IN CONFID~CE GEN~AL HOUSEHOLDSUWFX s 457
* PER: V~D VflRIAOLES 1974/4NUUSEH,lLII ‘3WEDULL
SURREY G M S SUBFILES
THT %.t%-=!’i%tmte of intewiev~
AJTu !Total m of households at the address ~~~oL>~
r’JP6RHlL*. & AREA sm. N, NLD.●* Faw.us IN 14askwumTime Hmmehold Schedule started . . . . .
MPCRFAH * - p. ,, w..; ,. “~fim~b:, lzc41-‘. r 4
, *
8
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-4-
TO EACH tKWItW C470UP
6. Now 1 would like to talk ateut YOUIthatl, . . . . . .
ADDRFSS OIti iT ~.i “ “
!rTv d,d you and . . . . . . . . . . . . . .mm mvmccmw
PMBE NUT
m
last tddress,
nHOvmcCROUP 2LIF mw TNAN ONS SPAWN GIVSN AT Q.6 ASK Q.7 I
LUA, ONE SU.93N ONLY AT Q.6. . . . SING
7 fiat was your s reason for .OVMS?
n
NDVIHC Mover’lnlv
CXOUP 1
nMOVINGC4K3UP2
dofs!mmCROUP 1
x
TO S4HS h7i0 ARE NSMBfRS OF~NDV1ffi CSPWP (SEE Q.2)DNA . . . . . . . .
““nx8 At the tme You moved from (ADDRESS CIVENAT Q.1) were you .1*o head of tht household -by that 1 mea” the pers.m u whose -e theaccmcdat.on was ovned or rented, Yes . . . . . . 1IF YSS
~o14c~tJT NO . . . . . . . ,uU(a) How long d.d you Lve at your last address? ~ . . . .NO. OF COWIETSD flMRS (kViITE O IF UNDER 1 W)
1 srv~~a<
CODE
mmGROUT:
x
B
G
lTD~T13MMDATIIXIus 5
= (.)) TJ PREEVNTXXJWLX!ATIMI\GE 5
-5-
PSSSEIT ALzC4WMT1W
TO ALL tNWSIXIO~
IF l=WAVAN SING >
TMN ASK MIL1 QS 2, 17-19, 2$28, TMN m To Fo~mLW3vlStT SSCTIDS
1. was this buildinsfirst ~f.lt
RuNNnm before 1919
PMNPT1 ‘“ ““’“ ~s~~:~
bctieen the Wu; (191%1944 . .or after the lwt War (1945 on?
I m.
~ 1, A- LAST HAR AU Hou SC(.) w., it first tuilt
RUNNING between 1945 ati L964
DPFAMPT or 196s or later?
0s
2 00 ycu wn or rent this (lMJslf/FIAT/ETC. )?
cma/is Edyins .ObJMHOUSE Re.ts/rent free . . .
TO TfUSE CIOIINC/SUYINC
30UNLE4SGL@FI m .t leasehold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
or freehold? . . . . . . . . . . . . . . . . . . . . . . . . . . .S. (or do TO. Wr f.. duty or gruund hrde.?)
c2wNtloaT4(. ) DO y.” own it atrigbt
.r are YOJ hTInK it on . mrtg~ge Or 10~? . . .
IF ~TW=/LOAN Mo&r&Amp(I) Will the prfnciPl of the sortgage be p@id hck
thrcugh an cmdomeat VOMCT tit you hve? Yes
(SKcmm )OSTOAOE FMTDXIDN mmms) No
lNIRODU~
T
MO~ Ifr(b) HLV mch was 7our last r-y=ent cm the endrnrnt _
paliq, plus the interest en the mortgmse? AWT —
i c) Hc.d wch was T-CW 3a#t htabent an ycur.ortgwe or l--?
(d) w long t pericd did thin cmerT. N.ol+ YI w !
5 (lAIy I just check) d. yw receive . rate rebate? Yes
1? S?s
(a) Hcw mch rebate do ycu receive?
(b) Nw long a pericd doa tNs corefl
No
RIITEMBO*AHMNT
ODE
1
!2
1T.
T
c
12
1
c
l--
m
IF’ CODE 4 0S 7lNTVXVINMBTIKATE
:’}S
I
4 CO TOQ2
1~C13T07 Q2CD TOQ3C4JTOQ6
CaTo Q5ASK (L)
ASK (b)&(d)ASK (c)&(d)
MoIIT4HTi
~(A?l.-.r ~E~‘*. ewnca
)HO”TMASK (a)&(b)cO1OQI5PAGE 8
CD T0Q15PACE 8
fo lf!OSE N2NT1NG/SE+TINO mm (mDso 2 AT Q.2~
6.
7.
9.
9.
1s it rented (provided) furnished or unfurnished?
&6/44TI=&~$J ~~%hti . . . . . . . . . . . . . . . . . . . . .Unfurnished/partly fum3shed. .,
k. any imsiness premises included fnthe rent for this acc~tion (in theaccommodation provided )?
3MS.UDE FAfdl 11EN78u S0
Doesthis acc-atim go with the presentjob of anyone in your household?
lwNTToi3
bho do you rent it f r.m?(W is it provided by?)
PSOMPT
AS
NmNssAsY
Yea . . .No . . . . .
Yes . . .No . . . . .
ORGANISATIONS ~E@7F&oq2.ac~AutbOrity . . . . . . . . . . . . . . . . . . . . . . . . . .
N.. Town Corporation or Co&ssion . . . . . . .
Property CO.pany . . . . . . . . . . . . . . . . . . . . . . . . .
Homing Association or Charitable Trust . .
Scottish Specia3 Ncusing Association . . . . .
Shployer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other m.gsnisation (SP3XXTY) . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
~IVfDOALV
Relative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fmployer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other individual . . . . . . . . . . . . . . . . . . . . . . . . .
m ‘fllOSE RENPING FRGN 3NDIVftlMLS (CODSJ 7-9 AT Q.9)
Lo. he. your landlord live in this Lmilding?
Yes . . .
~~~~D No . . . .
mos
1..2
12
12
0
1
2
3
4
5
6
7
8
9
12
urn1. 11
Z2101. 10
-7-
m fflfsr smlT3NQ/mmfNo mmf (CQmo z AT a.2~ ~E~T~~T
11. (a) I&u nmb rent d. y.. pay for this accomcdatiw?A~f’ —NUNS . . . . . . . .
RENT71 MF(b) Ikwlong .pericd does this cwm7 . . . . . . . . . . . . . . . . . . . .
12. W mfu receive a rent holiday - by that I mean certainweeks each year when you don,t have to WY any rent?
~gti~~eks~:::$
IF YSS
(a) For bw many weeks i“ the year d. ycu receive it? J
13. (a) Does the t (RRIT GIVEN AT Q.ll( a)) include rates . . . . . ..mdoym pay rate. separately? . . . . . . . . . . . . . . . . . . . . . .
(b) M yca pay rates? ~~~~s Yes...No. . . .
(
14. M Ycu receive any kid of rebate or allowance fromthe Cmmcil to help pay ycur rent or yc=ur rates?
EzEE!El Yes....No.....IF 2ES ~~B ~TF I
(a) Isthisrebate Orallcwmcef Orrent . . . . . . . . . . . . . . . . .S3nRmm or for rates . . . . . . . . . . . . . . . .PSUMFT or for lath? . . . . . . . . . . . . . . . . .
(0KUH3CH . . . .
~, ]mT_b Nw mmh rebate all.wance do m receive?
(c) Nw l.ns a vericd does this cover? MflrltmNENTSSLMfE/Af3.CWANCE . . . . . . . . . . . . . . . . . . . . . .
NATSRES4TE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(d) CJOKX UNSWSN NSNT OIVm AT Q.ll(a) IS U@E71WhANW?IT W fIEDUCTINO MT RSE&7E/AWANCS AiR@ SATS REOATZ> OR ~ &fore.
After.
/? Et47f+M7C *
“1s, p
GR033S33VP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
& RF3iT SSMTE/RmT A2.LOWWm .
z~,~wmmwm......., . . . . . . . . . . . . . . . . . .
. . . . . . . . . .
ew.lsmmT . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4CODE
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12
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RSNT7ssATs/\ ~wAN(
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. . . . . .
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REN
mv
REtwmiASK Q.ll( 1))
(Ano.ulGO TO Q.13(tPbx.A’avsm?lOf. rn)
ASK (a)GO TO Q.13(.
W m Q.13(,
P‘0””CQ TO Q.15
ASK (a)-(d)WI TO Q.15
==1
-8-
ALL HOUSmOUIS
Do you h,,,. e.thcr a fIxei bath or a B$17~f~xcd shower w~th hot water supply? Yes . . .
