United States Resident Questionnaire for Same Day Automobile Travel Between the U.S. and Canada

Welcome to Canada! Please take the time to tell us about this same day trip. This voluntary survey is a cooperative effort between the U.S. and Canadian Governments and is conducted under the authority of the Statistics Act (R.S.C. 1985, c. S-19). Your answers will be kept confidential. Your cooperation is essential and appreciated. Please print.

1. Where do you live?
   • Country:
     • United States
     • Canada
     • Other
   • State
   • City/Town
   • ZIP Code
2. On this trip, where and when did you enter Canada?
   • Name of Canadian border crossing
   • Date (Month / Day / Year)
   Your travelling party includes yourself and only those for whom you are able to report spending.
3. On this trip, how many people, including yourself, were in the travelling party?
4. What was the main destination on this trip?
   • Province
   • City/Town
5. What was the total spending (including cash or credit transactions) on this trip for all persons reported in Question 3? Estimates are appreciated or if no spending occurred, please check the appropriate box.
   • Spending:
     • Amount (.00)
     • Currency:
       • $ Canadian
       • $ U.S.
     OR
   • No spending
6. What was the main reason for this trip?
   • Commuting to work
   • Business
   • Pleasure (including shopping or entertainment)
   • Visit friends or relatives
   • Other (specify)

Thank you. Please drop this card in any mail box on your return to the U.S.

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