Copper Basin Community Harvest Survey, Wrangell-St. Elias National Park

Copper Basin Subsistence Update 2010

COMPREHENSIVE SUBSISTENCE SURVEY
CHISTOCHINA, ALASKA
January to December, 2010

HOUSEHOLD ID:

This survey is used to estimate subsistence harvests and to describe
community subsistence economies. We will publish a summary report, and
send it to all households in your community. We share the community
information with the Alaska Department of Fish and Game, the U.S. Fish
and Wildlife Service and the National Park Service. We work with the
Federal Regional Advisory Councils and with local Fish and Game
Advisory Committees to better manage subsistence, and to implement
federal and state subsistence priorities.
We will NOT identify your household. We will NOT use this information
for enforcement. Participation in this survey is voluntary. Even if you agree
to be surveyed, you may stop at any time.

COMMUNITY ID: CHISTOCHINA
RESPONDENT ID:
INTERVIEWER:
INTERVIEW DATE:
START TIME:
STOP TIME:
DATA CODED BY:
DATA ENTERED BY:
SUPERVISOR:

Batzulnetas at Tanada Creek, Upper Copper River

COOPERATING ORGANIZATIONS
CHEESH-NA' TRIBAL COUNCIL

WRANGELL-ST. ELIAS

DIVISION OF SUBSISTENCE

NATIONAL PARK AND PRESERVE

ALASKA DEPT OF FISH & GAME

P.O. BOX 241

P.O. BOX 439

333 RASPBERRY ROAD

GAKONA, AK 99586

COPPER CENTER, AK 99573-0439

ANCHORAGE, AK 99518

907-822-3503

907-822-5234

907-267-2353

Page 1 of 24

89

Copper Basin Subsistence Update 2010

HOUSEHOLD MEMBERS

HOUSEHOLD ID

Between JANUARY and DECEMBER, 2010…
…who lived in your household?
IS THIS PERSON
ANSWERING
QUESTIONS
ON THIS
SURVEY?

ID#
HEAD 1

(circle)

MALE
OR
FEMALE?
(circle)

Y

N

M

F

Y

N

M

F

ALASKA
NATIVE?
(circle)
Y

IN WHAT
YEAR
WAS THIS
PERSON
BORN?
(year)

WHERE WERE
HOW IS THIS
PARENTS LIVING
PERSON RELATED
WHEN THIS PERSON
TO HOUSEHOLD
WAS BORN?
HEAD 1?
(ak city or state)
(relation)

HOW MANY
YEARS HAS
THIS PERSON
LIVED IN
CHISTOCHINA?
(number)

WHAT IS THE
HIGHEST LEVEL
OF EDUCATION
ATTAINED?
(number)

YRS

YRS

YRS

YRS

N

01
Enter spouse or partner next. If household has a SINGLE HEAD, leave HEAD 2 blank.
HEAD 2

Y

N

02
Enter children (oldest to youngest), grandchildren, grandparents, brothers, sisters, or anyone else living full-time in this household.
03

Y

N

M

F

Y

N

YRS

YRS

04

Y

N

M

F

Y

N

YRS

YRS

05

Y

N

M

F

Y

N

YRS

YRS

06

Y

N

M

F

Y

N

YRS

YRS

07

Y

N

M

F

Y

N

YRS

YRS

08

Y

N

M

F

Y

N

YRS

YRS

09

Y

N

M

F

Y

N

YRS

YRS

10

Y

N

M

F

Y

N

YRS

YRS

11

Y

N

M

F

Y

N

YRS

YRS

12

Y

N

M

F

Y

N

YRS

YRS

13

Y

N

M

F

Y

N

YRS

YRS

14

Y

N

M

F

Y

N

YRS

YRS

15

Y

N

M

F

Y

N

YRS

YRS

PERMANENT HH MEMBERS: 01

CHISTOCHINA: 89

Page 2 of 24

Copper Basin Subsistence Update 2010

HOUSEHOLD MEMBER PARTICIPATION

HOUSEHOLD ID

Between JANUARY and DECEMBER, 2010…
…did this person...

Fish

PERSON
ID# FROM
Page 2

Process

(circle)

Large Land Mammals
Fish For
(circle)

Process
(circle)

Hunt
(circle)

Small Land Mammals
Furbearers
Process
(circle)

Hunt/Trap
(circle)

Birds & Eggs
Process
(circle)

Plants/Berries/Wood

Hunt/Gather
(circle)

Process
(circle)

Gather
(circle)

Head 1

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Head 2

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

03

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

04

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

05

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

06

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

07

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

08

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

09

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

10

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

11

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

12

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

13

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

14

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

15

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

PERMANENT HH MEMBERS: 01

CHISTOCHINA: 89

Page 3 of 24

Copper Basin Subsistence Update 2010

HOUSEHOLD MEMBER PARTICIPATION

HOUSEHOLD ID

Between JANUARY and DECEMBER, 2010…
…did this person...

