Canadian Resident Questionnaire for Same Day Automobile Travel Between the U.S. and Canada

Welcome back to Canada!

Please take the time to tell us about this same day trip. This voluntary survey is conducted under the authority of the Statistics Act (R.S.C. 1985, c. S-19) and your answers will be kept confidential. Your cooperation is essential and appreciated. Please print.

1. Where do you live?
   • Country:
     • Canada
     • United States
     • Other
   • Province
   • City/Town
   • Postal Code
2. On this trip, where and when did you enter Canada?
   • Canadian border crossing
   • Date (Month / Day / Year)
   Your travelling party includes yourself and only those for whom you are able to report spending.
3. How many people, including yourself, were in the travelling party?
4. What was the main destination on this trip?
   • State
   • City/Town
5. What was the total spending (including cash or credit transactions) on this trip for all persons reported in Question 3? Estimates are appreciated or if no spending occurred, please check the appropriate box.
   • Spending:
     • Amount (.00)
     • Currency:
       • $ Canadian
       • $ U.S.
     or
   • No spending
6. What was the main reason for this trip?
   • Commuting to work
   • Business
   • Pleasure (including shopping or entertainment)
   • Visit friends or relatives
   • Other (specify)

Thank you. Please drop this card in any mail box in Canada.

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