the population and provides information about the composition of Canada's diverse population.

16. What were the ethnic or cultural origins of this person's ancestors?

An ancestor is usually more distant than a grandparent.

For example, Canadian, Chinese, English, East Indian, French, Italian, Filipino, German, Cree, Mi'kmaq, Salish, Métis, Inuit, Scottish, Irish, Dutch, Ukrainian, Portuguese, Polish, Korean, Iranian, Vietnamese, Jamaican, Pakistani, Lebanese, Colombian, Mexican, Somali, etc.

  • Specify as many origins as applicable using capital letters.

17. Is this person an Aboriginal person, that is, First Nations (North American Indian), Métis or Inuk (Inuit)?

Note: First Nations (North American Indian) includes Status and Non-Status Indians.

If "Yes", mark " X " the circle(s) that best describe(s) this person now.

  • No, not an Aboriginal person
    • Continue with the next question
  • Yes, First Nations (North American Indian)
    • Go to question 19
  • Yes, Métis
    • Go to question 19
  • Yes, Inuk (Inuit)
    • Go to question 19

This question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.

18. Is this person:

Mark " X " more than one circle or specify, if applicable.

  • White
  • South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)
  • Chinese
  • Black
  • Filipino
  • Latin American
  • Arab
  • Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai, etc.)
  • West Asian (e.g., Iranian, Afghan, etc.)
  • Korean
  • Japanese
  • Other — specify:

19. Is this person a Status Indian (Registered or Treaty Indian as defined by the Indian Act of Canada)?

  • No
  • Yes, Status Indian (Registered or Treaty)

20. Is this person a member of a First Nation/Indian band?

If "Yes", which First Nation/Indian band?

For example, Musqueam Indian Band, Sturgeon Lake First Nation, Atikamekw of Manawan.

  • No
  • Yes, member of a First Nation/Indian band
    • Specify name of First Nation/Indian band.

21. What is this person's religion?

Indicate a specific denomination or religion even if this person is not currently a practising member of that group.

For example, Roman Catholic, United Church, Anglican, Muslim, Baptist, Hindu, Pentecostal, Lutheran, Presbyterian, Sikh, Buddhist, Jewish, Greek Orthodox, etc.

  • Specify one denomination or religion only.
  • No religion

Mobility

22. Where did this person live 1 year ago, that is, on May 14, 2018?

Mark " X " one circle only.

Note: For those who mark the fourth circle: Please give the name of the city or town rather than the metropolitan area of which it is a part.

For example:

  • Saanich rather than Victoria (metropolitan area)
  • St. Albert rather than Edmonton (metropolitan area)
  • Laval rather than Montréal (metropolitan area)
  • Born after May 14, 2018
  • Lived at the same address as now
  • Lived at a different address in the same city, town, village, township, municipality or Indian reserve
  • Lived in a different city, town, village, township, municipality or Indian reserve in Canada
    • Specify the name of the city, town, village, township, municipality or Indian reserve of residence 1 year ago.
      • Province/territory
      • Postal code
  • Lived outside Canada
    • Specify the country of residence 1 year ago

23. Where did this person live 5 years ago, that is, on May 14, 2014?

Mark " X " one circle only.

Note: For those who mark the fourth circle: Please give the name of the city or town rather than the metropolitan area of which it is a part.

For example:

  • Saanich rather than Victoria (metropolitan area)
  • St. Albert rather than Edmonton (metropolitan area)
  • Laval rather than Montréal (metropolitan area)
  • Born after May 14, 2014
  • Lived at the same address as now
  • Lived at a different address in the same city, town, village, township, municipality or Indian reserve
  • Lived in a different city, town, village, township, municipality or Indian reserve in Canada
    • Specify the name of the city, town, village, township, municipality or Indian reserve of residence 5 years ago.
      • Province/territory
      • Postal code
  • Lived outside Canada
    • Specify the country of residence 5 years ago

Place of Birth of Parents

24. a) Where was each of this person's parents born? - Father

Mark " X " or specify country according to present boundaries.

