LONG FORM - Microdata Library

43
6 12 7 13 8 9 10 11 1 2 17 20 21 22 23 B.- HOUSEHOLD IDENTIFICATION URBAN Hay 16 Mahlla BLOCK Head of household name Residencial address RURAL Building census No Environment A. GEOGRAPHICAL LOCATION OF THE HOUSEHOLD NAME IDENTIFIER Interviewer CODE CODE Republic of Iraq Ministry of Planning Central Statistical Organization (CSO) HH In cooperation with KRSO Swift Survey - 2017 LONG FORM Cluster serial N Street /Zokak Governorate NAME House number Qadha' Nahiya C.- CONTACT INFORMATION Mobile number: Fixed telephone: Result Interviewer Team supervisor Day Year Code Month

Transcript of LONG FORM - Microdata Library

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B.- HOUSEHOLD IDENTIFICATION

URBAN

Hay

16

Mahlla

BLOCK

Head of household name

Residencial address

RURAL

Building census No

Environment

A. GEOGRAPHICAL LOCATION OF THE HOUSEHOLDNAME

IDENTIFIER

Interviewer

CODE CODE

Republic of Iraq

Ministry of Planning

Central Statistical Organization (CSO)

HH

In cooperation with KRSO

Swift Survey - 2017

LONG FORM

Cluster serial N

Street /ZokakGovernorate

NAME

House numberQadha'

Nahiya

C.- CONTACT INFORMATION

Mobile number:Fixed telephone:

Result

Interviewer

Team supervisor

Day YearCode Month

SECTION 1: RATIONS

1

2

1

1

2

3

4

5

6 Other 2 __________

105 106In the past 12

months, for how

many months did

this household

receive this item?

Write (0) if did not

receive

1-WITHIN THE PAST MONTH

2-More than one month and up to three months

4-MORE THAN 12 MONTHS AGO >> NEXT ITEM

5-NEVER >> NEXT ITEM

Rice KG

Sugar

Vegetable oil LT

Other 1 __________

Wheat flour KG

108When was the last time this household received ..[ITEM]..

from the Ration Agent?

How much

ITEM did you

receive that

time?

How many

months does

this quantity

cover?

What price would

you pay in the

market to buy the

..[ITEM].. of same

quality?

Thousand dinars /

unitNB. OF MONTHS

KG

103

<< PART B

107

QUANTITY MONTHS

3-WITHIN THE PAST 12 MONTHS

UN

IT O

F M

EA

SU

RE

ME

NT

104

Amount paid to rations agent for value of rations and value of sacs/bags

CO

DE

ITEM NAME

Does the household receive rations according to the ration card?

PART A: RATIONS RECEIVED

101

102

YES

NO

How many members are in the ration card

OTHER 4

1

2

3

4

5

6 Other 2 __________

UN

IT O

F M

EA

SU

RE

ME

NT

109How much ..[ITEM]..

did this household

consume during the

past 30 days?

Write (0) if nothing and

move to next item

Vegetable oil

KG

KG

ITEM NAME QUANTITY

Wheat flour

Other 1 __________

Rice KG

Sugar

LT

115

3

What was the

total value of

the...[ITEM]... you

purchased?

Why was this purchase of

... [ITEM]...made?

How much of

the ...[ITEM]...

you consumed

was received

as a gift?

Write (0) if nothing and

move to question 114

QUANTITY QUANTITY QUANTITY QUANTITY

PART B: CONSUMPTION OF RATION ITEMS AND SIMILAR DURING THE PAST 30 DAYS

CO

DE

How much of

the ...[ITEM]...

you consumed

was produced

by the

household?

RATION WAS NOT

ENOUGH

110 111 112 113 114

1

THOUSAND

DINARS

How much of

this ..[ITEM]::

consumed

was received

as part of your

ration?

How much of the

...[ITEM]....you

consumed was

purchased?

RATION AND

OTHER SOURCES

NOT ENOUGH

2

WE WANTED

BETTER QUALITY

THAN THE RATION

TYPE OF HOUSING EXPENSE

INTERVIEWER:

YES 1

NO 2

1

2

3

4

5

water and sewer bill

Electricity from the public network bill

Write all expenditures if related in whole or part to the household consumption use.

Do not write the expenditure if it is not related to the said use

<< NEXT

Bill for electricity generated from a common generator

Land / Phone Line bill

Housing unit rent

SECTION 2: HOUSINGL

INE

NU

MB

ER

206 207

Has this household paid for

..[TYPE OF EXPENSE].. during the

past 12 months?

How much was

the last payment

that this

household made

for ..[TYPE OF

EXPENSE]..?

How many days did this last

payment covered?

204 205

THOUSAND

DINARS NUMBER OF DAYS PERCENTAGE

What is the estimated

proportion of use for non

household consumption such

as production and sale

activities carried out within

the housing unit?