No .
Do you have a flush tmlet? Yes . .No . .
IF YES(a) Is the entrance to it ~ 00 (
lND1 VIDUAL
(
reside your accomodatmn, . .PRMT AND m ts ~de your ●ccoda tmn LuCODE FIRST lns~de the klldmg, . . . . . . .7UAT APPLIF.5 outs,de the hilding, . . . . .
(a) HOW mnY bedroom do You ham, m.1.dmgbed s=ttm~ ,...s and sPare bedroom7 k-
~~ NO. ~
BED LOOqeS..(b) Are any of them used for ccmkmn m.ltie a bed s~ttmg mm for etiple; NO . .
( ADart f r.. that) do vw have a kltchm - Ye,
IF YES(a)
(b)
ih: t IS, a ~ in which you cook?tiITCH%~ “
Is the narrowest s=deless than 6ft wide KITSfrom wall to wall? less than 6ft
6ft or more
Do (any of) You ever eat .eals. .m .t or use lt .3 a mttmg Yes
room? t.flrE/4T ‘“what other moms do YOU have?
RNTSR DELfM, lNFORNANT1S NANFS FOR RCOLT BUTEXCUJDE DATNR~NS, fAVATORISS, CARAGPSMD RCQNSUSSD ENTIsSLY FOR BUSINESS
NM W Rw ~o~M~ +RINC—
)DF,
12
—
12
3
45
(e..12
12
—
12
. . . . . . . . . . . . . . . . . . . .
‘11
. . . . . . 2PPRoo.i+ * ““: :i.Jo .O;”.P@;r. F&+ . . . . ~
P.o:” .,? w.1+~}> . . . . 1
(UIY 1 ~ust check) do you let or wt-let an~of the room you have told t+. about? No x
K (dToQ17
3
U17;K (a)&(b)ITDQ19
DTDQ21
CDDE
w~:=
Rti
4RE
fT
. . . . .
‘UA4
A)
+
L6T1
2
3
4
IF TM mTSR IN W I
.ind do you share my of the rooms or the bath(shower) or flush tmlet w,th any otherhcusehol d, No , II x sRE Q 22,.
IF YFS ENTbN IN COWM I
nlm sEE Q 22
S IF A RCQN 1S mm LET/SUD-LET ~ SNARWCOUE ONLY AS SIIAREU
-9-
IN~VISWW C= FW ALL HOUSSXIOIILS
Is the znformant B# ●cc~ation the s-e ●sthe Nateable Unit? (SLS D=CZIIPTION DSTAINUI
mm NASTNOD??’ICS)
wYKIQ23
ASK Q.22 ,
Yes . . . . 1,No . .Doubtfu3 . . . . .:
< ,. ‘T *:.1),,
22( k)
,, ,X!,,.w,Are there any room in this
RATSASfX UNIT oral’
j!in addition to the onm YOD have told ●e .bmt?
II~ ND. OF ADDITImAl RCQAT~
1? N~, SNITZ On
_ favat.rms, bathroom, garages,rc.om used entirely for bainess
o
m AU NDUSEW311S
23 Have mT of the f .11 wing been l.sttiled .r rePlac~ ~ ( Pr Part Of)tbs acccnwhtion during the 1.s t 12 mmtlu7
PRUNTT
oAm CODE
AU TWAT
APPL1
1’I
I
or outside7u
1I
3 4
4~ EACH INSTALiATIDN RIN~ 1, ASK (.) AND RCCDRD I
(.) Was thm a replacement of an eximti~ ,m additional one, or was it the first one inthi~ acc-adation~
Nfll=Q24
-10-
m
24. Apart from painting and de.mr&ting, have any otherimprovements, a3terati.ns or repin been made to(ycur part of) this acc-cdation during the last12 80nth9?
SXCL41DElTWS CO- AT Q. 23 & ~lf yes . .QIPROVOIWTS HADE m mymm
so . . .
(a) Was the tota3 cost of them (other)improvemems, a3 terationa or ~rs DZ’fC
Uudereso . . . . . . . . . . . . . . . .
2S0 but less than e291 . . .RGfOIISGfROMFT ezso . . ~ EWO . . .
.I.esooo rmam? . . . . . . . . .,
OK . . . . . . . . . . . . . . .
To AIL NMmlfom
25. Do ycu have a telephone in your (part of the)accomcdat ion?
PRONE Yes . . .no . . . .
IF YFS PktotJlmJEhJ(a) Was it here when you ●oved in . . . . . . . . . . . . . . . . . . . . . . . .
OrhaveyO. haditinsta31ed? . . . . . . . . . . . . . . . . . . .
IF INSTA2LE0
(i) How long ago wm it ti,tdld? PH ~N~Tfiless than 1 year ago . . . . . . . . . . . . . . . .1 year Lmt less than 2 years ago . . . .2 years m . “5n . . . . .5*Vn nlo* . . . . .10 years ormre ago . . . . . . . . . . . . . . . .
(b) Do YCU have an extension to your telephme?
PUONECXT ,0....Yea . . .
Com
x
1
2
:-r1
2
3
4
5
12
12
00 m Q.25
Ass (a)
co m Q.25
Nwco “em2.25
m (dn m Q.2d
-3.1- 1
e!oK! TO (b)SS (i)
1
SS (b) .,
afuco m
LCODEfoALLNomfalo2m2d. 00 ycxi have in ycur (part of the)accwationmm
27. Are my of the follcuing item mmIMYavailable for use ti. ycur accmodatim? I
NCi7sTORF
k
Yes No
11V2DUAL any electric night storage heaters? . . . . I 2WNmPT
or any other form of cmtral heating? . . 1 2
c~IJTQ gflT
rYesOaa cooker qf?scoo~. . . . . . . . . . . . . . . . . . . . . . . . . .~e.tri. wok. ..~~%s”.~~... ;1 W.SMIIS nactie . ..W.fiSHM9.G.M.. InmmmITRS sewm~e .p-r~er ..s ~!fpp.~f. . . ~STOSEO Y2101V’21tlALOR PmMF1’ Fridge [E2020GE OSEP FRSSZE] t%!~.$ , 1UNDm vacuum .,emer .....~fi.qu~fl . . . . . .RSPAIR ~di./tmmistor . ..~k~l~ . . . . . . . . ;d TV set vhich you own . . . . . . . . . . . . . . . . . . 1TvTV set which you rent . . . . . . . . . . . . . . . 1~IF YZS m TV SEY
F
(a) Is it a ..lOUTS%O ~J 1. . . . . . . . .or bYack and white? . . . . . . . . . 2
—
No—
2
2
2
2
2
2
2
2
2—
IF ml’s mDE AS WYK)GR I
.COmQ.28
&OwmmQ. 28
2s. Is there a car or a van nomally avaibblefOr USt by you 0, ~ember.s of y.”= ho”,.h.ld?
/Yes . . ....1/1 I ASK (a)
IF YE! LNo ....... 2
i
(a) Is there .ne? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
MCARSor more than me? . . . . .. YIIN3+X ASK (i)
IF M2SE TNAN 0SS
4(i) Howoany.me there? . . . . . . . . . mTm NG. . . . . . . . . .
comFOT~IALmpsmSIETIONPAGE 12
vow co mPOTRiTIALmvslw+3EL!TIONPAGE 12
-12-
POTEHTLU HO-
: ‘OR ‘m’ “m 0’ ‘m ‘ous’”om la NY$ oAt the moment, are (any of) y.. serm.sl~thmhng of .O...g fro. tti~ ,dd,e,,, H6
1P Y’s
(a) UI1l you MOVINGall be moving t. the same address
( 0SS HOVINC GlOW)
RUNN2HG all be •ov,~ tut to d, fferent
RtafP7 addresses(TWOm HwMOVIKGC’0U7S)
or .,11 m2y some of you bemo”ing~
(ONE~ MC!IEM3V1NCCSOU’S)
m mm3E CODED z OR 3 AT Q I(a)
2 Wtuch of you w,ll be m,,% together - that ,sto the same address,
mm PE+ NW FOR EACH MOVING GROUT—
:ODE
t~
12
—
1
T.
