Canadian Centre for Justice Statistics
Policing Services Program

Confidential when completed

Complete a separate Victim questionnaire for each victim in this incident. Information is reported as of the incident date unless otherwise stated. To ensure records are complete, avoid leaving questions blank or scoring 'unknown' unless necessary. Detailed reporting instructions are found in the Homicide Survey Reporting Guide; available upon request. Verify that homicide information reported to the Homicide Survey matches with homicide information reported by your police service to the Uniform Crime Reporting (UCR) Survey.

This information is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.

Completion of this questionnaire is a legal requirement under this act.

Objective

This survey collects essential data to produce statistics on the incidence and characteristics of homicide offences in Canada. The information is used by federal and provincial policymakers as well as public and private researchers. The data are also widely disseminated by the media for purposes of general public information. The information may also be used by Statistics Canada for other statistical and research purposes.

Confidentiality

Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Statistics Canada will use the information from this survey for statistical purposes.

Record linkages

To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada may combine the information you provide with other survey or administrative data sources.
Instructions

Instructions

Please return this questionnaire by December 31st, 2020. Questionnaires may be returned by mail (see address below) or through the Electronic File Transfer system.

Correspondence

Statistics Canada
ATTN: AADPS
2nd Floor Section B15
Jean Talon Building
150 Tunney's Pasture Driveway
Ottawa, ON K1A 0T6
Phone: Toll free 1-888-659-8229
Fax: 1-800-755-5514
E-mail: statcan.homisurv-enqhomi.statcan@statcan.gc.ca

Fax or e-mail transmission disclosure

Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission. However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority of the Statistics Act.

