2015 UPDATING FORM 1.

1 - HOUSEHOLD MEMBERSHIP AND DEMOGRAPHIC INFORMATION

AREA CODE HH CONTROL NO.

Combine codes for Region, Province, Municipality/City, By and EA

HH SIZE

1 2 3 4 5 6 7 8 9 10

MEM NAME IS RHC DBIRTH ESTDBTH AGE SEX CSC PSC

NO

M Please give me the names of the I What Is the What is Is the given birth Compute for the Age Is (NAME) What What (NAME)
E persons who usually sleep and N relationship (NAME) Date date estimated? of all the members of male or (NAME) Physiological
M eat in your house and those who T of (NAME) of Birth? (Date of birth is the household as of female? Civil Status?
B are currently away from home E to the not known by the last birthday. Status?
E starting R household Use the format respondent)
R with the head of the household. V head? Mo/Da/Year If <6 yrs, record age
I Write the in months
N Write surname first. E estimated birth
U W date and code If >6 yrs, record age
M Refer to the Manual of accordingly. in years and months
B Instructions (MOI) S
E for the definition of Household T
R Membership. A
T
U
S

Relation to Estimate Date of Civil Physiological Code

MO DA YEAR YRS MOS Sex Code Status
Head Code Birth Code Code Status

0 1

0 2

0 3

0 4

0 5

0 6

0 7

0 8

0 9

1 0

1 1

1 2

1 3

1 4

1 5

Codes for # 3 Codes for # 4 Codes for # 6 Codes for # 10

(Interview Status) (Relationship to Household Head) (Estimated birth date) (Physiological Status)
0 - No 00 - Non-pregnant/Non-lactating
1 - Completed 1 - Household Head 15 - Uncle 1 - Yes female members
2 - Not at home 2 - Husband/Wife 16 - Aunt 01 - Pregnant, 1 month
3 - Refused 3 - Son 17 - Nephew Codes for # 8 02 - Pregnant, 2 months
4 - Partly completed 4 - Daughter 18 - Niece (Sex) 03 - Pregnant, 3 months
5 - Respondent 5 – Stepson 19 - Other Relative 1 - Male 04 - Pregnant, 4 months
incapacitated 6 – Stepdaughter 20 - Nonrelative 2- Female 05 - Pregnant, 5 months
6 - OCW/OFW 7 - Son in law 21 - Boarder 06 - Pregnant, 6 months
8 - Daughter in law 22 - Domestic Helper Codes for # 9 07 - Pregnant, 7 months
9 - Grandson (Civil Status) 08 - Pregnant, 8 months
10 - Granddaughter 1 - Single 09 - Pregnant, 9 months
11 - Father 2 - Married 10 - Lactating, 0-6 months
12 - Mother 3 - Widowed 11 - Lactating, 7-12 months
13 - Brother 4 - Separated 12 - Lactating, over 1 year
14 - Sister 5- Common-Law/Live-in 99 - Male Member
6 - Unknown
If both pregnant and lactating, code as pregnant
For pregnant or lactating, ask the weeks of pregnancy or months of lactation
 MO DA YR
REFERENCE DATE

RESEARCHER:_________________ EDITED BY:______________________

11 12 13 14 15 16 17
WRK
PARENTS BIO_PAR EDUC WORK OCCUPATION PLACE CLASS
LESS THAN 20
YEARS OLD FOR 3 YEARS OLD AND ABOVE FOR 10 YEARS OLD AND ABOVE

Who is the If biological What is the highest Did What is the occupation of (NAME) in the Where is What kind of worker is
FATHER Parents? educational (NAME) past 6 months? the Place (NAME)?
and attainment completed by work or of work
MOTHER 0 - No (NAME )? have job If engaged in 2 jobs, consider the one of
of the 1 - Yes or that occupies most of his/her time (in the (NAME)?
child? business past 6 months)
in the
past 6 If 50-50, get the one with higher salary or
months? income.

