Your diary of daily expenses
Diary Start Date
DD MM
Diary End Date
DD MM
Food from stores and other goods and services
Item #
Date of purchase
dd/mm (Example: 21/06)
Description of item
Write one item per line. See page 6 in the Diary Guide for help with this section.
Reminder: Please enter snacks, beverages and meals purchased from restaurants or fast-food outlets in the section that begins on page 15.
Cost - Do not include taxes and tips. $ ¢
For example:
21/06 No purchases
22/06 Gas 36.00
Snacks, beverages and meals purchased from restaurants or fast-food outlets
Item #
Date of purchase
dd/mm (Example: 21/06)
Restaurant code
Codes:
A = Table Service
B = Fast Food
C = Cafeteria
D = Other
See page 9 in the Diary Guide for full descriptions.
Check () the meal type
Breakfast
Lunch
Dinner
Snack or Beverage
Number of meals purchased - Include meals bought for people who do not live with you
Total cost - Include all taxes and tips. $ ¢
Alcoholic beverages - If alcoholic beverages were included in the bill, please provide an estimated cost. $ ¢
For example:
21/06 A () 02 25.74
21/06 D () 00 2.36
For office use only
Please do not write on this page.
Your interviewer will ask you the questions on this page when he/she returns to pick up this Diary of Daily Expenses.
1. Did you write “no purchases” in the diary for the days when your household did not make any purchases?
- Yes
- No
- Sometimes
- Made a purchase every day
2. Respondent comments:
3. Did you or any member of your household forget to record any of the following or any other expenses in the diary? Examples include gasoline and other related expenses, lottery tickets, cigarettes, newspapers, and babysitting.
- Yes - go to #4
- No - go to #5.
4. Please list the items that have been missed. Interviewer: Enter the description used by the respondent.
Description
Cost
5. During the 14 days when you were recording your purchases in the diary, were any members of your household away from home for overnight or longer?
- Yes - go to #6
- No - Thank you for participating in this survey.
6. Were the purchases made, while away from home for overnight or longer, included in the diary? Examples include costs for accommodation (hotel, motel, inn, B&B, etc.), restaurant meals, snacks, beverages or souvenirs.
- Yes – Thank you for participating in this survey.
- No – go to #7
7. Please list all the items. Do not include expenses that will be reimbursed. Interviewer: Enter the description used by the respondent.
Description
Cost
Comments
An interviewer will call you on:
Your completed diary will be picked up on:
At:
Thank you!
We greatly appreciate your participation.
Collected under the authority of the Statistics Act.
Revised Statutes of Canada, 1985, Chapter s19.
Confidential when completed