1. What is the incident file number assigned to this incident by the investigative police service?
2. What is the victim number?
   Note: If there is one victim in the incident, the victim number is 1. If there are multiple victims, number the Victim questionnaires sequentially, e.g., 1, 2, 3.
3. What was the name of the victim?
   • Name of victim:
   • Surname
   • Given name 1
   • Given name 2
   • Given name 3
   • Alias (if applicable)
   • Unknown
4. What was the sex at birth of the victim?
   Note: Refers to the sex assigned at birth of the victim and does not refer to their gender identity or sexual orientation.
   • Male – Go to question 6
   • Female
   • Unidentifiable human remains – Go to question 8
   • Unknown – Go to question 6
5. Was the female victim pregnant at the time of the incident?
   • Yes
   • No
   • Unknown
6. What was the victim's gender identity?
   Note: Refers to current gender which may be different from sex assigned at birth and may be different from what is indicated on legal documents. Male gender and female gender identities include cisgender and transgender persons. Other gender identity includes persons whose gender is reported as being: other than male or female, unsure of their gender, both male and female, or neither male nor female.
   • Male
   • Female
   • Other gender identity – Specify gender identity:
   • Unknown
7. What was the victim's sexual orientation?
   • Heterosexual
   • Homosexual, e.g., lesbian or gay
   • Bisexual
   • Other sexual orientation – Specify sexual orientation
   • Unknown
8. What was the victim's date of birth?
   Note: If the birth date is not known, provide the age of the victim at the time of the incident.
   • Birth date
   • Year / Month / Day
   • OR
   • Age in years - Specify age:
   • Infant less than 1 year of age
   • Unknown
9. Did the victim live on-reserve or off-reserve?
   • Lived on-reserve
   • Lived off-reserve, and recently lived on-reserve (within past 5 years)
   • Lived off-reserve, and lived on-reserve in the past (more than 5 years)
   • Lived off-reserve, and never lived on-reserved
   • Lived off-reserve, and unknown if ever lived on-reserve
   • Unknown
10. What was the victim's address?
    • Fixed address
    • Street number
    • Street name
    • Street type
    • Street direction
    • Apartment/unit
    • City, town, village
    • Reserve (if applicable)
    • County, township, rural municipality (if applicable)
    • Province, territory or state
    • Postal code or ZIP code
    • Country
    • No fixed address
    • City, town, village
    • Reserve (if applicable)
    • County, township, rural municipality (if applicable)
    • Province, territory or state
    • Country
    • Unknown
11. What was the marital status of the victim?
    Note: If the victim was less than 15 years of age at the time of the incident, select Never married (not living common law).
    • Married
    • Living common law, i.e., two people who live together as a couple but who are not legally married to each other
    • Never married (not living common law)
    • Separated (not living common law)
    • Divorced (not living common law)
    • Widowed (not living common law)
    • Unknown
12. What was the Aboriginal identity of the victim?
    • Not an Aboriginal person
    • First Nations person (status or non-status)
    • Métis
    • Inuit
    • Aboriginal person, but Aboriginal group is unknown
    • Unknown
13. What was the visible minority identity of the victim?
    A visible minority identity is reported for a victim who is non-Caucasian in race or non-white in colour, or who do not identify solely as an Aboriginal person.
    Not a visible minority is reported for a victim who is identified as solely an Aboriginal person, or not considered to be a member of a visible minority group, regardless of place of birth.
    Select all that apply
    • Victim was not a visible minority, i.e., identifies solely as Aboriginal or Caucasian in race or white in color
    • OR
    • South Asian, e.g., East Indian, Pakistani, Sri Lankan
    • Chinese
    • Black
    • Filipino
    • Arab
    • Latin American
    • Southeast Asian, e.g., Vietnamese, Cambodian, Laotian, Thai
    • West Asian, e.g., Iranian, Afghan
    • Korean
    • Japanese
    • Other visible minority – Specify visible minority:
    • OR
    • Visible minority, minority group unknown
    • OR
    • Visible minority information of victim is not collected or reported by police service
    • OR
    • Unknown
14. Was the victim a Canadian citizen?
    • Victim was a Canadian citizen
    • Victim was not a Canadian citizen
    • Citizenship information of victim is not collected or reported by police service
    • Unknown
15. What was the victim's immigration status?
    Note: An immigrant includes persons who are, or who have ever been, landed mmigrants or permanent residents. Such persons have been granted the right to live in Canada permanently by immigration authorities.
    • Victim was not an immigrant, e.g., Canadian citizen by birth, tourist
    • Victim was an immigrant, i.e., permanent resident
    • Victim was a non-permanent resident, e.g., work / study permit, refugee claimant
    • Immigration information of victim is not collected or reported by police service
    • Unknown
16. Was the victim involved in any of the following illegal activities?
    Note: Includes where the victim was suspected to be involved in illegal activities. Commodifying sexual activities refers to the victim's involvement in obtaining sexual services, procuring, receiving material benefit or advertising sexual service; does not refer to where the victim was working as a sex worker.
    Select all that apply.
    • Not involved in illegal activities – Go to question 18
    • OR
    • Illegal drug trade activities
    • Commodifying sexual activities, i.e., victim obtained, procured, received material benefit or advertised sexual services
    • Organized crime / street-gang activities
    • Human trafficking
    • Fraud
    • Other financial crime
    • Other illegal activity – Specify illegal activity:
    • OR
    • Unknown – Go to question 18
17. Was the victim's homicide related to their involvement in the illegal activities reported in question 16?
    • Yes
    • No
    • Unknown
18. What was the victim's employment status?
    Note: Not in the labour force refers to where the victim was either: less than 15 years old, an institutional resident, unable to work, or unavailable for work.
    • Employed (in labour force), e.g., full-time, part-time, casual, self-employed – Go to question 20
    • Unemployed (in labour force), e.g., seeking employment – Go to question 20
    • Not in the labour force, e.g., unable to work
    • Unknown – Go to question 20
19. What was the primary reason the victim was not in the labour force?
    Select only one.
    • Less than 15 years of age
    • Full-time student
    • Home or caregiver responsibilities
    • Retired
    • Disability or illness
    • Institutional resident, e.g., of a correctional facility, hospital, nursing home, community group home
    • Not eligible to work in Canada, e.g., illegal immigrant, work permit has not been secured
    • Other reason victim was not in the labour force – Specify the reason the victim was not in the labour force:
    • Unknown
20. What was the occupation of the victim?
    Note: If the victim was unemployed at the time of the incident, report their last legal occupation. Report if the victim was working as a sex worker in this question.
    • Occupation of victim – Specify occupation:
    • Unknown – Go to question 23
21. Was the victim's homicide related to their occupation?
    • Yes
    • No
    • Unknown
22. Was the victim working in policing or as a correctional worker, and was their death related to their occupation?
    Policing includes: police officers, special constables, recruits or cadets, and auxiliary police officers. It does not include other types of employees within policing such as civilians, public servants, volunteers.
    Correctional worker includes: correctional officers, parole officers, Wardens, medical staff, educators, social workers, volunteers, and other occupations within the correctional facility, e.g., caretaker or administrative staff.
    • Victim worked in policing and death related to occupation
    • Victim was a correctional worker and death related to occupation
    • Victim worked in policing, or as a correctional worker, but death was not related to occupation
    • Victim did not work in policing or as a correctional worker
    • Unknown
23. Was the victim receiving financial or social assistance?
    Note: Applies to both victims in the labour force, i.e., employed or unemployed, and victims not in the labour force.
    • Yes
    • No – Go to question 25
    • Unknown – Go to question 25
24. What was the source of financial or social assistance?
    Select all that apply.
    • Employment assistance or social assistance program, e.g., Employment Insurance (EI), Workplace Safety and Insurance Board (WSIB), Ontario Works (OW)
    • Disability support program, e.g., Ontario Disability Support Program (ODSP)
    • Financial support from family or friends
    • Financial or social assistance from a band / tribal council
    • Other financial or social assistance - Specify source of financial or social assistance:
25. Was this victim randomly selected?
    Note: Refers to a homicide that does not target a specific individual.
    • Yes
    • No
    • Unknown
26. Was the victim considered to be a missing person at the time of their death?
    Note: Report "Yes" if an active missing person's report for the victim was filed with any police service at the time their death. Does not refer to previous missing person's reports that were not active at the time of their death, i.e., instances where the victim had been reported as missing and subsequently found alive.
    • Yes
    • No
    • Unknown
27. Does the victim have on record any previous convictions of criminal activities?
    Select all that apply.
    • No previous convictions of criminal activities
    • OR
    • Crime against the person
    • Homicide
    • Sexual assault violation, i.e., aggravated sexual assault, sexual assault with a weapon, other sexual assault
    • Other sexual violations, e.g., exploitation, invitation to sexual touching, incest, corruption of morals
    • Assault, i.e., aggravated assault, assault with a weapon or causing bodily harm, assault level 1, all other types of assault
    • Kidnapping, abduction, or forcible confinement
    • Trafficking of persons
    • Hostage taking
    • Robbery
    • Commodification of sexual activities, i.e., victim was convicted of obtaining, procuring, receiving material benefit or advertising sexual services
    • Harassment, e.g., criminal harassment, harassing communications
    • Utter threats to person
    • Other crime against the person
    • Crime against property
    • Arson
    • Break and enter
    • Theft
    • Fraud
    • Mischief
    • Other crime against property
    • Other offences
