ARCHIVED — ORDERS IN COUNCIL

Vol. 144, No. 26 — June 26, 2010

STATISTICS CANADA

2011 Census of Agriculture

P.C. 2010-793 June 17, 2010

Her Excellency the Governor General in Council, on the recommendation of the Minister of Industry, pursuant to section 20 and subsection 21(1) of the Statistics Act (see footnote a), hereby prescribes the questions to be asked in the 2011 Census of Agriculture, in accordance with the annexed schedule.

2011 CENSUS OF AGRICULTURE

STEP 1   IMPORTANT

• Complete one questionnaire for each agricultural operation and return by mail.
• If additional questionnaires are needed, call us free of charge at 1-877-777-2011.
• If an extra questionnaire is received for the same agricultural operation, return it in the separate postage-paid envelope provided.

CONFIDENTIAL WHEN COMPLETED

The confidentiality of your census responses is protected by law. This information is collected under the authority of the Statistics Act, R.S.C. 1985, c. S-19, and must be provided by law.

STEP 2  Answer the following questions about each person responsible for the MANAGEMENT DECISIONS made for this agricultural operation as of May 10, 2011.

1. OPERATOR 1

• Surname or family name
• Given name and initial(s)
• Date of birth

○ Day
○ Month
○ Year

• Sex

○ Male
○ Female

• Mailing address
• Name of village, town or city
• Province
• Postal code
• Area code
• Telephone no.
• Alternate telephone no. (optional)

2. OPERATOR 2

• Surname or family name
• Given name and initial(s)
• Date of birth

○ Day
○ Month
○ Year

• Sex

○ Male
○ Female

• Mailing address (if different from that of operator 1)
• Province
• Postal code
• Area code
• Telephone no.

3. OPERATOR 3

• Surname or family name
• Given name and initial(s)
• Date of birth

○ Day
○ Month
○ Year

• Sex

○ Male
○ Female

• Mailing address (if different from that of operator 1)
• Province
• Postal code
• Area code
• Telephone no.

If there are more than three operators, provide names and addresses in the COMMENTS section on page 16.

STEP 3  Answer the following questions for EACH OPERATOR.

Copy the names in the SAME ORDER as in STEP 2.

OPERATOR 1          OPERATOR 2          OPERATOR 3

4. Name

• Surname or family name
• Given name and initial(s)

5. Did this operator live on this agricultural operation at any time during the last 12 months?

• No
• Yes

6. Farm work

In 2010, what was each operator’s average time contribution to this agricultural operation? (Include custom work done for others.) (Fill in one circle only per operator.)

• On average, more than 40 hours per week
• On average, 30 to 40 hours per week
• On average, 20 to 29 hours per week
• On average, fewer than 20 hours per week

7. Other work

In 2010, did this operator receive a wage or salary from another job or operate another business not involved with this agricultural operation? (Do not include custom work done for others.)

• No
• Yes

If Yes, indicate the average time contribution to all other work. (Fill in one circle only per operator.)

• On average, more than 40 hours per week
• On average, 30 to 40 hours per week
• On average, 20 to 29 hours per week
• On average, fewer than 20 hours per week

STEP 4  Answer the following questions about the OPERATING ARRANGEMENT of this agricultural operation in 2011.

8. Enter the Business Number (GST/HST) issued by Canada Revenue Agency for this agricultural operation.

9. Enter the farm name (if applicable).

10. What is the operating arrangement of this operation? (Fill in one circle only.)

• Sole proprietorship
• Partnership without a written agreement
• Partnership with a written agreement
• Family corporation (including corporations with one shareholder)
• Non-family corporation

Enter the corporation name (if different from the farm name).

If question 10 does not describe the operating arrangement of this operation or if there is more than one Business Number for this operation, report in the COMMENTS section on page 16.

STEP 5  Enter the MAIN FARM LOCATION of this operation.

11. Enter the civic address.

• Number
• Road or street
• Name of village, town, city or municipality
• Province

12. In the Prairies, enter the quarter, section, township, range and meridian (if applicable).

• Quarter
• Section
• Township
• Range
• Meridian

STEP 6  What UNIT OF MEASURE will be used to report land areas? Use this unit to report all areas throughout the questionnaire unless otherwise specified. (Fill in one circle only.)