  • Born in Canada
  • Born outside Canada — specify country:


24. b) Where was each of this person's parents born? - Mother

Mark " X " or specify country according to present boundaries.

  • Born in Canada
  • Born outside Canada — specify country:

Answer questions 25 to 49 for each person aged 15 years and over. Continue only for each person aged 15 years and over (born before May 14, 2004).

Education

25. Has this person completed a high school (secondary school) diploma or equivalent?

Examples of high school equivalency certificates are General Educational Development (GED) and Adult Basic Education (ABE).

High school diploma or certificate

  • Yes, high school diploma
  • Yes, high school equivalency certificate
  • No

26. a) Has this person completed a Registered Apprenticeship or other trades certificate or diploma?

Mark " X " as many circles as applicable.

For example, hairstyling, cooking, electrician, carpentry, etc.

Registered Apprenticeship or trades certificate or diploma

  • Yes, Certificate of Apprenticeship or Certificate of Qualification (Journeyperson's designation)
  • Yes, other trades certificate or diploma
  • No

26. b) Has this person completed a college, CEGEP or other non-university certificate or diploma?

Exclude: any certificates or diplomas reported in question 26 a).

Mark " X " as many circles as applicable.

For example, accounting technology, industrial engineering technology, legal assistant, etc.

College, CEGEP or other non-university certificate or diploma

  • Yes, certificate or diploma from a program of less than 3 months
  • Yes, certificate or diploma from a program of 3 months to less than 1 year
  • Yes, certificate or diploma from a program of 1 year to 2 years
  • Yes, certificate or diploma from a program of more than 2 years
  • No

26. c) Has this person completed a university certificate, diploma or degree?

Mark " X " as many circles as applicable.

    University certificate, diploma or degree

    • Yes, university certificate or diploma below bachelor level
    • Yes, bachelor's degree (e.g., B.A., B.A.(Hons.), B.Sc., B.Ed., LL.B.)
    • Yes, university certificate or diploma above bachelor level
    • Yes, degree in medicine, dentistry, veterinary medicine or optometry (M.D., D.D.S., D.M.D., D.V.M., O.D.)
    • Yes, master's degree (e.g., M.A., M.Sc., M.Ed., M.B.A.)
    • Yes, earned doctorate (e.g., Ph.D.)
    • No

    27. What was the major field of study of the highest certificate, diploma or degree that this person completed?

    Please be specific.

    For example, automobile mechanics, health care attendant, medical laboratory technology, civil engineering, agricultural economics, etc.

    Print in capital letters.

    • Major field of study of highest certificate, diploma or degree
    • OR
      No certificate, diploma or degree higher than high school
      • Go to question 29

    28. In what province, territory or country did this person complete his or her highest certificate, diploma or degree?

    • In Canada — specify province or territory:
    • OR
      Outside Canada — specify country:

    29. At any time since September 2018, has this person attended a school, college, CEGEP or university?

    Mark " X " as many circles as applicable.

    Report only attendance for courses that can be used as credits towards a certificate, diploma or degree. Distance learning for credit is included.

    At any time since September 2018

    • Yes, attended elementary, junior high school or high school
    • Yes, attended trade school, business school, community college, technical institute, CEGEP or other non-university institution
    • Yes, attended university
    • No, did not attend school at any time since September 2018

    Labour Market Activities

    Note: Many of the following questions refer to the week from Sunday, May 5 to Saturday, May 11, 2019. Call 1-855-850-2019 for more information.

    30. During the week of Sunday, May 5 to Saturday, May 11, 2019, how many hours did this person spend working for pay or in self-employment?

    Please enter the total number of hours worked for pay or in self-employment at all jobs held during the week of May 5 to May 11.