3
—
TO ALL MoVING GROUPS
3 WI1l p. be m.vmg to a private reaxdenceor WI1l you be .ovng to so.etlung d~fferentsuch as a hotel, for example, (.J
Pr.vate resxdence
Hotel, etc
TO Au GROUPS MOV2NG TO A PRIVATE RESIDENCE{COD~ 1 AT Q 3)
4 WI1l your new hoe be I. Fq,lani, Scotland,Wales or elsewhere, (omit)
Lm~~ ‘
~DK~tin~
=] EfSSWm . .1’ CODFD 1-3
r.) !41.!.1 . . .. . d. .“!, ,l.lnk
ASK (,)SS’ Q.9
Mf2w Q3
WJ’2UQ2
U3DE
1
2
12
:
5
CODE
me
1
2
12
:
5
I
-u-
TO AU. CPQUPSWW25G ?0 A 7RIVATS RES2DFNCS 2N-T iR1TA2fl (CODKD1-4 AT Q 4)
(d)5 Would mpne else jdn you do is not liriq here no~?
FNTM NO OF Pms3NS 2F Nom Wms o a
6 mm hs= F. done .2vut tryti to f2nd smewhere to
A5K OPYNLY, Tlfm FT=IPI Am fiOT HlNT2_ SF$f%fi@LlZ2ve?
Ham yc.U tpPlid tO the Council?
Hme you de enquiries w2th agents or landlordstout a place to tuy?
or abut a plsce t. rent-
Have y.. abertised or replied to &rertisement9.tm t a place t. by 7
or atmt a place to rent7
Omm (“mm)
ElKIV2NGWJ3UP 1
1~TO AU, GSOGPSMIVIf@J m A FTWATN RESIfAfWs (WD3D 1 AT Q.~)
1I 7. bhy have you and . . . . . . . . . . . . . . . decaded %. move?
‘Et’ WV21C cxfouP
PRDSY,FULU /
8. mat in your a reason f m. mo7i11’7ASK (t)
—L
mm
u
KIV2NCMAitiMOVE
a.s QmGP 1 /
mm1.7 m
03DE—-
0 V2NcR(7JP 1
—m
i
11
11
1—
—
—10
F
22
22
2—
—
—
x
W DE
WV2NGcFafP 2
—m.
-i
11
11
1—
—
—NO
T
22
22
2—
—
x
—.
.M
—.—
——
—...
dw
&0.-
e—.
..!9
d.
..
..
::::
:::::
u)s2
.
-16-
COtWLETS THIS PAGE FOR AU HOUSWOL16 IHIZUDING NON-N3SPIMDFIPIS
A. TYPe .f =c.~odatxon .ccup~ed by this household TYPE,CODE %ole house, bungalow, detached ... . . . . . . . . . . .OHS . “,” , semidetached . . . . . . . . .mot! ,! “,” , temaced/end of terrace . . . . .0S3SIW
r
Plat/,nalsonette, pwpose built . . . . , . . .ATION,Ii’ IN
Other flat/mm.mette/roou . . . . . . . . . . .Lkelling wath business prmses
DOUBT. . .
ASKDther (speuf, ) . . . . . . . . . . .
TM. . . . . . . . . . . . . .
B. 1s the accc+tmdatmn on more than one flo.m+
~roA&~s :S . . . . . .. . . .c. m HLWSPJKlLt6 CDDS214, 5. 6 DN 7 at Q.A.
fiat ,s the flooraccomodatmn,
level
N FLOORS
OTHERS LWA . . . . . .
of the rain lim.ng put of the
Nasemnt/Sem-Lwsement . . .Orc.und Floor/Street Lwel . . . .First n .Second n .?bmd n . . . .Fourth . .Fifth ‘,6thto 10th Floor .“. ” . . .llth to 20th n .Dver 20th n . .
OSTAIN FFJM RATINJ OFITCEpoUPVDt+~E
(a) Yearly &te Poundage for rateable umt —>
(b) cross Value of rateable umt(s) covering (Om;t)th,s household
(d) Descrlptlo. eg Flat, Shop -th flat, & lomtim inbuilding given in Sating Valuation List
. . . . . . . . . . . . . ““(+1)””””:.... .. ..
lNTFRvISHW. AUTHDSISITIDH NO
“~wT,.. no,,.. hr,l,l .. I,. A>,l. ..m.l . . . .
~DE
XJs
123
4
i
7
12
12
1
012
:
:789
_
llLWAfIM
IP.. . . . .. . . . . . .
W’MB
w To (t)
Q31UB
WfOB
!ATEPA ID‘houwr OP
,nric m ID I
)fA M.#J7H
03
:,’
t:
i;: # ~flIvW va41~8Lcsj,’:”’i?,l:;t,. :::iew+&”gN ,SF
Time individual schedule started . . . . . . . . . . . . . . . . . . .. .
;!)l.,,..
1. Did YOU do any paid work last week- that is the 7 days endinE lastSunday?
‘F‘O(.)tie. th..sh Y.. were., tworki”~ did you have ajob ‘Aich you were awayfrom last week? . . .
IF NO(i
PROMPT ANDRING FIRSTTHATAPPLIES
Yes . . . . . . . . . . . . . . .No—X ASK (a)
EMPLoYEDYes . . . . . . . . . . . . . . .N.—X ASK (i)
(~6. LO~b,MO I.J,TU ok” i<
fast week were youwaiting to take up a job which you had
.Iready obtained ?.... . . . . . . . . . . . . . . . .out of employment but looking for work?. .or would you have looked for work but for
temporary sickness or injury?. . . . . . . .NCNEOFSHESE. . . . . . . . . . . . . . . . . . . . . . . .
MfN JLRI LAS? WEEK (MM -T IF CQDED 3, .4 OR 5 at Q.1~
I+ RING _
““’’’’’’’’’”-T2“HotfE2?:::::Gii5c4:?........htlrsEG ..?..... ... ..... ..........l .:Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
H? H.LXC,6 P. .y. . . . . .h~.S.CXg 6.?.!! .
L_L‘~/
. . . . ..N.I.F.9.GG.G. P..* . . . . . . . . . . . . . . . . . . ‘v
I i1
CODE I1
I
34
56
I CO?OQ.2
1GO TO Q.2
husEfHtL*lfmPL*
IGO TO Q.2GO TO Q.28M PAGE 13(’ — (j, I;j)1? MANAGER, SUPER1NTE4D~T OR SEfJ_Q(PmED ti=d (. PI C , d~D u ,,,<
rFNOTNANffiERSTC, DNA. . . . . . . . . . . . . . . . . . . . . . . X
(a) Number of employees i“ the establishment250r more . . . . . . . . . . . . . . . . . I1-24 . . . . . . . . . . . . . . . . . . . .
a“””””’””””’”””‘‘*;Y
T“”
e’+
m
10
.
-1 .
I
#N
‘fPXnYsss ONLY
km your employer pay youanything when you are offsick? s
-.4
IF SELF-QIP~ED, DNA . . .
Yes . . .
CKWly % ::::
frees your employer run a privafc pension wh.ae. . wperann.at i.” xheu,e?
Yes . . .
SKCLUDSSTATEGNAOUATSDPENSICM , PEAJSLOIUS:::::ANfIf.UHP SW PATNENTS
IF YES
(.) DO Y.. below t. the s.h.mez Yes . . .pkps~o~ NO....IF YES
(i) DO YOU have to make a Yes . . .contribution? PEfuScoNT ‘O““””
IF NO
(ii) fiY a= YOU..t in the scheme?
FEfds’fuelNot oldeno.gh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PNDBE Not been with the fi~ kmg e“..gh . . . . . . . . .FOR Af.Lyoo old . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .NSASCNSTemDoraW iobo”lv . . . . . . . . . . . . . . . . . . . . . . . . .
Nc.t”inte”~~ ted . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Other i-easons (SPECISY) . . . . . . . . . . . . . . . . . . . .
(f’J&. l=,ti~ Rmsom eNLy C.-D.% J
~m AND mm W@#l?+WORKINGS,’S7 fOiffKID 1 ATQ.1 fNA...
‘O YOUw th. full National Insur~cecontribution or the special rate formarried women (widows)? MoMEfdNl
(a) DO.S anyone pay a NationalInsurance c.mtrib. ti.” onyour behalf?
No ccmtrib.tion paid . . . . . . . . . .Full NI cmtributiom . . . . . . . . .Special rate . . . . . . . . . . . . . . . . .DK . . . . . . . . . . . . . . . . . . . . . . . . . . .
(.-J ) Yes. ..No....
IF YES
( i ) 1S this the full Nat i.mal ILSUWW,.mtrl but i on or the special ratefor married women (widows) ? (..+)
FU1l N1 co”tributicm . . . . . . . . .Spcci*l rate . . . . . . . . . . . . . . . . .
:ODE
x
1
;
x
1
:4
12
SEE Q.10
L% (a)
SEE U.lo
L5K (i)iSK (ii)
SES Q.1O
WE Q.1o
;OTO Q.]]