13.

• Acres
• Hectares
• Arpents (Quebec only)

1 acre = 0.40 hectare = 1.18 arpents
1 hectare = 2.47 acres = 2.92 arpents
1 arpent = 0.85 acre = 0.34 hectare

STEP 7  Answer the following questions about the TOTAL AREA OF WORKABLE and NON-WORKABLE LAND of this operation in 2011.

Area in 2011

LAND AREA owned, leased, rented, crop-shared or used

14. Total area owned (Include all workable and non-workable land.)

15. Leased FROM governments (land operated under licence, permit or lease, etc.)

16. Rented or leased FROM others

17. Crop-shared land USED by this operation

18. Other areas USED by this operation (land trading, rent-free, etc.)

19. TOTAL of questions 14 to 18

LAND AREA used by others

20. Area of land USED BY OTHERS (rented, leased or crop-shared TO others, land trading, rent-free, etc.)

NET AREA of this operation

21. Question 19 minus question 20. This is the NET AREA. (This is the area to be reported on throughout the questionnaire.)

STEP 8  Answer the following questions about HAY and FIELD CROPS grown on this operation.

• Include

○ all hay and field crops to be harvested or used as green manure in 2011, even if they were sown or planted in an earlier year;
○ all land to be seeded, even if not yet seeded.

• Report the areas only once, even if more than one crop will be harvested in 2011.
• Report vegetables in STEP 9 and fruits, berries and nuts in STEP 11.

Area in 2011

22. Wheat

• Spring wheat (Report durum wheat below.)
• Durum wheat
• Winter wheat (to be harvested in 2011)

23. Oats

24. Barley

25. Mixed grains

26. Corn

• Corn for grain (Report sweet corn in STEP 9.)
• Corn for silage, etc.

27. Rye

• Fall rye (to be harvested in 2011)
• Spring rye

28. Canola (rapeseed)

29. Soybeans

30. Flaxseed

31. Dry field peas (Report fresh green peas in STEP 9.)

32. Chick peas (including garbanzo beans)

33. Lentils

34. Dry white beans (navy and pea beans)

35. Other dry beans (pinto, kidney, cranberry beans, lima, etc.)

36. Alfalfa and alfalfa mixtures for hay, silage, green feed, dehydrated alfalfa, etc.

37. All other tame hay and fodder crops for hay or silage (clover, sorghum, etc.) (Report pasture in STEP 12.)

38. Forage seed to be harvested in 2011 for seed (including turf grass seed) (Report sod in STEP 10.)

39. Potatoes

40. Mustard seed

41. Sunflowers (standard and dwarf varieties)

42. Canary seed

43. Ginseng

44. Buckwheat

45. Sugar beets

46. Caraway seed

47. Triticale

48. Other field crops (tobacco, hemp, spelt, coriander and other spices, etc.) — Specify:

49. TOTAL area of hay and field crops (Total of questions 22 to 48)

STEP 9  Are any VEGETABLES grown on this operation for sale?

• Report potatoes, dry field peas and field beans in STEP 8.
• Report greenhouse vegetables in STEP 20.
• No   - Go to STEP 10
• Yes  - Report the total area planted or to be planted in 2011.
         - Report in the same unit of measure as in STEP 6.

Example: An operation grows 7 1/3 acres of sweet corn for sale. This area would be reported as: 7 1/3

Area in 2011 (Fraction)

50. Sweet corn

51. Tomatoes

52. Cucumbers (all varieties)

53. Green peas (Report dry field peas in question 31, on page 5.)

54. Green and wax beans

55. Cabbage (Report Chinese cabbage below.)

56. Chinese cabbage

57. Cauliflower

58. Broccoli

59. Brussels sprouts

60. Carrots (including baby carrots)

61. Rutabagas and turnips

62. Beets

63. Radishes

64. Shallots and green onions

65. Dry onions, yellow, Spanish, cooking, etc.

66. Celery

67. Lettuce (all head and leaf varieties)

68. Spinach

69. Peppers

70. Pumpkins

71. Squash and zucchini

72. Asparagus, producing

73. Asparagus, non-producing

74. Other vegetables (herbs, rhubarb, melons, garlic, gourds, etc.) — Specify:

75. TOTAL area of vegetables (Total of questions 50 to 74)

STEP 10  Are any SOD, NURSERY PRODUCTS or CHRISTMAS TREES grown on this operation for sale?