    Exclude number of hours:

    • away due to illness, on vacation or any other reasons

    Include number of hours:

    • working for wages, salary, tips or commission
    • working overtime
    • working in his/her own business, farm or professional practice, alone or in partnership
    • working directly towards the operation of a family farm or business without formal pay arrangements (e.g., assisting in seeding, doing accounts)
    • Number of hours (to the nearest hour)
      • Go to question 36
    • OR
      None
      • Continue with the next question

    31. During the week of May 5 to May 11, 2019, was this person on temporary lay-off or absent from his/her job or business?

    Mark " X " one circle only.

    • No
    • Yes, on temporary lay-off from a job to which this person expects to return
    • Yes, on vacation, ill, on strike or locked out, or absent for other reasons


    32. During the week of May 5 to May 11, 2019, did this person have definite arrangements to start a new job within the next four weeks?

    • No
    • Yes

    33. Did this person look for paid work during the four weeks from April 14 to May 11, 2019?

    For example, did this person contact an employment centre, check with employers, place or answer newspaper ads, etc.?

    Mark " X " one circle only.

    • No
      • Go to question 35
    • Yes, looked for full-time work
    • Yes, looked for part-time work (less than 30 hours per week)

    34. Could this person have started a job during the week of Sunday, May 5 to Saturday, May 11, 2019 had one been available?

    Mark " X " one circle only.

    • Yes, could have started a job
    • No, already had a job
    • No, because of temporary illness or disability
    • No, because of personal or family responsibilities
    • No, going to school
    • No, other reasons

    35. When did this person last work for pay or in self-employment, even for a few days?

    Mark " X " one circle only.

    • In 2019
      • Continue with the next question
    • In 2018
      • Continue with the next question
    • Before 2018
      • Go to question 49
    • Never
      • Go to question 49

    36. For whom did this person work?

    For self-employed persons, enter the name of their business. If the business does not have a name, enter the person's name.

    Print in capital letters as follows: Name of firm, government agency, etc.

    • Name of firm, government agency, etc.
    • Section, plant, department, etc. (if applicable)

    37. What kind of business, industry or service was this?

    Please be specific. For example:

    • primary school
    • municipal police
    • wheat farm
    • shoe store
    • road construction
    • Kind of business, industry or service

    38. What was this person's work or occupation?

    Please be specific. For example:

    • general practitioner
    • fishing guide
    • civil engineer
    • secondary school teacher

    (If in the Armed Forces, give rank.)

    • Occupation

    39. In this work, what were this person's main activities?

    Please be specific. For example:

    • diagnose and provide care
    • guided fishing parties
    • design and build bridges
    • taught mathematics
    • Main activities

    40. In this job or business, was this person mainly:

    Mark " X " one circle only.

    • working for wages, salary, tips or commission?
      • Go to question 42
    • working without pay for his/her spouse or another relative in a family farm or business?
      • Go to question 42
    • self-employed without paid help (alone or in partnership)?
    • self-employed with paid help (alone or in partnership)?

    41. If self-employed, was this person's farm or business incorporated?

    • No
    • Yes


    42. At what address did this person usually work most of the time?

    Example: 365 Laurier Ave. West

    • Number
    • Name
    • Type
    • Direction

    If direction (e.g., North, South, East or West) is a part of the street address, please include it.

    If street address is unknown or if the address is a post office box, specify the building or nearest street intersection. Do not give a post office box number.

    Please give the name of the city or town rather than the metropolitan area of which it is a part.

    For example:

    • Saanich rather than Victoria (metropolitan area)
    • St. Albert rather than Edmonton (metropolitan area)
    • Laval rather than Montréal (metropolitan area)

    If the address of work is different than the address of the employer, please provide the address where this person actually works (e.g., school teachers should provide the address of their school, not the address of the school board).

    • Worked at home (including farms)
      • Go to question 45
    • Worked outside Canada
      • Go to question 45
    • No fixed workplace address
      • Continue with the next question
    • Worked at the address specified below:
      • Street address (see example)
      • City, town, village, township, municipality or Indian reserve
      • Province/territory
      • Postal code

    43. a) How did this person usually get to work?