PERSON

Build Fish Wheels

Sew Skins/Cloth

Cook Wild Foods

ID# FROM
Page 2

(circle)

(circle)

(circle)

Head 1

Y

N

Y

N

Y

N

Head 2

Y

N

Y

N

Y

N

03

Y

N

Y

N

Y

N

04

Y

N

Y

N

Y

N

05

Y

N

Y

N

Y

N

06

Y

N

Y

N

Y

N

07

Y

N

Y

N

Y

N

08

Y

N

Y

N

Y

N

09

Y

N

Y

N

Y

N

10

Y

N

Y

N

Y

N

11

Y

N

Y

N

Y

N

12

Y

N

Y

N

Y

N

13

Y

N

Y

N

Y

N

14

Y

N

Y

N

Y

N

15

Y

N

Y

N

Y

N

PERMANENT HH MEMBERS: 01

CHISTOCHINA: 89

Page 4 of 24

Copper Basin Subsistence Update 2010

HARVESTS: COMMERCIAL SALMON FISHING

HOUSEHOLD ID

Do members of your household USUALLY participate in COMMERCIAL SALMON FISHING ?........... Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household participate in commercial salmon fishing?....................................... Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate the number of salmon ALL MEMBERS OF YOUR HOUSEHOLD REMOVED FROM COMMERCIAL HARVEST FOR
PERSONAL USE OR SHARING in 2010. INCLUDE the fish you gave away, ate fresh, fed to dogs, lost to spoilage, caught as incidental
catch while fishing for another species, or got by helping others. If harvested with others, report ONLY YOUR SHARE of the catch.
IN 2010
DID MEMBERS OF
YOUR HH…
CATCH AS
COMMERCIAL INCIDENTAL
CATCH
FISH FOR
_______?
_______?
(circle)
(circle)
CHINOOK (KING) SALMON
113000000
SOCKEYE (RED) SALMON
115000000
COHO (SILVER) SALMON
112000000
CHUM (DOG) SALMON
111000000
PINK (HUMPIES) SALMON
114000000
UNKNOWN SALMON

IN 2010, HOW MANY
______ DID YOU REMOVE
IN 2010, HOW MANY
FROM THE CATCH &
____________ WERE GIVE AWAY TO CREW
OR OTHERS?
REMOVED FOR
YOUR OWN USE?
OTHERS
CREW
(number)
(number)

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

ID NUMBER FROM
PAGE 2
PERMIT
HOLDER
CREW
(number)
(number)

119000000

COMMERCIAL SALMON FISHING: 03

CHISTOCHINA: 89

Page 5 of 24

Copper Basin Subsistence Update 2010

HARVESTS: COMMERCIAL NON-SALMON FISHING

HOUSEHOLD ID

Do members of your household USUALLY participate in COMMERCIAL NON-SALMON FISHING ?........... Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household participate in commercial non-salmon fishing?......................................... Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate the number of commercially harvested non-salmon fish ALL MEMBERS OF YOUR HOUSEHOLD REMOVED FROM
COMMERCIAL HARVEST FOR PERSONAL USE OR SHARING in 2010. INCLUDE the fish you gave away, ate fresh, fed to dogs, lost to spoilage,
caught as incidental catch while fishing for another species, or got by helping others. If harvested with others, report ONLY YOUR SHARE of the
IN 2010
DID MEMBERS OF
YOUR HH…
CATCH AS
COMMERCIAL INCIDENTAL
CATCH
FISH FOR
_______?
_______?
(circle)
(circle)
HALIBUT
121800000
HERRING
120200000
HERRING SPAWN ON KELP
120306000
HERRING SAC ROE
120304000
PACIFIC COD (GRAY)
121004000
PACIFIC TOM COD
121008000
SCULPIN
123000000
STARRY FLOUNDER
121406000
SMELT
120400000
ROCKFISH
122600000
LAMPREY
122000000
LINGCOD

IN 2010, HOW MANY
____________ WERE
REMOVED FOR
YOUR OWN USE?
(number)