• Report greenhouse products in STEP 20.
• No  - Go to STEP 11
• Yes  - Report the total area under cultivation in 2011.

Area in 2011

76. TOTAL area of SOD under cultivation for sale

77. TOTAL area of NURSERY products grown for sale (shrubs, trees, vines, ornamentals, bulbs, etc., grown out-of-doors)

78. TOTAL area of CHRISTMAS TREES grown for sale (Include naturally established or planted areas, regardless of stage of growth, that are pruned or managed with the use of fertilizer or pesticides.)

STEP 11  Are any FRUITS, BERRIES or NUTS grown on this operation for sale?

• No  - Go to STEP 12
• Yes  - Report in the same unit of measure as in STEP 6.

Area in 2011 (producing and non-producing) (Fraction)

79. Apples

80. Pears

81. Plums and prunes

82. Cherries (sweet)

83. Cherries (sour)

84. Peaches

85. Apricots

86. Grapes

87. Strawberries

88. Raspberries

89. Cranberries

90. Blueberries (highbush blueberries and wild blueberries grown on managed land)

91. Saskatoons

92. Other fruits, berries or nuts (nectarines, currants, blackberries, hazelnuts, etc.) — Specify:

93. TOTAL area of fruits, berries and nuts (Total of questions 79 to 92)

STEP 12

Area in 2011

94. Enter the NET AREA from question 21 on page 4

Report below how the area in question 94 is used.

95. Sum of all areas reported for field crops and hay, vegetables, sod, nursery products, Christmas trees, fruits, berries and nuts (Total of questions 49, 75, 76, 77, 78 and 93)

96. Summerfallow (Include chemfallow.)

97. Tame or seeded pasture (Do not include areas to be harvested for hay, silage or seed.)

98. Natural land for pasture (Include woodland used as pasture.)

99. Woodlands and wetlands (woodlots, sugarbush, tree windbreaks, bush, ponds, bogs, marshes, sloughs, etc.)

100. All other land (idle land, land on which farm buildings, barnyards, lanes, home gardens, greenhouses and mushroom houses are located)

101. TOTAL of questions 95 to 100 (This total should equal the NET AREA reported in question 94.)

STEP 13  If SUMMERFALLOW was reported in question 96, what is the area on which each of the following forms of weed control will be used in 2011?

Area in 2011

102.

• Chemfallow only
• Summerfallow, tilled only
• Chemical and tillage weed control on the same land (Do not include area already reported as “Chemfallow only” or “Summerfallow, tilled only.”)

STEP 14  Indicate all PRACTICES and LAND FEATURES on this operation: (Fill in all applicable circles.)

103.

• Crop rotation
• In-field winter grazing or feeding
• Rotational grazing
• Plowing down green crops
• Winter cover crops
• Nutrient management planning
• Windbreaks or shelterbelts (natural or planted)
• Buffer zones around water bodies

STEP 15  For the LAND SEEDED or TO BE SEEDED, report the area of each of the following practices:

• Include the area that was prepared last fall or this spring.
• Do not include land in summerfallow this year.

Area

104.

• No-till seeding or zero-till seeding (Include direct seeding into undisturbed stubble or sod.)
• Tillage that retains most of the crop residue on the surface (Include minimum tillage.)
• Tillage that incorporates most of the crop residue into the soil

STEP 16  In 2010, what was the area from which crop residue (straw, stover, stalks) was BALED for bedding or sale?

• Include residue (straw) from small grains and oilseeds, and corn stalks.
• Do not include hay, corn silage or other forages.