    If this person used more than one method of travel to work, mark the one used for most of the travel distance.

    Mark "Subway or elevated rail" for:

    • Vancouver SkyTrain,
    • Toronto Subway/RT,
    • Montréal Metro.

    Mark "Light rail, streetcar or commuter train" for:

    • Vancouver West Coast Express,
    • Calgary CTrain,
    • Edmonton LRT,
    • Toronto streetcars,
    • Toronto GO Train,
    • Ottawa O-Train,
    • Montréal commuter trains.
    • Car, truck or van — as a driver
      • Go to question 43 b)
    • Car, truck or van — as a passenger
      • Go to question 43 b)
    • Bus
      • Go to question 44 a)
    • Subway or elevated rail
      • Go to question 44 a)
    • Light rail, streetcar or commuter train
      • Go to question 44 a)
    • Passenger ferry
      • Go to question 44 a)
    • Walked to work
      • Go to question 44 a)
    • Bicycle
      • Go to question 44 a)
    • Motorcycle, scooter or moped
      • Go to question 44 a)
    • Other method
      • Go to question 44 a)

    43. b) How many people, including this person, usually shared the ride to work in this car, truck or van?

    • Drove alone
    • 2 people
    • 3 or more people

    44. a) What time did this person usually leave home to go to work?

    • hour
      • min
      • a.m.
      • p.m.

      44. b) How many minutes did it usually take this person to get from home to work?

      • Number of minutes

      45. a) In this job, what language did this person use most often?

      • English
      • French
      • Other language — specify:

      45 b) Did this person use any other languages on a regular basis in this job?

      • No
      • Yes, English
      • Yes, French
      • Yes, other language — specify:

      46. How many weeks did this person work in 2018?

      Please enter the total number of weeks worked for pay or in self-employment at all jobs held in 2018.

      Include those weeks in which this person:

      • was on vacation or sick leave with pay,
      • worked full time or part time,
      • worked for wages, salary, tips or commission,
      • was self-employed,
      • worked directly toward the operation of a family farm or business without formal pay arrangements.
      • None
        • Go to question 49
      • OR
        Number of weeks

      47. During most of those weeks, or part time?

      Mark " X " one circle only.

      • Full time (30 hours or more per week)
      • Part time (less than 30 hours per week)

      48. In 2018, did this person pay for child care, such as day care or babysitting, so that this person could work at his or her paid job(s)?

      When child care or day camps help several people work, enter the amount only once.

      Answer "Yes" or "No".

      If "Yes", also enter the total amount for 2018.

      • Yes
        • $
      • No

      49. In 2018, did this person pay child or spousal support payments to a former spouse or partner?

      Support payments are covered by an agreement to pay a fixed amount on a regular basis. Exclude all other gifts or transfers of money. Include only support payments actually paid.

      Answer "Yes" or "No".

      If "Yes", also enter the total amount for 2018.

      • Yes
        • $
      • No

      Step E

      Answer questions E1 to E10 about this dwelling.

      The questions refer to May 14, 2019 unless otherwise specified.

      A dwelling is a separate set of living quarters with a private entrance from the outside or from a common hallway or stairway inside the building. This entrance should not be through someone else's living quarters.

      E1. Who pays the rent or mortgage, taxes, electricity, etc., for this dwelling?

      If more than one person contributes to such payments, mark " X " as many circles as apply.

      • Person 1
      • Person 2
      • Person 3
      • Person 4
      • Person 5
      • A person who is listed on another questionnaire for this dwelling
      • A person who does not live here

      E2. Is this dwelling:

      Mark " X " one circle only.

      • owned by you or a member of this household (even if it is still being paid for)?
      • rented (even if no cash rent is paid)?

      E3. Is this dwelling part of a condominium development?

      • Yes
      • No

      E4. a) How many rooms are there in this dwelling?