    • Other Criminal Code offence, e.g., gaming / betting, offensive weapons, other Criminal Code not otherwise specified above
    • Controlled Drugs and Substances Act (CDSA) or Cannabis Act offence
    • Other federal / provincial statute
    • OR
    • Unknown
28. Was the victim in custody, or under community supervision?
    i.e., remand, sentenced custody, probation or bail
    For adult victims (18 years and older), this includes remand, sentenced custody, i.e., federal or provincial sentence, or intermittent sentence, other temporary detention, probation, conditional sentence, bail, or other community program.
    For youth victims (12 to 17 years of age), this includes pre-trial detention, provincial director remand, secure or open custody, community portion of a custody sentence, intensive or deferred custody / supervision, supervised probation, bail, or other community sentence.
    • Yes
    • No
    • Unknown
29. What was the primary method used to cause death?
    Select only one.
    • Shooting
    • Stabbing
    • Beating or blows
    • Strangulation, suffocation, drowning
    • Drug overdose
    • Poisoning or lethal injection, i.e., not related to drug overdose
    • Smoke inhalation or burns, e.g., fire, liquid, acid
    • Exposure or hypothermia
    • Abusive head trauma, i.e., previously "shaken baby syndrome"
    • Motor vehicle impact or collision
    • Neglect or failure to support life
    • Other primary method – Specify method used to cause death:
    • Unknown
30. What was the primary weapon used to cause death?
    Select only one.
    • Firearm
    • Rifle or shotgun
    • Handgun
    • Other firearm-like weapon, e.g., nail gun or pellet gun
    • Firearm – type of firearm is unknown
    • Knife/object
    • Knife
    • Other piercing or cutting instrument
    • Club or blunt instrument
    • Explosive
    • Motor vehicle
    • Ligature, e.g., rope, belt, cable
    • Substance
    • Burning liquid or caustic agent
    • Poison, drug, gas or fume – Go to question 44
    • Fire – Go to question 44
    • Water – Go to question 44
    • Other
    • Physical force, i.e., by hands, feet – Go to question 44
    • Other primary weapon, e.g., electricity, dog, pillow, sand – Go to question 44
    • No weapon was used – Go to question 44
    • Unknown – Go to question 44
31. What is the classification of the primary weapon?
    Note: Refers to the classification of weapons in Canada according to the Criminal Code and regulations prescribing certain firearms and other weapons (including components and parts of weapons, accessories, cartridge magazines, ammunition and projectiles), as prohibited, restricted or non-restricted.
    • Prohibited weapon, e.g., some handguns, altered rifles and shotguns, full or converted automatics, some crossbows
    • Restricted weapon, e.g., handguns that are not prohibited; semi-automatics, centre-fire rifles, and shotguns with barrel shorter than 470mm
    • Non-restricted weapon, e.g., ordinary rifles and shotguns
    • Not applicable, i.e., weapon type not required to be classified
    • Unknown
32. Who owned the primary weapon at the time of the incident?
    • Charged / suspect-chargeable (CSC)
    • CSC Number
    • CSC Surname
    • CSC Given name 1
    • Victim reported on this questionnaire
    • Other, e.g., owned by workplace or other person
    • Unknown
33. Was the primary weapon initially obtained legally?
    • Yes
    • No – Go to question 35
    • Unknown
34. Was the charged / suspect chargeable (CSC) that caused the fatal wound in legal possession of the primary weapon at the time of the incident?
    Note: Refers to where the primary weapon used to cause death was a firearm, knife / object, or a substance such as a caustic agent or a drug.
    • CSC Number
    • CSC Surname
    • CSC Given name 1
    • Yes
    • No
    • Unknown
35. Was the primary weapon legally owned at the time of the incident?
    Note: A weapon is legally owned when it has been obtained according to the law, and all legal requirements to own the weapon are in place and up-to-date, e.g., credentials and documentation.
    • Yes – Go to question 37
    • No
    • Unknown – Go to question 37
36. What was the status of the illegally owned primary weapon at the time of the incident?
    • Stolen from the legal Canadian owner
    • Lost or missing from the legal Canadian owner
    • Illegally purchased from legal Canadian owner
    • Illegal weapon, e.g., never legally owned in Canada, smuggled into Canada, purchased on the dark net, homemade
    • Unknown
37. Was the primary weapon recovered?
    • Yes – if the primary weapon is not a firearm, go to question 44.
    • No – if the primary weapon is not a firearm, go to question 42.
    • – if the primary weapon is not a firearm, go to question 44.
38. What was the action type of the firearm used to cause death?
    • Single-shot or manual repeating, i.e., bolt, lever, pump, break (or hinge) and revolving action
    • Semi-automatic
    • Fully automatic
    • Unknown
39. If the firearm was a rifle or shotgun, was it sawed-off, cut or altered in any other way that resulted in the total length of the firearm being less than 660 mm or it having a barrel that is less than 457 mm long?
    • Yes
    • No
    • Unknown
40. Was the firearm registered with the Canadian Firearms Registry, or the province of Quebec's Service d'immatriculation des armes à feu (SIAF)?
    Note: Canadian Firearms Registry includes verified firearms that are either restricted or prohibited and were registered by persons possessing a valid Possession and Acquisition Licence (PAL). Does not refer to non-restricted firearms.
    Quebec's Service d'immatriculation des armes à feu (SIAF) refers to all non-restricted firearms.
    • Yes
    • No
    • Unknown
41. Was the firearm sent for tracing?
    • Yes
    • No
    • Unknown
42. Where did the firearm originate from?
    • Canada, individual
    • Canada, business
    • United States, individual
    • United States, business
    • Other foreign country, individual or business
    • Unknown
43. Did the charged / suspect chargeable (CSC) that discharged the fatal shot possess a valid firearms licence for the classification of firearm used in this incident?
    • Yes
    • No
    • Unknown
44. Did the victim have a suspected or known mental illness or a developmental disorder?
    Note: This question refers to the investigating officer's assessment of the victim at the time of the incident, and is not a medical diagnoses.
    • Yes – Specify illness or disorder:
    • No
    • Unknown
45. Did the victim have a suspected or known physical disability or limitation?
    Note: This question refers to the investigating officer's assessment of the victim at the time of the incident, and is not a medical diagnoses.
    • Yes – Specify disability or limitation:
    • No
    • Unknown
46. Had the victim consumed a substance such as alcohol, drugs, or an intoxicating substance, during the period leading up to the incident?
    Select all that apply.
    • Alcohol consumed
    • Drugs consumed
    • Intoxicating substance consumed, e.g., inhalant
    • OR
    • The victim did not consume alcohol, drugs or an intoxicating substance
    • OR
    • Information not available, e.g., medical examiner or Coroner's report results not received
    • OR
    • Unknown
47. Was the victim first to use, or threaten to use, physical force or violence in this incident?
    • Yes
    • No
    • Unknown
48. 48. What was the relationship between the closest charged / suspect-chargeable (CSC) and the victim?
    Note: The relationship is in the direction of CSC to the victim. If more than one CSC is identified in this incident, select the relationship type of the closest CSC to the victim. For the purposes of the Homicide Survey, the relationship types are organized here within a hierarchy beginning with the closest relationships, e.g., married spouse, to the furthest, e.g., stranger.
    Select only one.
    • Spouse
    • Married spouse
    • Common-law spouse, i.e., living together as a couple but who are not legally married to each other
    • Separated married spouse (not living common law)
    • Separated common-law spouse
    • Divorced spouse (not living common law)
    • Family member (non-spouse)
    • Parent
    • Step-parent
    • Child
    • Step-child
    • Sibling (including step sibling)
    • Extended family member, e.g., in-law, niece/nephew, grandchild, aunt/uncle
    • Intimate partner (non-spouse)
    • Intimate partner, e.g., boyfriend or girlfriend
    • Ex-intimate partner, e.g., ex-boyfriend, ex-girlfriend
    • Extra-marital intimate partner
    • Other intimate partner
    • Acquaintance
    • Close friend
    • Casual friend
    • Family friend
    • Roommate, i.e., non-family or intimate partner
    • Other household member, i.e., non-family or intimate partner, e.g., boarders
    • Temporary house guest, e.g., room rental guest, or other overnight guest
    • Intimate partner of a family member (includes ex-partners)
    • Neighbour
    • Business relationship (legal), e.g., landlord, tenant, colleagues, business co-owners
    • Authority figure, e.g., teacher, doctor, babysitter, coach, clergy, nurse
    • Reverse authority figure, e.g., student-to-teacher, patient-to-doctor / nurse, child-to-babysitter
    • Criminal relationship, e.g., drug trafficker to drug user, customer to sex trade worker, organized crime / street gang affiliation
    • Co-substance user, e.g., relationship based solely on co-substance use
    • Co-institutional facility member, e.g., co-inmate, co-resident of a long-term care facility
    • Other acquaintance
    • Other person
    • Other relationship type – Specify relationship type:
    • Stranger (include where the closest CSC was known to the victim for less than 24 hours before their death)
    • Unknown
49. Who is the closest charged / suspect-chargeable (CSC) to this victim?
    Note: In cases where two CSCs share the same type of closest relationship to the victim, e.g., both CSCs are the victim's parents, select the CSC whom most contributed to the homicide of the victim, according to the investigation, e.g., the CSC who used the primary weapon, or who was most involved in the events leading up to the homicide.
    • Only 1 CSC identified in this incident
    • Closest CSC (if more than one identified in the incident):
    • CSC Number
    • CSC Surname
    • CSC Given name 1
    • No CSC identified, i.e., incident is not cleared – Go to end of survey
50. Was there a history of family or intimate partner violence involving this victim and the closest charged / suspect-chargeable (CSC) identified in the incident?
    Note: Refers to a history of violence between the closest CSC to this victim. Applies to where the relationship was reported in question 48 as: spouse, family (non-spouse), or intimate relationship (non-spouse).
    • Yes
    • No
    • Unknown
51. Was there an active order preventing contact between the closest charged / suspect-chargeable (CSC) and the victim at the time of the incident?
    e.g., peace bond, restraining order, protection order
    • Yes
    • No
    • Unknown