Area in 2010

105. Report the area from which crop residue was baled in 2010

STEP 17  Were HERBICIDES, INSECTICIDES, FUNGICIDES, COMMERCIAL FERTILIZER or LIME used on this operation in 2010?

• Do not include greenhouse or mushroom areas.
• No  - Go to STEP 18
• Yes  - Report land areas only once for each input, even if there was more than one application in 2010.

106. Report the area of land on which each of the following inputs was used on this operation in 2010:

Area in 2010

• Herbicides
• Insecticides
• Fungicides
• Commercial fertilizer
• Lime

STEP 18  Was an IRRIGATION system used on this operation to apply water on land in 2010?

• Do not include

○ greenhouse or mushroom areas;
○ the area of land where only manure was applied by irrigation.

• No  - Go to STEP 19
• Yes

107. Report the area of land irrigated for each of the following in 2010:

Area in 2010

• Irrigated alfalfa, hay and pasture
• Irrigated field crops
• Irrigated vegetables
• Irrigated fruits
• Other irrigated areas (nursery, sod, etc.)

Specify:

STEP 19  Was MANURE used or produced on this operation in 2010?

• No  - Go to STEP 20
• Yes

108. Which of the following apply to the manure used or produced on this operation in 2010? (Fill in all applicable circles.)

• Applied on this operation
• Applied on land that was rented TO others
• Sold or given to others
• Bought or received FROM others
• Other (composted, processed, dried, stored, etc.)

Specify:

109. For manure applied on this operation in 2010, report the area of land for each method of application.

Area in 2010

• Manure spread naturally by grazing livestock
• Solid or composted manure, incorporated into soil
• Solid or composted manure, not incorporated
• Liquid manure, injected or incorporated into soil
• Liquid manure, not incorporated

STEP 20  Are any GREENHOUSE PRODUCTS grown on this operation for sale?

• Report sod, nursery products and Christmas trees in STEP 10.
• No  - Go to STEP 21
• Yes

110. Will the area be reported in square feet or square metres?

• square feet OR
• square metres

Area in 2011

111. TOTAL area under glass, plastic or other protection used for growing plants (Do not include area used for cold frames.)

Of this total, report the area on May 10, 2011 for each of the following:

112. Flowers (cut flowers, bedding and potted plants, etc.)

113. Greenhouse vegetables

114. Other greenhouse products (cuttings, tree seedlings, etc.)

Specify:

STEP 21  Are any MUSHROOMS grown on this operation for sale?

• No  - Go to STEP 22
• Yes

115. Will the area be reported in square feet or square metres?

• square feet OR
• square metres

Area in 2011

116. TOTAL growing area (standing footage) for mushrooms on May 10, 2011

STEP 22  Were any MAPLE TREES TAPPED on this operation in 2011?

• No  - Go to STEP 23
• Yes

Number of taps in 2011

117. TOTAL number of taps made on maple trees in the spring of 2011

STEP 23  Does this operation own any BEES for honey production or BEES for pollination?

• No  - Go to STEP 24
• Yes  - Report bees owned, regardless of location.

Number of colonies

118. On May 10, 2011, how many live colonies of honeybees (used for honey production or pollination) are owned by this operation?

Number

119. On May 10, 2011, how many other pollinating bees (leafcutter, blue orchard, bumble, etc.) are owned by this operation?

Select one unit of measure:

• Gallons or
• Number of bees or
• Colonies

STEP 24  Are there any POULTRY on this operation on May 10, 2011?

• No  - Go to STEP 25
• Yes  - Report all poultry on this operation, regardless of ownership, including those grown under contract.

- Include poultry for sale and poultry for personal use.

- Do not include poultry owned but kept on an operation operated by someone else.

Number of birds on May 10, 2011

Chickens for eggs

120. Pullets intended for laying table eggs, under 19 weeks

121. Laying hens that produce table eggs, 19 weeks and over

122. Layer and broiler breeders (pullets and hens)

Chickens for meat

123. Broilers, roasters and Cornish (Report breeders in question 122.)

124.TOTAL hens and chickens (Total of questions 120 to 123)

Other poultry

125. Turkeys (all ages)

126. Other poultry (geese, ducks, roosters, ostriches, emus, pheasants, quail, pigeons, etc.)

Specify:

STEP 25  In 2010, were any CHICKENS or TURKEYS produced on this operation for sale?