IN 2010, HOW MANY
______ DID YOU REMOVE
FROM THE CATCH &
GIVE AWAY TO CREW
OR OTHERS?
CREW
OTHERS
(number)

Y

N

Y

N

LBS

LBS

LBS

Y

N

Y

N

GAL

GAL

GAL

Y

N

Y

N

GAL

GAL

GAL

Y

N

Y

N

GAL

GAL

GAL

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

GAL

GAL

GAL

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

IND

IND

IND

ID NUMBER FROM
PAGE 2
PERMIT
HOLDER
CREW
(number)
(number)

121606000

COMMERCIAL NON-SALMON FISHING: 03

CHISTOCHINA: 89

Page 6 of 24

Copper Basin Subsistence Update 2010

HARVESTS: COMMERCIAL MARINE INVERTEBRATE HARVEST

HOUSEHOLD ID

Do members of your household USUALLY participate in COMMERCIAL MARINE INVERTEBRATE HARVEST ?................Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household participate in commercial marine invertebrate harvest?.................................................... Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate the commercially harvested marine invertebrates ALL MEMBERS OF YOUR HOUSEHOLD REMOVED FROM COMMERCIAL
HARVEST in 2010. INCLUDE the marine invertebrates you gave away, ate fresh, fed to dogs, lost to spoilage, caught as incidental catch while
fishing for another species, or got by helping others. If harvested with others, report ONLY YOUR SHARE of the catch.
IN 2010
DID MEMBERS OF
YOUR HH…
CATCH AS
COMMERCIAL INCIDENTAL
CATCH
FISH FOR
_______?
_______?
(circle)
(circle)
TANNER CRAB
501012000
DUNGENESS CRAB
501004000
SHRIMP
503400000
SQUID
503800000
OCTOPUS

IN 2010, HOW MANY
____________ WERE
REMOVED FOR
YOUR OWN USE?
(number)

IN 2010, HOW MANY
______ DID YOU REMOVE
FROM THE CATCH &
GIVE AWAY TO CREW
OR OTHERS?
CREW
OTHERS
(number)

Y

N

Y

N

LBS

LBS

LBS

Y

N

Y

N

LBS

LBS

LBS

Y

N

Y

N

GAL

GAL

GAL

Y

N

Y

N

GAL

GAL

GAL

Y

N

Y

N

IND

IND

IND

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

ID NUMBER FROM
PAGE 2
PERMIT
HOLDER
CREW
(number)
(number)

502200000

COMMERCIAL MARINE INVERTEBRATE HARVEST: 03

Page 7 of 24

CHISTOCHINA: 89

Copper Basin Subsistence Update 2010

HARVESTS: SALMON

(NON-COMMERCIAL)

HOUSEHOLD ID

Do members of your household USUALLY harvest SALMON ?...........................................................................Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST salmon?.............................................................Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

Please estimate how many salmon ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010, including with a rod and reel.
INCLUDE salmon you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If fishing with others, report ONLY
YOUR SHARE of the catch. Do not include fish caught and released.
IN 2010, HOW MANY __________
IN 2010
DID YOUR HOUSEHOLD…
DID MEMBERS OF
YOUR HH…
…CATCH
…CATCH
…CATCH
…CATCH

(circle)
CHINOOK (KING) SALMON
113000000
SOCKEYE (RED) SALMON
115000000
COHO (SILVER) SALMON
112000000
CHUM (DOG) SALMON
111000000
PINK (HUMPIES) SALMON
114000000
LANDLOCKED SALMON

Kokanee
116000000
UNKNOWN SALMON

WITH
WITH A
WITH A
WITH
FISH
DIPNET?
ROD AND
OTHER
WHEEL?
REEL?
GEAR?
(number taken by each gear type)

UNITS
(ind, lbs)

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

119000000
These columns should include all the
harvests: salmon HARVESTED by
members of this household in 2010.
SALMON
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE salmon than in recent years?....................................... X L S M
X = DO NOT USE
If SAME or DO NOT USE, skip the next question.
If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HARVEST salmon?

On MAP, mark all harvest locations for page subject.