DD MM YYYY

302 303

PURCHASED 1

RECEIVED AS GIFT FROM OTHER HHOLDS 2

RECEIVED AS GIFT FROM OTHERS 3

YES 1 PAYMENT FOR WORK 4

NO 2 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

321401 --

321402 --

321403 --

322401 --

322402 --

452101 BOTTLE

452102 BOTTLE

452103 --

452204 LITER

452205 LITER

452206 LITER

453101 LITER

453102 LITER

4190

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

Kaz commercial

Article fat and pigments shoes

Material Maintenance shoes

Other (Kietin .... etc.)

Wages dye and repair

Other (rental shoes .... etc)

Liquid from the gas station

Liquid gas trading

Liquid gas by pipeline

Kerosene from the station

Engine Oils

White oil from the station

White oil trading

Total Page

SECTION 3: Expenditures on Non-Food Services and Commodities during the past 30 days

Have the members of this household acquired …[ITEM].. during the 30 days previous to

the first day of the interview?

ASK QUESTION (301) ABOUT EACH ITEM IN THE LIST

FIRST

IF THE ANSWER TO Q. 301 IS YES, ASK Q. 302 TO 304

304How much has your

household spent or what

is the estimation for all

quantities of ...[ITEM]..

bought or received

during last 30 days for

the first day of interview

ITE

M C

OD

E

301How much ..[ITEM]..

did this household

consume during the

past 30 days?

What's the main source of all these …[ITEM]'s… acquired?

HIES-II, Household Questionnaire - version 0A S3.ORI 5/44

454101 --

454102 --

454103 --

454104 --

552101NUMBER

552102 NUMBER

552103 NUMBER

552104 NUMBER

552105 NUMBER

552106 NUMBER

552107 NUMBER

552108 NUMBER

552109 NUMBER

4330

561101 KILOGRAM

561102 KILOGRAM

561103 KILOGRAM

561104 KILOGRAM

561105 LITER

561106 LITER

561107 --

561108 --

561109 --

561111 --

561112 --

561113 --

561114 --

561115--

561116

--

4490

Dish towels

Materials against insects

Floor cloth wipers

Paper products (table linens, bags, vacuum cleaners,

dishes)

Other materials (matches, candles, wicks, clothes hangers,

pins, knitting needles, embroidery needles, Kchtbanat,

thread, thread couscous, fire extinguisher, screws, rubber

gloves)

Total Page

Washing powders and cleaning business

Washing and cleaning fluids

Minor

Air Freshener

Cleaning the glass

Cleaning tools, brooms, scanners

Cleaning brushes

Hand tools and equipment (saw, hammer, hooks, Kirk, etc.

..)

Soap commercial

Total Page

Detergents and cleaning supply

Massabh hand

Dry Batteries

Alarms

Knobs and locks

Other (small tools and accessories diverse ...)

Soap Supply

Ladders or stairs

Coal

Wood

Amplitude

Other (remains of plants, fronds, etc. ..)

Curtain rails

Light bulbs and Florsnat

HIES-II, Household Questionnaire - version 0A S3.ORI 6/44

562101 --

562102 --

562103 --

562104 --

562105 --

562106 --

612101--

611101 --

611102 --

611103 --

611104 --

722104 LITER

722105 LITER

722106 LITER

722107 LITER

722108 --

4690

723101--

723102 --

731105 --

731101 --

731103 --

731104 --

732101 --

732102 --

732103 --

810101 --

4790

Transport of passengers by sea

Wages Hmalah

Wages luggage transfer offices

Commissions and travel agents

Mail expenses (stamps, parcels, money orders)

Total Page

Total Page

Engineering (mechanical, electrical, plumbing, backup

tools, Benjrgi)

Wash and Auto Detailing

Passenger train

Passenger transport by road (inside and outside Iraq)

Passenger transport by air

Kerosene from the station

Kaz commercial

Motor oil from the station

Commercial engine oils

Others (distilled water, Antervriz ... etc.)

Other pharmaceutical products

Guard wages

Chef wages

Medical devices (Termotr, syringes, medical plaster, gauze,

cotton, etc. ..)

Chronic drugs

Chronic disease drugs is

Contraceptives

Wages of a maid

Wages of driver

Wages for farmers

Nanny wages

HIES-II, Household Questionnaire - version 0A S3.ORI 7/44

830101 --

830102 --

830103 --

830104 NUMBER

830105 NUMBER

830106 --

830107 --

830108 --

830109 --

830110 --

830111 --

942101 --

942102 --

942103 --

942104--

942105 --

942106--

942107 --

4960

To lease videotapes and CD

Total Page

Data transport services and the Internet

Internet connectivity services

Expenses of the Telecommunications

Telephone and fax services other

The value of movie tickets, theater, concerts

Expenditure on museums and libraries

Phone and fax rental

Works of art galleries and exhibitions

Expenses of visiting historical monuments, parks and zoos

Services Photographers (photographs, film processing etc

...)