• No  - Go to STEP 26
• Yes  - Report the production on a live weight basis.

127. Will production be reported in kilograms or pounds?

• kilograms OR
• pounds

Production in 2010 (live weight)

128. Broilers, roasters and Cornish

129. Turkeys

STEP 26  In 2010, were any EGGS produced on this operation for sale?

• No  - Go to STEP 27
• Yes  - Report the number of dozens in 2010.

Dozens of eggs in 2010

130. Table eggs (dozens)

131. Hatching eggs (dozens)

STEP 27  Was there a COMMERCIAL POULTRY HATCHERY located on this operation in 2010?

• No  - Go to STEP 28
• Yes

Number of birds hatched in 2010

132. In 2010, how many chicks or other poultry were hatched?

STEP 28  Are there any LIVESTOCK on this operation on May 10, 2011?

• No  - Go to STEP 29
• Yes  - Report all animals on this operation, regardless of ownership, including those that are boarded, custom-fed or fed under contract.

- Include all animals kept by this operation, regardless of ownership, that are pastured on a community pasture, grazing co-op or public land.

- Do not include animals owned but kept on a farm, ranch or feedlot operated by someone else.

CATTLE OR CALVES

133. Are there any cattle or calves on this operation?

• No  - Go to question 140
• Yes

Number

134. Calves, under 1 year

135. Steers, 1 year and over

136. Heifers, 1 year and over:

• for slaughter or feeding
• for beef herd replacement
• for dairy herd replacement

137. Cows:

• mainly for beef purposes
• mainly for dairy purposes

138. Bulls, 1 year and over

139. TOTAL cattle and calves (Total of questions 134 to 138)

SHEEP OR LAMBS

140. Are there any sheep or lambs on this operation?

• No  - Go to question 145
• Yes

Number

141. Rams

142. Ewes

143. Lambs

144. TOTAL sheep and lambs (Total of questions 141 to 143)

PIGS

145. Are there any pigs on this operation?

• No  - Go to question 152
• Yes

Number

146. Boars

147. Sows and gilts for breeding

148. Nursing pigs

149. Weaner pigs

150. Grower and finishing pigs

151. TOTAL pigs (Total of questions 146 to 150)

OTHER LIVESTOCK

152. Are there any other livestock on this operation?

• No  - Go to STEP 29
• Yes  - Report animals of all ages unless otherwise specified.

Number

153. Horses and ponies

154. Goats

155. Llamas and alpacas

156. Rabbits

157. Bison (buffalo)

158. Elk

159. Deer (Do not include wild deer.)

160. Wild boars

161. Mink (Report breeding stock only.)

162. Other livestock (fox, donkeys, mules, chinchillas, etc.)

Specify:

STEP 29  Answer the following questions about the MARKET VALUE of land and buildings on this operation.

• Include

○ the value of all land and all structures such as houses, farm buildings, silos, etc., that are part of this operation;
○ the value of all fixed equipment such as bulk tanks, farrowing pens, etc., in farm buildings on this operation.

• Do not include the value of any land and buildings rented or leased TO others.

Present market value (dollars only)

163. Estimate the present market value of land and buildings that are:

• owned
• rented or leased FROM others or governments

STEP 30  Answer the following questions about FARM MACHINERY and EQUIPMENT that are owned or leased by this operation as of May 10, 2011.

• Include all farm machinery and equipment that are jointly owned or leased with a different operation.
• Do not include machinery that is rented on a short-term basis (hourly or daily rentals).

Example: An operation owns one baler, valued at $20,000, and shares ownership of another baler, valued at $10,000, equally with another operation. These two balers would be reported as:

1 1/2

25,000.00

Number owned and leased (Fraction)

Present market value (owned and leased)
(dollars only)

164. Tractors:

• under 60 p.t.o. hp. (including garden tractors, ATVs, etc.)
• 60 - 99 p.t.o. hp.
• 100 - 149 p.t.o. hp.
• over 149 p.t.o. hp.