Thank you for your cooperation.

Canadian Centre for Justice Statistics
Policing Services Program

Confidential when completed

Complete a set of Homicide Survey questionnaires for all incidents of homicide that are founded and culpable (i.e., determined to be criminal in nature). This includes incidents of: murder – first degree, murder – second degree, manslaughter and infanticide as defined by the Criminal Code. Information is reported as of the incident date unless otherwise stated. Separate Victim and Charged / Suspect-Chargeable (CSC) questionnaires are required for each person identified in the incident. To ensure records are complete, avoid leaving questions blank or scoring 'unknown' unless necessary. Detailed reporting instructions are found in the Homicide Survey Reporting Guide; available upon request. Verify that homicide information reported to the Homicide Survey matches with homicide information reported by your police service to the Uniform Crime Reporting (UCR) Survey.

This information is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.

Completion of this questionnaire is a legal requirement under this act.

Objective

This survey collects essential data to produce statistics on the incidence and characteristics of homicide offences in Canada. The information is used by federal and provincial policymakers as well as public and private researchers. The data are also widely disseminated by the media for purposes of general public information. The information may also be used by Statistics Canada for other statistical and research purposes.

Confidentiality

Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Statistics Canada will use the information from this survey for statistical purposes.

Record linkages

To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada may combine the information you provide with other survey or administrative data sources.

Instructions

Please return this questionnaire by December 31st, 2020. Questionnaires may be returned by mail (see address below) or through the Electronic File Transfer system.

Correspondence

Statistics Canada
ATTN: AADPS
2nd Floor Section B15
Jean Talon Building
150 Tunney's Pasture Driveway
Ottawa, ON K1A 0T6
Phone: Toll free 1-888-659-8229
Fax: 1-800-755-5514
E-mail: statcan.homisurv-enqhomi.statcan@statcan.gc.ca

Fax or e-mail transmission disclosure

Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission. However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority of the Statistics Act.