Other cultural services

Wages landline

Wages for telephone calls

Wages set the phone

Card mobile phone

Chandelier Card

Telegraph services, telex and fax

HIES-II, Household Questionnaire - version 0A S3.ORI 8/44

954101 --

954102 --

954103 --

954104 --

954105 --

954106 --

954107 --

954108 --

954109--

954110--

1040101 --

1040102 --

1040103 --

1211201 --

1211202 --

1211203 --

1211204 --

1211205 --

5140

Nursery and kindergarten expenses

Barber Men's wages

Drawing materials, paint, fabric painting (paper, plates,

dyes, wax and pastel, water and brushes)

Other personal care

Scissors, Paper

Gum

Paper clips

Other (rulers, engineering tools, chalk, pens portfolio ... etc.)

Custody fees

Kindergarten fees

Sharpener and eraser

Carbon papers and tapes

Women's wages Barber

Wages bath

Wages sauna and massage

Total Page

Alcabsat and pins and pins for Eabsat drawing

Books and pamphlets

Pens of all kinds

HIES-II, Household Questionnaire - version 0A S3.ORI 9/44

442101--

444101--

1213101--

1213102--

1213103--

1213104--

5180

Non-electric machines (shavers, shaving machine,

scissors, file, brush teeth, comb etc ...)

Personal hygiene items (soap, medical bath, shaving

cream, toothpaste ... etc.)

Beauty products (lipstick, nail polish, perfume body,

perfumes and fragrances)

Other products (toilet paper, tissue paper, sanitary napkins,

diapers for the children ... etc)

Total Page

Number of lines completed for section

Wages for garbage collection and waste (sewage entertain

... etc.)

Other services (guarding, maintenance of elevators ... etc)

HIES-II, Household Questionnaire - version 0A S3.ORI 10/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

311101 Men's woolen fabrics METER

311102 Women's woolen fabrics METER

311103 Woolen fabrics for children METER

311104 Men's cotton fabrics METER

311105 Women's cotton fabrics METER

311106 Cotton fabrics for children METER

311107 Men's silk fabrics METER

311108 Women's silk fabrics METER

311109 Silk fabrics for children METER

311110 Men's Synthetic Fabric METER

311111 Women's synthetic fabrics METER

311112 Synthetic fabrics for children METER

311113 Payment for sewing Men's Clothing --

311114 Payment for Sewing Women's Clothing --

311115 Payment for Clothes children --

311116 Other clothing articles --

5670 Total Page

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

HIES-II, Household Questionnaire - version 0A S4.ORI 11/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

312101 Coats NUMBER

312102 Jackets NUMBER

312103 Pants NUMBER

312104 Coats NUMBER

312105 Shirts NUMBER

312106 Underwear NUMBER

312107 Suits NUMBER

312108 Dishdasha NUMBER

312109 Wool cloak NUMBER

312110 Pajamas NUMBER

312111 Eshmag NUMBER

312112 Headband NUMBER

312113 Arakjan NUMBER

312114 Juarib PAIR

312115 Sportswear NUMBER

312116 Sweater NUMBER

312117 T-Shirt NUMBER

312118 Men's other garments NUMBER

5850 Total Page

HIES-II, Household Questionnaire - version 0A S4.ORI 12/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

312201 Coats NUMBER

312202 Jackets NUMBER

312203 Pants NUMBER

312204 Coats NUMBER

312205 Shirts NUMBER

312206 Underwear NUMBER

312207 Full allowance NUMBER

312208 Dishdasha NUMBER

312209 Mantle NUMBER

312210 Pajamas NUMBER

312211 Skirt NUMBER

312212 Gergd NUMBER

312213 Towel NUMBER

312214 Shawls, tie NUMBER

312215 Juarib PAIR

312216 Sportswear NUMBER

312217 Sweatshirts NUMBER

312218 T-Shirt NUMBER

312219 Other women's ready made clothing NUMBER

6030 Total Page

HIES-II, Household Questionnaire - version 0A S4.ORI 13/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

312301 Coats NUMBER

312302 Jackets NUMBER

312303 Pants NUMBER

312304 Coats NUMBER

312305 Shirts NUMBER

312306 Underwear NUMBER

312307 Suits NUMBER

312308 Dishdasha NUMBER

312309 Sportswear NUMBER

312310 Pajamas NUMBER

312311 Skirt NUMBER

312312 Sweatshirts NUMBER

312313 Juarib PAIR

312314 Other children's clothing --

6170 Total Page

HIES-II, Household Questionnaire - version 0A S4.ORI 14/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

313101 Tie NUMBER

313102 Handkerchief NUMBER

313103 Gloves of all kinds PAIR

313104 Belts NUMBER

313105 Carriers of pants NUMBER

313106 Caps NUMBER

313107 Sewing thread and knitting --

313108 Buckles --

313109 Buttons --

313110 OTHER --

314101 Wages repair clothing --

314102 Payments for sewing clothes --

314103 Ironing clothes --

314104 Washing clothes --

314105 Clothing dye --

314106 Mending clothing --

314107 Rental of clothing --

314108 Other fees (laundry, repair and rental ...) --

6340 Total Page

HIES-II, Household Questionnaire - version 0A S4.ORI 15/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