165. Pick-ups and cargo vans

166. All other farm trucks

167. Cars and other passenger vehicles used in the farm business

168. Combines

169. Swathers and mower-conditioners

170. Balers

171. Forage harvesters

172. Tillage, cultivation, seeding and planting equipment

173. Irrigation equipment

174. All other farm machinery and equipment not reported above, such as elevators, wagons, manure spreaders, dryers, portable grinder-mixers, sprayers, harvesting equipment, workshop equipment, etc.

175. TOTAL present market value of all farm machinery and equipment (Total of questions 164 to 174)

STEP 31  Answer the following questions about the GROSS FARM RECEIPTS of this operation in 2010 (calendar year) or for the last complete accounting (fiscal) year.

• Account books or completed income tax forms, if available, are useful in completing this page.
• Report gross receipts (before deducting expenses).
• Include

○ receipts from all agricultural and forest products sold;
○ program payments and custom work receipts.

• Do not include

○ sales of capital items (quota, land, machinery, etc.);
○ receipts from the sale of any goods purchased only for retail sales.

Amount (dollars only)

176. What were the TOTAL gross farm receipts?

177. Of the above, what were the sales of firewood, pulpwood, logs, fence posts and pilings?

STEP 32  Answer the following questions about the OPERATING EXPENSES of this operation in 2010 (calendar year) or for the last complete accounting (fiscal) year.

• Include only the farm business share of amounts paid.
• Do not include costs of any goods purchased only for retail sales.

Amount (dollars only)

178. Fertilizer and lime

179. Herbicides, insecticides, fungicides, etc.

180. Seed and plants (Do not include materials purchased for resale.)

181. Feed, supplements and hay

182. Livestock and poultry purchases

183. Veterinary services, drugs, semen, breeding fees, etc.

184. Custom work, contract work and hired trucking

185. Wages and salaries (including all employee benefits):

• paid to family members
• paid to all other persons

186. All fuel (diesel, gasoline, oil, wood, natural gas, propane, etc.)

187. Repairs and maintenance to farm machinery, equipment and vehicles

188. Repairs and maintenance to farm buildings and fences

189. Rental and leasing of land and buildings (including community pasture and grazing fees)

190. Rental and leasing of farm machinery, equipment and vehicles

191. Electricity, telephone and all other telecommunications services

192. Farm interest expenses (Do not include payment of principal or amount of debt outstanding.)

193. All other farm business operating expenses not reported above, such as property taxes, packaging materials, farm and crop insurance premiums, irrigation levies, legal and accounting fees, etc. (Do not include depreciation or capital cost allowance.)

194. TOTAL farm business operating expenses (Total of questions 178 to 193)

STEP 33  If any wages or salaries were paid in 2010, report the total number of employees and total number of weeks or hours of PAID WORK.

• Do not include custom or contract workers.

195. Paid on a year-round basis (full-time or part-time)

• Number of employees
• Paid work in 2010

○ Total weeks for all employees OR
○ Total hours for all employees

196. Paid on a seasonal or temporary basis

• Number of employees
• Paid work in 2010

○ Total weeks for all employees OR
○ Total hours for all employees

STEP 34  Is a COMPUTER used for this farm business?

Examples: Internet, bookkeeping, record keeping, banking, etc.

• No  - Go to STEP 35
• Yes

197. Is the Internet used for this farm business (marketing, checking weather or prices, etc.)?

• No  - Go to STEP 35
• Yes

198. Does this operation have high-speed Internet access?

• No
• Yes

STEP 35  Does this operation produce any ORGANIC products for sale?

• No  - Go to page 16
• Yes

199. What is the status of the organic products in 2011? (Fill in all applicable circles.)

• Certified by an organic certifying body
• Transitional (in the process of becoming certified)

200. Enter the name of the certifying body.

201. Report the status in 2011 for the organic products produced for sale. (Fill in all applicable circles.)

Organic products for sale

• Field crops (grains, oilseeds, etc.) or hay

○ Certified
○ Transitional

• Fruits, vegetables or greenhouse products

○ Certified
○ Transitional

• Animals or animal products (meat, dairy products, eggs, etc.)