LSK (a)
;0’0 Q.11
\SK (i):0 ‘0 Q.11
]To Q.11
-5-
TO ALL ENPKMEE.$ AND SELF-ENPfDYED
11. Hrnlong have you bee” with your pres.mt eIIIployer/self-employed (in your main job)?
S-owl?nlasLe.. than12 month, . . . . . . . . . . . . . . . .12mo”ths or more . . . . . . . . . . . . . . . . . .
12. Now.-y changes of employer have y.” ~~ B c ~ # ~made i“ the last 12 months? ●
IF NO IIU+’1OUSEMPLUINENT IN LAST12 ML?NTIA5,ENTEN 0
FOR EACAiJOB STANTED IN LAST 12 lKlllliS, ASK
(a) Thinking of your job with your . . . . . . . . employer(PNESSNT, LAST, STC. )
(As a self-employed person)
●
RLNNINGPN’NPINuTco IN.;ONEONLY
(b)
●
I
I
how did you ~ hear about it?Was it through
Toi3tIEAf21”
an Fmploymcnt Sxd,mge . . . . . . . . . . . . . . .a prlvatc cmploywc,, t .Igc”cy . . . . . .anadvertiscrncnt . . . . . . . . . . . . . . . . . . . . .a relative or f,ic,, d . . . . . . . . . . . . . . . . .direct appli cat ion to a, crnploycr . . . . .or in some othe z way? (SI>NCIFY). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Did ycm have a pcri od wi tho”t workbzfore you found your ~ job?
708u&JE&f PYes . . . . .No . . . . .
IF YES(i) Curing that pc!’icd without work, how lang
were you ~ looking for work ~forcyou found your pr. scnc job?
fklY. . . . . . . . . . . . . . . . .
Winks . . . . . . . . . . . . . . . . . . . .
~06Loo~ tiontl,s . . . . . . . . . . . . . . . . . . .Did ,,’>1 look at :,11 . . . . . .
CDDK
12
. . . . . . .
ASK Q. 12CO TO Q.13
,.,
I
-6-
(.) D,d YOU belong to a pensmn scheme run byy.., prcv.o.s e.pl.yer?
IF YES(,) M,e. you left your prev.o.s
cnploye r
PREvPEN 1 ~d .d you trnnsf er your pens... rwhts
to your present ~ob, .INDIVflSJAL d ,d you reta~” any penslo” r.ghts
‘i’” ‘0” are “the’ “’”’”S PREVPm. or WL1l be able to draw mtho future,
PROMPT‘:~n~b:lo:,ref””d 0’ ‘O”rPrlEVPiwas then some other system,
llovc you reta, ”.d any pens... r@tsPREvPEfuk
from any (other) prev,ou. Job wh,ch
YOU arc e, thcr draw, ng n.. or w.11hc able to d raw , n the future,
o-1-HPEf6 :’EXCLUDP STATE CRADUATF’DPFllSICSWmm LmlF SW PAYNE?4TS
-o Am woRmNc OvER ]0 HOURS PER ~K
WORKS10 HDURS OR Mss, fNA
1,’ 1, kc to t ,Ik to you abou the way youabout your Job
Smn.t ,m,. people have a P,emral feeling of be,nE‘cd-up w, tl, tl,c ,, ,ob. fM YOU ever feel l%ketl,, .,
YesNo
lb YES(.) \+o.ld you .ny you feel 1, he th, s Ut3F(ZDUP
marly all the t.mef a , rly oft.”.omct, mc, but not often
or r,,.21y,
CODE
123
!.s N
12
212
1212
12
1
12
ASK (.)GO TDQ13.9XQ14
NOWGO TOQ 13
●
SSS Q 35APASS 16
*
SK (a)ITOQ15
SK Q 15 1
-7-
15 1,m gmng t. show you a l,st of state=nts h,ch descr~te the waypeople feel ato.t the,r ~.b I,d like TO. to t,ck one tox foreach statement to sar whether or “ot xt IS tme of your Job
For example, lf To. feel that to say your job IS secure is - -=ry tne, you would t~ck tmx 1, .f YOU feel it is dot at all *true YUI would t,ck tmx 7 If you feel it IS n=.thercomvle tely true nor completely untrue, Y.. bvuld t,ck oneof &e tuxes 1. between
m DE COUPIETSJ s’ mmmmms
1
2
3
4
5
6
7
8
9
lD
My job .s scc.re
MY work M Mt.rest_
HY sup.r~ Lsors -eeasy co &et on w~th
1 can always t“,” tosomeone for advice lf 1“cc’ ,t
1 can eas.ly get thetool , and CWlpli.”tth. t I think arcnccczsary to do the~ob
HY fellow workers arcC.?Y to &ct on w.th
The pace at td,,ch 1am expected to vork wr.. sonablc
Tberc arc &ood cbanccsto get on
HY usual t~c home pay.s goad
she hours are good
V12RYTRUE
,.+
NOM PLB4SE NAND TliE CWb5TT0mAIRR Mm m f!+E lNTmvlEWR
NOT AT . ‘OF-5 NOT APPLY/AIL IWE OF NO IWWRTANCE
7 ~BS5CUUREbhflfldelnntl Guonnm’NmnTclonnuclnn130sm
..
::\
::\
::\,
&j
\
●●
●
2-:c1h
d
m
-10-
AND lNFQWIAHT CARD A
J W[uch of the statements . . th.s cardcanes nearest, . . the whole, to what&b ~hink abut your present (ma.. )
Very satlsf.ed
To E?5AT f’a.rly satisf~edNeither sat~sfmd nor d~ssat~s fledRather dissat,sf,edVery d,ssat,sf,ed
(.) H.Y 1 Just check, what art the reasons~Y YOU ar. ..t Cmpletely sat,s fled ‘ )
J(b) May 1 just check, what art the reasonswhy y.” are d,ssat.sfied ,
=1--oRsfl-rY3 + (ZE+l.
a--oksl -rY4
M. you scr, o.sly thmkmg oflcav,ng y.”, Present employer (self - employed job),
Yes
~ ~fl VETO ~ ,0 ‘.... ...
IF YES(a) (M.!Y 1 check) *Y IS th.s,
For rcasom already given atQ 20 (a) or (b)
For other ,,,s.”s(SPFZIFY BE2.OW)
(fufuf MA XIMU4 OF 3 f?Ews;m)
1
2
1
2
,sk Q.21
Isk (a)
isk (b)
I19( (’a) mm5SE Q,35PAGS 15SEE Q 3APAOE 16 0
Km SEE Q 35PAGE 15
-11-
TO THOSE WAITXNG TO STASY A NEH JOB OR TYMfOSANILY SICK]CODED 3 OR 5 AT QI )
22 L8st week were Ycu on the books of m fapl.ymentExchange (Yath bpl.qme”t Of fl.e) ?
m THOSE ~K2fic MN kum LAST NEtK (CODEO 4ATQ1~
23 Ycwqv. told me ycm wert Io.kmg for work last mekturng the seven days endiw last .9mday
we= Ycm on the books of an Employment Exch=x.e ~K~fi
●(Ycath Ihplopent Office ) 7
.ge”cy?~K~fl’were you . . the taoks of a pr.vate employment
INDIVID-UAL ~ KhDVE
d.d you advert.se or reply to arherusments
~ R d~d you make a dmect approach to a prospect,= ~Jk’ Elemployer ,
were you awa,tmg the results of Job ap l.catzcns~LJ14REsuL-
d~d you do anythng else to f i.d wor!d(SFWIFT) w ~oTHEf
?0 THDSE RSGISTESSD Wm. EllfXOfMfNT SXCHANGE-TO Qs 22 or 23
DNA24 D.d you draw, or ..11 ycm draw, any
.nemplo~”t benef. t for last wrek 7Yes
No
uAJE1-l P~ENIF YES
(a) D,d th,s xncl.de or were ycm ahopad (will this m.1.de ur ..11 ya!.1,. be Pld) Uly Suppleme”taI’Yallowance ? Yes
No
. . . . .
(x
I
2
E
2
2
2
2
2
2
—
1
2
DTOQ24DmQ25
;fX Q 24
13 TOQ25
LSK (a)
XI TOQ25
.:
1s!1
16
::::::::::::
::
w23
-14-
TIIOSE RETIRED, KEEPfNC HOUSE, OR 021NG KWTHIHG ELSE,T HELK (CODED +5 AT Q ‘x3), FROVIDED 69 YEARS OR UNfIg
lFSTUDfNT - CODED 1 AT Q 28 ltiA . . . . . . .