321101 Leather Shoes PAIR

321102 Non Leather Shoes PAIR

321103 Slippers PAIR

321104 Sports Shoes PAIR

321105 Other (clog slippers .. etc. ..) PAIR

321201 Leather Shoes PAIR

321202 Non Leather Shoes PAIR

321203 Slippers PAIR

321204 Sports Shoes PAIR

321205 Other (clog slippers .. etc. ..) PAIR

321301 Leather Shoes PAIR

321302 Non Leather Shoes PAIR

321303 Slippers PAIR

321304 Sports Shoes PAIR

321305 Other (clog slippers .. etc. ..) PAIR

6490 Total Page

HIES-II, Household Questionnaire - version 0A S4.ORI 16/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

521101 Sheets and mattresses Number

521102 Blankets and Back Number

521103 Ready pillows Number

521104 Duck and quilts Number

521105 Towels and towels Number

521106 Sheets for tables Number

521107 Table linens Number

521108 Wool kg

521109 Cotton kg

521110 Feathering kg

521111 Foam METER

521112 Wages Ndavh --

521113 Fabrics for Furniture METER

521114 Wages of sewing furniture --

521115 Wages Repair --

521116 Textiles and other furnishings --

562201 Wash carpets and rugs --

562202 Clean linens and home furnishings steam --

562203 Rental of furniture and furnishings, carpets, household equipment --

562204 Other Services --

6670 Total Page

621101 General practitioner --

621102 Private doctor --

621103 Orthodontics --

622101 Dentist --

HIES-II, Household Questionnaire - version 0A S4.ORI 17/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

622102 Cost of installing dentures --

622103 Repair and maintenance --

622104 Dental Services Other --

623101 Wage analysis --

623102 X-ray payments --

623103 Nurse wages --

623104 Fees are authorized midwife --

623105 Physical Therapy --

623106 Rental of therapeutic equipment --

623107 Medicinal herbs --

623108 Fees for ECG --

623109 Fees for Sonar --

623110 Fees for MRI --

623111 Other medical services (Nursing, blue needles, orthopedic, physical therapy, etc.) --

623112 Ambulance services --

623113 Therapeutic equipment hire --

6860 Total Page

624101 Fees for kidney washing --

624102 Chemotherapy --

624103 Other therapeutic services --

630101 Government hospital --

630102 Private hospital --

630103 popular clinic --

630104 Health center --

630105 Costs of treatment outside of Iraq --

HIES-II, Household Questionnaire - version 0A S4.ORI 18/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

630106 Other services for hospitals --

914101 Videotapes --

914102 Cassette tapes and CDs --

914103 CDs for PC --

914104 Ordinary and color photographic films --

914105 Other means of recording --

933101 Natural plants --

933102 Artificial plants --

933103 Others (such as fertilizer requirements, pot ... etc.) --

7000 Total Page

HIES-II, Household Questionnaire - version 0A S4.ORI 19/44

DD MM YYYY

402 403

PURCHASED 1

ASK QUESTION (401) ABOUT EACH ITEM IN THE LIST FIRST RECEIVED AS GIFT FROM OTHER HHOLDS 2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

IF THE ANSWER TO Q. 401 IS YES, ASK Q. 402 TO 404 SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE 6

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

ITE

M C

OD

E

SECTION 4: Expenditures on Non-Food Services and Commodities during the past 90 days

Have the members of this household acquired …[ITEM].. during the 90 days previous to the first day of the interview?

401

What's the main source of all these …[ITEM]'s… acquired?

404

How much has your

household spent or what is

the estimation for all

quantities of ..[ITEM]...

bought or received during

the 90 days preceding the

first day of interview?

What is the quantity of the

..[ITEM]... bought or

acquired by your

household during the 90

days preceding the first

day of interview?

941101 City Games Tickets --

941102 Sports tickets --

941103 The value of the participation of social clubs, sports and cultural rights (including membership fees and donations for the club ... etc.)--

941104 Expenses of the fitness centers --

941105 Rental equipment and supplies for sports and leisure --

941106 Training programs (swimming, music ... etc.) --

941107 Extension services tourism --

941108 Services, entertainment and other sports --

1120101 Hotels --

1120102 The role of tourism and resorts --

1120103 Dormitories --

1120104 Other services stay in Iraq --

1120201 Living expenses out of Iraq --

7130 Total Page

Number of lines completed for section

HIES-II, Household Questionnaire - version 0A S4.ORI 20/44

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

431101 Restoration, repair and maintenance of housing -

431102 Home decorating -

431103 Dye house -

432101 Acts of housing maintenance -

511101 Bedroom -

511102 Reception room -

511103 Dining table with chairs Number

511104 Buffet food Number

511105 Living room -

511106 Bed of all kinds Number

511107 Chair Number

511108 Table Number

511109 Wardrobe Number

511110 Library Number

511111 Kitchen counters Number

511112 Tepel Lamb Number

511113 Pictures and paintings Number

511114 Antiques, statues Number

511115 Ready curtains of all kinds Number

511116 Chandeliers Number

511117 Mirror Number

511118 Vases Number

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

HIES-II, Household Questionnaire - version 0A S5.ORI 21/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