○ Certified
○ Transitional

• Maple products

○ Certified
○ Transitional

• Herbs, spices or garlic

○ Certified
○ Transitional

• Other — Specify:

○ Certified
○ Transitional

EXPLANATORY NOTE

(This note is not part of the Order.)

The Order prescribes the questions to be asked in the 2011 Census of Agriculture.

[26-1-o]

STATISTICS CANADA

2011 Census of Population

P.C. 2010-792 June 17, 2010

Her Excellency the Governor General in Council, on the recommendation of the Minister of Industry, pursuant to subsections 19(1) and 21(1) of the Statistics Act (see footnote b), hereby fixes May 2011 as the month in which a census of population shall be taken by Statistics Canada and prescribes the questions to be asked in the 2011 Census of Population, as set out in the annexed schedule.

SCHEDULE

STEP A

CONFIDENTIAL WHEN COMPLETED

1. Print your telephone number:(______) -______-______________

2. Complete this section if there is no printed address in the address space above or if the printed address does not correspond to this dwelling.

No. and street or lot and concession _________________________

Apt. no. __________

City, municipality, town, village, Indian reserve _____________________

Province/territory ____________________

Postal code _____ ______

STEP B

1. How many persons usually live at this address as of May 10, 2011, including yourself? Include all persons who have their main residence at this address, even if they are temporarily away.

See the instructions on page 3 (joint custody, students, permanent residents, secondary residence, etc.).

Number of persons _______________

2. Including yourself, list below all persons who usually live here. Begin the list with an adult followed, if applicable, by that person’s spouse or common-law partner and by their children. Continue with all other persons who usually live at this address.

Family name and given name of all persons

person	FAMILY NAME		GIVEN NAME
Person 1
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Person 8
Person 9
Person 10

1. WHOM TO INCLUDE IN STEP B

• All persons who have their main residence at this address on May 10, 2011, including newborn babies, room-mates and persons who are temporarily away;
• Canadian citizens, permanent residents (landed immigrants), persons asking for refugee status (refugee claimants), persons from another country with a work or study permit and family members living here with them;
• Persons staying at this address temporarily on May 10, 2011 who have no main residence elsewhere.

2. WHERE TO INCLUDE PERSONS WITH MORE THAN ONE RESIDENCE

• CHILDREN IN JOINT CUSTODY should be included in the home of the parent where they live most of the time. Children who spend equal time with each parent should be included in the home of the parent with whom they are staying on May 10, 2011.
• STUDENTS who return to live with their parents during the year should be included at their parents’ address, even if they live elsewhere while attending school or working at a summer job.
• SPOUSES OR COMMON-LAW PARTNERS TEMPORARILY AWAY who stay elsewhere while working or studying should be listed at the main residence of their family, if they return periodically.
• PERSONS IN AN INSTITUTION for less than six months (for example, in a home for the aged, a hospital or a prison) should be listed at their usual residence.

IF THIS ADDRESS IS:

• a SECONDARY RESIDENCE (such as a cottage) for ALL PERSONS who stayed here on May 10, 2011 (all these persons have their main residence elsewhere in Canada), mark this circle. Print your name, your telephone number and your main residence address at the bottom of this page. Do not answer other questions.
• a DWELLING OCCUPIED ONLY BY RESIDENTS OF ANOTHER COUNTRY VISITING CANADA (for example, on vacation or on a business trip), mark this circle. Print your name, your telephone number and your country of residence at the bottom of this page. Do not answer other questions.
• the HOME OF A GOVERNMENT REPRESENTATIVE OF ANOTHER COUNTRY (for example, embassy or high commission) and family members, mark this circle. Print your name, your telephone number and the country that you represent at the bottom of this page. Do not answer other questions.

Name _______________________

Telephone number (____) - ________ - ______________

No. and street, city, province or territory/country ___________________________________

___________________________________

STEP C

Did you leave anyone out of Step B because you were not sure the person should be listed? (For example, a person living at this address who has another home, a person temporarily away, etc.)