1. What is the incident file number assigned to the incident by the investigative police service?
2. What is the name of the police service and, if applicable, detachment that completed the investigation and reported the incident?
   • Municipal or First Nations police service
   • Royal Canadian Mounted Police (RCMP)
   • Specify detachment:
   • Specify service type:
   • e.g., rural, municipal, headquarters
   • Ontario Provincial Police (OPP)
   • Specify detachment:
   • Specify service type:
   • e.g., rural, municipal, headquarters
   • Sûreté du Québec (SQ)
   • Specify detachment:
   • Royal Newfoundland Constabulary (RNC)
   • Specify detachment:
   • Special / Independent investigative unit
3. Who is the lead investigative police officer for this incident from the primary investigative police service?
   • Rank or position
   • Given name
   • Surname
   • Telephone number (including area code) Example: 123-123-1234
   • Extension number (if applicable)
   • E-mail address
4. What is the name of the police service and, if applicable, detachment in whose jurisdiction the incident occurred ?
   Note: The option Same as reported in question 2 does not apply to an incident investigated by a special / independent investigative unit.
   • Same as reported in question 2.
   • i.e., primary or lead investigative police service is also the police service in whose jurisdiction the incident occurred
   • Municipal or First Nations police service
   • Royal Canadian Mounted Police (RCMP)
   • Specify detachment:
   • Specify service type:
   • e.g., rural, municipal, headquarters
   • Ontario Provincial Police (OPP)
   • Specify detachment:
   • Specify service type:
   • e.g., rural, municipal, headquarters
   • Sûreté du Québec (SQ)
   • Specify detachment:
   • Royal Newfoundland Constabulary (RNC)
   • Specify detachment:
5. How many homicide victims are in this incident?
6. How many charged / suspect-chargeable (CSC), i.e., accused, persons are identified in this incident?
   • Number of CSCs:
   • CSCs not identified, i.e., incident is not cleared
7. What was the incident date, i.e., the date of attack
   Note: If the exact date is unknown, provide an estimated date. In the case of a missing person, report the date the victim was last seen alive or was reported missing.
   • Year / Month / Day
8. What was the report date, i.e., date when incident determined to be a homicide?
   • Year / Month / Day
9. 9. In what time frame did the incident occur?
   • From 00:01 to 04:00
   • From 04:01 to 08:00
   • From 08:01 to 12:00
   • From 12:01 to 16:00
   • From 16:01 to 20:00
   • From 20:01 to 24:00
   • Unknown
10. 10. What is the location type where the incident occurred?
    • Residential location
    • Single home, house, townhouse
    • Dwelling unit, e.g., apartment, rooming house, dormitory
    • Commercial dwelling unit, e.g., hotel, motel, bed & breakfast
    • Nursing home, e.g., long-term care facility
    • Retirement home, e.g., assisted or supportive living residence
    • Community group home
    • Non-residential location
    • Private property structure – Go to question 12
    • New or used car dealership – Go to question 12
    • Bank or other financial institution – Go to question 12
    • Convenience store – Go to question 12
    • Gas station – Go to question 12
    • School, during supervised activity – Go to question 12
    • School, not during supervised activity – Go to question 12
    • University/College – Go to question 12
    • Other commercial / corporate place – Go to question 12
    • Other non-commercial / corporate place, i.e., public institution – Go to question 12
    • Parking lot – Go to question 12
    • Transit bus / Bus shelter – Go to question 12
    • Subway / Subway station – Go to question 12
    • Other public transportation or connected facility – Go to question 12
    • Street, road, highway – Go to question 12
    • Open area – Go to question 12
    • Construction site – Go to question 12
    • Bar, restaurant, after-hours club – Go to question 12
    • Religious institution – Go to question 12
    • Hospital – Go to question 12
    • Pharmacy – Go to question 12
    • Correctional institution – Go to question 12
    • Halfway house / Young offender group home – Go to question 12
    • Homeless shelter / Mission – Go to question 12
    • Privately owned vehicle – Go to question 12
    • Taxi, limousine – Go to question 12
    • Other location type – Specify location type: – Go to question 12
    • OR
    • Unknown – Go to question 12
11. What was the occupancy status of the residence where the incident occurred?
    Note: Occupancy status for dwelling unit and commercial dwelling unit is based on whether the victims and/or the charged / suspect-chargeables (CSCs) reside in the same unit where the incident occurred.
    • Joint occupancy by one or more victims and any CSC
    • Occupied by one or more victims, but not occupied by any CSC
    • Occupied by any CSC, but not occupied by any victim
    • Occupied by any victim, and unknown if occupied by any CSC
    • Not occupied by any victim, and unknown if occupied by any CSC
    • Neither any victim nor any CSC were occupants
    • Unknown
12. Is the geographic location where the incident occurred on-reserve or off-reserve ?
    Occurred on-reserve: refers to where the geographic location where the incident occurred is within an area, i.e., a census subdivision (CSD), legally affiliated with First Nations or Indian bands such as: Indian reserve (IRI), Indian settlement (S-É), Indian government district (IGD), terres réservées aux Cris (TC), terres réservées aux Naskapis (TK) and Nisga'a land (NL).
    Occurred off-reserve: refers to where the geographic location where the incident occurred is in an area, i.e., a CSD, not defined as on-reserve.
    Note: If the police service jurisdiction in which the incident occurred does not have any on-reserve areas within its boundaries, select Occurred off-reserve. For more information about determining on-reserve or off-reserve locations, consult the Homicide Survey Reporting Guide.
    • Occurred on-reserve
    • Occurred off-reserve
    • Unknown
13. What is the street address where the incident occurred?
    Note: If the specific street address is not available, provide the nearest intersecting street names.
    • Specific street address
    • Street number
    • Street name
    • Apartment/unit
    • Street direction
    • Street type
    • OR
    • Nearest intersecting streets
    • Nearest intersecting street name 1
    • Street direction 1
    • Street type 1
    • Nearest intersecting street name 2
    • Street direction 2
    • Street type 2
14. What is the city, postal code, county or reserve where the incident occurred?
    • City, town, village
    • Postal code (Example: A9A 9A9)
    • County, township, rural municipality (if applicable)
    • Reserve (if applicable)
15. What are the X-Y coordinates of the location where the incident occurred?
    • Latitude (X-Coordinate)
    • Longitude (Y-Coordinate)
16. What is the most serious violation of the incident?
    • Murder – first degree
    • Murder – second degree
    • Manslaughter
    • Infanticide
17. What is the incident clearance status ?
    Select only one.
    • Not cleared
    • Still under investigation – Go to question 19
    • Insufficient evidence to proceed – Go to question 19
    • Cleared by charge or charges recommended – Submit CSC form(s)
    • Cleared by charge (includes charges recommended)
    • Charges recommended but all declined by Crown
    • Cleared otherwise – Submit CSC form(s)
    • Suicide of the CSC
    • Death of the CSC (not suicide)
    • Reason beyond control of the department (policy)
    • Diplomatic immunity
    • CSC is under 12 years of age
    • Committal of the CSC to a mental health facility
    • CSC outside Canada, cannot be returned
    • CSC involved in other incidents
    • CSC is already sentenced
    • Departmental discretion
    • Diversionary program
    • Incident cleared by a lesser statute
    • Incident cleared by other municipal / provincial / federal agency
18. What is the clearance date of the incident?
    Note: The clearance date of the incident cannot be before the incident date, i.e., date of attack, or the report date, i.e., date when incident determined to be a homicide.
    • Year / Month / Day
19. What was the most serious related offence committed by the charged / suspect-chargeables (CSCs) that led to the incident?
    Note: A CSC does not have to be identified to provide a response to this question. There must be a direct and immediate connection between the related offence and the incident itself.
    Select only one.
    • No related offence associated with the incident, i.e., intent to commit the homicide from the outset
    • Crime against the person
    • Sexual assault violation, i.e., aggravated sexual assault, sexual assault with a weapon, other sexual assault
    • Other sexual violations, e.g., exploitation, invitation to sexual touching, incest, corruption of morals, etc.
    • Assault, i.e., aggravated assault, assault with a weapon causing bodily harm, assault level 1, all other types of assault
    • Kidnapping, abduction, or forcible confinement
    • Trafficking of persons
    • Hostage taking
    • Robbery – personal
    • Robbery – bank, other commercial institution
    • Commodification of sexual activities, e.g., obtaining sexual services, procuring
    • Harassment, e.g., criminal harassment, harassing communications
    • Utter threats to person
    • Other crime against the person
    • Crime against property
    • Arson
    • Break and enter
    • Theft
    • Fraud
    • Mischief
    • Other crime against property
    • Other offences
    • Other Criminal Code offence, e.g., gaming, betting, offensive weapons, other Criminal Code not otherwise specified above
    • Controlled Drugs and Substances Act (CDSA) or Cannabis Act offence
    • Other federal or provincial statute
    • OR
    • Unknown
20. Was the incident related to illegal drug trade activities?
    Note: Refers to if the incident was related to the illegal Controlled Drugs and Substances Act (CDSA) or Cannabis Act offences for: possession, trafficking, import/export, and production of illegal drugs. This question does not refer to whether any CSC, and/or victim, were under the influence of drugs at the time of the incident.
    • Yes
    • Suspected
    • No – Go to question 22
21. What type of drugs were associated with the illegal drug trade activities in this incident?
    Note: This question does not refer to whether the CSC and/or victims were under the influence of these drugs at the time of the incident.
    Select all that apply.
    • Heroin
    • Cocaine, and cocaine derivatives, e.g., crack cocaine
    • Fentanyl, and fentanyl derivatives, e.g., carfentanil
    • Other opioids (other than heroin and fentanyl), e.g., morphine, oxycodone, hydrocodone, methadone
    • Meth / crystal meth, i.e., methamphetamine
    • Ecstasy / MDMA, i.e., methylenedioxymethamphetamine
    • Other dissociative or hallucinogenic drugs, e.g., PCP, LSD, GHB, ketamine
    • Cannabis and cannabis derivatives
    • Other controlled drugs and substances
    • Related to illegal drug trade – types of drugs unknown
22. Was the incident related to organized crime / street gang involvement?
    Note: Refers to incidents committed by, and for the benefit of, a criminal organization. Differences in the number of organized crime / street gang related homicide incidents reported to the UCR survey and Homicide Survey will result in a follow-up from Statistics Canada.
    • Yes
    • Suspected
    • No
23. Was the incident related to a terrorist or security threat group?
    Note: Refers to incidents committed in relation to, in whole or in part, political, religious, or ideological purpose, objective, or cause, with the intention of intimidating the public, or a segment of the public, with regard to its security.
    • Yes
    • Suspected
    • No
24. Was the incident motivated by hate ?
    Note: Refers to incidents motivated by hate based on race, national or ethnic origin, language, colour, religion, sex, age, mental or physical disability, sexual orientation, or any other similar factor. Differences in the number of homicide incidents motivated by hate reported to the UCR survey and to the Homicide Survey will result in a follow-up from Statistics Canada.
    • Yes
    • Suspected
    • No – Go to question 26
25. What was the principal factor that motivated the hate crime?
    Note: If more than one option could apply, report the principal factor motivating the incident.
    Select only one.
    • Race/ethnicity
    • Includes race, colour, nationality or ethnic origin
    • Religion
    • Sexual orientation
    • Includes bisexual, heterosexual, homosexual, asexual, pansexual and unknown sexual orientation
    • Language
    • Mental or physical disability
    • Sex
    • Includes transgender and intersex
    • Age
    • Other similar factor, e.g., political motivation, person in uniform
26. What was the primary apparent motive related to the incident?
    Note: If more than one option applies, report the apparent motive most relevant to the incident. If, after an investigation, no apparent motive was determined, select No apparent motive. In incidents where the apparent motive cannot be determined because the incident is not cleared, or involves unidentified remains, select Unknown.
    Select only one.
    • No apparent motive, i.e., where the investigation has not determined an apparent motive
    • Hate motivation
    • Terrorism or security threat
    • Illegal drug trade activities, e.g., possession, trafficking, import/export, and production of illegal drugs
    • Concealment of a child, e.g., killing and hiding a newborn
    • Intent to conceal information or actions
    • Assisting a suicide, i.e., not in relation to legal application of medical assistance in dying
    • Euthanasia, i.e., not in relation to legal application of medical assistance in dying
    • Sexual motivation
    • Custody dispute, e.g., access to children
    • Settling of accounts or debts, e.g., drug or gang-related debts, gambling debts
    • Financial gain or protection of assets
    • Revenge
    • Jealousy or envy
    • Argument or quarrel
    • Frustration, anger, despair
    • Fear of apprehension
    • Personal protection, e.g., battered spouse
    • Honour based
    • Other primary apparent motive – Specify motive:
    • OR
    • Unknown
27. Did a child or youth witness the incident?
    Includes witnesses under the age of 18 at the time of the incident, whether or not they were related to any victim or CSC in the incident.
    • Yes
    • No
    • Unknown
28. Provide the narrative for this homicide incident.
    Note: In the lead investigators own words, provide greater detail of the circumstances and the events leading up to the incident.