SALMON : 04

CHISTOCHINA: 89

Page 8 of 24

Copper Basin Subsistence Update 2010

HARVESTS: OTHER FISH

(NON-COMMERCIAL)

HOUSEHOLD ID

Do members of your household USUALLY harvest OTHER FISH ?......................................................................
Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST other fish?...........................................................
Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

Please estimate how many other fish ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010, including with a rod and reel.
INCLUDE other fish you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If fishing with others, report
ONLY YOUR SHARE of the catch. Do not include fish caught and released
IN 2010, HOW MANY __________
IN 2010
DID YOUR HOUSEHOLD…
DID MEMBERS OF
YOUR HH…
…CATCH
…CATCH
…CATCH

(circle)
RAINBOW TROUT
126204000
LAKE TROUT
125010000
CUTTHROAT TROUT
126202000
TROUT

Unknown
126200000
DOLLY VARDEN
125006000
GRAYLING
125200000
PIKE
125400000
BURBOT

Ling Cod
124800000
ROUND WHITEFISH
126412000
HUMPBACK WHITEFISH
126408000
BROAD WHITEFISH
126404000
LEAST CISCO
126406060
UNKNOWN WHITEFISH
126400000
SUCKER
126000000
Continue on next page

WITH
WITH
WITH
OTHER
GILL NET
ROD AND
OR SEINE?
REEL?
GEAR?
(number taken by each gear type)

UNITS
(ind, lbs)

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

These columns should include all the
harvests: other fish HARVESTED by
members of this household in 2010.

OTHER FISH: 06

CHISTOCHINA: 89
Page 9 of 24

Copper Basin Subsistence Update 2010

HARVESTS: OTHER FISH

(NON-COMMERCIAL)

HOUSEHOLD ID

…continued
Please estimate how many other fish ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010 , including with a rod and reel.
INCLUDE other fish you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If fishing with others, report ONLY
YOUR SHARE of the catch. Do not include fish caught and released.
IN 2010, HOW MANY __________
DID YOUR HOUSEHOLD…
…CATCH
GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
HALIBUT
121800000
HERRING
120200000
PACIFIC COD (GRAY)
121004000
PACIFIC TOM COD
121008000
STARRY FLOUNDER
121406000
SMELT
120400000
ROCKFISH
122600000
LAMPREY
122000000
LINGCOD

…CATCH

…CATCH

WITH
WITH
WITH
GILL NET
ROD AND
OTHER
OR SEINE?
REEL?
GEAR?
(number taken by each gear type)

UNITS
(ind, lbs)

Y

N

Y

N

Y

N

Y

N

LBS

Y

N

Y

N

Y

N

Y

N

GAL

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

GAL

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

121606000

These columns should include all the
harvests: other fish HARVESTED by
members of this household in 2010.
OTHER FISH
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE other fish than in recent years?....................................... X L S M
X = DO NOT USE
If the SAME or DO NOT USE, skip the next question.

If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HARVEST other fish?

On MAP, mark all harvest locations for page subject.

OTHER FISH: 06

CHISTOCHINA: 89
Page 10 of 24

Copper Basin Subsistence Update 2010

HARVESTS: MARINE INVERTEBRATES/SHELLFISH

HOUSEHOLD ID

Do members of your household USUALLY harvest MARINE INVERTEBRATES/SHELLFISH ?.........................
Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST marine invertebrates/shellfish ?..........................
Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many marine invertebrates/shellfish ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010. INCLUDE
marine invertebrates/shellfish you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If fishing with others,
report ONLY YOUR SHARE of the catch.

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
DUNGENESS CRAB
501004000
KING CRAB
501008000
TANNER CRAB
501012000
RAZOR CLAMS
500612000
FRESHWATER CLAMS

IN 2010, HOW MANY __________
DID YOUR HOUSEHOLD HARVEST?
(number taken)

UNITS
(ind, lbs,gal)

Y

N

Y

N

Y

N

Y

N

LBS

Y

N

Y

N

Y

N

Y

N

LBS

Y

N

Y

N

Y

N

Y

N

LBS

Y

N

Y

N

Y

N

Y

N

GAL

Y

N

Y

N

Y

N

Y

N

GAL

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

500604000

These columns should include all the
harvests: marine invertebrates/shellfish
HARVESTED by members of this
household in 2010.
MARINE INVERTEBRATES/SHELLFISH
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE marine invertebrates/shellfish than in recent years?..... X L S M
X = DO NOT USE
If the SAME or DO NOT USE, skip the next question.

If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HARVEST marine invertebrates/shellfish?
On MAP, mark all harvest locations for page subject.

MARINE INVERTEBRATES/SHELLFISH: 08

CHISTOCHINA: 89
Page 11 of 24

Copper Basin Subsistence Update 2010

HARVESTS: LARGE LAND MAMMALS

HOUSEHOLD ID

Do members of your household USUALLY hunt for LARGE LAND MAMMALS?.........................................................................Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST large land mammals?................................................................Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many large land mammals ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010. INCLUDE large land
mammals you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If hunting with others, report ONLY YOUR
SHARE of the catch.