IF 700R0vsR, OR CO~D 2 AT Q 28 fmA . . . .
Last week wem you on the books of an FaplopentExchange (i.auth fmplo~ent Of f,ce)~
Dld You draw, or ..11 YWJ draw, any .ner,plopentbcnef,t for last week ,
YesHo I
IF YES~/lA~ENP~
(a) D.d th.s include or were y.m also pad (H.11tlms mcl”de or WI1l ycu also be pa~d) anysupplcme nt ary allowance?
YesNo /
\Do you ,ntend to do any pad work (aga,n) ,. thef“turc ~ Yes
NKAq A//tJ NoUncertain
(a) H.w soon do You lnte”d to
I
U.th,n the nextlook for work (again) ? 6 months
(b) I, y.. WC,e ,0 ..rk ~~ HC~ SIX months b.t k.than 1 y.,, fran “OW(aga~n) how soon do y.. One year or more frmthink you would start “ 0“look,ng , OK . . . . . . . . . . . . .
What stops you fmn lmkmg for work earlmr than that ,
u14EWE fookmg after own ch~ldrt”fmkmg after other people,s children
.T’PLY Other (SFT!AXFY)
FI~ST ~ IZC I%WC)
CODFn 1 0R2 A~Qc ~—.
(a) n. the child rcn who stop y..frcm look,n~ for work go toSCbCd y.t 0, are” 8t theyold enough ,
(b) Would you look for work earlierSatisfactory arra”gme”ts couldmade to look after the ch,ldmn
All &Ks&; ‘BNone &o to schoolSane E. to school,
some dons t
If
~ WKCHI~)(YesNo
CODE
x
x
12
12
12
123
12
:
12
3
12
OTOQ 36AAM 16DmIN CATIONAG5 18
DIOQ320TOQ33
~ (.)DTDQ33
S (a)S (b)3TOQ$AAGE 16
EE fNm-rslmimxWE 1s
$E IN TFX-[Sum{m\GE 15
..
-15- *
H
lliTERVIEXER G+=K.
TD ALL WHDMAYWDMWITWN THE NEXT 12~TlLT . . . . . . . . . . . . . . . . . . . . . . . . . .. SEEQ 35(COIASD1 OR 2 AT Q.33 (a) .+ (b))
lU ALL OTNSFS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CO IOQ%APAGE 16
I
I
‘o
i~
TO ALL D1RD2TE0 TO TNIS WZ.5TIDN IROV1OED 59 YEAM DR uNDER
IF 60 OR OVER, MIA
35 Arc YOU serrmdsly thlnkutE of taking a course oftraznmg or of educat.on so that yw can do apart~c.1.r type of Job with a ncw employer 9
-l-f?4
IF YES
(a) What wmld th,s mm’se be 7
(b) would it ix full-time?m- part-time7
(-, t)7r?A.!NF~
(c) How long wculd the cm.irse last,up to and mcl.dmg onc year■ore than one year 1(
(d) What sort of work wmld you be able t. doas a r.suit of taking th.s cmrse-
-rQalwoccCMXIJPATKON. . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..(O`
12
I If working (ceded 1 at Q 1) see Q @A, Fge 16If “mmpl.yed (ceded 3-5 at Q 1) go to Q 36B, Page 16Tf , . . . . . ...11. .n, ct. vc (coded 7-5 xt Q 28) R. to Q 311A, Pace lfi
IX fllX ATmflm OFHIS PACK
LVK (a) - ((;EE mx ATDF?DH OFlUS PACE
>)
SK (1)5Fr mx AT~TfON OFIRIs PACE
)-Cn b-w)IItlSS DISLA3W0 IO THIS QU5,TTIDN
WT ftiA IT3NPnssfNT JoB12mITfls DR w....
. NOW I,d like you to 2hhk back o-r 2be last12 months, that is to ( . . . ..~~) . . . . . . . . . ..~~).tkl”~ Y.” at any tA,e dur~ those 12 months beenouc of employment and eifher looking for remit or mitjngto take up .s job that you had abeady obfained?
Yes . . . . .
N.Y . . . . .
INDSE bTOdlP20XED LAST bEW, (CODSO 3-5 AT Q. I ]
@.H frrn the period Ycufve just told ■e aboutwhen you weren I t WOrkin.q, have you at any othertime during the last 12 rnnths, that is since( . . . .. DAY. . . . . . . . . .. MmN). been cut of employmentmd either 1+oking for tiurk or waiting to take UPa job that you had already obtained?
Yes . . . . .
No . . . . . .
MSE AN~lNC YES AT Q.36A or 36B
How my times in the last 12 months were ycuout of employment hit wanting to work?
SXCWDE ANY PIXIOD ALREADYnmTxONsn AT Q.. 22-27
No. c.f times . . . . . . .
WOE
x
1
2
1
2
. . . . . .
oomMmA?msPAOB 18
D TO Q.33
omSNCATIWAm 18
3 m Q.37
>mlIlcATTDNkGE 18
38(a) nlinking of your . . . . . . . . . . . . . . . . . . . . . . .. Period(MST RIXWT, ‘MD NOST RSC~T, STC)
of unempl.pent, were Y.. . . the books of an
~plo~ent ~.h~ge (Youth ‘Employment Office)?
Yes . . . . . .
Giid
&31 NO
(i) Did You take any other steps tofind w.14c during that period?
sPmXFY mu PSDBE WLi
mmD
NOW A= (b)
Ew.SE
(b) bring that period how long altogether werey.11 OUt Of eLIPlOFent tUt Wlltillg t. work?
INCUIOE ANY TIME WAITING IO TASE UP A JODOR TEMPONASILY SICX
Less than I week . . . . . . . . . . . . . . .1 week Lut less than 1 month . .1 month hut less than 3 months .3 months hut less than 6 months.
\ 6 months tut 1.ss than 1 yczr. .ly=ro~mo . . . . . . . . . . . . . . . . . . .
1-
NOW CO TO IMIICATION PAGE 1H
Ostcentriod
2
i-
2
mns-
Zndmostece”teriod
1
2
MLs-
l’dLIStcentriod
1
2
i--
2
1234
:
~
thOStCentriod
1
2
1
2
i2
:
:
-18-
EDUCATION
Are you at present attend, ng any sort oflet..= or recreation classes, d.rmg theday or ,. the even,ng~
OUCREC NoYes
IF YES(a) What type of c023ege or organ. sat.on ms
these classes,RECTYPE
Evem,ng ln,t,tute/Colle&e of Mtift Fducat,onUn.vers, ty (Sxtra-m.ral dept )Workers Yd.cat. onal AssocxatIo” (W E A )Other (SPECIFY fTPE AND GIVE NW)
0 TmosE KED 49 on OTIDER
(O1L+) IF 70 OR OVER, fNA
IF’ 50-69, HA
Apart f mm le, s.re classes, a- you at present
attend’”g a ‘chOO1 0’ ‘011=5 ED UC U O Wf .22-tune
3DE or part-tbre~
IE IF NEITHER NlflTHEi . \[RST (a) Are you taking a recogmsed trade apprent~ceshxp,
IAT rece,v.nE any other form of ed.cat, o” such
PPLIES as by correspondence or pr~vate tutor, orst.dyxng on your O!.TI for an exam orq.al~flcatton?
NDNE DF TNESE(INCLUDE SANDWIQf/fILiXK nihsl ETUD~TS AT WORKNDH
3 THDSE ATTFIIDING .4 S(SImL/WLU2X FUGTIHE (CODED I AT Q 2
(a) Do You expect to complete your full.tme ed.catxonFDw IL FIAJ
RUNNING .Lth,n the next 6 months
PRDNPT 6 rao”ths but less than 1 year from nowor more than 1 ,ear from now,
(b) Do you expect to do my pa,t-t,me orvacat, on work before tben~
EDL4C va~ i%’IF YES(I) ~en do you th.nk th. s .111 beELn?
)(o+ J-withln the mxt 6 monthsRU?WING 6 month, but less than 1 year from “..PRWPT or mom tbm I year from “..?
mmmi wORiffNG . .
COOE
,
12
Y
x
{12
3
4
5\
123
12
—
123x
ASK (a)SEEQZ
SEEQ2
EEQ5‘AGE 21OIUQbAGE 2D
DfDQ30mQ4SK (a)
fA2TDQ6PAGE 20
= (1)Llm Q
mmQ4
-19-TD IIiDSE 2N NwTMI OR pAm-T m EDucAT1~ (CODED I OR2ATQ2~
A Are you a.m.ng t. pass m examnat ,.., or to obtaina q.al, f,cat.o”, ●t the end of th. s course?