Waiver

Statistics Canada is seeking your permission to publish data from this survey for your police service. This permission must be provided by someone with the authority to provide consent on behalf of your organization.

1. Do you provide consent on behalf of your police service to the Chief Statistician of Canada to authorize the release and publication of aggregated data reported on the Homicide Survey questionnaires for this incident, i.e., Incident, Victim, Charged / Suspect-chargeable, Supplemental Policing Victim, and Supplemental Correctional Worker Victim questionnaires, excluding personal identifiers, e.g., name, date of birth, FPS number, to the public?
   Aggregated data may directly or indirectly identify your police service. It is understood that this permission may be rescinded at any time by telephoning the Canadian Centre for Justice Statistics and then confirming by letter.
   • Yes, I agree
   • No, I do not agree
2. Please provide contact information for the person with the authority to provide consent on behalf of your organization.
   • First Name
   • Last Name
   • Title
   • Email address
   • Example: user@example.gov.ca
   • Telephone number (including area code)
   • Example: 123-123-1234
   • Extension number (if applicable)
   • Fax number (including area code)
   • Example: 123-123-1234
   • Name of police service / special investigations unit
   • Detachment (if applicable)
   • Date (year / month / day)

Canadian Centre for Justice Statistics
Policing Services Program

Confidential when completed

Complete a separate Charged / Suspect – Chargeable (CSC) Questionnaire for each CSC in this incident. Information is reported as of the incident date unless otherwise stated. To ensure records are complete, avoid leaving questions blank or scoring 'unknown' unless necessary. Detailed reporting instructions are found in the Homicide Survey Reporting Guide; available upon request. Verify that homicide information reported to the Homicide Survey matches with homicide information reported by your police service to the Uniform Crime Reporting (UCR) Survey.

This information is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.

Completion of this questionnaire is a legal requirement under this act.

Objective

This survey collects essential data to produce statistics on the incidence and characteristics of homicide offences in Canada. The information is used by federal and provincial policymakers as well as public and private researchers. The data are also widely disseminated by the media for purposes of general public information. The information may also be used by Statistics Canada for other statistical and research purposes.

Confidentiality

Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Statistics Canada will use the information from this survey for statistical purposes.

Record linkages

To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada may combine the information you provide with other survey or administrative data sources.

Instructions

Please return this questionnaire by December 31st, 2020. Questionnaires may be returned by mail (see address below) or through the Electronic File Transfer system.

Correspondence

Statistics Canada
ATTN: AADPS
2nd Floor Section B15
Jean Talon Building
150 Tunney's Pasture Driveway
Ottawa, ON K1A 0T6
Phone: Toll free 1-888-659-8229
Fax: 1-800-755-5514
E-mail: statcan.homisurv-enqhomi.statcan@statcan.gc.ca

Fax or e-mail transmission disclosure

Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission. However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority of the Statistics Act.

1. What is the incident file number assigned to the incident by the investigative police service?
2. What is the charged/suspect – chargeable (CSC) number?
   Note: Refers to the order of the charged / suspect-chargeable questionnaires. For example, if there is one CSC in the incident, the CSC number is 1. If there is more than one CSC, the questionnaires are numbered sequentially, e.g., 1, 2, 3.
3. What is the name of the charged/suspect – chargeable (CSC)?
   • Name of CSC:
     • Surname
     • Given name 1
     • Given name 2
     • Given name 3
     • Alias (if applicable)
     • Unknown
4. What is the clearance status of the charged / suspect-chargeable?
   Select only one.
   • Cleared by charge or charges recommended
     • Cleared by charge (includes charges recommended)
     • Charges recommended but all declined by Crown
   • Cleared otherwise
     • Suicide of CSC
     • Death of CSC (not suicide)
     • Reason beyond control of the department (policy)
     • Diplomatic immunity
     • CSC under 12 years of age
     • CSC committed to mental health facility
     • CSC outside Canada, cannot be returned
     • CSC involved in other criminal incidents
     • CSC already sentenced
     • Departmental discretion
     • Diversionary program
     • Incident cleared by a lesser statute
     • Incident cleared by other municipal / provincial / federal agency

5. On which date were charges laid or recommended, or cleared otherwise, against the charged / suspect-chargeable (CSC)?
   Note: If only one CSC is identified in the incident, this date equals the Clearance Date of the incident.