Formal Education Work Place of Class of

FATH MOTH BFAT BMOM Completed Code Code Occupation Code Work Worker Code
Code

Codes for #11 Codes for # 13 Post-Secondary Non. Codes for #14 Codes for #15 Codes for #17
Copy the member # Elementary Tertiary/Technical (Has Work) Pls. see PSOC (Class of Worker)
11 Grade I Vocational 2012
Codes for #12 12 Grade Il 41 1st Year Without work/business 1 - Worked for private
(Biological Parents) 13 Grade III 42 2nd Year/3rd Year 00 No occupation Codes for # 16 household
0 - No 14 Grade IV 43 Graduate, specify 01 House keeper (Place of work) 2 - Worked for private
1 – Yes 15 Grade V Course 02 Student establishment
16 Grade VI (if w/ VII) 03 Pensioner 0 - At home 3 - Worked for
Codes for # 13 17 Graduate College 1 - Local, away government/
(Highest Educational 51 1st Year With work/business from home government
Attainment) High School 52 2nd Year 11 With job or business 2 - Abroad corporation
21 1st Year HS/Grade 7 53 3rd Year 12 With job or business 9 - NA (for 4 - Self-employed w/o any
99 Not Applicable 22 2nd Year HS/Grade 8 54 4th/5th Year cand Student housekeepers, employee
(<3y0) 23 3rd Year HS/Grade 9 55 Graduate, specify pensioners, 5 - Employer in own family
77 Alternative Learning 24 4th Year HS/Grade 10 course 99 Not applicable students, no operated farm or
System (ALS) 25 Grade 11 (<10y.0.) occupation) business
00 No Grade Completed 26 Grade 12 Post Graduate 6 - Worked with pay on
01 Nursery 27 High School Graduate 66 Master's Graduate, own family operated
02 Kinder Specify course farm or business
03 Preparatory 67 PhD Graduate 7 - Worked without pay in
Specify course own family operated
farm or business
9 - NA (for housekeepers,
pensioners, students,
no occupation)
2015 UPDATING FORM 1.2-HOUSEHOLD AND OTHER DEMOGRAPHIC INFORMATION

AREA CODE RESEARCHER ____________________

(Copy from NNS Form 1.1)

HH CONTROL NO. EDITED BY ____________________

(Copy from NNS Form 1.1)

NAME OF RESPONDENT _______________________ MEMBER NUMBER

(Copy from NNS Form 1.1) (Copy from NNS Form 1.1)
This form collects information on the socio-economic stars of the sample household. This includes information on the roe and kind of materials used for dwelling
unit, tenure status and number of bedrooms of the dwelling unit, type of fuel used, presence of electricity, utilities and appliances owned. The toilet facility, water
and sanitation, garbage disposal and other information which have bearing on the health status and exposure to diseases of th e household are also collected.
I. HOUSEHOLD INFIORMATION
1. What Is the tenure status of the dwelling unit 1 - Owned/amortized/owner-like possession
you are occupying? 2 - Rented
TENURHWS 3 - Rent-free with consent
"Ano ang estado ng inyong pagtira dito sa inyong bahay?” 4 - Rent-free without consent
2. What Is the tenure status of the lot you are
1 - Owned/amortized/owner-like possession
Occupying?
2 - Rented
TENURLOT 3 - Rent-free with consent
"Ano ang estado ng inyong pagtira dito sa lupang
4 - Rent-free without consent
kinatatayuan ng inyong bahay?”
Based on observation of (name of observer) (For questions 3-6)
3. What is the type of dwelling unit of the household? 1 - Single house
2 - Duplex
"Ano ang uri ng bahay na inyong tinitirahan? 3 - Multi-unit residential (three units of more)
4 - Commercial/industrial/agricultural (office,
DWELTYPE factory, and others)
5 - Institutional living quarter (hotel, hospital,
and others)
6 - Other housing unit (boat, cave, and others)
4. What is the main roofing material of the household's 1 - Galvanized iron/aluminum
dwelling unit? 2 - Tile concrete/day tile
3 - Half galvanized iron and half concrete
"Ano ang pangunahing uri ng bubong ng inyong bahay? 4 - Wood
ROOF 5 - Cogon/nipa/anahaw
6 - Asbestos
7 - Makeshift/salvaged/improvised materials
8 - Others, specify_______
5. What is the main material used for the wall of 1 - Concrete/brick/stone
the household's dwelling unit? 2 - Wood
3 - Half concrete/brick/stone and half wood
"Ano ang pangunahing uri ng dingding ng inyong bahay?" 4 - Galvanized iron/aluminum
5 - Bamboo/sawali/cogon/nipa
WALL 6 - Asbestos
7 - Glass
8 - Makeshift/salvaged/improvised materials
9 - Others, specify___________
10 - No walls
6. What is the main flooring material of the household's 1 - Earth, Sand
dwelling unit? 2 - Wood planks FLOOR
3 - Coco Lumber/Bamboo
“Ano ang pangunahing uri ng sahig ng inyong bahay?" 4 - Marble
FLOOR 5 - Parquet or polished wood
6 - Ceramic tiles
7 - Vinyl or asphalt strips
8 - Plain cement
7. In your dwelling unit, how many rooms are used for
sleeping? Actual number of rooms:_______
BEDROOM 0 - None(one-room affair)
"Ilan ang silid tulugan ng inyong bahay?"
8. What is/are the type of fuel(s) does your household use
for cooking? 1 - Electricity
2 - Liquefied petroleum Gas (LPG)
"Ano ang inyong kadalasang ginagamit na pangluto ng 3 - Natural gas
inyong pagkain"? 4 - Kerosene
FUELUSED 5 - Charcoal
Multiple Responses. Check all that applies. 6 - Wood
0 - No 7 - Agricultural Crop
1 - Yes 8 - Animal Dung
9- Others, Specify__________
Continuation…
8a. What is the main type used for cooking? 1- Electricity
2 - Liquefied petroleum Gas (LPG)
"Ano ang inyong pangunahing ginagamit na pangluto ng inyong 3 - Natural gas
pagkain? 4 - Kerosene
FUELMAIN 5 - Charcoal
6 - Wood
7 – Agricultural Crop
8 – Animal Dung
9 – Others, Specify___________________
9. Does your household or any member of the household own BICYCLE ACTUAL NO.
the following transport utilities: How many? SINGLE Bicycle/trisikad
CARJIPVAN Motorcycle/tricycle
"Meron ba kayo o kahit sino sa inyong pamilya ng mga sumusunod TRACTOR
na sasakyan ." Car/Jeep/an
CARITELA
BOAT Tractor
Multiple Responses. Check all that applies Animal-drawn cart/Animals
0 - No
1 - Yes Motor Boat/Banca