I--L1ASK (a)-(c)GDTOQ5IF YSS
4
(a) fiat q.allf.cat,o. (s )/exa.n.natlOn(s ) are you .MI.”S at?(b) khat are the ma~or ..bJects Mvolwd-
(.) fiat .s tbe award,ng tnst.t.tm”? (lSiA 13@c+C)
(a) (b) (c)
w fie.ti.. .i.d .t
(O1lK NU D~IIL9 UC!JJD1=
Andlw 1-ilt”tl.. . . CQ1lW on
ImOJmlm __ ____ –M*’ -b~-’(”)( u ,mrcuu) m,
mu I I 1
5 hht type of school o, collegeare you attend.ng?
.%c.mdarr school ,. EimZand, Ua2es or N Ireland
secondary ModemComprehend ,ve (.”cl Sixth Form (!mllege )GrammarD,rect GrantI“depe”de tit (eg P.bl LC school/pr.vate
school )
secondary school m Scotland(sPECIFY TIllf ~ GIVE NAPE AND TOW ~.)
. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
~ec,al school (for hand, cap d, ES+, reined ,.1,
rhosp,tal school, etc ) LOCAL AUIWOR3YT)
Other school (SPSCIFl ).. .
wfkllege of Sd.cat,on (Teacher Train,ng
Callege)UnxversltyOther college (SPECIFX T9PE @ C1ti NIM)
. . . . . .
. .
EDuC FULL ‘
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:PUEI?.11.11.10C31W~SpW~tCJ“~~,.q,,LJ,P,,o,Js
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ml
-—.,.
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—.
— ●
-
(%. ..
UNINTNY OF BIRllf AND RSLAT1VE7 WCUPATIOS
E Pf16!EtJT5 * - UWE*6K Iws?moor’s p4“nad UW-6 j- U. W6UOLS
In what country were you born?tw0017M
F@and............................."..............Scotland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .wales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .N. Ire.land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .@tside UK (GIPE P_TN~ OF -fly) . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF MM CUTSIOS UK (COOSO Z AT Q.1)6S?RIU(3U<
(a) In biut year did you ~ arrivein the United Ki”gdoa? >
lNTERVISWlfR CXRCK - 1s in fomant ts father i. thehousehold
IF YES GIVE PSRSCN NO.IF NO RING~ X AsKQs. z&3
In diat country was your father Pfl 130uti ib,?nl?. .. .......... .. ........ .... ............ .. .....How would y.. de scr ibc your fathertsusual job?
Pfi SEG +Dc.”pation .....................................
P fl sums..?....................... ... .
I“dustl’y............................................................................k?).....
employee . . . . . . . . . . . . . . . . . . . . . . .
‘ (...self-employed with employees . . . Zself-employed withom employees. 3
lNTENWSWN CNECK - 1s in fomant 1s amther in thebo,,schold
IF YFS GIVS PERSDRNO.
IF NO RING+X ASK Q.4
1. what .ow,try was your mother MA BORN+bon,? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . .
. . . . .
I
. . . . .
Ef.m
Ous.f
O TOSfB2K Q.A
:0 TOXSCK Q.B
WE Q.5
;EE Q.5
.3.
TO ALL NARRISD W- WITS NNSBANDNOT IN HOUSfMOLD
DNA, WffWED . . . . . . . . . . . . . .
DNA, OIMER . . . . . . . . . . . . . . . .
5. blut is (was) your husband, s pre..mt(m.st recent) main job?
s~4.H.u.s.5 . . . . . . . . . .Occyxati.m. . . . . . . . . . . . . . . . . . . . . . . .
::::::::::::::::::::::::::::::::::?:::::::::::::::::::
lr,dmy....................6.T.*.~ . . . . . . . . . . . . . . . . . . . .
employ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...1self -cn,ploycd with employe es.. . . . . . . . . .2self-employed witho. t C. F.lOY. CS. . . . . . .3
TO W]IKfWSDULY
406What was your I,”sband 1s W occup. ticm for most of hisworkimg life?
No “s”.1 OCC LOtl . . . .
?ScG.&.!.D...* . ......Occupatim ....................
/
\;:i::::;":::::::::::::::i;;;:~l::::::::::::::::":::::I......................................................
I
CInploycc......................... ....self-.mpl.ycd with cwployc. s . . . . . ...1 f+vnploycd wi thout cmpl oyec. . . . .
0 ●
IF NO USUAL WCUPATI DN
(a) M,at ..s Your husband’s last .iob? I
O...,.,.”.............................J.>...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. A........
‘“du”ry““””””””’”””’’””””’”””’’1”’”::.............................!?..!! ....“iplofwc.........................self-employed with employees . . . . .s.,lf-ctnploycd wi tlmut mplo,vccs .
NOWGO TO ffEALlll PAGE ’26
x
x
.1m!
t
“(. .
0 TO Q.6
Kf TO NL4L’fll‘AGE 26
X) TO (,, )
.;,) TO,IK(M.TNlP,\c.Kx)
26 -
M
y-&
I D< you 1, long-s tand, ng ,11”. ss,d,s,,l, l,ly or .nf,, m,!y~
CHuoti ;;s
,.,,,. ,,0.
-----
To
w
I* 11 I I,rl! COW LATN, fl.> t you,..!, ,, !,, ,,! !I.y ..,,
1,s
No
L ,“,,, ?1,. tut less Ibam 1 ,,., .i~”
] ).., ~t l~SS thar z ye>,. AC.; ycal. h- 1*.. 11.,> : years a~.
,, !, !! “ 5 “ “,, ,, ,, ,, ,, ~r, ,, !!
1,) ,..,, . 0, ..,,~l?,}l hlRIH
mnF,
12
:Ha(
#N
------
1s1q>] a,. . . ..-.
;/ 1
.. throughout the year
m
sane of the tme
PR[MPT -
or hardly ever,
m
IF MOST DF THE TIFDI
( 1 ) h yw have to spend most of ycurtume m bed be.a..e of (QUOTEUWLA1NT)7
r..
No
!
::=,:
.~r
::::::::
::2,.1:.::::::
N
——
-30.
=
3 ~i-..g the 2 weeks ending last .imday, apartfrom vxs.ts to . hospxtal, did you talA to adoctor for any reason at a21?
TOecl-rtlr YesNo
IF YESt@ OCC&AT
(a) H.. m=y t~es d~d Y.. talk t. hn
EXCWDE ~ SSfLTATIDNS MADE ON BFXALF.’ OF ~ED llflDE23 16 U4 lUU~LD
(b) On whose teha7 f was th,s con,ultatioomade~
Inrorman t
A.% (C) - (f]l
Other memhr of household 16 or over
EzBzl
someone outs,de household
~
(C) tiat .as the cons.ltatxon atout~pKOBE mn mu DETAILS fNCWD2N0 CAUEE
~DF’ Sane ~llness/d~sab=lity as Q 1ALL TNAT Same illness/nyxy as Q 2APF%Y Other (SPSXIFY)
13
\
1
i];2,3
1 A= (a)-(b)2 Sss sNmv2EwR
— Cl+EXX PACE 32
,3\
,1,2
L
(d)
(e)
-31-
was this consultation under theNational Nea2th service? ., . . . . . . . . .
or paid for pri?ate17? . . . . . .
wan the doctor
. OP (i. fwly doctor)?
suws2flG or was he a specmliat?‘Mpr or was he some other knd
=~fdoctor? (SP~IP~ . . . . . . . . .
L-l””. ..-...........
(f) D1d YOU talk to hm
by telephone?
~wmG at your home7
FW3W-T m h.. s.r6ery7
elsewhere (EP~~ )7
ElCUCUL7
“o
~
(~DH~SALWRE GIvX NANE
. .
. .
● m niOsE 03NwLT2Nc w AT .mcmY (OJDED 1AT (e) ND 3 AT (f) AS (I)
OTWSS> LUA . .
m(.) SOmetlmes a surgeryL. cm .t, mm,
mmetm. s part of a group Pract,ce.and somctmcs ,t 1s housed u aHealth Centrc was the s.rsery
YOU went to, ~ a Heflth C~tre’
R
cm,”,, Ye,“o No
IF TSS GIVE NAME ~D ADIRESS
11”’”. . . ...!
u .,”
isa
.32.
ISl12WISW21 (XYEIX . save a31 l.an&standing cemphints bean comu3tei ●boutin reference period
NO 3DN0-sIAVD3N0 OOY07A3NTS, INA . . . . . . x
M.L . . . . . . . . . . . . . . . ..>occk-ti -1m m Q.SYea - 1 PAOS 33. . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes -SQIE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
S0 -MOSS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I
A= Q.4
3tlR SAQf ILISG-ST12JD3NGWW3A~T SOT 0MS12,1?XI -T
4. TC+I havw just told ■e that you suffer from (ml%fLIS&STANDIVG CONPLA3NT). How l-g wo did y..~ tdk to a doctor about it, sput from visitsto a hospital?
am
Nm CCOtPLA3STNO. 310)1 Q.1 -}
Ueekof interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
kSS thll 3 months aKO
cm No. ‘F ‘s ~
3 =mths tut lCSS than 6 Mths . . . . . . . . . . . . . . . . .
6wnthslxt less than lyear . . . . . . . . . . . . . . . . . . .
1 year tut less than3 years . . . . . . . . . . . . . . . . . . .
3 years tut 1.ss than 5 yeas . . . . . . . . . . . . . . . . . . .
5yeans.rwre agO . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Never . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(yfl, F,as T 2 O.VL.Y C*Dm 1
NOW 03 lU Q.5 PAGS 33
(n........
i
. . . . .
2+J3
1\’)5
~6
7
am
_
1
. . . . . .
2
3
>43ts.
a6
7
-33-
To ALL
Nculshould like totalkalmut the month of . . . . . . . . . . . . . . . . . .
SAso INYrmMAwf cm c
5. tin is a 3ist of health and wdfnm serrices *ich peoplecan ●ttend or from which people car. receive tisits infheir hrna. W uonft apply to you tmt others may.b%uld ~ te33 8t wbetber YOU 8ade use of any of these mD1
services durhtg . . . . . . . . . . . . ...?
kJEL+=tqRE Yes . . . . . . . .I
1
m . . . . . . . . . 2
ASK (a)-(c)
OD m 0.6
r? m
(a) Which of them have you made “S. of?WYIWK IF I!S.SDOW MOIA3F OF LIII~. IF SO HTSR DW PIWS SLIISm
●(b) ibwnany times did Youmake”se of . . . . . . . durkng .1 . . ...?
(c) Iibo put YOU in touch with the . . . . . ...?
u iiLF411e i
aE”;E7
1.il..lth ti,itor.tt.niiw .tyo”rh c.. . . . . . . . . . . . . . . . . . . . . . . . .
.Im. hi.t w.. .ti.xmg .t yc.u ,-. . . . . . . . . . . . . . . . . . . . . . . . .
chiro@, ,..’.I.. pwided by Co”rdl .* .“rGcry .,’ ,lini. . . .
Mr+@iti .ttetiirg.t yo”rhc.. . . . . . . . . . . . . . . . . . . . . .I
(=W M RWSWI!K>S -LE CW1)Hm.b.. P . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
L*. +**..,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,.., m for .M. r,y m. by Go,, mil., “.l”mtary bd, . . . . . .
F“ilypl.ndr.gclmi,.............. .. ................
Cwvic., -.wt. *t. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B.,*,., . . .O”M,, b. . . paoi-nat., .,,.,. . . E.,.-n.t.l .Oihm-m aft d r.lsx.tioo C1.8SCS
Ha”if. .tt.d,w.t yo”r,m. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
., O.,.I “.rk=r/cbi M C.,. orricar/ti, mr, 0,,,.,,.Lt,.dir.g., y,.r k.. . . . . . . . . . . . . . . . . . . . . . . .
,
2
3
,
5
6
7
@
9
,0
,,
12
,3
,6
—
. .. . .. .. .. .. .. ... . . . l---
6 NOW 1 should l,ke to talk &_.oUt the months of, and Dumng these three
. . . ths were you m h.osp~tal as an npat,cntovenqht or longer?
/lv PA-r :s
L
1 As (a)-(d)2 SAT rflmvm
Q!ES PAGE 35
~l~~fiT * - ~e,k h .F IN ●n rlrwrIT Yss si.q~~ ,*
F.4s T 3 f---~ m
(a) *at month d.d You leave hosp,tal,%7
“’” “~ 1st ~SIT2nd VISIT *
3rd TLSIT <
(b) How many- .,,, y.” Ill AJt.J14HTSi
‘asp’”] ‘l’”=’’’’” ~
E!2El
(C) fiat was tit. matter w.rh You,lTfDllE FOll FULL DETAfLS fNCINDfNG CAUSE, AND fUROPFRATION, TTfEATM~T, ETC WILE ~ NOSpITW ~
cOnE MTH Same as Q 1 (I e lmg-standmg ccmplamt )IF Af’1’LTGifiLl 1?:
0 the, (SPSCIFY )
(d) H,, c ,.” n N.It.0,,.l Hc,lth p,t,e”t
F1
or R p, ,Wte f!at, mt? ~zzIF fi{[VATh ASK (,)
(l) fI,d YOU IXIY for the bed ~ the treatment, 23“rJutfor a pr, vat, bed? :4
NOW W 1 TNTF’RVIFhhN CHFCK ON FACE 35
I
mvc
am,,8,.
-35-
RUW’ISW?X CH~K - Have ●ll l.ng-standmg m-plants 97.,, r~se t. anmratlent spell in referent. period.
I
II/pCheo& OXK
NOIDN&5TMIDINC 03NP1.WNTS, UiA x m m Q.8
Yes - AU 1PAGE 36
Yes - SJNS 2
!+3 - NONE 3\ASX Q 7
mR SAC’ LDNGSTANDmO COtiTfAfNT NOT GIVING RISS 10 fNPATIIfiT SPF2L
●~Tlll 5JNPLAINT NO. FTfO!lQ.1 +
H7 Now thutkmE akout your (QOOVZ l13NC-STANDfNG OJMPLAfNT),
ha= you ever been MI hosp,tal w an mpat,cnt ovcrm.gl,t rl t-ior longer Lmcause of It? ./> 2
IF Txs‘ -)
(.) HOWlow w. -r. YOU l~t in h.w,-l .S
\mpat.e”t teca.se of your (WOTE IDNGSTAXDIN0JNFI.UNT)7
ImDE
)lonth of intem,e.
!L_i_l
1 L
DATE kss than 6 .mths ago 2Wlf!mL~
6 mmths hit less than 1 year 3 3 ?
mPrfAL 1 year Lut 1.ss than 5 years 4 4 4
5 years or ~re %o 5 f s
NOW al m Q.8 PACE 36
ix-37-
(e) (Uay I just check) was this asP. result of m accident or injwy?
Yes . . . . . . . . . .
m
m . . . . . . . . . .
(-mm(i) What kind of maccident was it?
;
Lv2
d Vm
-u‘2
m -36-
-u
8. tmriw thernnths of . . . . . . . . . ami . . . . did ~u.ttd~a Wti=.t the asualty or outpatimt deputwnt of aImspital (.prt frun ame or past-natal clinics)?
1-
G—1
i*
)---II
:1.213
4
:
* V]al
1
Lb
I11:2-3)4
56
h V18[
-i-
2
Id
OUT~m ~....... ; ASK (a)-(b). . . . . . . . sm Im’3Rv2mmg
CAiSCKPACE 40IFm
(a) uhi.hrnnth was this?(b) lkw many times didyo. attend in that mmth?
\
jl,2-3
456
—
2
3
45
___
1
—
Road traffic accident in course of w-ark
(
. . . . .Road traffic accident ~ in cowse of work .
mwPY Accident at work (not mad traffic) . . . . . . . . . .
12
‘:
:
2
3
45
AS Accident at Iwme . . . . . . . . . . . . . . . . . . . . . . . . . . . . .NsCMSARY Accident at sct@ol/college . . . . . . . . . . . . . . . . . . .
Other accident (SPSCIFY KIND ~20LMTION)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a) lionth~
(b) NO. of times
C?flnl oPflTti 2 0 Ptmf3O?NfJi O?NOZ . . . . . 0?N03 8-~ ..... ~ b . . . . . .
FWl SACll VIS2T ASK (C)-(i). RE~D VLV2TS SYART1?+3W~H ti4RLIE?f VIS2T IN RSFFRSNCE PIRIOD UEs
?4 W811
7*
:1
L2
it’%>~1
:2
(.)
(d)
Did YO” make this visit as
a htimal Nealth ~tient . . . . .
or as a private patient? . . . . . .
Mut was the matter with YOU?MOBE RR NIL DSI’AILV IIKSAIDIM2 CAUSE
(f) Which clinic or department of .wt-patients didyo” attend?
( O.-r t)
2
3
IN1OR2TY L73DE~Cas.alty /accident/emergency . . . . . .
3
45
1:.
—1s[1w—
CODE
{
Physiotherapy ....................
AL2 X-ray (deep X-ray or radimTNAT treatment = CODE 5) . . . . . .APPLY Other (SPEC2FY) . . . . . . . . . . . . . . . . . .
45
im-!0,
—.
(g) Did you have an ap~intmc,,t at a specifictime for this visit? ( “ ,-
Yes . . . . . . .No . . . . . . . . . .
1
-3 Ll -
TO TM3SE CODED 3-~
CWJALTY/ACCIDFNf/FMk3fCENCY, DNA
li30T0Q.9(
(h) What happend . . that ms.t?IRODE ~ TREATNShT RECEIVUI ~ ANY APPLIANCETk3TED m FITTED .
(I) hd YOU see a consultant or a wec~allston that ,1,, t or mt, \
9 P+M thmkmg back to your (f.rst) v,s,t toOUt-patients . . (CUOTE MONTHDF 1st VISIT FCMMm ~HpMINT/ACCIDSNf ) bad p. .tte”dd anyde~rt..nt of tius IWSPLC.1 before that abut
Y..r (w~E ~mINT/ACCIDEATJ7(.,+(
Yes, attmd.d before
-’
No, not attended b.r...
m
10 D,d your doctor (dmt.st) or anotherhosp~tal write a letter about your
(OUJTF 133MPtA1NT/AUXDWT) for that(f,rst) VIs,t,
Yes . . .
\
m
~? LE1-i A ~—- -“ “
(j? LE7-2A m
uur-
, “In,.
x
12
1
2
GUI
T
mm
,.5Vls,—
$x
12
—
mm
a V18
x
12
-39-
TO TWSE hTiD DID NOT tL4VE A IETTFR(coDED 2 AT Q.1O)
~ (.) ::p~:l~lk t. . doctor before goims to the
a L9F’GP14 Yea . . . . . . . .‘~ : ~
**0PGP2A
‘G&n\llbmm opf4P3A
~.) Did he suggest y.. went along to3 the tmspita17
‘L : TO TllJSE bWO DID tA?T TAM TO A DXILR]CODKD 2 AT Q. lcla~)
●’ (,) HIIy did,..,. to the hos,ltalrather than to ● doctor,
e (TOT~E MV2EE DOCKM DID NDI SWCCESTCJ31ffiTO TNE NDSF2TAL (CDDF212 AT Q.1O (a)(.~)
thy did you go to the Imspitalq \
ntc—
m
ml!
Q.8(#—
1
2
—
1
2
—
8,-4.
I
::
-42-
=
13 Are you at present on a waltInE lxst for adn.ssmn toI,osp.tal M an mpat,ent (apart frm a straightforwardmatern, ty booking),
Yes
/f’ ft?t’T ,0IF Yss
(a)
EEACLUDEVJLUHTdSYWAITINGT3ME
How long ham you been on the wa,tug l,at(that is, how long ,s .t since the doctorsaid you would have to @ ,nto hosp, talbile. a M “~, avadable )?
Less than one week
Completed weeks up to yester.3ay _
lfwr+~~
lNTE+VIEKm CHD2K
A. Are there any ch,ldren under 16 m the household
(06:0 ;s
rnDE
1
2
0
1
2
1
2
s (a)
0 TO 1HCEiV21XU,HECK SuDw
-43-
-o
~m
FOR lt. bOSYANTS ACSD 16 MD 17 U.Sk .WJRINC SSW-WKTII11ON.~SINILE
II .VmF-mHPl PTIOII,m A
1 HaYe you ever smoked a cl~ar?tte, a cigar or . p, pe?
1;; Lwlmii’‘c ~0-~T CICASSITE .9UKORS (@.3D~ ~2)3
4
.s (i)
0 7D SL7K2HCEXTIONAGE 43
5
Abut how many c, Earrltes a @ do TO.usual] y smoke at seekends?
NC14WCWD-[N0
And atu. t how m,my cigarettes a ~ doy.. usually sm.ke d.r.n~ the week,
C1C7UL=K -NO
LCSS than 1
MKED A DAK-
Less than 1
SU3KKD A DAY4
D@ y.. ma,nly sm.ke $.~t~r~l~P~~garette,
RUNhING PR[l!!l>T~DE DNF ONLY
or pla, n or unt.ppcd .> Earet tesor hand rolled c.garetr es?
~ TD SW3KIIC;EIX1ON‘ACE 43
@ IU NON-CIC.4RETTE 3KlKllK5 (OJllLD 2- ~~12 )
6 Ha.e you ever smoked ugarettes rep].+ 1y7
clqfl~~z &
IOALLNIa_k@HAVI LXZII flWED (03DLC 1 AT Q 1 )u Mmmn, INA
7 Do >.. smoke a pipe at ●ll mwada> S7 PIPEYes
~ ‘“IF ND
(a) Have >0. eve, sm.ked a p.pe reAularl Y?
PIPH?E< :
ODE
x
12
12
0
D
12
x
12
12
,maz1. lNTLRvIEh=.IFXK PAGE 44
) m Q.3170Q6
EEQ7
SSEQ7
@mQR
O1u Q8~ (.)
(17(>QR
-46-
2N OINFUMNCE
a
-u
1 Liu I.C the 1a.t 12 .onths hawe IOU received an7 money fra thefcJllowin.g sources?
PLEASE RECORD YES OR NO IR COL (1 J OH PACE 47 —
L
(1)PLEAS1
~g?~
(a)
(b) I~tdcEH p
timings as m employee?(70TAL FIKNl A2L JOOSfNCf.ODfSC VACfS, EA2ARY,TIPS, B2NUS & ~~ISSION ) 1 2
-mg, from l:mdfcs_E F
ment (incl.dfng ●oneydr.m for mm use] 7 12
FOR EACH KfRD OF INmlNf RfmR02D SIKMl SXmCES (a) m (g) PfzAss M.%T31 Q,s 2 and 3
2 f%l nh”g just of YOW (EACH KIND OF I,7CCUS) how mch h= YOU receivedfrcm that in the last 12 *onths b- any deductions were made?
oPI,EASE ENTER THE MOUNT IN COL (2) ON PAGE 47 IF YOO CA.VNOT GIVE A12 M3.7T8 FIGuRE> PLEASE GIVE Afl = IJDNTIILI OR kEESJY AIUUrlT
3 For ho, many wtcks in the last 12 months did you receive sny mm-my fromthat source?
PLEASE REcORD IN COL (3) ON PACE 47 THIS INFOR14ATION IS ND2’ REQUIREDFDR IRCC2VE FRCU SELF- FMPLOfh%ET
FOR EVfRY .9XIRCE RfJXIVED SUR LESS IMW 52 kTXFL5
(.) Are you c.rre.tl y receitig money f r.. that so.rce7
PLEASF. REcORO YES OR NO IR COL 3 (d ON PAdS 47g)
TOR tACH K2ND OF 1N03HE RFJxIVED M83H .SJURCES (h) TO
4 Now th,nking J.. t of your (EACH KIMD OF IIICW),,.,, ,ed from that ,. the last 12 ■onths?
PLEASE ENTER THE ANGiLVT In CDL (2) ON PAGE
/
xt.Jc PcfJ(c) P*nsion (s) from former
c9p10yer (or Imsband Bseqloyer )? 12
(d ~ “atio”d ~nmrm:er.J:t:e:
ment or Wid.ow,s Pcmsi on? 1 2
(’e) ~pammts fro. the16JCSUPO
(,).Wpple.entary Allow- +2
2
(f) Other k,nd s of regularmllowancea from Organlma-tions, friends or relati~es
I
rti%%”%%,z~~ THscholar,h, p) 12
(g) Rmt from proprty7
c
I(h) Cross ~t from
savings accounta ,sank acco””ts ,
I
fNC llV~Sntish Savings Donds,Nat.onal Dmel.went
2
2
2
-47- fi
u’,,k4
J-
et-lb
PEl
IL*
Sul
Co$
:01
&
“s.—
(Y
b. or.,*—
U%
;14Jb
I.J
LJ\
d
w
7rW—
Lk’SW flLWE R3XS2V2NC NATIONAL 2SSFL4JICE RS7~T OR W120W1S PBSSION (93URCE(d) ) ~
5 D1d your retirement/widow*s pensjon include or were youPLEASE
also paid MY wpplcme”t=y bermfit last v.ek?RING
YesTAJcPEvSB h.
1
. !-., .-, -” 2
3jl*-“*“’
394*-“’“’
mlvssnw-.,““
..
User Guide 1SchedulesHousehold ScheduleIndividual ScheduleDerived Variables for Income Section
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