511119 Other (furniture, equipment ...) -

7760 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 22/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

512101 Rugs Square meters

512102 Carpet Square meters

512103 Floor mats Square meters

512104 Extension Square meters

512105 Wages Repair -

512106 Other (rugs, blankets the land .... etc.) -

531101 Fridge Number

531102 Frozen Number

531103 Water cooler Number

531104 Other (refrigerators and air-cooling ...) -

531201 Electric washing machine Number

531202 Electric clothes dryer Number

531203 Dishwasher, electric Number

531204 Electric iron Number

531205 Other (washing machines and dryers, ironing ...) -

7880 Total Page

531301 Gas cooker Number

531302 Electric cooker Number

531303 Cook oil Number

531304 Electric oven Number

531305 Electric grill Number

531306 Gas grill Number

HIES-II, Household Questionnaire - version 0A S5.ORI 23/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

531307 Premz Number

531308 Oven gas Number

531309 Other (round .... etc.) -

531401 Electric heater Number

531402 Gas heater Number

531403 Oil heater Number

531404 Air Conditioning (Aarkandashn), and Sbelt .... etc. Number

531405 Chilled Number

531406 Electric fan Number

531407 Electric heater Number

531408 Gas fireplace Number

531409 Oil heater Number

531410 Other (heaters, air-conditioning ...) -

8070 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 24/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

531501 Electric vacuum cleaner Number

531502 Non-electric vacuum cleaner for carpets and rugs Number

531503 Other cleaning equipment -

531601 Private generator Number

531602 Electric sewing machine Number

531603 Non-electric sewing machine Number

531604 Electric sewing machine Number

531605 Non-electric sewing machine Number

531606 Electric machine embroidery Number

531607 Embroidery machine, non-electric Number

531608 A water filter Number

531609 Treasury Home (Qash) Number

531610 Home Appliances other major -

532101 Electric mill Number

532102 Electric Juicer Number

532103 Mixers Number

532104 Fryers Number

532105 BBQ Meat Number

532106 Elbit Number

532107 Machine, electric meat Number

532108 Flesh of non-electric machine Number

532109 Non-electric mill Number

HIES-II, Household Questionnaire - version 0A S5.ORI 25/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

532110 Other (Toaster .... etc.) -

8290 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 26/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

533101 Home appliance repair -

533102 Rental home appliances -

533103 Spare parts for household appliances -

540101 Kitchenware Glass -

540102 Kitchen is glass -

540103 Repair, maintenance and rental Housewares -

551101 Machine Cut Iial Number

551102 Tools and equipment for homes and gardens of other -

613101 Glasses and contact lenses -

613102 Headphones -

613103 Pressure device Number

613104 Wheelchairs Number

613105 Crutches Number

613106 Denominated ligaments of the neck Number

613107 Device to measure sugar Number

613108 The value of dentures Number

613109 Artificial limbs Number

613110 Belts medical Number

613111 Repair and maintenance -

613112 Others (therapeutic appliances and equipment ...) -

8480 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 27/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

711101 Cars (year of manufacture without 2000) Number

711102 Cars (Year of Make 2000 and above) Number

711103 Purchase of vehicles (caravans) Number

711104 Buy Boats Number

711105 Motorcycles Number

711106 Bicycles Number

711107 Animal-drawn vehicles Number

711108 Animals necessary to drag the wagons Number

711109 Other (purchase and transport ...) -

721101 Tires Number

721102 Liquid batteries Number

721103 Other backup tools -

721104 Car accessories (brushes, other spare parts) -

724101 Annual car -

724102 Driver license -

724103 Car registration fees -

724104 Paid parking -

724105 Insurance expenses Alsarat -

724106 Other expenses (fees for driving instruction, rental cars without driver)-

8680 Total Page

820101 Landline Number

820102 Mobile phone Number

HIES-II, Household Questionnaire - version 0A S5.ORI 28/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

820103 Cordless phone Number

820104 Chandelier Number

820105 Fax Number

820106 Amplifiers for mobile Number

820107 Repair and maintenance -

820108 Other (phone and fax equipment, etc. ...) -

911101 TV size less than 26 knots Number

911102 TV size 26 knots or more Number

911103 Registered Number

911104 Video Number

911105 Radio Number

911106 Radio Recorder Number

911107 Loudspeakers Number

911108 TV antennas Number

911109 Video game consoles (Atari, Play ..... etc.) Number

911110 Satellite services Number

911111 Audio-visual equipment and other information processing equipment-

8840 Total Page

912101 Imaging camera Alfotgrave Number

912102 Video Camera Number

912103 Equipment and other devices (equipment, film processing and enlargement)Number

913101 PC Number

HIES-II, Household Questionnaire - version 0A S5.ORI 29/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

913102 Printers and software for computer Number

913103 Instruments Calculator Number

913104 Typewriter Number

913105 Other information processing equipment -

915101 Repair and maintenance of equipment, sound, image, imaging equipment and information processing-

921101 Tents of the trips -

921102 Buy a boat -

921103 Horse, donkey, etc. ..... -

921104 Horse-drawn vehicles -

921105 Others (saddles, bridle, veterinary services and feed ... etc.) -

922101 Musical instruments (piano, violin, guitar, drums ... etc.) -

922102 Tables (pool, tennis ... etc.) -

922103 Maintenance and repair -

9010 Total Page

931101 Card games, chess, table -

931102 Play of all kinds (cars, toys, electronic games, etc. ...) -

931103 Requirements collection of postage stamps (postage stamps used or canceled albums stamps ... etc.)-

931104 Software Video Games -

931105 Other (collection of coins, medals and models of animals, pets, plants ... etc.)-

932101 Rackets -

932102 Football, tennis, table ... Etc. -

932103 Equipment bodybuilding and weightlifting ... Etc. -

HIES-II, Household Questionnaire - version 0A S5.ORI 30/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

932104 Fishing hooks -

932105 Other equipment (firearms for hunting and personal protection, stoves, grills, tents for the trips)-

932106 Repair and maintenance -

934101 Buy Pets -

934102 Pet Supplies -

934103 Other Materials -

935101 Veterinarian -

935102 Medicines for animals -

935103 Veterinary services of the other -

9170 Total Page -

HIES-II, Household Questionnaire - version 0A S5.ORI 31/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

951101 Cultural books (atlas, dictionary, encyclopedias, books, binders, etc. ...)-

951102 Textbooks -

951103 Foreign textbooks -

953101 Alkatolokut and advertising materials and Alcartat -

953102 Posters, greeting cards, ads, messages -

953103 Maps and models of the Earth -

953104 Other publications -

960101 The value of the participation of school trips -

960102 Tours in Iraq (accommodation and living expenses and entertainment)-

960103 Hajj and Umrah -

960104 Other flights out of Iraq -

1010101 Expenses and tuition fees at the primary -

1010102 Expenses of private lessons at the primary -

1010103 Expenses and tuition fees for the intermediate level -

1010104 Expenses of private lessons for the intermediate level -

1010105 Expenses and tuition fees for the preparatory phase -

1010106 Tutoring expenses for the preparatory phase -

1010107 Other expenses -

9320 Total Page

1020101 Expenses and tuition fees for undergraduate -

1020102 Expenses of studies, diploma and master's and doctoral -

1020103 Expenses Tutorials -

HIES-II, Household Questionnaire - version 0A S5.ORI 32/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

1020104 Other expenses -

1030101 Vocational training and developmental -

1030102 Language programs -

1030103 Computer programs -

1030104 Training programs and other developmental -

1212101 Electrical items (shaving machine, hair dryer ... etc.) -

1212102 Repair and maintenance -

1212103 Other (electrical appliances for personal care, ...) -

1231101 Gold and Jewelry Accessories -

1231102 Clocks -

1231103 Watches Women and Men -

1231104 Maintenance and repair of watches and jewelry -

1231105 Other (jewelry, clocks and watches ...) -

9450 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 33/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

1232101 Women's bag -

1232102 Men's bag and the Governor -

1232103 School bag -

1232104 Suitcase -

1232105 Goods for children (children of a vehicle ... etc.) -

1232106 A variety of personal effects -

1232107 Sunglasses Men and Women -

1232108 Lighters -

1232109 Umbrella -

1232110 Key Chain -

1232111 Walking stick -

1232112 Accessories is not gold -

1232113 Repair and maintenance of other personal belongings -

1232114 Other personal effects -

9580 Total Page

1270101 Fees for legal services -

1270102 Membership fees and subscriptions -

1270103 Expenditure on weddings and concerts -

1270104 Expenditures on funerals -

1270105 Spending on ads -

1270106 Expenses extraction official papers (such as civil status, marriage certificate, death certificate ... etc.)-

1270107 Stockbrokers' wages -

HIES-II, Household Questionnaire - version 0A S5.ORI 34/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

1270108 Wages of lawyers -

1270109 Photocopying expenses and extract the documents (passport, certificate courses etc ...)-

1270110 Expenditures on school shooting notes -

1270111 Costs of borrowing from banks -

1270112 Health insurance premiums -

1270113 Accident insurance premiums -

1270114 Life insurance premiums -

1270115 Health insurance premiums and other accidents -

1270116 Property fees -

1270117 Banking fees and commissions -

1270118 Border exit fees -

1270119 Court fees -

1270120 Other (expenses on services ...) -

9730 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 35/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

151 The cost of purchasing a dwelling for the family -

152 Expenses for building or expanding the household dwelling -

153 The cost of purchasing a piece of land for housing -

154 Housing projects premiums -

155 Premiums to extend sewer and paving -

156 Buy gold bars, jewelry and rare antiques -

157 Purchase of foreign currencies -

158 Purchase of shares and bonds -

159 Other capital expenditure of the family -

128 Cash dowry - goods for a bride -

161 Gifts in kind -

162 Cash gifts -

163 Donations and alms and zakat -

164 After marriage dowry and alimony -

165 Offenses (traffic, etc. ...) -

166 Other transfers within Iraq -

167 Other transfers out of Iraq -

168 Religious vows and expenses -

169 Tribal fund subscription -

170 Tribal payment subscription -

171 Other transfer expenses -

172 Total Page

HIES-II, Household Questionnaire - version 0A S5.ORI 36/43

SECTION 5: Acquisition of non-Food Services and Commodities during the past 12 months

DD MM YYYY

502 503

PURCHASED 1

RECEIVED AS

GIFT FROM

2

YES 1 RECEIVED AS GIFT FROM OTHERS 3

NO 2 PAYMENT FOR WORK 4

SELF PRODUCTION 5

OTHER SOURCE. SPECIFY AFTER ANSWE CODE

ITEM DESCRIPTION UNIT QUANTITY THOUSAND DINARS

Start date _ _ / _ _ / _ 201 expiry date _ _ / _ _ / _ 201

IF THE ANSWER TO Q. 501 IS YES, ASK Q. 502 TO 504

ASK QUESTION (501) ABOUT EACH ITEM IN THE LIST

FIRST

501

Have the members of this household acquired …[ITEM].. during the 12 months previous to

the first day of the interview?

What is the quantity of

...[ITEM].. bought or

acquired by your

household last 12 months

before the first day of the

interview?

How much has your

household spent or what is

the estimation for all

quantities of ...[ITEM]..

bought or received during

last 12 months for the first

day of interview

504What's the main source of all these …[ITEM]'s… acquired?

6

ITE

M C

OD

E

Number of lines completed for section

HIES-II, Household Questionnaire - version 0A S5.ORI 37/43

603

INSTRUCTIONS

1 Cash expenditure from rations 1

2 PURCHASED IN CASH FROM OTHER SOURCES 2

3 RECEIVED AS GIFT FROM OTHER HHOLDS 3

4 RECEIVED AS GIFT FROM OTHERS 4

1 YES PAYMENT FOR WORK 5

2 NO SELF PRODUCTION 6

DINARS OTHER SOURCE… SPECIFY AFTER ANSWER 7

11 1 102 Commercial rice (imported)

11 1 103 Commercial rice (local)

11 1 105 Other rice (broken rice, etc.)

11 1 203 Brown wheat flour (commercial)

11 1 205 White wheat flour (commercial)

11 1 301 Burghul (cracked wheat)

11 1 302 Habbiya (whole roasted wheat)

11 1 304 Maccaroni and vermicelli

11 1 305 Starch

11 1 308 Children's food (commercial)

11 1 310 Corn chips

11 1 311 Other products from cereals (ground maize, popcorn,

etc.)

11 1 401 Bread, all types

11 1 402 Buns, all types and sizes

11 1 405 Cake

11 1 406 Biscuits

11 1 407 Rusk and zwieback

11 1 409 Other bread and bakery products

11 2 101 Mutton, fresh

11 2 102 Mutton, frozen

11 2 103 Beef, fresh

11 2 104 Beef, frozen

00 0 080 TOTAL

(1) ask this question for each item in the table and write 1 if yes and

2 if no

(2) When you are finished, ask questions 602 to 604 for substances

that were answered in601, "Yes

Liter

Number

NO UNIT

unit of

measurementQUANTITY

Section 6: Food consumption over the past 7 daysIT

EM

CO

DE

601 602 604Have you consumed ..[ITEM].. during the past 7 days? How much ..[ITEM].. did

your household consume

during the past 7 days?

How much did you pay

for or what is the value

of ..[ITEM].. consumed

during the past 7 days?

What is the main source from which you got most of the …[ITEM]..

consumed during the past 7 days?

KILOGRAM

11 2 105 Chicken, frozen

11 2 106 Chicken, alive

11 2 107 Goat meet

11 2 109 Red meats (imported)

11 2 126 Chicken liver, kidney and heart

11 2 127 Barbecued chicken or fried fish

11 2 132 Canned meat (including sausage)

11 3 101 Fresh water fish, fresh

11 3 102 Sea fishes, fresh

113103 Fish, frozen

11 3 105 Canned fish

11 3 106 Shrimps

11 3 108 Other types of fish and seafood

11 4 101 Fresh milk

114102 Fresh milk (imported)

11 4 103 powdered milk (commercial)

11 4 104 Condensed milk

00 0 081 TOTAL

11 4 105 Formula milk

11 4 107 Yogurt

11 4 109 Local cheese

114110 Imported cheese

114111 Buffalo cream (local)

114112 cream (imported)

114113 Butter

11 4 111 Packed cream

114118 Other

11 4 201 Eggs (chicken)

114202 Eggs chicken (imported)

11 5 102 Vegetable fat (commercial)

11 5 105 Vegetable oil (commercial)

11 5 107 Sesame oil

11 5 109 Other oils

11 6 101 Orange

11 6 102 Lemon

11 6 104 Mandarins

11 6 105 Sour orange

11 6 108 Other citrus fruits

00 0 082 TOTAL

11 6 109 Green plum

11 6 110 Peach

11 6 113 Raw olives

11 6 114 Apricot

11 6 115 Cherry plum

11 6 116 Other (lotus, azarole, etc.)

