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Household Template 24 -Form Fill

Interview Details
Q01

Investigator

Q02

Supervisor

Q03

Date of Interview

Q04

Interview Start Time

Q05

Interview End Time

Q06

GPS Coordinates

Household Identification
A01

District

A02

Sub-Division

A03

Taluka

A04

Project/Comparison Village

A05

Cluster Code

A06

Village code

A07

Village Census Code

A08

Interview S.No.

A09

Respondent Name

A10

Respondent Phone Number

A11

Age of respondent

A12

Gender of respondent

A13

Religion of the respondent

A14

Social Category of the respondent

A15

Education qualification of the respondent?

A16

Highest education qualification of any member of the HH?

A17

Does your household belong to APL or BPL category?

A18

What is the type of your family?

A19

Does your household have a bank account?

A20

Is the head of the HH a male member or female member ?

A21

Total number of members in the household.

A22

How many members are there in your household in each of these categories ?

A23

How many working members are there in your household?

A24

In what all sources of employment the members of your HH engaged?

A25

Does any member of your HH or in your blood relation migrate to other cities/places?

A26

What are the reasons for migration by the HH member/s?

A27

How many members of your HH have migrated to another city/ place?

A28

On average, for how many days in the last one year did the HH members stay away from your home?

A29

Is there any member in your household who is part of SHG?

A30

Is there any member in your household who is part of a Farmer producer company (FPC)?

A31

Is any member of your household part of any district/block level Panchayati Raj Institution/ or Market committee/Agriculture produce market committee?

A32

What specific position do you or your household member hold ?

Agricultural Land Ownership
B01

Does your household own or has leased-in any agricultural land in past 12 months?

B02

Total agricultural land owned (as per 8A).

B03

On whose name in your family is this agricultural land registered?

B04

Total cultivable land

B05

Leased-in land in the past 12 months

B06

Total land cultivated in the past 12 months

B06_1

Kharif

B06_2

Rabi

B06_3

Summer

B07

Do you have a source of irrigation for the land that you cultivate?

B08

Owned Land under irrigation in the past 12 months

B08_1

Kharif

B08_2

Rabi

B08_3

Summer

B09

Total leased land under irrigation in the past 12 months

B09_1

Kharif

B09_2

Rabi

B09_3

Summer

B10

Do you borrow or purchase water from someone’s source or have your own source of irrigation?

B11

What is the cost of purchasing water incurred by you in the last 12 months?

B12

Do you have any water harvesting structure?

B13

What kind of water harvesting structure do you have ?

B14

What are the sources of irrigation that you use to cultivate your land?

B15

Is the dug well surrounded by fence or wall?

B16

What is the size of the farm pond?

B17

Is the farm pond covered by plastic or lining ?

B18

What is the source of water for the farm pond?

B19

Are you able to meet your irrigation requirements from these sources?

B20

How do you draw water from these sources to your field?

B21

Is the pump star-rated or energy saving ?

B22

How many pumps do you own?

B23

How many metres of pipes have you installed in your field?

B24

What type of pipes do you use?

B25

What method of irrigation do you use?

B26

Land under drip irrigation in the past 12 months

B26_1

Kharif

B26_2

Rabi

B26_3

Summer

B27

Land under sprinkler irrigation in the past 12 months

B27_1

Kharif

B27_2

Rabi

B27_3

Summer

B28

What is the flow rate of your drip system?

B29

What is the flow rate of your sprinkler system?

B30

Do you have any land under orchards or plantation?

B31

How much of your land is under orchard or plantation?

B32

Do you have any trees in the periphery of your agriculture land?

B33

Which all trees have you planted in the periphery of your agricultural land?

B34

Do you practice protected cultivation using shade net?

B35

How much of your area is under protected cultivation using shade net?

B36

What do you cultivate under shade net?

B37

Do you do protected cultivation using poly house?

B38

How much of your area is under protected cultivation using Polyhouse?

B39

What do you cultivate under polyhouse?

B40

Do you do protected cultivation using poly tunnel?

B41

How much of your area is under protected cultivation using Polytunnel?

B42

What do you cultivate under polytunnel?

B43

Do you have fencing for your farm?

B44

How much area is under graded/ compartment bunding?

B45

What mulching practices do you follow in your field?

Crop Production
C01

Crop Code

C02

How much of the agricultural land was used in the cultivation of this crop in the last _______ season?

C03

How much of this land is under irrigation for this crop ?

C04

When did you sow this crop? (month/ week)

C05

When did you harvest this crop? (month/ week)

C06

Watering type?

C07

What is the spacing between Drips for this crop?

C08

What is the spacing between Sprinklers for this crop?

C09

Total irrigations for this crop?

C10

Irrigation Number

C11

Irrigation month/week

C12

Watering days per irrigation

C13

Irrigation time in Hours/day (pumping hrs)

C14

What type of seeds did you use for this crop?

C15

How much of this area is cultivated using certified seeds of improved variety?

C16

Can you tell which type of certified/improved seed variety did you use?

C17

Did you use any farm tool/machinery for this crop?

C18

How much was your total harvest?

C19

From this production, how much have you sold? (in quintals)

C20

What was the average market price you got for this crop? (price per quintal)

C21

What was the total income from the sale of this crop?