10. Do you have electricity in the household? 0 - No connection (with electricity in the area)
1 - Yes
"Meron ba kayong kuryente sa inyong bahay?" 2 - Yes, using generator
ELECTRCT 3 - Yes, own connection but
temporarily disconnected
4- Yes, tap from neighbor
5 - No electricity in the area
11. What functioning household appliances/ fixtures does COMPU ACTUAL NO.
the household have? How many? TELEPHONE Computer/Laptop/Tablet/Playstation
CELLPHONE Telephone (landline)
"Anu-ano ang mga kasangkapan sa inyong bahay SMARTPHONE
na gumagana at ginagamit ninyo?, llan po ito?" Basic Cellphone (Call & text)
TELEVISION
RADIO Smartphone
Actual no. VCD Television
CAMERA Radio/Cassette Recorder
REF VCD/DVD Player/Mini component/karaoke
RANGERS Camera/Video Camera
BLENDER Refrigerator/Freezer
GENERATOR
Stove/Range/Microwave Oven
AIRCON
WASHMCN Food processor/blender
FAN Electric generator
SEWMCN Air Conditioner
PIANO Washing Machine/dryer
WALL CLOCK Electric Fan
SALA_SOFA Sewing Machine
Piano/organ
Wall clock
Sala Set/sofa
I. WATER AND SANITATION
12a. What is the main source of drinking water Piped Water (waterworks system)
of the household? 11 - Piped into dwelling
12- Piped to yard/plot
"Ano ang pangunahing pinagkukunan 13 - Public tap/stand pipe
ninyo ng tubig na inyong iniinum?"
21 - Tube well or borehole

Dug Well
31 - Protected Dug Well
32 - Unprotected Dug Well
WDRINKNG
Water from Spring
41 - Protected spring
42 - Unprotected spring

51 - Rainwater
61 - Tanker truck
71 - Cart with small tank
81 - Surface water (river, dam, etc.)
91 - Bottled/Mineral water
12b. Do you make your water safer to drink?
0 - No Q#13
"Mayroon ba kayong ginagawang paraan DRINKSAFE 1 - Yes
upang ang inyong tubig ay maging malnis 9 - NA (if bottled water) Q#13
at ligtas inumin?