11 6 117 Apple

11 6 118 Melon

11 6 119 Water melon

11 6 120 Pomegranate

11 6 121 Grape

11 6 122 Banana

11 6 123 Pear

11 6 124 Fig

11 6 126 Kiwi

11 6 131 Fresh dates

11 6 202 Canned olives

11 6 203 Sultanas

11 6 205 Tirshana (dried halved apricots)

11 6 207 Dried dates

00 0 083 TOTAL

11 6 209 Almonds

11 6 210 Walnut

11 6 211 Coconut

11 6 216 Pistachio

116219 Other (currants, dried apricot paste)

11 7 101 Tomatoes

11 7 102 Okra

11 7 103 Egg plant

11 7 104 Squash, pumpkins

11 7 105 Stringed beans

11 7 106 Broad beans

11 7 107 Peas

11 7 108 Grean beans

11 7 109 Cauliflower

11 7 110 Cabbage

11 7 111 Potato

11 7 112 Onions

11 7 113 Green onions

11 7 114 Dry garlic

11 7 116 Spinach

00 0 084 TOTAL

11 7 118 Turnip

11 7 119 Beetroot

11 7 120 Turnip cabbage

11 7 121 Green pepper

11 7 122 Carrots

11 7 123 Radish

11 7 124 Lettuce

11 7 125 Swisschard

11 7 126 Cucumber

11 7 129 Mushroom

11 7 130 Other fresh, frozen and dried vegetables

11 7 201 Tomato paste

11 7 202 Fava beans (canned)

11 7 204 Other canned vegetables

11 7 302 Dry white beans (commercial)

11 7 303 Dry broad beans

11 7 305 Chick peas (commercial)

11 7 306 Ground chick peas

11 7 308 Lentils (commercial)

11 7 309 Dry stringed beans

00 0 085 TOTAL

11 7 310 Vigna

11 7 313 Other

11 7 401 Potato crisps

11 8 102 Sugar (commercial)

11 8 103 Assorted sweets

11 8 104 Chocolate

11 8 105 Jam

11 8 106 Honey

11 8 107 Date syrup

11 8 108 Artificially flavored juice

11 8 109 Chewing gum

11 8 110 Ice-cream

11 8 111 Ice

11 8 112 Other sugar products

11 9 102 Salt (commercial)

11 9 103 Vinegar

11 9 104 Cardamon

11 9 105 Nomi Basrah

11 9 106 Pickles

11 9 109 Spices

00 0 086 TOTAL

11 9 112 Baking powder

11 9 113 Yeast

11 9 116 Sauces and flavors

11 9 117 Other

12 1 102 Tea (commercial)

12 1 103 Coffee and instant coffee

12 1 104 Cocoa

12 2 101 Gaseous beverages

12 2 102 Mineral waters

12 2 103 Purshus Water

12 2 105 Fruit juice

12 2 106 Sherbet (all types)

12 2 107 Other waters, soft drinks, etc

21 1 106 Other alcoholic drinks

22 1 101 Cigarettes

22 1 102 Tobacco

111 1 101 Sandwich (all types)

111 1 102 Kebab, tikka and liver (grilled in skewers)

111 1 106 Various meal dishes

111 1 107 Non-alcoholic beverages (tea, coffee, juice, soda

water, etc)

00 0 087 TOTAL

111 1 108 Alcoholioc beverages (beer, arak, whisky, etc)

45 2 201 Gasoline from station / normal (for generators)

45 2 202 Gasoline station / Mohsen (for generators)

45 2 203 Commercial gasoline (for generators)

72 2 101 Gasoline from station / normal (for personal

transportation)

72 2 102 Gasoline station / Mohsen (for personal transportation)

72 2 103 Commercial gasoline (for personal transportation)

111 1 110 Other expenditure on restaurants, cafes and food

taken away from home

11 1 209 Grain and other products (wheat, barley, barley flour ,

yellow corn, etc.)

11 1 303 Meal .. Semolina

11 2 129 Other meat (fresh, frozen, or refrigerated)

95 2 101 Newspaper, magazines and other periodicals

00 0 088 TOTAL

701 702 703 704 705 706

NUMBER YEAR DINARS YEAR DINARS

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

06 Electric washing machine

03 Motorcycle

SECTION 7: DURABLE GOODS

07 Electric generator

08 TV

05 refrigerator

What is the total number of

…DURABLE GOOD]...

owned by the members of

this household?

04 COOLER

01 Car

02 Taxi (if it's also being used by household)

LIN

E N

UM

BE

R

Com

mod

ity o

rder

acc

ordi

ng to

last

acq

uire

d

What is the estimated price you pay if

you buy the item?

How much have you paid for this

..[DURABLE GOOD]..?

CommodityIF RECEIVED FREE OF CHARGE,

MENTION THE IMPUTED VALUE

When did you aquire this

..[DURABLE GOOD]..?

Manufacture year for the good

HIES-II, Household Questionnaire - version 0A S7.ORI 43/44