• No
• Yes —> Specify the name, the relationship and the reason.

Name(s) and relationship _________________________________________

Reason _______________________________________________

STEP D

1. Is anyone listed in Step B a farm operator who produces at least one agricultural product intended for sale? (Crops, livestock, milk, poultry, eggs, greenhouse or nursery products, Christmas trees, sod, honey, bees, maple syrup products, furs, etc.)

• No —> Go to Step E
• Yes

2. Does this farm operator make the day-to-day management decisions related to the farm?

• No
• Yes

STEP E

Copy the names in Step B to Question 1, on top of page 4.

Keep the same order.

1.  NAME

In the spaces provided, copy the names in the same order as in Step B. Then answer the following questions for each person.

PERSON 1

Family name _______________________

Given name _______________________

2. SEX

• Male
• Female

3. DATE OF BIRTH AND AGE

Date of birth and age

example	Day	Month	Year	Age
Example:	23	0 2	1 9 7 4	3 7

If exact date is not known, enter best estimate.

For children under the age of 1, enter 0.

Day 

Month

Year

Age

4. MARITAL STATUS

Mark one circle only.

• Never legally married
• Legally married (and not separated)
• Separated, but still legally married
• Divorced
• Widowed

5. Is this person living with a common-law partner?

Common-law refers to two people who live together as a couple but who are not legally married to each other.

• Yes
• No

6.  RELATIONSHIP TO PERSON 1

For each person usually living here, describe his or her relationship to Person 1.
Mark or specify one response only.
Adopted children should be considered sons and daughters.
Children in joint custody should be included in the home of the parent where they live most of the time.
Children who spend equal time with each parent should be included in the home of the parent with whom they are staying on May 10, 2011.
For all children, please consider the relationship to Person 1 and Person 2.
If none of the choices apply, specify this person’s relationship to Person 1 under “Other”.
Examples of “Other” relationships to Person 1:
• brother-in-law or sister-in-law • niece or nephew • grandfather or grandmother • room-mate’s son or daughter • lodger’s husband or wife • employee • etc.

PERSON 1

• PERSON 1

PERSON 2

• Opposite-sex husband or wife of Person 1
• Opposite-sex common-law partner of Person 1
• Same-sex married spouse of Person 1
• Same-sex common-law partner of Person 1
• Son or daughter of Person 1 only
• Son-in-law or daughter-in-law of Person 1
• Grandchild of Person 1
• Father or mother of Person 1
• Father-in-law or mother-in-law of Person 1
• Brother or sister of Person 1
• Foster child
• Room-mate, lodger or boarder
  Other — Specify
  ____________________________________________________________
  ____________________________________________________________

PERSON 3, etc.

• Son or daughter of both Persons 1 and 2
• Son or daughter of Person 1 only
• Son or daughter of Person 2 only
• Son-in-law or daughter-in-law of Person 1
• Grandchild of Person 1
• Father or mother of Person 1
• Father-in-law or mother-in-law of Person 1
• Brother or sister of Person 1
• Foster child
• Room-mate, lodger or boarder
  Other — Specify
  ____________________________________________________________
  ____________________________________________________________

7.  What is the language that this person first learned at home in childhood and still understands?

If this person no longer understands the first language learned, indicate the second language learned.

• English
• French
  Other ______________________________________________

STEP F

If you are answering on behalf of other people, please consult each person.

F1.  This question is for all persons listed on the questionnaire.

Only if you mark “YES” to this question will your census responses and family history be part of the historical record of Canada. A “YES” means your census responses will be available to family members and historical researchers, 92 years after the 2011 Census, in 2103.

If you mark “NO” or leave the answer blank, your census responses will never be made available to future generations.

Does this person agree to make his or her 2011 Census information available in 2103 (92 years after the census)?

• Yes
• No

EXPLANATORY NOTE

(This note is not part of the Order.)

The Order fixes May 2011 as the month in which Statistics Canada will conduct the 2011 Census of Population and prescribes the questions to be asked in the 2011 Census of Population.

[26-1-o]

Footnote a
R.S., c. S-19

Footnote b
 R.S., c. S-19