      Count: kitchen, bedrooms, finished rooms in attic or basement, etc.

      Do not count: bathrooms, halls, vestibules and rooms used solely for business purposes.

      • Number of rooms

      E4. b) How many of these rooms are bedrooms?

      Count: all rooms designed as bedrooms, even if they are now used for something else. Also count basement bedrooms.

      • Number of bedrooms

      E5. When was this dwelling originally built?

      Mark the period in which the building was completed, not the time of any later remodelling, additions or conversions. If year is not known, give best estimate.

      • 1920 or before
      • 1921-1945
      • 1946-1960
      • 1961-1970
      • 1971-1980
      • 1981-1990
      • 1991-1995
      • 1996-2000
      • 2001-2005
      • 2006-2010
      • 2011-2015
      • 2016-2018
      • 2019

      E6. Is this dwelling in need of any repairs?

      Do not include desirable remodelling or additions.

      • No, only regular maintenance is needed (painting, furnace cleaning, etc.)
      • Yes, minor repairs are needed (missing or loose floor tiles, bricks or shingles, defective steps, railing or siding, etc.)
      • Yes, major repairs are needed (defective plumbing or electrical wiring, structural repairs to walls, floors or ceilings, etc.)


      E7. Is this dwelling located on an agricultural operation that is operated by a member of this household?

      • Yes
        • Go to step F on the next page
      • No
        • Continue this section

      Answer questions E8 to E10 for this dwelling even if you own or rent more than one dwelling. If the exact amount is not known, please give a best estimate.

      E8. a) For this dwelling, what are the yearly payments (last 12 months) for electricity?

      • None
      • Included in rent or other payments
      • OR
        $ per year

      E8. b) For this dwelling, what are the yearly payments (last 12 months) for oil, gas, coal, wood or other fuels? 

      • None
      • Included in rent or other payments
      • OR
        $ per year

      E8. c) For this dwelling, what are the yearly payments (last 12 months) for water and other municipal services?

      • None
      • Included in rent or other payments
      • OR
        $ per year

      For renters only, answer parts E9. a) and E9. b):

      E9. a) What is the monthly rent paid for this dwelling? 

      • Rented without payment of cash rent
      • OR
        $ per month

      E9. b) Is this dwelling subsidized?

      Subsidized housing includes rent geared to income, social housing, public housing, government assisted housing, non-profit housing, rent supplements, and housing allowances.

      • Yes
      • No

      For owners only, answer parts E10. a) through E10. e):

      E10. a) What are the total regular monthly mortgage or loan payments for this dwelling?

      • None
        • Go to part c)
      • OR
        $ per month

      E10. b) Are the property taxes (municipal and school) included in the amount shown in part a)?

      • Yes
        • Go to part d)
      • No

      E10. c) What are the estimated yearly property taxes (municipal and school) for this dwelling?

      • None
      • OR
        $ per year

      E10. d) If you were to sell this dwelling now, for how much would you expect to sell it?

      • $

      E10. e) What are the monthly condominium fees?

      • None
      • OR
        $ per month

      Step F

      If more than five persons live here, you will need an extra questionnaire; call 1-855-850-2019.

      You have now completed your questionnaire. Please mail it today. If you have lost the return envelope, please mail the questionnaire to:

      Statistics Canada
      PO BOX 99998, STN FED-GOVT
      Ottawa, ON K1A 9Z8

      Thank you for your co-operation.

      Comments

      Please use the space provided below if you have concerns, suggestions or comments to make about:

      • the steps to follow or the content of this questionnaire (for example, a question that was difficult to understand or to answer),
      • the characteristics of the questionnaire (for example, the design, the format, the size of the text).

      The law protects what you tell us

      The confidentiality of your responses is protected by law. All Statistics Canada employees have taken an oath of secrecy. Your personal information cannot be given to anyone outside Statistics Canada without your consent. This is your right.

      Date modified: