annex 3: questionnaire - world...
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798
Volume III
Annex 3: Questionnaire
Part 1. Socio-Economic DataSection 1: Household RosterSection 2: Rations Received and Consumption of ProvisionsSection 3: HousingSection 4: EducationSection 5: HealthSection 6: Activities, Entertainment, and Hobbies Section 7: Job Search and Past Employment
Part 2. Monthly, Quarterly, and Annual ExpendituresSection 8: Expenditures on Nonfood Services and Commodities (past 30 days)Section 9: Expenditures on Nonfood Services and Commodities (past 90 days) Section 10: Expenditures on Nonfood Services and Commodities (past 12 months)
Part 3. Daily Expenditures, Income, and OtherSection 11: Daily Expenditure on Repetitive Food and Nonfood CommoditiesSection 12: Jobs during the Previous 12 MonthsSection 13: Wage EarningsSection 14: Nonwage Earning ActivitiesSection 15: Income from Property and TransfersSection 16: Durable GoodsSection 17: Loans, Credits, and AssistanceSection 18: Risk
Statistical Classifications Used in Coding the Questionnaire
The following manuals and classifications were used in coding the questionnaire:
The Classification of Individual Consumption According to Purpose (COICOP)
was used to code consumption commodities and services.
International Standard Industrial Classification of All Economic Activities, third
revision (ISIC3) was used in coding economic activities.
International Standard Classification of Occupations (ISCO) issued by ILO in
1988 was used in the classification of occupations.
Iraq Administrative Units Manual
1.
2.
3.
4.
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Annex 3: Survey questionnaire
Part No. 1: Socio-Economic Data
A. FIRST IDENTIFICATION Code
06 Governorate
07 District
08 Area
09 Quarters
10 Alley (Street)
11 Country
12 Village
13 Class Draw circle around appropriate answer
Provinces1 Rural2 Suburban3 Urban / Central
Baghdad Suburban 2 Rural 1
Urban / CentralAl-Rasafah 4 Al-Sader City 3
Al-Karekh 5
14 The number of the building for the survey
C. FIELD STAFF Signature CODE Date
23 INTERVIEWER 24 0-/--/--
25 TEAM LEADER 26 27 0-/--/--
28 DATA ENTRY OPER. 29 30 0-/--/--
31 CENTRAL SUPERVISOR 32 33 0-/--/--
40 Has Household been include in MICS3 Survey? Draw circle around correct answer Yes No
For Researcher: Pls double check against families included in MICS3 Survey
ا�ستيفاء بيانات اال�ستمارة
01 02 03
WAVE (1 - 18) TEAM INT. (1 - 3)
The Ministry of Planning and Development Cooperation
Central Organization for Statistics and Information Technology (COSIT)
The Republic of Iraq For eradication of poverty and enhancing the socio-economic status of the households in Iraq
In cooperation with the Kurdistan Regional Statistical Commission (KRSCO)
Household Socio-Economic Survey in Iraq (IHSES 2007 - 2006)
HOUSEHOLD IDENTIFIER
04 05
CLUSTER HH
B. HOUSEHOLD IDENTIFICATION
15 Household head name
16 Work address
17 Household size
18 HOUSEHOLD SIZE
19 Telephone number
20 Work tel. no.
21Numeral dorm for this household
22 No. of this Questionnaire
D- Visits of Field Researchers RESULT OF THE INTERVIEW
35 First Visit 0-/--/--
36 Second Visit 0-/--/--
37 Third Visit 0-/--/--
38 Fourth Visit 0-/--/--
39 Fifth Visit 0-/--/--
1
2
3
4
5
6
7
8
34
Fully achieved
Partially achieved
No usable Information
Unaccomplished: Household refused interview
Unaccomplished: Household not present
Unaccomplished: House not found
Unaccomplished: Housing unit not occupied
Unaccomplished: Housing unit is seasonal
104Date of BirthWhat is the date of birth of ..[name]..
103Age in Full Years
If less than one year,write (0)
102Gender
Male 1
Name
Write the name the Head of the Household first, followed by the name of the husband / wife then the children as per age (the ones who are unmarried first, then the ones who are married with their families…husband / wife and their children) then the name of the father / mother, then the brother / sister then the other relatives then those who are not related to the Household
101
ID C
OD
E
Female 2
Year MonthDayYear
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section One: Household RosterNumber of ‘collection’
lines in this page
802
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Annex 3: Survey questionnaire
Section One: Household Roster
Exclusive for Household Members that are 12 years of age or older
107Place of birthIn which province was ..[name] born? And in what environment?Governorate Code
106Was..[name] ..born in thisprovince?
105What is ...[NAME]... relationship to the head of the household?
Ind
ivid
ual
’s C
od
e
109
SPOUSE’S ID
CODE
108
Marital status
What is the marital
status of ..[name]Wife / Husband2
Wasit26Dhouk11Daughter / Son3
Salah-Eddin27Erbil, Kurdistan Region15Yes 1 107 B
Son/Daughter-in-law4
If more then onewife, write thename of the oneliving within theHousehold.If more than onewife within theHousehold, writethe name of thefirst one
Al-Najaf28Al-Sulaimaniya13Grandchild5
Married1Al-Qadisiya31Ninevah12No 2Mother or Father6
110 Never married2Al-Muthanna32Kurkuk14Sister or Brother7
110 Divorced3Thi-Qar33Diala21Other relatives8
110 Separated4Misan34Al-Anbar22Unrelated to the household
9
110 Widow5Basrah35Baghdad23
OtherCountry
90Babil24
Kerbala25
If the husbandor wife were notmembers of thehousehold, Code98
107 B
Environment
1 - Urban
2 - Rural
107 A
Province Code
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
114What is the main reason for theabsence of the …[name].. during the last 12 months away from home?
113How many months has… [name] been absentduring last 12 months from the household?
112Has [name] been absent from home for one month or more during last 12 months
111What is the code of the father of [name]
If the father is deceased (dead) 99
110What is the code of the mother of[name]
If the mother is deceased (dead)Code 99
Ind
ivid
ual
's C
od
e
Education011 yes
Work022 no
Health reasons03 Next Person
Visiting friends or relatives04
Family problems05
Birth06If the father was not a member ofthe Household
Code 98
If the mother was not a member ofthe Household
Code 98
Jail07
Tourism08
Escorting a patient09
Other [name them]10
Months
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section One: Household Roster
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Annex 3: Survey questionnaire
Section Two: Received Supplies Rations & Consumption of Provisions & the like
A Rations received
201 Does the household receive its rations via a "Ration Card"?
1 Yes
2 No Part B
202 How many “Rations Cards” does the household have?
203 How many household members are recorded in the ration card/ cards for this household?
A Household members of 1 year or more in age
B Children under 1 year
of age
C Total
Number Number Number
What is the total cost paid by the HH, including bags and transportation? 204
AValue of
provisionsrations
BValue of
Sacks / bags
CTransport cost
to place of residence
DTotal
1,000dinar dinar 1,000dinar dinar 1,000dinar dinar 1,000dinar dinar
Mat
eria
l Co
de Ask Questions 205 - 221
For Each Material
Material Unit
Wheat flour Kg
Rice Kg
Sugar Kg
Oil or vegetables fat Kg
Chickpeas Kg
White beans Kg
Lentils Kg
Tea Kg
Powder milk Kg
Salt Kg
Soap Kg
Detergents Kg
Baby powder milk Kg
Children nutrients Kg
Kg
Kg
Kg
Kg
Kg
99 Total
Section Two: Received Supplies Rations & Consumption of Provisions & the like
A Rations received
213
Why did
you sell or
traded
in this
material?
212
What was
the value of the
…[ITEM] that
was sold or
traded?
211
To whom did you sell or trade this
…[ITEM]
210
What was
the
quantity
that you
sold
or traded
of the
..[ITEM]..
that was
received?
209
What was
the
quantity
that you
gave
away
(donated)?
208
What price
would you pay
to buy
the ..[ITEM].. of
same quality?
207
How many
months are
covered
by this
quantity?
206
What is
the
quantity of
the …
[ITEM] ..
that you
have
received
the
last time?
205
When wasthe last timethe household received the …[ITEM]from the
agent?
ITE
M C
OD
E
Relative or friend
1
PoorQuality
1Supplyagent
2during last month
1
No needfor it
2Restaurant/workshop
3
Person buying supply rations selling to others
4
during last 3 months
2Need formoney
3Write“zero”if nothingand move on to thenext item
Write “zero”if nothing
more than 3 mon-12mon
3Other4
Other5neverreceived
4
secondMaterial
Code1,000 DindinarCodeQuantityQuantity1,000 DindinarMonthsQuantityCode
01
02
03
04
05
06
07
08
09
10
11
12
13
14
99
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Annex 3: Survey questionnaire
Section Two: Received Supplies Rations & Consumption of Provisions & the like
B. Consumption of ration items and similar during the past 30 days
221How muchof the...[ITEM]... you consumed was produced bythe house--hold?
220How muchof the...[ITEM]...youconsumedwas received as a gift?
219Why was thispurchase of... [ITEM]...made?
218What was thetotal value of...[the...[ITEM?you purchasedthe value of))incomingquantities in (216 + 217)?
217How muchof the ....[ITEM]... youconsumed was purcasedfrom themarket?
216How muchof ITEMconsumedwaspurchasedfrom theration itemssold on themarket?
215How muchof this...[ITEM]...consumedwas received aspart of yourration?
214How much ITEM].. did]..this householdconsumeduring thepast 30days?
ITE
M C
OD
E
Supply rationinsufficient
1
Write “Zero”for None
Write “Zero”for None
Supply ration & othersourcesinsufficient
2
Write “Zero”for None
Write “Zero”for None
Write “Zero”for None
“Write “Zero for None and move onto the nextitem
Wanted better qualitythan rations
3
If the answers were “zero” for both columns, move toquestion 220 other4
QuantityQuantityCode 1,000Din dinarQuantityQuantityQuantityQuantity
01
02
03
04
05
06
07
08
09
10
11
12
13
14
99
Section Three: Housing
Would you say that your housing unit is:311
A) Lack in room number or area of rooms?
1 Yes
2 No
B) Lacks utilities inside the unit (e.g. garden, garage, storage, utilities…) or their areas?
1 Yes
2 No
C) Old or deteriorated building
1 Yes
2 No
B. Acces to water and disposable wastes
How do you dispose your garbage?312
Indicate most used method
1 Taken by the municipality or its contractor
2 Put in special containers
3 Throw outside the residential unit
4 Burn them
5 Submerge with soil
6 Other (mention)
Main sewage disposal method313
1 Public network
2 Septic tank
3 Covered canal
4 Un-covered canal
5 Other (mention)
A. CHARACTERISTICS OF THE DWELLING
301 How many households are there in this dwelling
Number <-----
302 How long have you been staying in this housing unit No. of years <-----
Type of housing unit303
1 House
2 Flat
3 Clay house
4 Bamboo house
5 Other (mention)
Principal material of the walls of the housing unit304
1 Blocks
2 Stone
3 Cement blocks
4 Thermostone
5 Concrete ready made / pre-cast
6 Clay
7 Bamboo
8 Other (mention)
Principal material for the ceiling of the housing unit305
1 Re-enforce concrete
2 Steel girders
3 Wood
4 Other (mention)
Principal material for the flooring of the housing unit306
1 Ceramics
2 Blocks
3 Cement
4 Soil
5 Other (mention)
Principal material for windows307
1 Aluminum
2 Iron
3 Wood
4 Other (mention)
308 What is the total area of the residential unit and the residential grounds that is being occupied by the household?
A- Total Built Area M²
B- Area of the land M²
PARTS OF THE HOUSING UNIT USED BY THE HOUSE--HOLD
Ser
ial
How many rooms [describe types] do you have for
PartsJointly
with otherhouseholds
Specific to the house
hold
310309
No.No.
Bedroom01
Hall02
Living room03
Dining room04
Kitchen05
Bathroom06
Bathroom with utilities07
Separate utilities08
Storage09
Garage with ceiling10
Garden11
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Section Three: Housing
Does the household have raw water to water the garden ?319
1 Yes
2 No
What is the state of the sanitary utilities (bathrooms) and their locations?
320
1 Inside the residential unit and specific for the household
2 Inside the residential unit but shared with other Households
3 Outside the residential unit but specific to the Household
4 Outside the residential unit but shared with other Households
5 There are no sanitary utilities
What is the method used to cool the residential unit?321
1 Air-condition
2 Cooling device
3 Fan
4 Other (mention)
5 There are none 323
What’s the most likely used method for cooling inside the residential unit?
322
1 Central
2 Partially central
3 Non-central
4 Other (mention)
C. ACCESS TO SOURCES OF ENERGY
What are the main sources of electricity?323
1 Public network
2 Shared generators
3 Special generator
4 There is no electricity326
First Second Third
325How many hoursper electricity was provided during those days?
324How many days per week did your household use of ..[SOURCE]..?Source
Ser
ial
If ‘zero’ go to next source
Hours / DayDay / Week
Public network1
Community generator
2
Private generator3
What is the main source of water?314
1 The residential unit is tied to a public water network
2 Public network: public tap
3 Water tank
4 River or canal
5 Open well
6 Lake or pool
7 Water spring
8 Stagnant water
9 Other (mention)
Are there interruptions in the availability of water from public network? 315
1 Stable supply
2 Interruption once or less monthly
3 Interruption once or less weekly
4 Interruption more than once a week
5 Interruption daily
6 Poor running water
7 No public network 318
8 There is a network but it does not work 318
Is the water coming from the public network sufficient?316
1 Yes 318
2 No
How do you deal with water shortages?317
1 Purchase
2 River or canal
3 Public tap
4 Bring water from other areas
5 Usage of water pump
6 Other (mention)
Do you treat the water before usages?318
1 Yes, by boiling
2 Yes, by filtration
3 Yes, by treating it chemically
4 Yes, using water bottles
5 Yes…other
6 No
A- For drinking
B- For cooking
C- For washing
D- For other purposes
What are the problems? (you can mention more than on)333
Draw a circle around the one or more choices
1 Bad situation of the road
2 Traffic jams and condensations
3 Scarcity or distant transport means
4 Hard to reach the transport means
5 Personal security
6 Other (mention)
What type of main road leads to the residential unit?334
1 Paved street
2 Partially paved
3 Paved road, non-paved pavement
4 Road covered with pebbles
5 Soil road
6 Other (mention)
7 There is no land road
How old is this dwelling?330
1 Less than 1 year
2 One year to less than 5 years
3 Five years to less than 10 years
4 Ten years to less than 20 years
5 Twenty years to less than 30 years
6 Thirty years to less than 50 years
7 Fifty years or more
D. OWNERSHIP STATUS AND MONTHLY IMPUTED RENT OF THEHOUSING UNIT
Ownership of residential unit327
1 Owned by the household 329
2 Private sector
3 Public sector
4 Governmental sector
5 Other (mention)
Type of occupancy of the residential unit328
1 Rented
2 Provided by the owner
3 Free in agreement with owner
4 Free without agreement with owner
5 Other (mention)
If you were to reside in a similar dwelling, what would be the estimated rental monthly value?
329
1,000 dinar
Section Three: Housing
326What are the used sources of energy for the usages of [activity]..
Activity
seria
l
1 Electricity form public network
2 Electricity from shared generator
3 Electricity from private generator
4 Liquid gas cylinders
5 Kerosene
6 Wood, coal, plant-sources
7 Dung of animals
8 Other (mention)
Source Code
SixthFifthFourthThirdSecondFirst
Cooking1
Lighting2
Heating3
Warming water4
The environmental influences on the residential unit
331Is your householdaffected for this
..[ENVIRONMENTALIMPACT TYPE]…?
Type
Ser
ial
Largely affected1
Little effect2
Very little effect3
No affect at all4
Smoke and gas01
Dust02
Bad odor03
Noise04
Insects, rodents, dogs or other animals05
Garbage near residential unit06
Rain and stagnant water07
Outlets of sanitary systems08
Humidity09
Insufficient ventilation10
Security risks11
Insufficient lighting12
Other (mention)13
Does the household members suffer from transportation problems?
332
1 Yes
2 No 334
E. ENVIRONMENTAL IMPACTS AND ACCESS TO FACILITIES
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Section Three: Housing
F. COMMUNICATIONS
336What is the number of [means of communications] that the household have?
Means of Communications
Ser
ial
Put ‘zero’ if none
If (10) or more, write (9)
No.
Land / phone lines1
Mobile phones2
Internet lines3
Satellite4
Other5
335What’s the distance from your household to the nearest …[FACILITY NAME]…?
Facility
Ser
ial
1 Less than 100 meters
2 From 101 to 300
3 From 301 to 500
4 From 501 to 1,000
5 More than 1 km to 5 km
6 More than 5 km to 10 km
7 More than 10 km
Code
Elementary school01
Mid or high school02
Public hospital03
Private hospital04
Medical center / doctor05
Pharmacy06
Police station07
Post office08
Place of worship09
Youth center10
Bank11
Fire station12
Municipal council13
Public bus waiting station14
Private bus / taxi15
Markets16
Section Three: Housing
G. EXPENSES ON HOUSING
339What is the estimated proportion of use for non household consumption such as production and sale activities carried out within the housing unit?
338What is the length of period for which the pay--ment was made for ..[ITEM]..?
337What was the last payment for this ..[ITEM].. as related to this residential unit?
ITEM DESCRIPTION
Ser
ial
Previous Debts not included
Write zero if the household did pay (for this material) and move on to the next paragraph Write “zero” if there
are noneToFrom
Percentage (%)YearMonthDayYearMonthDay1,000 dinars
The rent of a house rented from the Government, the Public Sector or the Private Sector
1
Water2
Sewerage3
Raw Water4
Electricity from the public network
5
Electricity from shared Generators
6
Land / phone Line7
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Annex 3: Survey questionnaire
Section Four: Education
All Household Members Aged 6 Years or more
401What language can you deal with, and what is your level of proficiency in that language?
ID C
OD
E
C - Third LanguageB -Second LanguageA - Mother Tongue
C4C3C2C1B4B3B2B1A4A3A2A1
Level ofLevel ofLevel ofLanguageLevel ofLevel ofLevel ofLanguageLevel ofLevel ofLevel ofLanguage
speakingwritingreadingcodespeakingwritingreadingcodespeakingwritingreadingcode
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
LanguageCode
Arabic1
Kurdish2
Turkmen3
Syria4
Chaldean5
English6
French7
Persian8
Other Languages9
Skill LevelCode
Cannot1
Weak2
Medium3
Good4
Section Four: Education
All Household Members Aged 6 or More
406What are the highest certifications you have attained?
405Have you ever attended literacy classes?
404Can you readand write
403What is the main reason why you never attended school?
402Have youever attendedschool?
Ind
ivid
ual
’s C
od
e
There is no school01
There are no seats at school02
No certificate, illiterate01yes,1There are no sanitary utilitiesat school
03
No certificate, I only read02currently attending
No
1Transport is very difficult and unsafe
04Yes, at--tended inthe past
1
No certificate, I read and write
03There is no female teacher05
Elementary04There is absolutely no teacher at all06
Intermediate (mid school)05Yes, I wasenrolled inthe past
2I just read2Household cannot afford school expenses
07406
Preparatory06Work for the family08
Vocational07Work for someone else09Yes, I amcurrentlyattending
2
Diploma from an institution08no, never attended
3Disability or disease10
Bachelor degree09I read & write
3Marriage11
Higher diploma10Family not interested12407
Masters degree11[NAME] not interested13
PhD. (doctorate)12There are no documents14No3
Other13For all answers, move to Section Five: 501
Social reasons15
Other16
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
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Annex 3: Survey questionnaire
Section Four: Education
All Household Members Aged 4 or more
Exclusive for Household Members between 6 - 50 Years of Age
409Look at Question 402 in case the person was currently enrolled in school.
408Is the [name] 50 years or less?
407What is the number of school years and the repeat years that you have spent?
ID C
OD
E
411Is the school or university that you arecurrently enrolled in a public or private one?
410Which level or grade are you enrolled at now (or was enrolled) at school or university?
410
1 Elementary
2 Mid SchoolOtherwise ask the person if she /he had been enrolled in school during the last 12 months
3 Preparatory (or equivalent)
Public in Iraq14 Institute
Private in Iraq25 College
Other in Iraq36 Higher Education
Outside Iraq47 Other
Yes1
Yes1
No2No2
414Move to Section Five: 501
(B)Repeat Years
(A)School Years
Grade / ClassLevel / Stage
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Four: Education
Exclusive for Household Members between 6 - 50 Years of Age
415What is thedistance between the school/university andplace of \residence?
414What is the main reason why you left school or did not enroll in school / university?
413Are you cur--rently enrolled or continuing in school or university?or have youleft(dropped-out)education?
412How oldwere youwhen youenrolled inschool forthe first time?
Ind
ivid
ual
’s C
od
e
Disability or disease10There is no school01
Marriage11No available seats at school02
Family not interested12Unavailability of sanitary utilities03
[Name].. Not interested13Transport is very difficult or unsafe04
Social reasons14There is no female teacher05
There ae no documents15There absolutely no teacher at all06Is attending
415
1
I was expelled / dismissedFrom school
16The household cannot pay the expenses
07
I concluded my education17
Other18Work for the family08
Work for someone else09Dropped out definitely
2
Move to Section Five: 501
Km MeterYears
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
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Annex 3: Survey questionnaire
Section Four: Education
Exclusive for Household Members between 6 - 50 Years of Age
ID C
OD
E
418How has the household spend (exerted expenditures) during the last 12 months to avail edu--cation for your on ….?
If the responding person was unable but to give you the total sum of amount, write “-2” in the special fields and the total amount in column (9) n
417How much time does it take to reach the school or university?
416What is the main transport means to school or uni--versity
On foot1
Private car2
Public car3
Bicycle4
Residency in same building
5
Other6
9 - 8 - 7 - 6 - 5 - 4 - 3 - 2 -1 -
TotalOtherPrivate lessons
Transport
Booksand
schoolsupplies
ResidencyFoodUniform
or sportsuniform
Tuitionfees
1,000dinar
1,000 dinar
1,000dinar
1,000dinar
1,000dinar
1,000 dinar
1,000dinar
1,000dinar
1,000dinar
Minutes
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Five: Health
All Household Members
Part (A): Disability & Chronic Diseases
506Have you
received any help for the
disability /chronic diseaseduring last 12
months in any ofthe following?
505How manyyearsagodidyou
becomechronicallyill?
504-AWhat is the chronicdisease that you are
suffering from?
504Do yousufferfrom achronic
disease?
503Howmanyyearsagodidyou
becomedisabledl?
502-AHow did you
become disabled ?
502What is the Disabilitythat you are suffering
from?
501Doyou
sufferfromany
disability?
ID C
OD
E
Since birth01
Injury due to Work
02
Diabetes01Disease dueTo work
03
Blindness01
No Chronic/disAble.
00High bloodPressure
02Deafness02
No helpReceived
01Chronic inflammation
03ChemicalStrike orEnriched Uranium
04Dumbness03
Public Hospital
02Cancer04Inability of speech04
Public health Cen.
03Psychological Diseases
05(Oldest
One)Land mines05Inability to walk05
Clinic/priVate hosp
04Nervous system Dis. & Sensory Organs (paralysis)
06Other - Related to civic conflict
06Mobility inability06
GeneralDoctor
05Limping07
Specialist Doctor
06Heart diseases07Because Of wars
07Mental retardations08
Nurse07Respiratory (hardBreathing)
08Yes1Due to a disEase that is notRelated to work
08Multiple disabilities09Yes1
Pharmacy08Digestive system Diseases (stomach,Intestines, …)
09Other
10
Popular Procedures
09No2TrafficAccident
09No2
Clergyman10Disease10506 Other relatedto civic conflict
10504
Outside Iraq11Anemia11
Other12Other12
No. ofYears
ThirdSecondFirstNo. ofYears
ThirdSecondFirstThirdSecondFirst
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
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Annex 3: Survey questionnaire
Section Five: Health
Part (B): Illness & Injuries
508What sort of illness or injury have you suffered from?
507Have you suffered from any illness or injury in the last 30 days?
ID C
OD
E
InjuriesDiseases
Hepatitis12High sugar level (diabetes)01
1 Torn LigamentsRespiratory system and chest diseases
13Pressure02
2 Head Injuries And Internal Injuries
Women diseases, such as pregnancy and post-natal com--plications
14Heart diseases03
Kidneys04
3 FracturesBlood diseases15Tumors05
Do not list any chronic disease of disability that has beenmentioned before
4 PoisoningInflammation of the thyroid gland
16High level of blood Cholesterol
06
5 BurnsSkin diseases and syphilis disease
17Mental diseases07
6 OtherDiseases leading to impotency18Psychological diseases08
7 510 Not availableDiseases of the sexual and urinary systems
19Nervous system diseases and sensory organs (paralysis)
09
Parasitic and contagious diseases
20 502 / A-504
Other diseases21Digestive system diseases10
There are none22Thyroid gland11Yes1
No2
519
B -Code of the Most Important Injury
A - Code of the Most Important Disease
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Five: Health
All Household MembersPart (B): Illness & Injuries
512Where is this medical service located?
511Where have you received the medical care / remedy?
510Did you receive medical care because of this illness or injury?
509If it were an injury of …What was the main reason for this injury?
ID C
OD
E
Same area1Public hospital01
Same district2Public medical center02
Same province3Clinic / private hospital03Traffic accident1
Other province4General doctor04Yes1Accident due to work2
Specialist doctor05Other accidents3
Medical assistant06No2Family violence4
Nurse07517 Assault outside family5
Pharmacy08Civic disturbances6
Popular medical procedures09Other reasons7
Clergyman10
516 Outside iraq 11
Other12
If more than one, select the most important
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
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Annex 3: Survey questionnaireSection Five: Health
All Household MembersPart (B): Illness & Injuries
516What is the total that has been spend on the following entries in the last 30 days?518
515How long did it take to reach
the health facility by utilizing
the actualadopted
mean(s )?
514What’s the
main mean ofcommuting
to this healthfacility?
513What is the
distancebetween this
MedicalServices
Location andthe
Residence?
ID C
OD
E
On foot1
Private car
2
Public transport car
36
Total
5
Other
4Lab test,
x-ray, ultrasound, other
3Consultation and Hospital
Fees
2
Medicines
1Accessibility
to medical
services entity
Bicycle4
Other5
1000 Din dinar1000 Din dinar1000 Din dinar1000 Din dinar1000 Din dinar1000 Din dinarMinute KM Meter
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Five: Health
All Family MembersPart (B): Illness & Injuries
519INTERVIEWER: PLEASE LOOK AT PERSON'S AGE, GENDER AND MARITAL STATUS IN THE THE HOUSEHOLD ROSTER AND CLASSIFY THE PERSON AS FOLLOWS:
518How many days were you absent from your normal activities due to illness or injury?
517Why you didn't receive medical care for this illness or injury?
ID C
OD
E
Inability to withstand cost01
The person is a child of less than 5 years of age1
Difficulty in securing means of transport02
Unavailability of a (female) doctor / nurse03
525 Unavailability of a doctor 04
Unavailability of medical means (place)05
The person is a married divorced, separated or widowed woman of 12 – 49 years of age
2
The illness was mild06
Unavailability of the proper services07
Social reasons08
Next questionUnsafe, due to the security status09
Other10
Other3
Go to Section Six: 601
Number of Days
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
822
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Annex 3: Survey questionnaire
Section Five: Health
All Women: Married or Divorced or Widowed, aged 12 - 49
Part (C ): Prenatal and postnatal care
Exclusive to recently married or divorced or widowed women
All Women: Married, divorced, widowed, aged 12 - 49
ID C
OD
E
523Have you had any complications during pregnancy or during giving birth which required medical attention?
522Have you had any medical care during the last pregnancy and giving birth?
521When was the last time you gave birth?
520Have you ever given birth to a child?
524Are you currently pregnant?
Yes1Yes1Yes1Yes1
No2No2No2No2
Go to Section Six (601524
YearMonth
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Five: Health
Children of less than 5 yearsPart (D): Breast-Feeding and Inoculations (Vaccinations)
All Children less than 5 years old
ID C
OD
E
If the child has a vaccination card, record the following (otherwise ask the mother): has the child received the following vaccines?
527Is ..[NAME].. in posses--sion of a “Vac--cination Card”?
526Has ..[NAME].. ever been vaccinateds?
525Has ..[NAME]..
received natural breast feedingduring the first
six months?
534Hepatitis
533Measles
532Dosage child got of Triple Vaccine/ DPT Diphtheria, Whooping Cough, Tetanus
531DPT
530The number of dosages / injections taken against Polio
529Polio
528Tuber--culosis (B.C.G.)
Yes1Yes1Yes1Yes1Yes1Yes1Yes1Yes, breast feeding only
1
No2No2No2No2No2No2No2Yes, partial breast feeding
2
533 531 Next Person
No3
# of dosages# of dosages
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
824
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Annex 3: Survey questionnaire
Section Six: Activities, Entertainment & Hobbies
For All Household Members Aged 10 and Above
606What isthe totalof hoursyou usetheInternetper week?
605What is the purpose of your using the Internet (as per importance)
604What arethe areas ofusage of theInternet(as perimportance)
603Place ofInternet Usage as perimportance
602Do you use the Internet
601Please indicate if you practice any of these following activities or hobbies and what time intervals do you do that?
ID C
OD
E
No, never1
Sometimes2
Email1Home1Less than 2 hours per week3
Pleasure1Chat2Internet Café
2From 2 hours to less than 5 hours per week
4
Talk relatives friends
2Talk to others
3Educational Institute
3From 5 hours to less than 10 hours per week
5
Search site
4Yes1Ten hours or more per week6
Work / Job
3Other5Work4No2FEDCBA
Study Research
4Other5Column 701 (Section Seven)
Artactivities
as hobby
Sportsactivities
Socialnon
politicalactivities
Politicalactivities
Readingother
material
Readingdailynews
papersOther5
Hrs/Week3213214321
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Seven: Job search and past employment
For All Household Members Aged 6 and AbovePart A: Looking for Work
704Why don’t you want work? (or more work)?
703Do you want work or more work of which kind? For example: paid job, new work, or more work?
702Why haven’t your worked during the last seven days, not even for one hour (indicate main reason)?
701How many working hours have you worked during the last seven days?
ID C
OD
E
708 I currently work full time01Next Person
Question401
Too young, low age01
Full-time student 02
I cannot find a job02Social reasons03
708 Satisfied with my status 03706I have a contract and will start work soon
04
708 Housework dedicated female04704Diability / Handicapped05
708 Social ties05704Retired06
708 Too old for work or retired06704House wife07
708 Too young for more work07704I have no desire08
708 Student08I am temporarily away from work due to illness or vacation or other reason (maternity leave …)
09
708 Too ill/unable take more work09
708 Have income no need to work10Due to end of work10
708 Due to the state of security11Yes1I was dismissed11
708 Other12705 I was unable to get a job12
No2Due to security reasons13If one hour or more 703 Other14
Number of Hours
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
826
Volume III
827
Annex 3: Survey questionnaire
Section Seven: Job search and past employment
For All Household Members Aged 6 and AbovePart A: Looking for Work
707If there had been job opportunities last week or will be available during the next two weeks, are you ready to start work?
706What have you done for the sake of attaining work?
705When was the last effort or procedure you have taken to search for work (or get more work) of any kind?
ID C
OD
E
1 I asked friends / relatives
2 I applied directly to the work owner's)
3 I registered at the "Employment / Labour Office"
4 I followed up on job opportunities advertisementsLast seven days1
5 I promoted myself by placing and advertisement about my workDuring last month2
6 I tried to find work outside IraqBefore more than a month3
7 I contacted an NGP(non-governmental organization)I never searched 7074
8 I contact local authorities (local governments)
9 Other means
Yes1
No2
Third ProcedureSecond ProcedureFirst Procedure
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Seven: Job search and past employment
For All Household Members Aged 6 and AbovePart B: Previous and Current Employment
710When did you stop doing the last full-time job you had?
709What was your occupation in the last full-time job you had?
708Are you engaged or have you ever been engagedin a full-timewage job?
ID C
OD
E After conclusion of interview with this person, complete data for next person starting with question 401Yes1
No 2
Next Person Question 401 YearMonthProffesion CodeJob Description
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
828
Volume III
829
Annex 3: Survey questionnaire
Content
1 Section One: Household Roster
4 Section Two: Received Supplies Rations & Consumption of Provisions & the like
6 Section Three: Housing
11 Section Four: Education
16 Section Five: Health
23 Section Six: Activities, Entertainment & Hobbies
24 Section Seven: Job search and Past Employment
Serial Date Notes Taker Job Title Comments Signature
1 0_ / _ _ / _ _
2 0_ / _ _ / _ _
3 0_ / _ _ / _ _
4 0_ / _ _ / _ _
5 0_ / _ _ / _ _
6 0_ / _ _ / _ _
7 0_ / _ _ / _ _
8 0_ / _ _ / _ _
9 0_ / _ _ / _ _
10 0_ / _ _ / _ _
11 0_ / _ _ / _ _
12 0_ / _ _ / _ _
13 0_ / _ _ / _ _
14 0_ / _ _ / _ _
15 0_ / _ _ / _ _
Notes
Part No. (2): Daily Ledger
A. FIRST IDENTIFICATION Code
06 Governorate
07 District
08 Area
09 Quarters
10 Alley (Street)
11 Country
12 Village
13 Class Draw circle around appropriate answer
Provinces1 Rural2 Suburban3 Urban / Central
Baghdad
Suburban 2 Rural 1
Urban / Central
Al-Rasafah 4 Al-Sader City 3
Al-Karekh 5
14 The Number of the Building for the Survey
C. FIELD STAFF Signature CODE Date
23 INTERVIEWER 24 0-/--/--
25 TEAM LEADER 26 27 0-/--/--
28 DATA ENTRY OPER. 29 30 0-/--/--
31 CENTRAL SUPERVISOR 32 33 0-/--/--
40 Has Household been include in MICS3 Survey? Draw circle around correct answer Yes No
For Researcher: Pls double check against families included in MICS3 Survey
ا�ستيفاء بيانات اال�ستمارة
01 02 03
WAVE (1 - 18) TEAM INT. (1 - 3)
The Ministry of Planning and Development Cooperation
Central Organization for Statistics and Information Technology (COSIT)
The Republic of Iraq For eradication of poverty and enhancing the socio-economic status of the households in Iraq
In cooperation with the Kurdistan Regional Statistical Commission (KRSCO)
Household Socio-Economic Survey in Iraq (IHSES 2007 - 2006)
HOUSEHOLD IDENTIFIER
04 05
CLUSTER HH
B. HOUSEHOLD IDENTIFICATION
15 Household head name
16 Work Address
17 Household Size
18 HOUSEHOLD SIZE
19 Telephone Number
20 Work Tel. No.
21Numeral Form for this household
22 No. of this Questionnaire
1
2
3
4
5
6
7
8
34
Fully Achieved
Partially Achieved
No usable Information
Unaccomplished: Household refused interview
Unaccomplished: Household not present
Unaccomplished: House not found
Unaccomplished: Housing unit not occupied
Unaccomplished: Housing unit is seasonal
D- Visits of Field Researchers RESULT OF THE INTERVIEW
35 First Visit 0-/--/--
36 Second Visits 0-/--/--
37 Third Visit 0-/--/--
38 Fourth Visit 0-/--/--
39 Fifth Visit 0-/--/--
Volume III
830
Annex 3: Survey questionnaire
831
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
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M].
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acq
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803
Ho
w m
uch
has
yo
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use
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hat
is
the
esti
mat
ion
fo
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l qu
anti
ties
of
..[IT
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].. b
ou
gh
t o
r re
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ed d
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ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
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use
ho
ld
du
rin
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he
30
day
s p
rece
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g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
D
inar
Q
uan
tity
Un
itIt
em D
escr
ipti
on
Sh
oes
Nee
ds
--S
hoe
crea
m o
r dy
e41
11
--M
aint
aini
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ater
ial
4115
--O
ther
4119
Rep
air
and
Ren
tin
g S
ho
es
--D
ye a
nd r
epai
r fe
es41
23
--O
ther
: re
ntin
g41
27
Gas
Cyl
inde
rLi
quid
gas
from
the
stat
ion
4151
Cyl
inde
rLi
quid
com
mer
cial
gas
4157
--Li
quid
gas
via
pip
es41
63
Fu
el f
or
Sp
ecia
l Gen
erat
ors
Lite
rG
asol
ine
from
the
stat
ion
4165
Lite
rC
omm
erci
al g
asol
ine
4167
Lite
rE
ngin
es o
ils41
73
Liq
uid
Fu
el
Lite
rW
hite
fuel
from
the
stat
ion
4181
Lite
rC
omm
erci
al w
hite
fuel
4183
Tota
l of t
his
page
4190
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
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803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
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l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
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ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
So
lid F
uel
Coa
l42
11
Woo
d42
23
Mat
al :
kind
of o
il42
35
Oth
er: r
emai
ns o
f ani
mal
s, d
ung.
..Sm
all T
ools
and
Acc
esso
ries
4247
Sm
all T
oo
ls a
nd
Acc
esso
ries
Num
ber
Man
ual t
ools
and
equ
ipm
ent,
such
as:
ham
mer
, saw
, cu
tters
,...
4259
Num
ber
Sta
irs a
nd L
adde
rs42
61
Num
ber
Cur
tain
s R
ails
4273
Num
ber
Flo
rissa
nt a
nd L
ight
Lam
ps42
85
Num
ber
Han
d-he
ld L
ight
s (T
orch
es)
4297
Num
ber
Dry
Bat
terie
s43
09
Num
ber
Ala
rm S
yste
ms
4311
Num
ber
Lock
s an
d K
nobs
4323
Num
ber
Oth
er s
mal
l too
ls a
nd a
cces
sorie
s43
29
Tota
l of
this
pag
e43
30
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Volume III
832
Annex 3: Survey questionnaire
833
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
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ain
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M].
. in
acq
uir
ed?
803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
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l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
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ht
or
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iere
d b
y yo
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ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Co
nsu
mab
le H
ou
seh
old
Go
od
s
Kg.
Soa
p su
pplie
s43
35
Kg.
Com
mer
cial
soa
p43
47
Kg.
Det
erge
nts
supp
lies
4359
Kg.
Com
mer
cial
det
erge
nts
4361
Lite
rLi
quid
dis
hwas
hing
and
cle
anin
g de
terg
ents
4373
Lite
rS
tron
g de
terg
ents
like
Fla
sh43
85
--A
ir F
resh
ener
4397
--G
lass
Cle
anin
g P
rodu
cts
4409
--P
estic
ides
4411
--D
istil
led
Wat
er44
23
--C
lean
ing
Item
s: B
room
s, m
ops…
4435
--C
lean
ing
stan
ds44
47
--K
itche
n to
wel
s44
59
--F
abric
for
mop
s44
61
--P
aper
pro
duct
s: n
apki
ns, b
ags
for
the
vacu
um c
lean
er…
4473
--O
ther
Item
s: m
atch
es, c
andl
es, w
icks
, sta
rch,
pin
s, n
eedl
es,
embr
oide
ry n
eedl
es, t
hist
le, t
hrea
ds, w
indi
ng th
read
s, n
ails
, fir
e ex
tingu
ishe
r pa
rts,
rub
ber
glov
es…
4485
Tota
l of
this
pag
e44
90
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Do
mes
tic
Ser
vice
s
--M
aid’
s fe
es44
97
--C
ook’
s fe
es45
09
--D
river
’s fe
es45
11
--G
ardn
er’s
fees
4523
--N
anny
/ b
aby
sitte
r fe
es45
35
--G
uard
’s fe
es45
47
Oth
er M
edic
al P
rod
uct
s
--M
edia
l equ
ipm
ent:
ther
mom
eter
, fun
nel,
med
ical
ban
da--
ges,
gau
ze, c
otto
n, …
4561
Pha
rmac
eutic
al P
rodu
cts
--M
edic
ines
for
chro
nic
dise
ases
4585
--M
edic
ines
for
non-
chro
nic
dise
ases
4597
--C
ontr
acep
tives
4609
--O
ther
pha
rmac
eutic
al p
rodu
cts
4613
Fu
el f
or
Per
son
al T
ran
spo
rt
Lite
rF
uel f
rom
the
stat
ion
4647
Lite
rC
omm
erci
al F
uel
4659
Lite
rE
ngin
es o
ils fr
om th
e =
stat
ion
4661
Lite
rC
omm
erci
al e
ngin
es o
ils46
73
--O
ther
: dis
tille
d w
ater
, ant
i-fre
eze…
4685
Tota
l of
this
pag
e46
90
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Volume III
834
Annex 3: Survey questionnaire
835
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Rep
air
and
Mai
nte
nan
ce o
f P
erso
nal
Tra
nsp
ort
--F
ixin
g ve
hicl
es: m
echa
nica
l, el
ectr
ical
, pip
ing,
spa
re
part
s, p
unct
ures
..46
97
--W
ashi
ng a
nd lu
bric
atin
g47
09
Co
st o
f P
ub
lic T
ran
spo
rt
--P
asse
nger
s T
rans
port
by
Tra
in47
11
--P
asse
nger
s T
rans
port
by
Pla
ne47
27
--P
asse
nger
s T
rans
port
by
Sea
4735
Oth
er T
ran
spo
rt S
ervi
ces
--P
orte
r fe
es47
59
--Lu
ggag
e sh
ippi
ng o
ffice
s fe
es47
61
--C
omm
issi
ons
for
trav
el a
gent
s47
73
Po
stal
Ser
vice
s
--P
osta
l exp
endi
ture
s: s
tam
ps, p
arce
ls, t
rans
fers
4785
To
tal o
f thi
s pa
ge47
90
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Ph
on
e an
d F
ax S
ervi
ces
--P
hone
inst
alla
tion
fees
4807
--F
ees
of la
nd li
ne /
phon
e48
15
--P
hone
cal
ls c
harg
es48
23
Num
ber
Mob
ile c
ards
: re
fills
4831
Num
ber
Thu
rayy
ah c
ards
: sa
telli
te s
ervi
ce48
39
--Te
legr
ams,
Fax
and
Tel
ex S
ervi
ces
4847
--D
igita
l ser
vice
s an
d In
tern
et48
55
--C
onne
ctio
n to
the
Inte
rnet
4863
--C
ost o
f tel
ecom
mun
icat
ions
and
wire
less
4871
--R
entin
g ph
ones
and
faxe
s48
79
--O
ther
pho
ne a
nd fa
x se
rvic
es48
87
Cu
ltu
ral S
ervi
ces
--C
ost o
f tic
kets
to c
inem
a, th
eatr
e or
con
cert
s49
05
--E
xpen
ditu
res
on li
brar
ies
and
mus
eum
s49
13
--A
rt s
how
s an
d ex
hibi
tions
4921
--V
isiti
ng h
isto
rical
pla
ces,
pub
lic p
lace
s an
d th
e zo
o49
29
--R
entin
g vi
deo
tape
s or
CD
s / D
VD
s49
37
--P
hoto
grap
hy S
ervi
ces:
film
s an
d de
velo
ping
film
s49
45
--O
ther
cul
tura
l ser
vice
s49
53
Tota
l of
this
pag
e49
60
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Volume III
836
Annex 3: Survey questionnaire
837
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Wri
tin
g a
nd
Art
s M
ater
ial
--B
ooks
and
cop
yboo
ks49
79
--P
ens
of a
ll so
rts
4987
--S
harp
ener
s, e
rase
r49
95
--C
arbo
n pa
per
and
tape
s50
03
--S
tapl
es, s
tapl
ers
and
pins
5011
--P
aper
sci
ssor
s50
19
--G
lue
5027
--P
aper
Clip
s50
35
--P
aint
ing
mat
eria
l on
pape
r, ca
nvas
, fab
ric a
nd p
late
s,
boar
ds, w
ax d
yes,
pas
tel,
wat
er c
olou
rs, .
.50
43
--O
ther
: rul
ers,
geo
met
ry to
ols,
cha
lk, p
enci
l hol
der/
sac
…50
51
Nu
rser
y E
xpen
dit
ure
s
--N
urse
ry fe
es50
73
--K
inde
rgar
ten
fees
5077
--N
urse
ry a
nd K
inde
rgar
ten
expe
nses
5081
Per
son
al C
are
--M
en’s
Bar
ber
Cha
rges
5107
--W
omen
’s H
aird
ress
er C
harg
es51
15
--B
ath
Cha
rges
5123
--S
auna
and
mas
sage
5131
--O
ther
per
sona
l car
e51
39
Tota
l of
this
pag
e51
40
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
804
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
803
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
802
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
30
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
801
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
30 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T IT
EM
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Co
llect
ion
of
Was
te a
nd
Gar
bag
e
--C
ost o
f col
lect
ing
garb
age
and
was
te, i
nclu
ding
: ope
ning
of
blo
cked
sew
age
syst
ems
5143
Oth
er S
ervi
ces
Rel
ated
to
th
e P
lace
of
Res
iden
ce
Oth
er s
ervi
ces:
gua
rdin
g, fi
ele
vato
rs51
46
Oth
er E
qu
ipm
ent
and
Pro
du
cts
for
Per
son
al C
are
--N
on-E
lect
rical
s: s
havi
ng to
ols,
sha
ving
bla
des,
sci
ssor
s,
file,
toot
h br
ush
, com
b..
5153
--P
erso
nal H
ygie
ne: m
edic
ated
soa
p, s
havi
ng c
ream
, too
th
past
e..
5161
--B
eaut
y P
rodu
cts/
Mak
e-U
p: li
pstic
k, n
ail p
olis
h, a
tom
izer
, bo
dy s
pray
, per
fum
es..
5169
--O
ther
pro
duct
s: to
ilet p
aper
, tis
sues
, pam
pers
..51
77
Tota
l of
this
pag
e51
80
No.
of l
ines
fille
d fo
r S
ectio
n E
ight
Sec
tio
n E
igh
t: E
xpen
dit
ure
s o
n N
on
-Fo
od
Ser
vice
s an
d C
om
mo
dit
ies
du
rin
g t
he
pas
t 30
day
s
Volume III
838
Annex 3: Survey questionnaire
839
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Clo
thin
g
Met
erW
oole
n m
en fa
bric
5511
Met
erW
oole
n w
omen
fabr
ics
5523
Met
erW
oole
n ki
ds fa
bric
5535
Met
erC
otto
n m
en fa
bric
s55
47
Met
erC
otto
n w
omen
fabr
ics
5559
Met
erC
otto
n ki
ds fa
bric
s55
61
Met
erS
ilk m
en fa
bric
s55
73
Met
erS
ilk w
omen
fabr
ics
5585
Met
erS
ilk k
ids
fabr
ics
5597
Met
erS
ynth
etic
men
fabr
ics
5609
Met
erS
ynth
etic
wom
en fa
bric
5611
Met
erS
ynth
etic
kid
s fa
bric
s56
23
ــTa
ilorin
g fe
es fo
r m
en56
35
ــD
ress
mak
ing
fees
for
wom
en56
47
ــD
ress
mak
ing
fees
for
kids
5659
ــO
ther
clo
thin
g ite
ms
5663
Tota
l of
this
pag
e56
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Sec
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n N
ine:
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res
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No
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oo
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ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Clo
thes
Rea
dy
mad
e m
en’s
clo
thin
g
Num
ber
Coa
ts56
73
Num
ber
Kni
tted
5685
Num
ber
Pan
ts56
97
Num
ber
Qam
asel
/ ve
st57
09
Num
ber
Shi
rts
5711
Num
ber
Und
erw
ear
5723
Num
ber
Who
le s
uits
5735
Num
ber
Long
dre
ss57
47
Num
ber
Woo
len
cloa
k57
59
Num
ber
P.J.
s57
61
Num
ber
Hea
d dr
ess
- tr
aditi
onal
wea
r57
73
Num
ber
The
rop
e-lik
e ci
rcle
ato
p he
ad d
ress
5785
Num
ber
A s
ort o
f hea
d dr
ess
“ara
qjee
n57
97
Pai
rS
ocks
5809
Num
ber
Spo
rts
wea
r58
11
Num
ber
Blo
use
5823
Num
ber
T-sh
irt58
35
--R
eady
mad
e m
en’s
wea
r58
47
Tota
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e58
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ine:
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No
n-F
oo
d S
ervi
ces
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Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Volume III
840
Annex 3: Survey questionnaire
841
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Rea
dy
mad
e w
om
en’s
wea
r
Num
ber
Coa
ts58
59
Num
ber
Jack
ets
5861
Num
ber
Pan
ts58
73
Num
ber
Qam
asel
/ ve
st58
85
Num
ber
Shi
rts
5897
Num
ber
Und
erw
ear
5909
Num
ber
Sui
ts59
11
Num
ber
Flo
win
g lig
ht c
loak
/ su
mm
er59
23
Num
ber
Clo
ak
5935
Num
ber
Paj
amas
5947
Num
ber
Ski
rts
5959
Num
ber
Jurg
hod
5961
Num
ber
Wra
p59
73
Num
ber
Sca
rf59
85
Pai
rS
ocks
5997
Num
ber
Spo
rts
wea
r60
09
Num
ber
Blo
use
6011
Num
ber
T-sh
irt60
17
Num
ber
Oth
er r
eady
mad
e w
omen
’s g
arm
ents
6023
Tota
l of t
his
page
6030
Sec
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n N
ine:
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end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Kid
s W
ear
Num
ber
Coa
ts60
35
Num
ber
Jack
ets
6047
Num
ber
Pan
ts60
59
Num
ber
Qam
asel
/ ve
st60
61
Num
ber
Shi
rts
6073
Num
ber
Und
erw
ear
6085
Num
ber
Sui
ts60
97
Num
ber
Ligh
t sum
mer
clo
cks
6109
Num
ber
Spo
rts
wea
r61
11
Num
ber
Paj
amas
6123
Num
ber
Ski
rts
6135
Num
ber
Blo
use
6147
Pai
rS
ocks
6159
--O
ther
kid
s w
ear
6161
Tota
l of
this
pag
e61
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Sec
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ine:
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res
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No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Volume III
842
Annex 3: Survey questionnaire
843
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Oth
ers
So
rts
of
Wea
r an
d A
cces
sori
es
Num
ber
Nec
k-tie
6173
Num
ber
Han
dker
chie
fs61
85
Pai
rG
love
s of
all
sort
s61
97
Num
ber
Bel
ts62
09
Num
ber
Pan
ts h
olde
rs62
11
Num
ber
Hat
s62
23
--T
hrea
ds fo
r se
win
g an
d kn
ittin
g62
35
--Z
ippe
rs62
47
--B
utto
ns62
59
--O
ther
6261
Dry
Cle
an, M
end
ing
an
d R
enti
ng
--C
loth
es r
epai
r fe
es62
73
--C
loth
es k
nitti
ng fe
es62
85
--C
loth
es ir
onin
g62
97
--C
loth
es w
ashi
ng63
09
--C
loth
es d
ying
6311
--C
loth
es d
arni
ng63
23
--C
loth
es r
entin
g63
35
--O
ther
fees
: dry
cle
an, fi
, ren
ting…
6339
Tota
l of
this
pag
e63
40
Sec
tio
n N
ine:
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end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Sh
oes
Men
’s S
ho
es
Pai
rLe
athe
r sh
oes
6347
Pai
rN
on-le
athe
r sh
oes
6359
Pai
rS
lippe
rs63
61
Pai
rS
port
s sh
oes
6373
Pai
rO
ther
: clo
gs, …
6385
Wo
men
’s S
ho
es
Pai
rLe
athe
r sh
oes
6397
Pai
rN
on-le
athe
r sh
oes
6409
Pai
rS
lippe
rs64
11
Pai
rS
port
s sh
oes
6423
Pai
rO
ther
: clo
gs, …
6435
Kid
s S
ho
es
Pai
rLe
athe
r sh
oes
6447
Pai
rN
on-le
athe
r sh
oes
6459
Pai
rS
lippe
rs64
61
Pai
rS
port
s sh
oes
6473
Pai
rO
ther
: clo
gs, …
6485
Tota
l of
this
pag
e64
90
Sec
tio
n N
ine:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Volume III
844
Annex 3: Survey questionnaire
845
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Fab
rics
, L
inen
, Tap
estr
y
Num
ber
Mat
tres
ses
and
bed
shee
ts64
97
Num
ber
Bla
nket
s65
09
Num
ber
Rea
dy m
ade
pillo
ws
6511
Num
ber
Ben
ch a
nd q
uilt
6523
Num
ber
Tow
els
6535
Num
ber
Tabl
e lin
en ,
or c
over
s65
47
Num
ber
Tabl
e m
ats
/ nap
kins
6559
Kg.
Woo
l65
61
Kg.
Cot
ton
6573
Kg.
Fea
ther
6585
Met
erS
pong
e65
97
--F
ees
for
prep
arin
g m
attr
ess
6609
Met
erF
abric
s fo
r fu
rnitu
re66
11
--U
phol
ster
y fe
es66
23
--M
endi
ng fe
es66
35
--F
abric
s an
d ot
her
furn
ishi
ngs
6639
Ho
me
Ser
vice
s
--C
lean
ing
carp
ets
and
wal
l-to-
wal
l car
pets
6647
--C
lean
ing
linen
and
furn
iture
with
ste
am66
59
--R
entin
g fu
rnitu
re, f
urni
shin
gs, c
arpe
ts a
nd h
ome
equi
pmen
t66
61
--O
ther
ser
vice
s66
67
Tota
l of
this
pag
e66
70
Sec
tio
n N
ine:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Med
ical
Ser
vice
s
--G
ener
al D
octo
r66
73
--P
rivat
e D
octo
r66
81
--D
enta
l Car
e S
peci
alis
t : in
bra
ces
6689
Den
tal C
are
--D
entis
t67
09
--F
alse
teet
h m
ount
ing
6711
--R
epai
r an
d m
aint
enan
ce67
23
--O
ther
den
tal s
ervi
ces
6727
Su
pp
ort
ive
Med
ical
Ser
vice
s
--A
naly
sis
fees
6735
--X
-ray
fees
6747
--N
urse
fees
6759
--M
id-w
ife fe
es :
to a
ssis
t in
givi
ng b
irth
6761
--N
atur
al th
erap
y67
73
--R
entin
g tr
eatm
ent e
quip
men
t67
85
--N
atur
al h
erbs
6797
--C
ardi
olog
y68
09
--S
onar
6811
--U
ltra
soun
d68
23
--O
ther
med
ical
ser
vice
s: p
last
erin
g, in
ject
ions
…68
35
--F
irst a
id s
ervi
ces
6847
--R
entin
g of
ther
apeu
tic e
quip
men
t68
59
Tota
l of
this
pag
e68
60
Sec
tio
n N
ine:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Volume III
846
Annex 3: Survey questionnaire
847
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Oth
er T
reat
men
t S
ervi
ces
--K
idne
ys w
ash
6861
--C
hem
o th
erap
y68
73
--O
ther
trea
tmen
t ser
vice
s68
77
Ho
spit
al S
ervi
ces
--P
ublic
hos
pita
l68
85
--P
rivat
e ho
spita
l68
97
--P
opul
ar c
linic
6909
--H
ealth
cen
ter
6911
--C
ost o
f tre
atm
ent o
utsi
de Ir
aq69
23
--O
ther
hos
pita
l ser
vice
s69
27
Rec
ord
s K
eep
ing
Met
ho
do
log
ies
--V
ideo
s69
35
--Ta
pes
and
disk
s69
47
--P
C C
ompa
ct D
isks
: CD
s69
59
--R
egul
ar b
lack
and
whi
te o
r co
lour
ed fi
lms
6961
--O
ther
tapi
ng o
r re
cord
ing
mea
ns69
67
Gar
den
s P
lan
ts a
nd
Flo
wer
s
--N
atur
al p
lant
s69
73
--A
rtifi
cial
pla
nts
6985
--O
ther
: fer
tiliz
er…
6997
Tota
l of
this
pag
e70
00
Sec
tio
n N
ine:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
904
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
903
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
902
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
90
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
901
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
90 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
N
EX
T M
ater
ial
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
En
tert
ain
men
t an
d S
po
rtiv
e S
ervi
ces
--V
alue
of t
icke
ts to
the
fun
fair
7009
--V
alue
of t
icke
ts to
the
spor
ts m
atch
es70
11
--S
ubsc
riptio
n fe
es in
soc
ial,
cultu
ral a
nd s
port
ive
club
s,
incl
udin
g m
embe
rshi
p / i
nitia
tion
fees
, don
atio
ns, …
7023
--E
xpen
ses
at th
e sp
orts
cen
ter
7035
--R
entin
g eq
uipm
ent f
or e
nter
tain
men
t and
spo
rts
7047
--T
rain
ing
prog
ram
s: s
wim
min
g le
sson
s, m
usic
…70
59
--To
uris
m g
uida
nce
serv
ices
7061
--O
ther
spo
rtiv
e or
ent
erta
inm
ent s
ervi
ces
7065
Res
iden
cy S
ervi
ces
insi
de
Iraq
--H
otel
s70
73
--R
esor
ts a
nd to
uris
m o
utle
ts70
85
--In
tern
al s
ectio
ns70
97
--O
ther
acc
omm
odat
ions
insi
de Ir
aq71
03
Res
iden
cy S
ervi
ces
Ou
tsid
e Ir
aq
--E
xpen
ses
of li
ving
abr
oad,
out
side
Iraq
7125
Tota
l of
this
pag
e71
30
No.
of l
ines
for
Sec
tion
Nin
e
Sec
tio
n N
ine:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
90 d
ays
Volume III
848
Annex 3: Survey questionnaire
849
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Mat
eria
l fo
r m
ain
tain
ing
th
e h
ou
se a
nd
rep
air
it--
Rep
air,
repa
ir &
mai
ntai
ning
hou
se75
11--
Inte
rior
desi
gn w
orks
/dec
orat
ion
7523
--H
ouse
pai
nt75
35S
ervi
ces
for
repa
ir &
mai
ntai
ning
hou
se--
Ser
vice
s w
orks
to m
aint
ain
hous
e75
49F
urni
ture
& e
quip
men
t--
Bed
room
7573
--S
alon
/ Li
ving
Roo
m75
85N
umbe
rD
inin
g ta
ble
and
chai
rs75
97N
umbe
rD
inin
g C
ount
er -
Buf
fet
7609
--Li
ving
roo
m76
11N
umbe
rB
eds,
all
sort
s76
23N
umbe
rC
hairs
7635
Num
ber
Tabl
e76
47N
umbe
rC
lose
t76
59N
umbe
rLi
brar
y76
61N
umbe
rK
itche
n co
unte
rs76
73N
umbe
rTa
ble
Lam
p76
85N
umbe
rP
aint
ings
7697
Num
ber
Sta
tues
& a
rtifa
cts
7709
Num
ber
Cur
tain
s of
all
sort
s77
11N
umbe
rC
hand
elie
rs77
23N
umbe
rM
irror
s77
35N
umbe
rV
ases
7747
--O
ther
...F
urni
ture
or
equi
pmen
t 77
59To
tal o
f th
is p
age
7760
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Car
pet
s an
d fl
oo
r co
vers
M.S
q.C
arpe
ts77
61
M.S
q.W
all-t
o-w
all
7773
M.S
q.S
traw
str
etch
es77
85
M.S
q.R
ugs
7797
--R
epai
r fe
es78
03
--O
ther
(ca
rpet
s, fl
oor
cove
rs…
)78
07
Fri
dg
es a
nd
fre
ezer
s
Num
ber
Frid
ge78
11
Num
ber
Fre
ezer
7823
Num
ber
Wat
er c
oole
r78
35
--O
ther
(F
ridge
s, c
oolin
g de
vice
s…)
7839
Was
her
, dry
ers
and
iro
nin
g
Num
ber
Ele
ctric
clo
thes
was
her
7847
Num
ber
Ele
ctric
clo
thes
dry
er78
59
Num
ber
Ele
ctric
dis
h w
ater
7861
Num
ber
Ele
ctric
iron
7873
--O
ther
(w
ashe
rs, d
ryer
s, ir
onin
g …
)78
77
Tota
l of
this
pag
e78
80
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
850
Annex 3: Survey questionnaire
851
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Co
oki
ng
Num
ber
Gas
coo
ker
7885
Num
ber
Ele
ctric
coo
ker
7897
Num
ber
Fue
l coo
ker
7909
Num
ber
Ele
ctric
ove
n79
11
Num
ber
Ele
ctric
gril
l79
23
Num
ber
Gas
gril
l79
35
Num
ber
Old
fash
ione
d oi
l / fu
el li
ke la
nter
n79
47
Num
ber
Gas
Lan
tern
7959
--O
ther
79
63
Hea
ters
and
Air-
cond
ition
s
Num
ber
Ele
ctric
hea
ter
7973
Num
ber
Gas
hea
ter
7985
Num
ber
Fue
l hea
ter
7997
Num
ber
Air-
cond
ition
or
spl
it un
it80
09
Num
ber
Coo
ling
devi
ce80
11
Num
ber
Ele
ctric
fan
8023
Num
ber
Ele
ctric
hea
ter
8035
Num
ber
Gas
hea
ter
8047
Num
ber
Fue
l hea
ter
8059
--O
ther
(he
ater
s, c
ondi
tions
…)
8061
Tota
l of
this
pag
e80
70
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Cle
anin
g e
qu
ipm
ent
Num
ber
Ele
ctric
vac
uum
cle
aner
8073
Num
ber
Ele
ctric
vac
uum
cle
aner
for
carp
ets
and
wal
l to
wal
l80
85--
Oth
er c
lean
ing
equi
pmen
t80
89M
ain
ho
use
ho
ld e
qu
ipm
ent
Num
ber
Spe
cial
gen
erat
or80
97N
umbe
rE
lect
ric s
ewin
g m
achi
ne81
09N
umbe
rN
on-e
lect
ric s
ewin
g m
achi
ne81
11N
umbe
rE
lect
ric k
nitti
ng m
achi
ne81
23N
umbe
rN
on-e
lect
ric k
nitti
ng m
achi
ne81
35N
umbe
rE
lect
ric e
mbr
oide
ry m
achi
ne81
47N
umbe
rN
on-e
lect
ric e
mbr
oide
ry m
achi
ne81
59N
umbe
rW
ater
filte
r de
vice
8161
Num
ber
Hom
e S
afe
8173
--O
ther
mai
n ho
useh
old
equi
pmen
t81
85S
mal
l ho
use
ho
ld e
qu
ipm
ent
Num
ber
Ele
ctric
grin
der
8197
Num
ber
Ele
ctric
Jui
cer
(Squ
eeze
r)82
09N
umbe
rB
lend
ers
8211
Num
ber
Fry
ing
devi
ces
/ pot
s82
23N
umbe
rM
eat g
rills
8235
Num
ber
Ele
ctric
Kitc
hen
Set
8247
Num
ber
Ele
ctric
Mea
t Mac
hine
(di
cing
)82
59N
umbe
rno
n-el
ectr
ic m
eat m
achi
ne82
61N
umbe
rN
on-e
lect
ric g
rinde
r82
73--
Oth
er ..
.toas
ter
8285
Tota
l of t
his
page
8290
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
852
Annex 3: Survey questionnaire
853
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Rep
air
an
d R
enti
ng
Ele
ctri
c D
evic
es
--R
+A
137e
pair
hou
seho
ld d
evic
es82
97
--R
entin
g ho
useh
old
devi
ces
8309
--S
pare
par
ts o
f ele
ctric
equ
ipm
ent
8311
Gla
ssw
are,
tab
lew
are
and
ho
use
ute
nsi
ls
-- G
lass
kitc
hen
ute
nsils
8323
--N
on-g
lass
kitc
hen
uten
sils
8329
--F
ix, m
aint
ain,
ren
t, ki
tche
n ut
ensi
ls83
37
Ho
use
& G
ard
en e
qu
ipm
ent
& t
oo
ls
Num
ber
Loan
mow
er83
51
--O
ther
hou
se &
gar
den
equi
pmen
t83
57
Med
icin
al e
qu
ipm
ent
and
mat
eria
l
--E
ye-g
lass
es, c
onta
ct le
nses
8369
--H
earin
g ai
d83
73
Num
ber
Pre
ssur
e m
easu
ring
devi
ce83
85
Num
ber
Whe
el c
hair
8397
Num
ber
Cru
tche
s84
09
Num
ber
Nec
k pi
ece
8411
Num
ber
Sug
ar m
easu
ring
devi
ce84
23
Num
ber
Val
ue o
f art
ifici
al te
eth
set
8435
Num
ber
Art
ifici
al li
mps
8447
Num
ber
Med
icin
al B
anda
ges
8459
--R
epai
r a
nd M
aint
enan
ce84
73
--O
ther
(m
edic
inal
trea
tmen
t equ
ipm
ent…
.)84
77
Tota
l of
this
pag
e84
80
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Tran
spo
rt
Pu
rch
ase
of
Tran
spo
rtat
ion
Mea
ns
Num
ber
Car
s85
19
Num
ber
Pur
chas
e of
car
avan
s85
23
Num
ber
Pur
chas
e of
boa
ts85
35
Num
ber
Ste
am b
ikes
8547
Num
ber
Bic
ycle
s85
59
Num
ber
Car
riage
s pu
lled
by a
nim
als
8561
Num
ber
Ani
mal
s ne
eded
to p
ull c
arria
ges
8573
--O
ther
...tr
ansp
ort m
eans
pur
chas
e85
79
Sp
are
Par
ts &
Nee
ded
Eq
uip
men
t fo
r P
erso
nal
Tra
nsp
ort
Num
ber
Tire
s85
85
Num
ber
Liqu
id b
atte
ries
8597
--O
ther
spa
re it
ems
8609
--C
ar a
cces
sorie
s ...
seat
s, o
ther
par
ts86
11
Ser
vice
s R
elat
ed f
or
Eq
uip
men
t fo
r P
erso
nal
Tra
nsp
ort
--A
nnua
l car
lice
nse
8623
--D
river
s’ li
cens
e86
35
--C
ar r
egis
trat
ion
fees
8647
--C
ar p
ark
fees
8659
--C
ar in
sura
nce
fees
8661
--O
ther
exp
ense
s , …
driv
ing
less
ons,
ren
t a c
ar86
73
Tota
l of
this
pag
e86
80
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
854
Annex 3: Survey questionnaire
855
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Tele
ph
on
e an
d F
ax e
qu
ipm
ent
Num
ber
Pho
ne /
Land
line
8685
Num
ber
Mob
ile86
93
Num
ber
Wire
less
pho
ne87
01
Num
ber
Thu
rayy
ah (
Sat
ellit
e C
onne
ctio
n)87
09
Num
ber
Fax
8717
Num
ber
Pho
ne s
peak
ers
8725
--re
pair
and
Mai
nten
ance
8733
--O
ther
….p
hone
and
fax
equi
p87
41
Mu
ltim
edia
an
d In
form
atio
n S
yste
ms
Num
ber
TV
set
less
than
26
inch
8759
Num
ber
TV
set
of 2
6 in
ch o
r m
ore
8767
Num
ber
Rec
orde
r87
75
Num
ber
Vid
eo87
83
Num
ber
Rad
io87
91
Num
ber
Rad
io /
Rec
orde
r87
99
Num
ber
Spe
aker
s88
07
Num
ber
Ant
enna
s fo
r T
V88
15
Num
ber
TV
/Vid
eo G
ames
(A
tari
..etc
8823
Num
ber
Sat
ellit
e eq
uipm
ent
8831
--A
udio
-vis
ual /
mul
timed
ia a
nd o
ther
dig
ital /
info
rmat
ion
syst
ems
8839
Tota
l of
this
pag
e88
40
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Ph
oto
gra
ph
y, C
inem
atic
Ph
oto
gra
ph
y an
d O
ther
Vis
ual
Aid
s / C
amer
as
Num
ber
Pho
togr
aphi
c ca
mer
a88
59
Num
ber
vide
o ca
mer
a88
61
Num
ber
Oth
er e
quip
men
t and
inst
rum
ents
(en
larg
emen
t and
dea
ling
with
pho
tos…
)88
73
Dat
a P
roce
ssin
g D
evic
es
Num
ber
Per
sona
l Com
pute
r P
C88
85
Num
ber
Prin
ters
and
Sof
twar
e88
97
Num
ber
Cal
cula
tors
8909
Num
ber
Type
writ
ers
8911
--O
ther
Info
rmat
ion
or d
ata
proc
essi
ng d
evic
es89
15
Rep
air
an
d M
ain
ten
ance
--re
pair
and
mai
ntai
ning
aud
io-v
isua
l equ
ipm
ent,
phot
ogra
phy
or in
form
atio
n pr
oces
sing
8923
Lo
ng
-lif
e co
mm
od
itie
s fo
r en
tert
ain
men
t &
cu
ltu
re
--C
ampi
ng te
nts
8935
--P
urch
ase
of b
oats
8947
--H
orse
, don
key,
…89
59
--C
art p
ulle
d by
hor
ses
8961
--O
ther
..re
igns
, sad
dles
, vet
s, n
utrit
ion
8973
Lo
ng
-lif
e m
usi
cal i
nst
rum
ents
fo
r en
tert
ain
men
t in
sid
e re
sid
ence
--M
usic
al in
stru
men
ts: p
iano
, gui
tar,
viol
in, d
rum
s …
8985
--Ta
bles
(B
illia
rds/
pool
, tab
le te
nnis
…89
97
--R
epai
r a
nd M
aint
enan
ce90
09
Tota
l of
this
pag
e90
10
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
856
Annex 3: Survey questionnaire
857
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Gam
es a
nd
Ho
bb
ies
--C
ards
, che
ss &
bac
kgam
mon
9011
--A
ll so
rt o
f gam
es (
Go-
kart
s, e
lect
roni
c ca
rs …
9023
--S
tam
ps c
olle
ctio
n: c
urre
nt a
nd o
ld s
tam
ps, c
ance
led
stam
ps, a
lbum
s…90
35
--V
ideo
gam
es90
47
--O
ther
(co
in c
olle
ctio
n, g
arde
ning
, pet
s…)
9059
Sp
ort
s eq
uip
men
t, c
amp
ing
, en
tert
ain
men
t o
uts
ide
the
ho
use
--R
acke
ts90
61
--F
ootb
all,
socc
er, t
enni
s,..
9073
--B
ody
build
ing
and
liftin
g w
eigh
ts90
85
--fis
hing
and
fish
ing
rods
9097
--O
ther
(po
sses
sion
of g
uns
for
hunt
ing,
hob
by o
r se
lf de
fens
e, c
ampi
ng, …
9109
--re
pair
and
Mai
nten
ance
9111
Pet
s / T
ame
An
imal
s
--P
urch
ase
of p
ets
9123
--P
ets
need
s 91
35
--O
ther
mat
eria
l91
37
Vet
erin
ary
Ser
vice
s
--V
et91
47
--S
peci
al m
edic
ine
for
anim
als
9159
--O
ther
Vet
Ser
vice
s91
63
Tota
l of
this
pag
e91
70
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Bo
oks
--C
ultu
ral b
ook:
dic
tiona
ry, A
tlas
wor
ld m
aps,
enc
yclo
pedi
a,
book
s co
verin
g91
71
--A
ssig
ned
scho
ol b
ooks
9179
--E
xter
nal s
choo
l boo
ks91
87
Pu
blis
hed
Var
ieti
es
--C
atal
ogue
s, a
dver
tisem
ent,
card
s,91
97
--P
oste
rs, p
ostc
ards
, let
ters
,…92
09
--M
aps
and
Glo
be m
odel
s92
11
--O
ther
pub
licat
ions
9215
Tou
rist
Tri
ps
--F
ees
for
join
ing
scho
ol tr
ips
9223
--To
urs
insi
de Ir
aq, a
ccom
mod
atio
n, e
xpen
ses.
.92
29
--P
ilgrim
age
and
Om
ra tr
ips
9237
--O
ther
trip
s ou
tsid
e Ir
aq92
45
Ed
uca
tio
n
Ele
men
tary
, Pre
par
ato
ry &
Sec
on
dar
y
--E
xpen
ditu
res
and
Prim
ary
Sch
ool F
ees
9261
--P
rivat
e tu
torin
g fo
r pr
imar
y st
ages
9273
--E
xpen
ditu
res
and
mid
Sch
ool F
ees
9285
--P
rivat
e tu
torin
g fo
r m
id s
choo
l92
97
--E
xpen
ditu
res
and
Pre
para
tory
sch
ools
fees
9309
--P
rivat
e tu
torin
g fo
r pr
epar
ator
y sc
hool
9311
--O
ther
exp
ense
s
9315
Tota
l of
this
pag
e93
20
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
858
Annex 3: Survey questionnaire
859
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Un
iver
sity
an
d H
igh
er E
du
cati
on
--E
xpen
ditu
res
and
fees
for
univ
ersi
ty93
21
--E
xpen
ditu
res
for
Dip
lom
a st
udie
s, M
aste
rs o
r P
h.D
.93
29
--E
xpen
ditu
res
of p
rivat
e le
sson
s93
37
--O
ther
exp
ense
s93
45
Trai
nin
g
--V
ocat
iona
l and
Dev
elop
men
tal T
rain
ing
9357
--La
ngua
ges
prog
ram
s93
63
--C
ompu
ter
prog
ram
s93
75
--O
ther
voc
atio
nal a
nd d
evel
opm
enta
l pro
gram
s93
87
Per
son
al C
are
Ele
ctri
c E
qu
ipm
ent
--E
lect
ric E
quip
men
t (B
low
-dry
ers,
sha
ver,…
9399
--R
epai
r an
d m
aint
enan
ce94
01
--O
ther
per
sona
l car
e eq
uipm
ent
9405
Jew
elry
, Lar
ge
and
Han
d W
atch
es
--G
old
and
Dia
mon
ds to
wea
r94
13
--W
all C
lock
s94
21
--H
and
Wat
ches
, (fo
r m
en &
wom
en)
9429
--M
aint
aini
ng a
nd r
epai
r je
wel
ry &
wat
ches
9437
--O
ther
, gra
ndfa
ther
’s c
lock
, jew
elry
…94
45
Tota
l of
this
pag
e94
50
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Per
son
al L
ug
gag
e
--W
omen
’s c
arry
-on
9457
--M
en’s
bag
s an
d w
alle
ts94
63
--S
choo
l bag
s94
75
--T
rave
ling
Lugg
age
9487
--S
peci
al fo
r ch
ildre
n, p
ram
s …
9499
--V
ario
us p
erso
nal c
arry
-ons
9501
--S
un g
lass
es, m
en &
wom
en95
13
--Li
ghte
rs95
25
--U
mbr
ella
s95
37
--K
ey c
hain
s95
49
--C
anes
9551
--N
on-G
olde
n ac
cess
orie
s95
63
--R
epai
r an
d m
aint
ain
pers
onal
lugg
age
9575
--O
ther
per
sona
l lug
gage
9579
Tota
l of
this
pag
e95
80
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
860
Annex 3: Survey questionnaire
861
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Exp
end
itu
res
on
oth
er s
ervi
ces
--Le
gal s
ervi
ces
fees
9587
--M
embe
rshi
ps a
nd s
ubsc
riptio
ns fe
es95
99
--E
xpen
ditu
res
of w
eddi
ngs
and
occa
sion
s96
01
--E
xpen
ditu
res
of fu
nera
ls96
13
--E
xpen
ditu
res
on a
dver
tisin
g96
25
--E
xpen
ditu
res
of d
ocum
ents
ext
ract
ions
: mar
riage
cer
tific-
cate
s, c
ivic
doc
umen
ts, d
eath
cer
tifica
tes.
.96
37
--G
uida
nce
fees
9649
--La
wye
rs fe
es96
51
--E
xpen
ditu
res
for
phot
ocop
ying
or
extr
actin
g do
cum
ents
, pa
sspo
rts,
sch
ool c
ertifi
cate
s..
9663
--S
pend
ing
of p
hoto
copy
ing
scho
ol c
urric
ula
9675
--Lo
ans
expe
nses
from
ban
ks96
87
--H
ealth
insu
ranc
e fe
es96
91
--A
ccid
ent I
nsur
ance
Pol
icie
s96
95
--Li
fe in
sura
nce
polic
ies
9699
--In
stal
lmen
ts o
f hea
lth, a
ccid
ents
or
othe
r in
sura
nce
9703
--O
wne
rshi
p tr
ansf
er fe
es97
07
--B
ank
fees
and
com
mis
sion
s 97
11
--F
ees
for
leav
ing
bord
ers
9715
--C
ourt
fees
9719
--O
ther
: sp
endi
ng o
n se
rvic
es97
23
Tota
l of
this
pag
e97
30
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Fill
ed u
p li
nes
fo
r th
is p
age
Sta
rt D
ate
_ _
/ _ _
/ _
0 E
nd
Dat
e _
_ / _
_ /
_ 0
1004
Wh
at is
th
e m
ain
so
urc
e fo
r al
l th
e ..[
ITE
M].
. in
acq
uir
ed?
1003
Ho
w m
uch
has
yo
ur
ho
use
ho
ld
spen
t o
r w
hat
is
the
esti
mat
ion
fo
r al
l qu
anti
ties
of
..[IT
EM
].. b
ou
gh
t o
r re
ceiv
ed d
uri
ng
th
e 12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1002
Wh
at is
th
e Q
uan
tity
of
the.
.[IT
EM
]..
bo
ug
ht
or
acu
iere
d b
y yo
ur
ho
use
ho
ld
du
rin
g t
he
12
day
s p
rece
din
g
the
firs
t d
ay o
f in
terv
iew
?
1001
Hav
e yo
u o
r an
y m
emb
er o
f yo
ur
ho
use
ho
ld b
ou
gh
t o
r re
ceiv
ed w
ith
ou
t p
ayin
g
cash
fo
r an
y [.
.[IT
EM
]..]
du
rin
g t
he
12 d
ays
pre
ced
ing
th
e fi
rst
day
of
inte
rvie
w?
1
Y
es 2
No
NE
XT
Mat
eria
l
ITEM CODE
Cas
h s
pen
din
g1
Gif
ts a
nd
do
nat
ion
s fr
om
oth
er
ho
use
ho
lds
2
Gif
ts a
nd
do
nat
ion
s fr
om
ou
tsid
e h
ou
seh
old
sec
tor
3
Pay
men
t fo
r w
ork
4
Fro
m s
elf-
pro
du
ctio
n5
Oth
er, t
o b
e m
enti
on
ed a
fter
an
swer
co
de
6
Din
1000
Din
ar
Qu
anti
tyU
nit
Item
Des
crip
tio
n
Cap
ital E
xpen
ses
of th
e H
ouse
hold
--P
urch
ase
new
res
iden
ce97
37
--B
uild
ing
or a
ddin
g ex
tens
ions
9749
--B
uyin
g a
resi
dent
ial l
and
9751
--In
stal
lmen
ts fo
r ho
usin
g pr
ojec
ts97
63
--F
ees
for
sew
erag
e sy
stem
or
tilin
g97
75
--B
uyin
g G
old
Pla
tes,
or
jew
elry
or
antiq
ues
arts
9787
--P
urch
ase
of fo
reig
n cu
rren
cies
9799
--B
uyin
g sh
ares
and
bon
ds98
01
--O
ther
cap
ital e
xpen
ditu
res
of th
e H
ouse
hold
9813
Oth
er T
rans
fer
Exp
endi
ture
s
--B
ridal
end
owm
ents
and
pre
para
tions
9825
--In
Kin
d G
ifts
9837
--C
ash
gifts
9849
--D
onat
ions
, mon
ey to
the
poor
, Zak
at..
9851
--D
ivor
ce p
aym
ents
and
legi
slat
ive
alim
ony
paym
ents
9863
--T
raffi
c fin
es a
nd ti
cket
s98
75
--O
ther
con
vers
ions
insi
de Ir
aq98
87
--O
ther
con
vers
ions
out
side
Iraq
9899
--R
elig
ious
Pay
men
ts &
Vow
s99
01
--T
ribal
Fun
ds99
13
--T
ribal
Gro
ups
Mem
bers
hips
9925
--O
ther
tran
sfer
able
pay
men
ts99
29
Tota
l of
this
pag
e99
30
No.
of fi
lled
lines
for
Sec
tion
10
Sec
tio
n T
en:
Exp
end
itu
res
on
No
n-F
oo
d S
ervi
ces
and
Co
mm
od
itie
s d
uri
ng
th
e p
ast
12 d
ays
Volume III
862
Annex 3: Survey questionnaire
863
Content
Section 8: Expenditures on Non-Food Services and Commodities during the past 30 days
Section Nine: Expenditures on Non-Food Services and Commodities during the past 90 days
Section Ten: Expenditures on Non-Food Services and Commodities during the past 12 months
Serial Date Name of Notes Taker Job Title Comments Signature
1 0_ / _ _ / _ _
2 0_ / _ _ / _ _
3 0_ / _ _ / _ _
4 0_ / _ _ / _ _
5 0_ / _ _ / _ _
6 0_ / _ _ / _ _
7 0_ / _ _ / _ _
8 0_ / _ _ / _ _
9 0_ / _ _ / _ _
10 0_ / _ _ / _ _
11 0_ / _ _ / _ _
12 0_ / _ _ / _ _
13 0_ / _ _ / _ _
14 0_ / _ _ / _ _
15 0_ / _ _ / _ _
NotesPart No. (3): Daily Ledger
A. FIRST IDENTIFICATION Code
06 Governorate
07 District
08 Area
09 Quarters
10 Alley (Street)
11 Country
12 Village
13 Class Draw circle around appropriate answer
Provinces1 Rural2 Suburban3 Urban / Central
Baghdad
Suburban 2 Rural 1
Urban / Central
Al-Rasafah 4 Al-Sader City 3
Al-Karekh 5
14 The Number of the Building for the Survey
C. FIELD STAFF Signature CODE Date
23 INTERVIEWER 24 0-/--/--
25 TEAM LEADER 26 27 0-/--/--
28 DATA ENTRY OPER. 29 30 0-/--/--
31 CENTRAL SUPERVISOR 32 33 0-/--/--
40 Has Household been include in MICS3 Survey? Draw circle around correct answer Yes No
For Researcher: Pls double check against families included in MICS3 Survey
ا�ستيفاء بيانات اال�ستمارة
01 02 03
WAVE (1 - 18) TEAM INT. (1 - 3)
The Ministry of Planning and Development Cooperation
Central Organization for Statistics and Information Technology (COSIT)
The Republic of Iraq For eradication of poverty and enhancing the socio-economic status of the households in Iraq
In cooperation with the Kurdistan Regional Statistical Commission (KRSCO)
Household Socio-Economic Survey in Iraq (IHSES 2007 - 2006)
HOUSEHOLD IDENTIFIER
04 05
CLUSTER HH
B. HOUSEHOLD IDENTIFICATION
15 Household head name
16 Work Address
17 Household Size
18 HOUSEHOLD SIZE
19 Telephone Number
20 Work Tel. No.
21Numeral form for this household
22 No. of this questionnaire
D- Visits of Field Researchers RESULT OF THE INTERVIEW
35 First Visit 0-/--/--
36 Second Visits 0-/--/--
37 Third Visit 0-/--/--
38 Fourth Visit 0-/--/--
39 Fifth Visit 0-/--/--
1
2
3
4
5
6
7
8
34
Fully Achieved
Partially Achieved
No usable Information
Unaccomplished: Household refused interview
Unaccomplished: Household not present
Unaccomplished: House not found
Unaccomplished: Housing unit not occupied
Unaccomplished: Housing unit is seasonal
Volume III
864
Annex 3: Survey questionnaire
865
Household Roster (Abbreviated Content)
103102
101
The one conducting the interview: copy the name and gender and age of all household members from the First Section: (Household Roster on Section No. (1): Socio-Economic Data)
ID C
OD
E
Age in YearsGenderNames
1Male
2Female
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18 Day
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18
19
T
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Volume III
866
Annex 3: Survey questionnaire
867
Day
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21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
T
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01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
T
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- >20S
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: D
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Exp
end
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re o
n R
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itiv
e F
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d a
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No
n-F
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d C
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mo
dit
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Volume III
868
Annex 3: Survey questionnaire
869
Day
# 2
Nu
mb
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f L
ines
Co
llect
ed f
or
Th
is P
age
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f P
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22
23
24
25
26
27
28
29
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36
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38
39
T
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Volume III
870
Annex 3: Survey questionnaire
871
Day
# 3
Nu
mb
er o
f L
ines
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llect
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or
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age
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Volume III
872
Annex 3: Survey questionnaire
873
Day
# 4
Nu
mb
er o
f L
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Co
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or
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23
24
25
26
27
28
29
30
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03
04
05
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07
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11
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18
19
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Volume III
874
Annex 3: Survey questionnaire
875
Day
# 5
Nu
mb
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f L
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Co
llect
ed f
or
Th
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age
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23
24
25
26
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28
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30
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38
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T
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Volume III
876
Annex 3: Survey questionnaire
877
Day
# 6
Nu
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Volume III
878
Annex 3: Survey questionnaire
879
Day
# 7
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Volume III
880
Annex 3: Survey questionnaire
881
Day
# 8
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Volume III
882
Annex 3: Survey questionnaire
883
Day
# 9
Nu
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Volume III
884
Annex 3: Survey questionnaire
885
Day
# 1
0
Nu
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Co
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T
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A- Jobs of the household members For All Household Members Aged 6 or more
1203Please describe all work performed by allmembers of the household, for the last 12months, whether paid or not
1202What is the type of work in terms of wages?
Put x in the appropriate square
1201Please describe all work performed by all members of the household, for the last 12 months, whether paid or not
Comments of the Researcher
Job
Ser
ial N
um
ber
ID C
OD
E
1- Look for the self-employment activities, such as sewing, embroidery, fabrics, weing, ladies hairdressing, handicrafts, etc...
2- Look for work professions at the family farm and rearing of live stocks
010203040506070809101112
B- Non wage jobA- Wage job
Occupation
Code
Jan
uar
y
Feb
ruar
y
Mar
ch
Ap
ril
May
Jun
e
July
Au
gu
st
Sep
tem
ber
Oct
ob
er
No
vem
ber
Dec
emb
erB- 2B - 1
Other thanAgriculture
In Agriculture or other than Agriculture all the same
Occupation Code
InAgriculture
or otherDescription of the Occupation
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Note: Question in Column 1202* Column (A) Paid Job will be denoted in Section 13* Column (B) Non-Paid Agricultural Job B – 1 will be denoted in Section 14 Part (A)* Column (B) Non-Paid Non-Agricultural Job B – 2 will be denoted in Section 14 Part (B)
Section Twelve: Jobs during the last 12 Months
Volume III
886
Annex 3: Survey questionnaire
887
For All Household Members Aged 6 or more B- Family bussiness and self employment
1206 Put the Codes of the Household Members Who are Participating in this business.
1205Describe all the household businesses otherthan the mentioned agricultural ones viamembers of the household, such as: grocery,trade, selling newspaper on the side of theroad, taxi, etc...
Inte
rnal
Pro
ject
Co
de
(*)
Individual Code
UNPAID FAMILY WORKERSOne inCharge
ActivityCode
Description of the activity
Fifth Fourth Third Second First
A
B
C
D
E
F
* This will be indicated or referred to in Section Fourteen, Part (B)
1204How many hours have you worked in the last 7 day
7 6 5 4 3 2 1
Sat
urd
ay
Fri
day
Th
urs
day
Wed
nes
day
Tues
day
Mo
nd
ay
Su
nd
ay
Section Twelve: Jobs during the last 12 Months
1305How many individuals are working in the project, organization or institution that you are working at?
1304Is this ..[JOB].. included in retirement systems and social security?
1303What is the economical sector of the entity you are working this ..[JOB]..?
1302Economical ActivityDescribe in details the economical activity that the entity practices, where the individual is working
1301Copy the Individual ID CODE and the Job Serial Number from Section Twelve ONLY WAGE JOBS
LIN
E N
UM
BE
R
Governmental sector01
Public sector02
Private sector03
Cooperative sector04
Less than 5 employees
1Mixed sectors05
Local non-gov. organizations
065 - 10 employees
2International nongov. organization
0711 - 50 employees
3Yes1
No2Private household08
more than 50 employees
4Foreign sector09Job
Serial Number
ID CODE Other10Activity Code
Activity Description
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Thirteen: Wage Earnings
Volume III
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Annex 3: Survey questionnaire
889
Section Thirteen: Wage Earnings
1308What is your evaluation to the degree of danger at work
1307Is your health adversely effected by the following at the working environment of this ..[JOB]..?
1306What kind of air-conditioning is available to you at this ..[JOB]..?
LIN
E N
UM
BE
R
I
Other
H
Fatigue
G
Insects
F
Lighting
E
Noise
D
Humidity
C
Heat
B
Chemicals and
Radiation
A
Soil and Gases
Central air-conditioning
1 Very Dangerous
1
Dangerous2Non-central cooling and heating
2 Relatively Dangerous
3
Not Dangerous
4Has ceiling but no heating or cooling0
3
Partially subjected to weather conditions
4
1 Yes 1 Yes 1 Yes 1 Yes 1 Yes 1 Yes 1 Yes1 Yes1 YesTotally subjected to weather conditions
5 2 No 2 No 2 No 2 No 2 No 2 No 2 No2 No2 No
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Thirteen: Wage Earnings
1316What is the number of days of yearly vacations for this job?
1315What is the numberof daysof holidays for this job?
1314What are the weekly hours you work at this job?
1313How much time do you need to arrive to your place of work?
1312What is the main transportaion means to get you to your place of work?
1311What is the distance between your home and work place?
1310How do you describe your work’s continuity? (how long it will last)
1309How youcompare working hours in this ..[JOB].. with normal hours
LIN
E N
UM
BE
R
Continuous: 30 hours a week or more
1On foot1
Private car2Totally within
1Public car3
Bicycle4
Continuous: 30 hrs./wk or less
2Partially within
2 Resident in same building
5
Employer provides transport
6Totally outside
3Seasonal3
Other7Unorganized4
Other5
DaysDaysHoursMinutesKm M
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Volume III
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Annex 3: Survey questionnaire
891
1320 Does this work provide any?of the following privillages
1319 What is the unit on which wages are set?in this job
1318 What is the main means you used to get this?job
1317 Since when have you worked?for this employer
LIN
E N
UM
BE
R
I called a governmental employment center01
I called private employment centers02
I called employers personally, or via phone03
Daily1I filled in applications04
Weekly2I asked relatives / friends to search for me05
Bi-weekly3 I did some arrangements for activities fornew works or more
06
C
PaidVacation
B
Retirement
A
Inclusionin Health Care
Monthly4I asked humanitarian organizations07
Per piece5I contacted governmental institutions08
Other6I called multi-national forces09
I followed up on job opportunities ads10
I promoted my work via an advertisement11
Yes1Yes1Yes1Other12
No2No2No2
YearMonth
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Section Thirteen: Wage Earnings Section Thirteen: Wage Earnings
1324What was the total amount that you have received during the last 12 months for over-time, or as a donation / grant, or reward, or privileges or other benefits? (including in-kind payments) with the exception of your salary or wages?
Write ‘zero’ if nothing
1323What is the average of the amount you normal get after tax deduction or any other retirement deductions for the time duration that was specified in 1322?
Write ‘zero’ if nothing
One Thousand Dinars / Unit
1322What is the time interval that is covered by this last amount?Unit
1 Day2 Week3 Fortnight4 Month
1321What was the last salary or wages you have received after tax or retirement deductions?
Write ‘zero’ if nothing
B ABABABA
In KindCashIn KindCashUnitNo.of UnitsIn KindCash
1000 Dinar1000 Dinar1000 Dinar1000 Dinar1000 Dinar1000 Dinar
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Volume III
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Annex 3: Survey questionnaire
893
Part (A): Agriculture, rearing of live stock, fishing and forestry activities
A - 1 :Land
Record the total area of the land of all agricultural areas whether owned or run by the household
Has the household or one of its members had any agricultural land during the last 12 months?
Donum Evlec 1 Yes 2 No 1409
What was the actual cultivated area out of the agricultural areas that is owned or run by the household?
Who in the household owns or operate this land?
ID CODE
Donum Evlec 4321
A - 2: Plant Production
Section Fourteen: Non wage earning activities
1408What is the total amount received from sales of the ..[CROP].. during the last 12 months?
1407What is the quantity of ..[CROP].during the last 12 months, .that you have dealt with in any of the following ways?
1406
What was the
quantity that
was produced of
...[CROP]...
during the last 12
months by your
household? And
what is its
estimated value?
1405
Has the house--
hold or any of its
members
produced any
..[CROP].. in the
last 12 months?
1 Yes
2 No Next Typ
e o
f C
rop
IOther?
HI gave as in kind wages
GI gave to the owner as in kind pay--ment
FI used it as stor--age for the future
EBy us--ing it as seeds
DBy using it as fod--der for animals, last 12 months?
C By giving it as a donation in the last 12 months?
B By con--suming it by the house--hold during the last 12 months
A By selling it in the last 12 months?
Value at
1000 Dinars
Qty
Kg
Qty
Kg
Qty
Kg
Qty
Kg
Qty
Kg
Qty
Kg
Qty
Kg
Qty
Kg
Qty
Kg
Value at
1000 Dinars
Qty
KgCode
Crop
Description
Seeds1
Fruits2
Vegetables3
Dates4
Tobaco5
Other (list)6
Total7
A - 3 Livestock
1409 Does the household or any of its members have any activities with live stock / animal production
1 Yes
2 No
1410 How many animals does the household currently have?
Goats & Sheep Donkeys & Mules Bee-hives Cows Horses Other Water Baffalo Poultry
1411 How much has your household received from sales of animals in the last 12 months?
1412 How much has your household received from sales of animals products, such
as: (meat, honey, eggs, butter, dairy products, …etc) in the last 12 months?
1413 What is the value of what your household has consumed of animal products
(such as:meat, honey, eggs, butter, dairly products, …etc) in the last 12 months?
1413 -A What is the value of the products you gave to the owner as in kind payment?
1000 Dinars
1000 Dinars
Write 'zero' in case of no sales
1000 Dinars
Write 'zero' in case of no sales
1000 Dinars
Write 'zero' if nothing
Part (A): Agriculture, rearing of live stock, fishing and forestry activitiesA - 4: Livestock
1414 How much did you spend on the following during the past 12 months?
If the answer to question 1401 or 1409 is yes, go ahead to question 1414, otherwise, go to question 1415
1000 Dinars1000الفقرة DinarsClause of paragraph
Other, what is related to animal production13Fertilizers, pesticides01
Labour wages (cash and in kind)14seeds02
Interests and expenditures over agricultural loans15Seedlings (or sprouts)03
Outcome of the land16Sacs, plastic sheets, field tools, storage facilities, maintenance and fixing
04
Cash share of the owner from crops sales17Fuel to dry crops or for transport means or irrigation, etc…05
cash share of the owner from plants and animal pro--ductions sales
18Rental of catterpillar machinery (inclusive cost of fuel), rental of irrigation equipment …etc
06
Tax19Transport07
purchase of equipment and agricultural machinery20Irrigation (do not list fuel)08
Miscellanouse purchases, transportation means21Other , related to plant production09
improving the land22Fodder10
Purchase of productive animals23Veterinary11
Bard building, digging of canals and wells, building of warehouses
24Water and electricity12
<---Total25
What is the value and quantity of fish or other aqatic aninals which has been
ASold during last 12 months
BYou consumed at home during the last 12 months?
CGiven as gift or in kind donation during the last 12 months?
Value Amount Value Amount Value Amount
Kg. 1000 Diners Kg. 1000 Diners Kg. 1000 Diners
1417 How much did you spend (in total) during the past 12 months, to implement fishing and fisheries activities?
HIRED LABOR A. C. OTHER EXPENSES BOAT PURCHASE
1000 Diners 1000 Diners 1000 Diners
A - 6 Forestry and Woods Activities
A - 1417 Have you or any household member done any forestry or woods activities, last 12 months?
B - 1417 How much did your household receive from your sales?
C - 1417 How much did the household consume of products you gathered?
D - 1417 How much did you spend to get those products?
Write 'zero' for no sale1000 Diners
A - 5 Hunting Activities and Fisheries
1415 Have you or any household member hunted or breaded fish (or other aquatic animals), or prawns or crabls or oysters…etc in the last 12 months?
A - 1417 1 Yes
2 No
1 Yes
Bart B 2 No
Section Fourteen: Non wage earning activities
Fodder, veterenary material, rental escort, cooling, fixing and maintaining fishing nets, fuel for boat, fix and maintain boat, rent boat (cash), services (technical assistance)…
Write 'zero' for no sale1000 Diners
Write 'zero' for no sale1000 Diners
Volume III
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Annex 3: Survey questionnaire
895
Section Fourteen: Income, Cost of Production of Non-Paid Work Activities
Part (B): Non-paid work activities in all areas save agriculture
Do not list agriculture, fishing and forestry that had been recorded in Section
Fourteen, Part (A)
(*) Take project code from Section Twelve, Column 1205
B-1: PRODUCTION COST DURING THE PAST 12 MONTHS
NO MaterialProject A
(*)1000 Dinar
Project B(*)
1000 Dinar
Project C(*)
1000 Dinar
Project D(*)
1000 Dinar
Project E(*)
1000 Dinar
Project F(*)
1000 Dinar
1418 Raw Material
1419 Commodities bought with intention of sales
1420 Water and Electricity
1421 Cables, Post, Phone
1422 Fuel & Oil (for other than transport)
1423 Packaging Material
1424 Renting of Machinery / Equipment
1425 Repair and Maintain Machinery
1426 Rental of Utilities
1427 Cost of Transport, inclusive fuel & oil
1428 Repair and Maintain Utility Areas
1429 Other Expenditures
1430 Paid interest on work loans
1431 Cash payments to workers
1432 In-kind payments to workers
1433 Direct Tax
1434 Indirect Tax
1435 Total
B-2: PRODUCTION REVENUE DURING THE PAST 12 MONTHS
1436 Net profit from industrial work
1437 Depretiation value for produced goods
1438 Net profit from commercial work
1439 Net profit from building and construction
1440Net profit from communications and transp-port
1441 Net profit from services activities
1442 Total
B-3: WORK CONDITIONS
NOAsk these questions to the one in charge of the Family Bussines / Self Employmet Job
Project A
Project B
Project C
Project D
Project E
Project F
1443
What kind of airconditioning is available at place of work?
1 Central airconditioning
2 Non-Central heating and cooling
3 Has roof, but no heating or cooling
4 Partially open, subjected to weather conditions
5 Totally subjected to weather conditions
Section Fourteen: Income, Cost of Production of Non-Paid Work Activities
Part (B): Non-paid work activities in all areas save agriculture
B-3: WORK CONDITIONS
NOAsk these questions to the one in
charge of the Family Bussines / Self Employmet Job
Project A
Project B
ProjectC
Project D
Project E
Project F
1444
Is your health adversly affected by some of the following surrounding environment?
A Soil & Gases
B Chemicals & Radiation
1 Yas C Heat
2 No D Humidity
E Noise
F Lighting
G Insects
H Fatique
I Other
1445
What is your estimation to the degree of danger for this work?
1 Very dangerous
2 Dangerous
3 Relatively dangerous
4 Not dangerous
1446
How do you compare the working hours of the project with normal working hours?
1 It is within
2 It is partially within
3 It is totally outside
How do you describe sustainability / continouty of the work at the project?
1447
1 Permanent at 30 hrs. / week & more
2 Permanent at less than 30 hrs./week
3 Seasonal
4 Un-regular
5 Other
1448 What is the distance between work and
residence?
Km M Km M Km M Km M Km M Km M
What is the main means of transport to work?
1449
1 On foot
2 Private Car
3 Public Car
4 Bicycle
5 Residing in same building as work
6 Other (mention)
1450 What is the distance between work and
residence?
Minutes Minutes Minutes Minutes Minutes Minutes14
51 How many hours per week do you work at this project?
No.of Hours No.of Hours No.of Hours No.of Hours No.of Hours No.of Hours
1452 What are the yearly days of holiday for this
work at the project?
No.of Days No.of Days No.of Days No.of Days No.of Days No.of Days
Volume III
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Annex 3: Survey questionnaire
897
1502Who of the household members got income from ...[SOURCE]... and what was the total he/she received, last 12 months?
1501Has any of the household membersreceived income from ...[SOURCE]..., last 12 months?
1 Yes
2 No NEXT LINE
SO
UR
CE
NU
MB
ER
CAll Other Household Members
Write code of member of
highest income
BSecond Household
Member
AFirst Household
Member
ID CODE
1000 DinarID
CODE1000 Dinar
ID CODE
1000 DinarCodeSource of Income
Income from Ownership
From renting agricultural land1501
Income from agricultural land cooperative system
1502
Rental of vacant land 1503
Rent of residential buildings1504
Rent of non-residential buildings1505
Rent of machinery or equipment1506
Rent of means of transport1507
Other rentals1508
Shares profit1509
Profits from cooperative companies
1510
Interests on bonds & Trusts1511
Property Rights and Publications1512
Income from Selling an Owned Possession
Sales of agricultural land1513
Sales of non-agricultural land1514
Sales of Buildings1515
Sales of Machinery & Equipment1516
Sales of gold and jewelry1517
Sales of shares and bonds1518
Sales of foreign currency1519
Sales of long-life goods1520
Sales of other possessions1521
.... > total [1501 - 15211554
Section Fifteen: Income, Cost of Production of Non-Paid Work Activities
1502Who of the household members got income from ...[SOURCE]... and what was the total he/she received, last 12 months?
1501Has any of the household membersreceived income from ...[SOURCE]..., last 12 months?
1 Yes
2 No NEXT LINE
SO
UR
CE
NU
MB
ER
CAll Other Household Members
Write code of member of
highest income
BSecond Household
Member
AFirst Household
Member
ID CODE
1000 DinarID
CODE1000 Dinar
ID CODE
1000 DinarCodeSource of Income
Income from Ownership
Civil retirement1522
Military retirement1523
Inherited retirement1524
Social security retirement1525
Disability retirement1526
Special Funds retirement1527
Salary from Family Welfare Fund1528
Salaries of disabled1529
Maternity salaries1530
Social Protection Network Donations1531
Unemployment compensation1532
Emergency payments1533
Vocational Training Allocations1534
Educational Scholarships1535
Gifts, Donations and Compensations
From other families in Iraq1536
Other families outside Iraq1537
From Government1538
From other sources in Iraq1539
Other sources outside Iraq1540
In Kind Assistance
From other families in Iraq1541
Other families outside Iraq1542
From Government1543
From other sources in Iraq1544
Other sources outside Iraq1545
Other Transferable Income
Insurance compensations1546
Legal payments1547
Zakat Funds Support1548
Source of inheritance1549
Marriage endowment1550
Lottery winnings1551
Consumable loans1552
Other Transferable Income, e.g. selling of supplies shares …
1553
...> Total 1522 - 15531555
Section Fifteen: Income, Cost of Production of Non-Paid Work Activities
Volume III
898
Annex 3: Survey questionnaire
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Section Seventeen: Loans, credits and assistance
1 Did not receive any help
2 Governmental Sources
3 Private Sector Establishments
4 Foreign Organizations
5 Relatives inside Iraq
6 Relatives outside Iraq
7 Other than relatives inside Iraq
8 Other sources
Does the household have outstanding debts or loans or advances to the benefit of other households or establishments?1701
1 Yes
2 No 1705
01 Relatives inside Iraq
02 Relatives residing abroad
03 Friends / neighbors
04 Loan-givers / loan sharking
05 Merchant
06 House Owner
07 Employer
08 Governmental Entity or Bank
09 Civic Bank
10 Non-Governmental Organization
11 Other
12 I never got the loan 1705
1 Household consumable needs
2 Emergency: sickness, fire, flood, theft, injury
3 Ceremonial: wedding, funeral, …
4 House maintenance
5 Buy land
6 Build House
7 Buy House
8 Buy long-life consumable commodity
9 Pay back existing loans
10 Other
From which party did you get the loan(s), last 12 months (Write codes of 3 entities and as per their importance)1702
What is the main purpose of borrowing money, last 12 months (write 3 reasons’ codes, and as per importance)1703
1 None
2 Some ..... Less than 50%
3 Most ..... Less than 50%
4 All
What are the percentages of the loan values and accumulated advances with interests, last 12 months?1704
If the household received assistance (cash or other than cash), last 12 months, who is the donating entity? Write codes of entities, up to 3 most important
1705
First
Third
Second
First
Third
Second
First
Third
Second
Section Sixteen: Durable Goods
1604How much have you paid for this ..[DURABLE GOOD]..? If more than one, mention the last one
1603When did you aquire this ..[DURABLE GOOD]..? If more than one, memtion the last one aquired
1602What is the total number of …DURABLE GOOD]... owned by household or member of household?
1601Does the household or any of its memberpossess any of the following?
LIN
E N
UM
BE
R
1 Yes
2 No
NEXT DURABLE GOOD If it has been given to you free of charge, ask about its estimated value
DinarYearNumberDescription of Durable Good
Private car01
Taxi (if it’s also being used by household02
Small/ medium sized bus03
Bicycle04
Steam Bike05
Gas or electric cooker06
Fuel-run cooker07
Electric Blender08
Fridge09
Electric Washing Machine10
Iron11
Electric Water Heater12
Gas Water Heater13
Solar Water Heater14
Fuel-run Water Heater15
Cooling fan / device16
Water cooler17
Freezer18
Diswasher19
Electric Vacum Cleaner20
Radio / Recorder21
Coloured T.V22
Black and white T.V23
Video / recorder24
CD-Player / DVD25
Sewing machine26
Electric generator27
Electric fan28
Aircondition29
Personal Computer PC30
Play Station /Games31
Fuel-operated heater32
Gas heater33
Electric heater34
Sattelite35
Other36
Total37
Volume III
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Annex 3: Survey questionnaire
901
1802To compensate or avoid lowering or loosing income due to one or more of the aforementioned problems in the previous question, during last 12 months. Has the household done the following procedure [Name the procedure]
Ser
ial
Code: 1 Yes
2 NoType of Action, Procedure
Reducing quantity and quality of food1
Reducing expenditures2
Spending savings or investments3
I got loans from friends or relatives4
Got loan from employers, shark-loaners, merchants, Non-Governmental Organizations
5
Buying food against credit from merchants6
I got help from others in the community7
Selling: furniture, equipment, jewelry, doors, windows…8
Selling income generating equipment9
Renting land to others10
Placing a mortgage on house or land11
Selling livestock: females that can produce12
Selling house of land13
Selling supplies shares14
Got food & other items from rescue missions and programs from Government, NGOs and international agencies
15
One of the household members immigrated abroad to look for work16
One of the household members joined the armed forces or internal security forces17
I had to go for children’s labour or increase their hours of work18
I sent my sons to work under unjust contractual conditions19
I got the daughters to get married at a young age20
I started to beg21
I moved to another area22
Other (mention)23
I did no do anything24
Section Eighteen: Risks
1801Has any of the household members been adversity affected by [name problem], last 12 months?
Ser
ial
Code: 1 Yes
2 No Problem Type
Loss of job by any household member1
Lowering of wages of any of the household members2
Bankruptcy of commercial family business3
Sever sickness or accident to any household member4
Death of working household member5
Death of another household members6
Theft7
Violence due to the usual circumstances of Iraq8
Kidnapping, threading to kill, pertaining to usual circumstances in Iraq9
Other types of violence10
Another huge problem11
If all answer were NO, conclude the interview
Content
Section Eleven: Daily Repetitive Expenditures on Food Goods and Non-Food (Edible) Goods
Section Twelve: Work in the last 12 Months
Section Thirteen: Generating Income
Section Fourteen: Income and Cost of Production for Non-Paid Work Activities
Section Fifteen: Income from Ownership and Transferable
Section Sixteen: List of Long-Life Commodities
Section Seventeen: Loans, Advances, Assistance
Section Eighteen: Risks
Serial DateName of Person
Taking NotesJob Title Comments Signature
1 0_ / _ _ / _ _
2 0_ / _ _ / _ _
3 0_ / _ _ / _ _
4 0_ / _ _ / _ _
5 0_ / _ _ / _ _
6 0_ / _ _ / _ _
7 0_ / _ _ / _ _
8 0_ / _ _ / _ _
9 0_ / _ _ / _ _
10 0_ / _ _ / _ _
11 0_ / _ _ / _ _
12 0_ / _ _ / _ _
13 0_ / _ _ / _ _
14 0_ / _ _ / _ _
15 0_ / _ _ / _ _
Notes
Volume III
902
Annex 3: Survey questionnaire
903
Part No. (4): Daily Ledger
A. FIRST IDENTIFICATION Code
06 Governorate
07 District
08 Area
09 Quarters
10 Alley (Street)
11 Country
12 Village
13 Class Draw circle around appropriate answer
Provinces1 Rural2 Suburban3 Urban / Central
Baghdad
Suburban 2 Rural 1
Urban / Central
Al-Rasafah 4 Al-Sader City 3
Al-Karekh 5
14 The Number of the Building for the Survey
C. FIELD STAFF Signature CODE Date
23 INTERVIEWER 24 0-/--/--
25 TEAM LEADER 26 27 0-/--/--
28 DATA ENTRY OPER. 29 30 0-/--/--
31 CENTRAL SUPERVISOR 32 33 0-/--/--
40 Has Household been include in MICS3 Survey? Draw circle around correct answer Yes No
For Researcher: Pls double check against families included in MICS3 Survey
ا�ستيفاء بيانات اال�ستمارة
01 02 03
WAVE (1 - 18) TEAM INT. (1 - 3)
The Ministry of Planning and Development Cooperation
Central Organization for Statistics and Information Technology (COSIT)
The Republic of Iraq For eradication of poverty and enhancing the socio-economic status of the households in Iraq
In cooperation with the Kurdistan Regional Statistical Commission (KRSCO)
Household Socio-Economic Survey in Iraq (IHSES 2007 - 2006)
HOUSEHOLD IDENTIFIER
04 05
CLUSTER HH
B. HOUSEHOLD IDENTIFICATION
15 Household head name
16 Work Address
17 Household Size
18 HOUSEHOLD SIZE
19 Telephone number
20 Work tel. no.
21Numeral Form for this household
22 No. of this Questionnaire
D- Visits of Field Researchers RESULT OF THE INTERVIEW
35 First Visit 0-/--/--
36 Second Visits 0-/--/--
37 Third Visit 0-/--/--
38 Fourth Visit 0-/--/--
39 Fifth Visit 0-/--/--
1
2
3
4
5
6
7
8
34
Fully Achieved
Partially Achieved
No usable Information
Unaccomplished: Household refused interview
Unaccomplished: Household not present
Unaccomplished: House not found
Unaccomplished: Housing unit not occupied
Unaccomplished: Housing unit is seasonal
Description Unit of Measure Code
Bread and grains
Rice
Supplies Rice Kg 1011
Imported commercial rice Kg 1023
Local commercial rice Kg 1035
Rice flour Kg 1047
Other -- 1059
Seeds and its products
Wheat germ Kg 1061
Dark wheat germ supplies Kg 1073
Dark wheat germ commercial Kg 1085
White Wheat supplies Kg 1097
White commercial wheat Kg 1109
Barley Kg 1111
Barley flour Kg 1123
Yellow corn Kg 1135
Seeds and other products -- 1147
Products made from seeds
Burgul Kg 1159
Kind of seeds (Habbiyah) Kg 1161
Semolina Kg 1173
Noodles & Macaroni Kg 1185
Starch Kg 1191
Corn flakes Kg 1197
Infants Food Supplies Kg 1203
Infants Food Commercial Kg 1209
Yellow Corn Chips / Flakes Kg 1211
Sweet Corn Kg 1223
Other -- 1235
Bread and Products of Bakeries
All sorts of bread Kg 1247
Small loafs Kg 1259
Kahi Kg 1261
Klijeh Kg 1273
Cakes Kg 1285
Biscuits Kg 1297
Dried Sweet Cookies Kg 1309
Ready-made Pizza Kg 1311
Other Bakery Items Kg 1323
Fees for grinding and for ovens -- 1335
Meats
Fresh or frozen meat
Fresh Beef Kg 1347
Frozen Beef Kg 1359
Fresh Veal Kg 1361
List of Food Items, to use their codes in the daily ledger
Volume III
904
Annex 3: Survey questionnaire
905
Description Unit of Measure Code
Ready Cream Kg 1749
Fresh Cream Kg 1753
Other -- 1757
Eggs
Chicken Eggs No. 1761
Other kinds of eggs No. 1765
Oils
Oils and Gee
Vegetable fat supplies Kg 1873
Vegetable fat commercial Kg 1885
Animal fat Kg 1897
Vegetable oil supplies Liter 1909
Vegetable oil commercial Liter 1911
Olive oil Liter 1923
Rashi Kg 1935
Markin Kg 1947
Other fats and oils -- 1959
Fruits
Fresh fruits
Oranges Kg 1961
Sour Lime Kg 1973
Sweet Lime Kg 1985
Lankli Kg 1997
Mandarin Kg 2009
Grapefruit Kg 2011
Tangerine Kg 2023
Other citrus fruits Kg 2035
Pomalete Kg 2047
Plums Kg 2059
Pears Kg 2061
Aski-Dunya (orange tropical ) Kg 2073
Fresh Olives Kg 2085
Apricots Kg 2097
Alo-Palo Kg 2109
Za’rour -- 2111
Apples Kg 2123
Sweet Melon Kg 2135
Water Mellon Kg 2147
Pomegrade Kg 2159
Grapes Kg 2161
Bananas Kg 2173
Fat Pears Kg 2185
Figs Kg 2197
Kaka Kg 2209
Kiwi Kg 2211
Takki Kg 2223
Pineapples Kg 2235
Description Unit of Measure Code
Frozen Veal Kg 1373
Frozen Chicken Kg 1397
Alive Chicken Kg 1409
Goat Meat Kg 1411
Water Buffalo Meat Kg 1423
Red imported meats Kg 1429
Camel Meat Kg 1435
Pork Kg 1447
Other Animal’s Meat: Rabbit, etc Kg 1459
Internal parts Kg 1461
Intestines Kg 1473
Brain Kg 1485
Tongue Kg 1497
Kidneys Kg 1509
Goat Eggs Kg 1511
Lard Kg 1523
Chicken Liver, kidney, hearts Kg 1535
Chicken wings and necks Kg 1547
Other parts of chicken Kg 1559
Other Fresh Meat Kg 1561
Dried Meet (Bastermah) Kg 1573
Canned Meat including Hot Dogs Kg 1585
Cost of dicing meat -- 1597
Cost for grilling meat -- 1609
Cost for slaughtering -- 1611
Other Fresh or Frozen Meat -- 1623
Fish
Fish and Sea Food
Fresh river fish Kg 1635
Fresh sea fish Kg 1647
Frozen fish Kg 1659
Dried fish Kg 1661
Canned fish Kg 1673
Prawns Kg 1685
Other types of fish -- 1697
Milk
Milk and its derivatives
Fresh milk Liter 1709
Powder milk supplies Kg 1713
Powder milk commercial Kg 1717
Condensed milk Kg 1721
Children’s / infants milk Kg 1725
Yogurt Kg 1729
Sweet cheese Kg 1733
Imported cheese Kg 1737
Popular milk drink (Quaimar) Kg 1741
Butter Kg 1745
Volume III
906
Annex 3: Survey questionnaire
907
Description Unit of Measure Code
Carrots Kg 2697
Radish Kg 2709
Lettuce Kg 2711
Sileq (like spinach) Kg 2723
Cucumber Kg 2735
Canned, Dried and Frozen Vegetables Kg 2747
Kima (grows from thunder Kg 2761
Mushrooms Kg 2773
Other: Salary .. -- 2785
Preserved or canned vegetables
Tomato paste Kg 2797
Canned Brown Beans Kg 2809
Cooked and Canned Vegetables Kg 2811
Other canned vegetables Kg 2823
Preserved or canned vegetables -- 2835
Legumes
Dry beans supplies Kg 2847
Dry beans commercial Kg 2859
Dry Baqlah Kg 2861
Chick Pea supplies Kg 2873
Chick Pea commercial Kg 2885
Tahiniyyah for Humous Kg 2897
Lentils supplies Kg 2909
Lentils commercial Kg 2911
Dry Lobia (like green beans) Kg 2923
Mash Kg 2935
Sesame seeds Kg 2947
Hartman Kg 2959
Other legumes -- 2965
Products of vegetables
Gips Kg 2973
Other products Kg 2985
Sugar
Sugar and its products
Sugar supplies Kg 2997
Sugar Commercial Kg 3009
Mixed deserts Kg 3011
Nestle Kg 3023
Jam Kg 3035
Honey Kg 3047
Dates Honey Kg 3059
Factory Syrup -- 3061
Alek -- 3073
Coloured water ice-cream Kg 3085
Ice -- 3097
Other sugar products -- 3109
Unclassified food items
Unclassified food products
Description Unit of Measure Code
Cherries Kg 2247
Strawberries Kg 2259
Fresh Dates Kg 2267
Other (Citrus - Safargal…) Kg 2273
Canned and Dried Fruits
Canned fruits Kg 2285
Canned olives Kg 2297
Apricots Kg 2309
Dry Figs Kg 2311
Tarshanah Kg 2323
Qisi and Alloujah Kg 2335
Dried Dates Kg 2359
Canned Dates Kg 2361
Almonds Kg 2373
Walnut Kg 2385
Coconut No. 2397
Ground Coconut Kg 2409
Chestnuts and Oak Kg 2411
Seeds of water melon Kg 2423
seed of trees Kg 2435
Pistachios Kg 2447
Hazel nuts Kg 2459
Peanuts Kg 2461
Other : raising, dried apricot rolls -- 2467
Vegetables
Fresh, Frozen and Canned Vegetables
Tomato Kg 2485
Okra Kg 2497
Egg Plant Kg 2509
Qare’ (like Zucchini but stouter) Kg 2511
Lobya, like green beans but thinner Kg 2523
Green Baqleh (for salad) Kg 2535
Green Peas Kg 2547
Green Beans Kg 2559
Cauliflower Kg 2561
Lahhanah Kg 2573
Potatoes Kg 2585
Dry Onions Kg 2597
Green Onions / spring onion Kg 2609
Dry Garlic Kg 2611
Green Garlic Kg 2623
Spinach Kg 2635
Perbin Kg 2647
Shalgham Kg 2659
Beet Root Kg 2661
Kalm Kg 2673
Green pepper / belly pebber Kg 2685
Volume III
908
Annex 3: Survey questionnaire
909
Description Unit of Measure Code
Drugs
Cocaine -- 3523
Newspapers and Periodicals
Newspapers and Journals -- 3535
Magazines and Periodicals -- 3547
Restaurants and Coffee Shops
Restaurants and Coffee Shops and the like
Snacks & Sandwiches -- 3559
Kebab, Indian Tikka and Intestines -- 3561
Grilled chicken -- 3573
Fried and grilled fish -- 3585
Appetizers -- 3597
Various Meals -- 3609
Non-alcoholic beverages, coffee, tea, carbonated, juices -- 3611
Alcoholic Beverages, Whiskey, Brandy, wine… -- 3623
Hubble-Bubble -- 3635
Restaurants, Cafés and the like -- 3639
Fuel for Private Generators
Regular fuel from station Liter 4001
Super fuel from station Liter 4005
Commercial fuel Liter 4009
Fuel for Private Transport
Regular fuel from station Liter 4031
Super fuel from station Liter 4035
Commercial fuel Liter 4039
Fees for Public Transport
Passengers by land -- 4741
Passengers by sea -- 4749
Description Unit of Measure Code
Salt supplies Kg 3111
Salt commercial Kg 3123
Vinegar Liter 3135
Cardamom Kg 3147
Lumi small dried lime for cooking Kg 3153
Turshi Kg 3159
Processed olives Kg 3161
Mayonnaise -- 3173
Spices -- 3185
Darsin -- 3197
Black Pepper -- 3209
Baking Powder -- 3211
Yeast -- 3223
Kajub -- 3235
Mustard -- 3247
Sauces and Flavors -- 3259
Products of unclassified foods -- 3261
Non-alcoholic beverages
Coffee, Tea and Cocoa
Tea, from supplies Kg 3285
Tea, bought commercially Kg 3297
Coffee and Nescafe Kg 3309
Cocoa Kg 3311
Other tea, coffee and cocoa -- 3315
Gaseous/ Carbonated Drinks, Fruits & Vegetables Juices
Carbonated drinks Liter 3335
Mineral water Liter 3347
Soda Liter 3359
Fruits Juices Liter 3361
Kinds of syrups Liter 3373
Other Carbonated Drinks, Fruits & Vegetables Juices -- 3385
Alcoholic Drinks, Tobacco and Drugs
Alcoholic Beverages
Whiskey Liter 3397
Wine Liter 3409
Araq Liter 3411
Brandy Liter 3423
Beer Liter 3435
Other alcoholic drinks -- 3447
Tobacco
Cigarettes No 3459
Tobacco Kg 3461
Tumbak Kg 3473
Cigars No 3485
Hubble-Bubble Kg 3497
Sniffs Kg 3509
Other Tobacco -- 3511
Volume III
910
Annex 3: Survey questionnaire
911
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Volume III
912
Annex 3: Survey questionnaire
913
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Volume III
914
Annex 3: Survey questionnaire
915
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Volume III
916
Annex 3: Survey questionnaire
917
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Volume III
918
Annex 3: Survey questionnaire
919
Day
# 5
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Volume III
920
Annex 3: Survey questionnaire
921
Day
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Volume III
922
Annex 3: Survey questionnaire
923
Day
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Volume III
924
Annex 3: Survey questionnaire
925
Day
# 8
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Dat
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Volume III
926
Annex 3: Survey questionnaire
927
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# 9
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Volume III
928
Annex 3: Survey questionnaire
929
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# 1
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