   • Date of charges
     • Year / Month / Day
6. What is the most serious charge laid or recommended against the charged / suspect-chargeable (CSC)?
   • Murder – first degree
   • Murder – second degree
   • Manslaughter
   • Infanticide
7. What is the Finger Print Serial number (FPS number) of charged / suspect-chargeable?
   • FPS number – Specify:
   • FPS number not yet assigned, e.g., no previous convictions
   • Unknown
8. What is the sex at birth of the charged / suspect – chargeable?
   Note: Refers to the sex assigned at birth of the CSC and does not refer to their gender identity or sexual orientation.
   • Male
   • Female
   • Unknown
9. What is the gender identity of the charged / suspect – chargeable (CSC)?
   Note: Refers to current gender which may be different from sex assigned at birth and may be different from what is indicated on legal documents. Male gender and female gender identities include cisgender and transgender persons. Other gender identity includes persons whose gender is reported as being: other than male or female, unsure of their gender, both male and female, or neither male nor female.
   • Male
   • Female
   • Other gender identity – Specify gender identity:
   • Unknown
10. What is the sexual orientation of the charged / suspect – chargeable (CSC)?
    • Heterosexual
    • Homosexual, e.g., lesbian or gay
    • Bisexual
    • Other sexual orientation – Specify sexual orientation:
    • Unknown
11. What is the date of birth of the charged / suspect – chargeable (CSC)?
    Note: If the birth date is not known, provide the age of the CSC at the time of the incident.
    • Birth date
    • Year / Month / Day
    • OR
    • Age in years – Specify age:
    • Unknown
12. Does the charged / suspect – chargeable (CSC) live on-reserve or off-reserve?
    • Lives on-reserve
    • Lives off-reserve, and recently lived on-reserve (within past 5 years)
    • Lives off-reserve, and lived on-reserve in the past (more than 5 years)
    • Lives off-reserve, and never lived on-reserve
    • Lives off-reserve, and unknown if ever lived on-reserve
    • Unknown
13. What is the address information for the charged / suspect – chargeable (CSC)?
    • Fixed address
    • Street number
    • Street name
    • Street type
    • Street direction
    • Apartment/unit
    • City, town, village
    • Reserve (if applicable)
    • County, township, rural municipality (if applicable)
    • Province, territory or state
    • Postal code or ZIP code
    • Example: A1A1A1 or 12345
    • Country
    • No fixed address
    • City, town, village
    • Reserve (if applicable)
    • County, township, rural municipality (if applicable)
    • Province, territory or state
    • Country
    • Unknown
14. What is the marital status of the charged / suspect – chargeable (CSC)?
    Note: If the CSC was less than 15 years of age at the time of the homicide, select Never married (not living common law).
    • Married
    • Living common law, i.e., two people who live together as a couple but who are not legally married to each other
    • Never married (not living common law)
    • Separated (not living common law)
    • Divorced (not living common law)
    • Widowed (not living common law)
    • Unknown
15. What is the Aboriginal identity of the charged / suspect – chargeable?
    • Not an Aboriginal person
    • First Nations person (status or non-status)
    • Métis
    • Inuit
    • Aboriginal person, but Aboriginal group is unknown
    • Not provided by the CSC
    • Unknown
16. What is the visible minority identity of the charged / suspect – chargeable (CSC)?

    A visible minority identity is reported for a CSC who is non-Caucasian in race or non-white in colour, or who do not identify as solely an Aboriginal person.
    Not a visible minority is reported for a CSC who is identified as solely an Aboriginal person, or not considered to be a member of a visible minority group, regardless of place of birth.
    Select all that apply.

    • CSC is not a visible minority, i.e., identifies solely as Aboriginal or Caucasian in race or white in colour
    • OR
    • South Asian, e.g., East Indian, Pakistani, Sri Lankan
    • Chinese
    • Black
    • Filipino
    • Arab
    • Latin American
    • Southeast Asian, e.g., Vietnamese, Cambodian, Laotian, Thai
    • West Asian, e.g., Iranian, Afghan
    • Korean
    • Japanese
    • Other visible minority – Specify visible minority:
    • OR
    • Visible minority, but visible minority group is unknown
    • OR
    • Visible minority information for CSCs is not collected or reported by police service
    • OR
    • Unknown
17. Is the charged / suspect – chargeable (CSC) a Canadian citizen?
    • CSC is a Canadian citizen
    • CSC is not a Canadian citizen
    • Citizenship information for CSCs is not collected or reported by police service
    • Unknown
18. What is the immigration status of the charged / suspect – chargeable (CSC)?
    Note: An immigrant includes persons who are, or who have ever been, landed immigrants or permanent residents. Such persons have been granted the right to live in Canada permanently by immigration authorities.
    • CSC is not an immigrant, e.g., Canadian citizen by birth, tourist
    • CSC is an immigrant, i.e., permanent resident
    • CSC is a non-permanent resident, e.g., work / study permit, refugee claimant
    • Immigration information for CSCs is not collected or reported by police service
    • Unknown
19. Was the charged / suspect – chargeable (CSC) involved in any of the following illegal activities?
    Note: Includes where the CSC was suspected to be involved in illegal activities. Commodifying sexual activities refers to the CSC's involvement in obtaining sexual services, procuring, receiving material benefit or advertising sexual service; does not refer to where the CSC was working as a sex worker.
    Select all that apply.
    • Not involved in illegal activities – Go to question 21
    • OR
    • Illegal drug trade activities
    • Commodifying sexual activities, i.e., CSC obtained, procured, received material benefit or advertised sexual services
    • Organized crime / street-gang activities
    • Human trafficking
    • Fraud
    • Other financial crime
    • Other illegal activity – Specify illegal activity:
    • OR
    • Unknown – Go to question 21
20. Is the incident related to the charged / suspect – chargeable (CSC)'s involvement in the illegal activities reported in the previous question?
    • Yes
    • No
    • Unknown
21. What is the employment status of the charged / suspect – chargeable (CSC)?
    Note: Not in the labour force refers to where the CSC was either: less than 15 years old, an institutional resident, unable to work, or unavailable for work.
    • Employed (in labour force), e.g., full-time, part-time, casual, self-employed – Go to question 23
    • Unemployed (in labour force), e.g., seeking employement – Go to question 23
    • Not in the labour force, e.g., unable to work
    • Unknown – Go to question 23
22. What is the primary reason the charged / suspect – chargeable (CSC) is not in the labour force?
    Select only one.
    • Less than 15 years of age
    • Full-time student
    • Home or caregiver responsibilities
    • Retired
    • Disability or illness
    • Institutional resident, e.g., of a correctional facility, hospital, nursing home, community group home
    • Not eligible to work in Canada, e.g., illegal immigrant, work permit has not been secured
    • Other reason CSC is not in the labour force – Specify reason CSC is not in the labour force:
    • Unknown
23. What is the occupation of the charged / suspect – chargeable (CSC)?
    Note: If the CSC was unemployed at the time of the incident, report their last legal occupation. Report if the CSC was working as a sex worker in this question.
    • Occupation of CSC – Specify occupation:
    • Unknown – Go to question 25
24. Is the incident related to the occupation of the charged / suspect – chargeable (CSC)?
    • Yes
    • No
    • Unknown
25. Is the charged / suspect – chargeable (CSC) receiving financial or social assistance?
    Note: Applies to both CSCs in the labour force, i.e., employed or unemployed, and CSCs not in the labour force.
    • Yes
    • No – Go to question 27
    • Unknown – Go to question 27
26. What is the source of financial or social assistance?
    Select all that apply.
    • Employment assistance or social assistance program, e.g., Employment Insurance (EI), Workplace Safety and Insurance Board (WSIB), Ontario Works (OW)
    • Disability support program, e.g., Ontario Disability Support Program (ODSP)
    • Financial support from family or friends
    • Financial or social assistance from a band / tribal council
    • Other financial or social assistance – Specify source of financial or social assistance:
27. Does the charged / suspect – chargeable (CSC) have on record any previous convictions of criminal activities?
    Select all that apply.
    • No previous convictions of criminal activities
    • OR
    • Crime against the person
    • Homicide
    • Sexual assault violation, i.e., aggravated sexual assault, sexual assault with a weapon, other sexual assault
    • Other sexual violations, e.g., exploitation, invitation to sexual touching, incest, corruption of morals
    • Assault, i.e., aggravated assault, assault with a weapon or causing bodily harm, assault level 1, all other types of assault
    • Kidnapping, abduction, or forcible confinement
    • Trafficking of persons
    • Hostage taking
    • Robbery
    • Commodification of sexual activities, i.e., CSC was convicted of obtaining, procuring, receiving material benefit or advertising sexual services
    • Harassment, e.g., criminal harassment, harassing communications
    • Utter threats to person
    • Other crime against the person
    • Crime against property
    • Arson
    • Break and enter
    • Theft
    • Fraud
    • Mischief
    • Other crime against property
    • Other offences
    • Other Criminal Code offence, e.g., gaming / betting, offensive weapons, other Criminal Code not otherwise specified above
    • Controlled Drugs and Substances Act (CDSA) or Cannabis Act offence
    • Other federal / provincial statute
    • OR
    • Unknown
28. Was the charged / suspect – chargeable (CSC) in custody, or under community supervision? i.e., remand, sentenced custody, probation, or bail
    For adult CSCs (18 years and older), this includes remand, sentenced custody, i.e., federal or provincial sentence, or intermittent sentence, other temporary detention, probation, conditional sentence, bail, or other community program.

