The implementation of minimal competency assessment in Indonesia indicates that schools’ curricula must teach literacy and numeracy. However, whether the teacher is prepared to prohibit it must be explored. This article describes developing a questionnaire to survey the extent to which mathematics teachers prepare to prohibit literacy and numeracy. Questionnaire development was carried out in a six-step process: determining objectives, determining population and sample, determining how to collect responses, preparing questionnaires, conducting pilot surveys, and revising the questionnaire. The population of this questionnaire is all secondary school mathematics teachers in Indonesia. The questionnaire was designed based on a conceptual framework of preparedness to prohibit literacy and numeracy. The pilot survey was carried out through small-scale trials with three colleagues to detect flow questions and then revise them. The results of the development of the questionnaire instrument consisted of 36 questions divided into three parts. The opening section consists of general information about the questionnaire, general information on the respondents, and the respondents’ background. The content section consists of information on literacy and numeracy, self-development, learning literacy and numeracy or solving problems, and the potential for implementing literacy and numeracy learning. The closing section consists of acknowledgments and a contact person. This questionnaire is expected to be a disclosure tool in the downturn in teacher preparation in prohibiting literacy and numeracy.

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