(circle)
MOOSE
211800000
211800001
211800002
211800009
CARIBOU
211000000
211000001
211000002
211000009
BLACK BEAR
210600000
BROWN BEAR
210800000
DALL SHEEP
212200000
GOAT
211600000
DEER
211200000
BISON

(enter number by sex and month of take)
M
F
?
M
F
?
M
F
?
M
F
?

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

SEX

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD HARVEST?

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

UNITS
(ind)

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

IND

IND

210400000
LARGE LAND MAMMALS
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE large land mammals than in recent years?...................... X L S M
X = DO NOT USE
If the SAME or DO NOT USE, skip the next question.
If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HUNT FOR large land mammals?
…WHERE did members of your household HARVEST large land mammals?

On MAP, mark all harvest locations for page subject.
Circle all search areas on MAP

LARGE LAND MAMMALS: 10

CHISTOCHINA: 89
Page 12 of 24

Copper Basin Subsistence Update 2010

HARVESTS: SMALL LAND MAMMALS OR FURBEARERS

HOUSEHOLD ID

Do members of your household USUALLY hunt or trap for SMALL LAND MAMMALS OR FURBEARERS for subsistence?...Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST small land mammals or furbearers?.......................................Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many small land mammals or furbearers ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010.
INCLUDE small land mammals or furbearers you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If hunting
or trapping with others, report ONLY YOUR SHARE of the catch.

(circle)
BEAVER
220200000
PORCUPINE
222600000
SNOWSHOE HARE
221004000
RED FOX
220804000
CROSS FOX
220804020
WOLF
223200000
WOLVERINE
223400000
LAND OTTER
221200000
MUSKRAT

(enter number by month of take)

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

SEX

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD HARVEST?

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

UNITS
(ind)

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

222400000

Continue on next page

SMALL LAND MAMMALS: 14

CHISTOCHINA: 89

Page 13 of 24

Copper Basin Subsistence Update 2010

HARVESTS: SMALL LAND MAMMALS OR FURBEARERS

HOUSEHOLD ID

....continued
Please estimate how many small land mammals or furbearers ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010.
INCLUDE small land mammals or furbearers you gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If hunting
or trapping with others, report ONLY YOUR SHARE of the catch.

(circle)
WEASEL
223000000
LYNX
221600000
MARTEN
222000000
COYOTE
220400000
MINK
222200000
MARMOT
221800000
GROUND SQUIRREL
222800000
TREE SQUIRREL

(enter number by month of take)

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

SEX

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD HARVEST?

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

UNITS
(ind)

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

Y

N

Y

N

Y

N

Y

N

IND

222804000

SMALL LAND MAMMALS OR FURBEARERS
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE small land mammals or furbearers than in recent years? X L S M
X = DO NOT USE
If the SAME or DO NOT USE, skip the next question.
If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HUNT OR TRAP FOR small land mammals or furbearers?
…WHERE did members of your household HARVEST small land mammals or furbearers?
On MAP, mark all harvest locations for page subject.
Circle all search areas on MAP

SMALL LAND MAMMALS: 14

CHISTOCHINA: 89

Page 14 of 24

Copper Basin Subsistence Update 2010

HARVESTS: MIGRATORY WATERFOWL

HOUSEHOLD ID

Y
Do members of your household USUALLY hunt for MIGRATORY WATERFOWL?...................................................................

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST migratory waterfowl?...............................................................Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many migratory waterfowl ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010. INCLUDE migratory
waterfowl you gave away, ate fresh, lost to spoilage, or got by helping others. If hunting with others, report ONLY YOUR SHARE of the
catch.

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD HARVEST?

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
CANADA GEESE (CACKLERS)
410404040
CANADA GEESE (BIG LESSER)
410404080
CANADA GEESE (UNKNOWN)
410404000
WHITE-FRONTED GEESE

Specklebelly
410410000
SPECTACLED EIDER
410206060
BRANT (SEA GEESE)
410402000
EMPEROR GEESE
410406000
SNOW GEESE
410408000
GEESE (UNKNOWN)
410400000
TUNDRA SWAN (WHISTLING)
410604000
SANDHILL CRANE
410802000
MALLARD
410214000
NORTHERN PINTAIL

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

410220000
Continue on next page.

MIGRATORY WATERFOWL: 15

CHISTOCHINA: 89

Page 15 of 24

Copper Basin Subsistence Update 2010

HARVESTS: MIGRATORY WATERFOWL

HOUSEHOLD ID

...continued

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

GIVE AWAY?

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD HARVEST?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
GOLDENEYE
410210000
GREEN WINGED TEAL
410232060
CANVASBACK
410204000
BLACK SCOTER (BLACK DUCK)
410228020
DUCKS (UNKNOWN)

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

410200000

MIGRATORY WATERFOWL
Between JANUARY and DECEMBER, 2010…
X L S M
…Did your household use LESS, SAME, or MORE migratory waterfowl than in recent years?......................
X = DO NOT USE
If the SAME or DO NOT USE go on to next page.
If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HARVEST migratory waterfowl?
On MAP, mark all harvest locations for migratory waterfowl.
…WHERE did members of your household HUNT FOR migratory waterfowl?
Circle all search areas on MAP

MIGRATORY WATERFOWL: 15

CHISTOCHINA: 89
Page 16 of 24

Copper Basin Subsistence Update 2010

HARVESTS: OTHER BIRDS

HOUSEHOLD ID

Do members of your household USUALLY hunt for OTHER BIRDS?......................................................................................Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST other birds?...........................................................................Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many other birds ALL MEMBERS OF YOUR HOUSEHOLD HARVESTED in 2010. INCLUDE other birds you gave
away, ate fresh, lost to spoilage, or got by helping others. If hunting with others, report ONLY YOUR SHARE of the catch.

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD HARVEST?

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
PTARMIGAN
421804000
SPRUCE GROUSE

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

421802020

OTHER BIRDS
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE other birds than in recent years?........................................ X L S M
X = DO NOT USE
If the SAME or DO NOT USE go on to next page.

If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household HUNT FOR other birds?
…WHERE did members of your household HARVEST other birds?

On MAP, mark all harvest locations for other birds.
Circle all search areas on MAP

OTHER BIRDS: 15

CHISTOCHINA: 89
Page 17 of 24

Copper Basin Subsistence Update 2010

HARVESTS: BIRD EGGS

HOUSEHOLD ID

Do members of your household USUALLY look for BIRD EGGS?.......................................................................................Y

N

Between JANUARY and DECEMBER, 2010…
Y
…Did members of your household USE or TRY TO GATHER bird eggs?............................................................................

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many bird eggs ALL MEMBERS OF YOUR HOUSEHOLD GATHERED in 2010. INCLUDE bird eggs you gave
away, ate fresh, lost to spoilage, or got by helping others. If looking with others, report ONLY YOUR SHARE of the eggs.

UNKNOWN

DECEMBER

NOVEMBER

OCTOBER

SEPTEMBER

AUGUST

JULY

JUNE

MAY

APRIL

MARCH

FEBRUARY

JANUARY

IN 2010, HOW MANY __________ DID
MEMBERS OF YOUR HOUSEHOLD GATHER?

GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
GULL EGGS
431212000
GEESE EGGS
430400000
DUCK EGGS
430200000
EGGS (UNKNOWN)

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

430000000

EGGS
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE eggs than in recent years?.............................................. X L S M
X = DO NOT USE
If the SAME or DO NOT USE go on to next page.
If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household GATHER bird eggs?
…WHERE did members of your household LOOK FOR bird eggs?

On MAP, mark all harvest locations for bird eggs.
Circle all search areas on MAP

BIRD EGGS: 15

CHISTOCHINA: 89
Page 18 of 24

Copper Basin Subsistence Update 2010

HARVESTS: PLANTS AND BERRIES INCLUDING WOOD

HOUSEHOLD ID

Do members of your household USUALLY harvest PLANTS AND BERRIES INCLUDING WOOD?....................................................... Y

N

Between JANUARY and DECEMBER, 2010…
…Did members of your household USE or TRY TO HARVEST plants and berries including wood?........................................................ Y

N

IF NO, go to the next harvest page.
If YES, continue on this page…
Please estimate how many plants and berries including wood ALL MEMBERS OF YOUR HOUSEHOLD HARVESTING in 2010. INCLUDE plants and
berries including wood you gave away, ate fresh, lost to spoilage, or got by helping others. If harvesting with others, report ONLY YOUR SHARE of the
harvest.

IN 2010, HOW MANY
GIVE
AWAY?

RECEIVE?

USE?

TRY TO
HARVEST?

IN 2010
DID MEMBERS OF
YOUR HH…

(circle)
BLUEBERRY
601002000
LOW BUSH CRANBERRY
601004000
HIGH BUSH CRANBERRY
601006000
OTHER BERRIES

(List)
601000000
HUDSON BAY TEA

Labrador Tea
602018000
CLOUDBERRY
602036000
MUSHROOMS
US OO S
602040000
OTHER PLANTS

(List)
602000002
WOOD

Firewood
604000000
WOOD

(Specify Use)

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

____________
DID MEMBERS
OF YOUR HOUSEHOLD
HARVEST?
(number)

UNITS/NOTES
(each, gallons, buckets, etc.)

604000002

PLANTS AND BERRIES
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE plants and berries than in recent years?.........................................

X L S M
X = DO NOT USE

If the SAME or DO NOT USE go on to next page.

If different (LESS or MORE), how and why was your use different?

Between JANUARY and DECEMBER, 2010…
…WHERE did members of your household plants and berries including wood?

On MAP, mark all harvest areas for page subject.

PLANTS AND BERRIES: 17

CHISTOCHINA: 89

Page 19 of 24

Copper Basin Subsistence Update 2010

ASSESSMENTS

HOUSEHOLD ID

WILD RESOURCES
Between JANUARY and DECEMBER, 2010…
…Did your household use LESS, SAME, or MORE wild resources overall as in recent years?.................................. X L S M
X = DO NOT USE
If the SAME or DO NOT USE, skip the next question.
If different (LESS or MORE), how and why was your use different?

...Are there any resources your household avoided harvesting due to poor resource health and what was the issue?

Wild Harvest Assessment
In 2010 did your household get enough wild foods to meet its needs?

Y

N

Transportation
During 2010, did members of your household use the following
when harvesting or attempting to harvest wild foods?
boat
snowmachine
4-wheeler/ORV
airplane
dogsled
Does your household own, borrow, lease, or charter this equipment?
Own
Borrow
boat
snowmachine
4-wheeler/ORV
airplane
dogsled

Lease

circle

Y
Y
Y
Y
Y

N
N
N
N
N

Charter

Circle only responses that the respondent answered yes to above.

Y
Y
Y
Y
Y

N
N
N
N
N

Y
Y
Y
Y
Y

N
N
N
N
N

Y
Y
Y
Y
Y

N
N
N
N
N

Y
Y
Y
Y
Y

N
N
N
N
N

Comments:

Heating
What proportion of your household's heating comes from firewood?

circle

0%
1-25%
26-50%
51-75%
76-99%
100%
circle

In the past 5 years has your harvest area for firewood changed?

Y

N

If yes, please explain why?

How much do you spend annually to heat your home?
ASSESSMENTS

$
CHISTOCHINA: 89

Page 20 of 24

Copper Basin Subsistence Update 2010

JOBS

FOR EACH PERSON IN THE HOUSEHOLD, 16 YEARS OLD AND OLDER

HOUSEHOLD ID

Between JANUARY and DECEMBER, 2010…
…Did any members of your household earn money from a JOB or from SELF EMPLOYMENT?................................................................................ Y

N

For each member of this household born before 1995, please list EACH JOB held between JANUARY and DECEMBER, 2010.
For household members who did not have a job, write: "RETIRED," "UNEMPLOYED," "STUDENT," "HOMEMAKER," etc.
There should be at least ONE ROW for each member of this household born BEFORE 1995.

1ST JOB

SHIFT - PART TIME

JOB
LOCATION?
community

IN 2010,
WHAT MONTHS
DID HE OR SHE
WORK IN THIS JOB?
circle each month worked

ON-CALL, VARIES

FOR WHOM
DID HE/SHE
WORK
IN THIS JOB?
employer, SIC

PART TIME

WHAT KIND OF
WORK DID
HE/SHE DO
IN THIS JOB?
job title

FULL TIME

WHO
HAD
THIS
JOB?
person

REMEMBER COMMERCIAL
FISHING & TRAPPING
IF APPLICABLE.

SHIFT - FULL TIME

WORK
SCHEDULE…

We ask about jobs and income because we are trying to
understand all parts of the community economy. Many people use
wages from jobs to support subsistence activities. If one person
has more than one job, list each job on a separate line. (One
person may have several lines.)

circle one

IN 2010,
HOW MUCH DID
HE/SHE EARN
IN THIS JOB?
gross income

J F M A M J J A S O N D FT PT SF OC SP $

1 6 910100000
2ND JOB

SOC

2 6 910100000
3RD JOB

SOC

3 6 910100000
4TH JOB

SOC

4 6 910100000
5TH JOB

SOC

5 6 910100000
6TH JOB

SOC

6 6 910100000
7TH JOB

SOC

7 6 910100000
8TH JOB

SOC

8 6 910100000
9TH JOB

SOC

9 6 910100000
10TH JOB

SOC

10 6 910100000
11TH JOB

SOC

11 6 910100000
12TH JOB

SOC

12 6 910100000

SOC

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

/ YR

SCHEDULE
J F M A M J J A S O N D FT PT SF OC SP $

If a person is SELF-EMPLOYED (selling carvings,
crafts, bread, etc), list that as a separate job. Enter
"sewer," "carver," "baker," etc. as JOB TITLE. Work
schedule usually will be "ON CALL." For gross
income from self employment ("profit"), enter
revenue MINUS expenses.

/ YR

/ YR

SCHEDULE

If a person is UNEMPLOYED, specify retired, unemployed,
disabled, student, or homemaker as the JOB TITLE.
TRAPPING for barter or sale IS a job.
COMMERCIAL FISHING is recorded as "ON-CALL, VARIES"
for work schedule.

EMPLOYMENT: 23

WORK SCHEDULE
1 - Fulltime (35+
hours/week)
2 - Parttime (<35
hours/week)
3 - Shift (2 wks on/2 off,
etc.)

GROSS
INCOME
is the same as
TAXABLE
INCOME
on a W-2 form.

CHISTOCHINA: 89

Page 21 of 24

Copper Basin Subsistence Update 2010

OTHER INCOME

THIS PAGE IS ONLY FOR INCOME THAT IS NOT EARNED FROM WORKING

HOUSEHOLD ID

DIVIDENDS

Between JANUARY and DECEMBER, 2010…
Y N
…Did any members of your household receive a dividend from the Permanent Fund or a Native Corporation?............................
IF NO, go to the next section on this page.
If YES, continue below…
DID ANYONE
TOTAL
ALASKA PFD IN 2010
AHTNA INC. DIVIDENDS IN 2010
IN YOUR HH
AMOUNT
RECEIVE
ALL MEMBERS
1 PFD = $
1 share= #######
INCOME
OF YOUR HH
2 PFDs = $
100 shrs= #######
FROM _____
RECEIVED
3 PFDs = $
150 shrs= #######
IN 2010?
IN 2010?
4 PFDs = $
200 shrs= #######
(circle one)
(dollars)
5 PFDs = $
ALASKA PERMANENT
6 PFDs = $
Y N
$
/YR
FUND DIVIDEND
7 PFDs = $
32
8 PFDs = $
NATIVE CORPORATION
9 PFDs = $
Y N
$
/YR
DIVIDENDS
10 PFDs = $
13
11 PFDs = $
Between JANUARY and DECEMBER, 2010…
…Did any members of your household receive OTHER income such as SENIOR BENEFITS or UNEMPLOYMENT?.................

Y

N

IF NO, go to the next page.
If YES, continue below…

OTHER

CHILD BENEFITS

ELDER BENEFITS

ASSISTANCE

JOB BENEFITS

RECEIVED
IN 2010?
(circle one)
UNEMPLOYMENT

TOTAL AMOUNT
IN 2010?
(dollars)

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

$____________ per week
$____________ per month

for ______ weeks =
for ______ months =

Y

N

$

/YR

Y

N

$

/YR

12
WORKERS'
COMPENSATION
8
FOOD STAMPS
(QUEST CARD)
11
ADULT
PUBLIC ASSISTANCE
3
ALASKA SENIOR
BENEFITS (LONGEVITY)
6
PENSION &
RETIREMENT
5
SOCIAL
SECURITY
7
SUPPLEMENTAL
SECURITY
10
FOSTER
CARE
41
CHILD
SUPPORT
15
ENERGY
ASSISTANCE
9
OTHER (describe)

scratch paper for calculations

Depends
on
Income

OTHER INCOME: 24

$125 per month for 12 months = $1,500 per elder
$175 per month for 12 months = $2,100 per elder
$250 per month for 12 months = $3,000 per elder

CHISTOCHINA: 89
Page 22 of 24

Copper Basin Subsistence Update 2010

COMMENTS

HOUSEHOLD ID

DO YOU HAVE ANY QUESTIONS, COMMENTS, OR CONCERNS?

INTERVIEW SUMMARY:

BE SURE TO FILL IN THE STOP TIME ON THE FIRST PAGE!!!!

COMMENTS: 30

CHISTOCHINA: 89
Page 23 of 24

Copper Basin Subsistence Update 2010

DISCARD THIS PAGE
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