    For youth CSCs (12 to 17 years of age), this includes pre-trial detention, provincial director remand, secure or open custody, community portion of a custody sentence, intensive or deferred custody / supervision, supervised probation, bail, or other community sentence.

    • Yes
    • No
    • Unknown
29. Does the charged / suspect – chargeable (CSC) have a suspected or known mental illness or a developmental disorder?
    Note: This question refers to the investigating officer's assessment of the CSC at the time of the incident, and is not a medical diagnoses.
    • Yes – Specify illness or disorder:
    • No
    • Unknown
30. Does the charged / suspect – chargeable (CSC) have a suspected or known physical disability or limitation?
    Note: This question refers to the investigating officer's assessment of the victim at the time of the incident, and is not a medical diagnoses.
    • Yes – Specify disability or limitation:
    • No
    • Unknown
31. Had the charged / suspect – chargeable (CSC) consumed a substance such as alcohol, drugs, or an intoxicating substance, during the period leading up to the incident?
    Select all that apply.
    • Alcohol consumed
    • Drugs consumed
    • Intoxicating substance consumed, e.g., inhalant
    • OR
    • CSC did not consume alcohol, drugs or an intoxicating substance
    • OR
    • Information not available, e.g., drug testing reports not yet received
    • OR
    • Unknown

Thank you for your co-operation

Getting started

Why do we conduct this survey?

Statistics Canada is conducting a survey on Time Use. The purpose is to understand how much time Canadians spend on various activities. The information will be used to better understand the effect and cost of time stress, commuting times, time spent on paid and unpaid work and sleeping patterns of Canadians. This survey could also show how technology is helping us perform day-to-day tasks.

Although your participation is voluntary, your cooperation is important so that information collected will be as accurate and complete as possible.

Other available information

Authority to collect

This information is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.

Confidentiality

Your answers are collected under the authority of the Statistics Act and will be kept strictly confidential.

Record linkages

To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada may combine the information you provide with other survey or administrative data sources.

1. What is your age?

2. What is your name?

First name
Last name

3. To start, a few general questions related to time.

How often do you feel rushed?

Include: times when being pressed for time was a positive stimulant as well as times where
stress was felt because of the number of activities that needed to be done in a day.

1. Every day
2. A few times a week
3. About once a week
4. About once a month
5. Less than once a month
6. Never

4. How often do you feel you have time on your hands that you don't know what to do with?

Exclude: times when you chose to do nothing and times when you have to think for a few minutes about what to do next.

Select 'Never' if you can always think of something to do.

1. 1 Every day
2. A few times a week
3. About once a week
4. About once a month
5. Less than once a month
6. Never

The next questions will deal with your use of time for a 24-hour period starting at 4:00 in the morning.

You will be asked to provide details of your activities over a 24-hour period on a specific day. Please report all activities that lasted at least 10 minutes, including activities such as travelling from place to place.

You will be asked to list the different activities done yesterday.

5. The next questions will deal with your use of time for 24-hour period starting at 4:00 in the morning.

You will be asked to provide details of your activities over a 24-hour period on a specific day. Please report all activities that lasted at least 10 minutes, including activities such as travelling from place to place.

You will be asked to list the different activities done yesterday.

6. What were you doing at 4:00 am?

7. Starting at 4:00 am, how long did this activity last?

8. Please indicate if you were doing any of these activities at the same time.

9. Where were you?

10. Which mode of transport did you use?

11. Who was with you?

• 200 On my own
  OR
• 201 Spouse, partner
• 202 Household child, children (less than 15 years old)
• 203 Household child, children (15 years or older)
• 204 Parents or parents-in-law
• 205 Other household adult(s)
• 206 Other family member(s) from other households
• 207 Friends(s)
• 208 Colleague(s), classmate(s)
• 209 Other people

12. During this time period, did you use any information technology device such as a tablet, smartphone, computer or laptop?

1. Yes
2. No

13. On a scale of -3 to +3 where -3 means very unpleasant and +3 means very pleasant; at 4:00 o'clock, how would you rate the activity you were doing?

• -3
• -2
• -1
• 0
• +1
• +2
• +3