C22

What is your expenditure on seeds for this crop?

C23

What was your expenditure on fertilizers and manure for this crop?

C24

What was your expenditure on plant protection chemicals (chemical + bio) for this crop?

C25

What was/ would be the cost for transporting the produce to the market?

C26

What was the cost of hiring machinery/ tools for this crop?

C27

What was the cost of using diesel for this crop?

C28

What was the cost of using electricity for this crop?

C29

How much did you spend on hiring human labour?

C30

How much did you spend on irrigation/ purchasing water for this crop cost?

C31

How much do you pay for renting animal labour for this crop?

C32

How much do you pay as crop insurance for this crop?

C33

What were your Transaction cost (mandi tax, administrative fees etc.)?

C34

What costs did you incur for storage of this produce?

C35

Did you use any of the following inputs?

C35_1

Seeds

C35_2

Fertiliser – Nitrogen (Urea)

C35_3

Fertiliser – Potash (MOP)

C35_4

Fertiliser – Phosphate (DAP, SSP)

C35_5

Manure- Farm yield (Farm Yard Manure)

C35_6

Manure- Poultry

C35_7

Oil cake

C35_8

Chemical pesticides

C35_9

Biopesticides

C35_10

Machinery/agriculture tools

C35_11

Diesel

C35_12

Electricity

C35_13

Irrigation/Purchasing water (e.g. tankers)

C35_14

Minor repair and maintenance of machinery and equipment

C35_15

Interest

C35_16

Lease rent for land

C35_17

Transaction cost (mandi tax, administrative fees etc.)

C36

From where did you purchase/get this input?

C36_1

Seeds

C36_2

Fertiliser – Nitrogen (Urea)

C36_3

Fertiliser – Potash (MOP)

C36_4

Fertiliser – Phosphate (DAP, SSP)

C36_5

Manure- Farm yield (Farm Yard Manure)

C36_6

Manure- Poultry

C36_7

Oil cake

C36_8

Chemical pesticides

C36_9

Biopesticides

C36_10

Machinery/agriculture tools

C36_11

Diesel

C36_12

Electricity

C36_13

Irrigation/Purchasing water (e.g. tankers)

C36_14

Minor repair and maintenance of machinery and equipment

C36_15

Interest

C36_16

Lease rent for land

C36_17

Transaction cost (mandi tax, administrative fees etc.)

C37

Amount applied (kg or Litre/acre; hours used)

C37_1

Seeds

C37_2

Fertiliser – Nitrogen (Urea)

C37_3

Fertiliser – Potash (MOP)

C37_4

Fertiliser – Phosphate (DAP, SSP)

C37_5

Manure- Farm yield (Farm Yard Manure)

C37_6

Manure- Poultry

C37_7

Oil cake

C37_8

Chemical pesticides

C37_9

Biopesticides

C37_10

Machinery/agriculture tools

C37_11

Diesel

C37_12

Electricity

C37_13

Irrigation/Purchasing water (e.g. tankers)

C37_14

Minor repair and maintenance of machinery and equipment

C37_15

Interest

C37_16

Lease rent for land

C37_17

Transaction cost (mandi tax, administrative fees etc.)

C38

How much did you spend in total in the last 12 months?

C39

Was the machinery/ tool that you rent easily accessible and available when you need it?

C40

Are you engaged in seed production activity?

C41

For which crop and variety do you do seed production?

C42

What is the area under seed production?

C43

Where is the seed processing done?

C43A

Where do you sell the seeds?

C44

Is skilled labour(who are able to use modern farm tools or machinery) easily available in your village ?

Pest Management and knowledge of IPM: In the past 12 months
D01

Do you prepare Jeevamrut/Beejamrut/Neem extract etc. to apply it on your land ?

D02

Has any pest or disease affected your crop in the past 12 months?

D03

Is pest management followed in the godown/ storage facilities that you use to store your produce?

D04

Do you know about any natural enemies to pests?

D05

Do you use pesticides in your field?

D06

Please mention what safety precautions do you follow during spraying pesticides?

D07

How did you dispose the used pesticide container?

D08

Have you been informed about the safety instructions on how to use the pesticides in your local language either in training or while purchasing?

D09

From where did you get this information on safety instructions for pesticide use?

D10

Have you attended any training that informed you about different pests and their management?

D11

Crop (5 major crops)

D12

Pest/ Disease

D13

Which season

D14

What did you do when this happened?

D15

Type of pesticide used or measures adopted

D16

What type of biopesticide have you used or measures have you taken against pests?

D17

Are you aware if the pesticides you are using are not banned/ restricted for use ?

D18

Where did you get information about banned pesticides?

D19

Are you aware of soil testing?

D20

Do you have a soil health card?

D21

When was the last soil testing done?

D22

From where this soil testing was done

D23

The data needs to be entered based on information in the soil health card

D23_1

Soil Type

D23_2

Soil Depth(in foot)

D23_3

Sand %

D23_4

Silt %

D23_5

Clay %

D23_6

Soil Organic C

D23_7

Total Nitrogen

D23_8

Total Phosphorus

D23_9

Total Potassium

D24

Are you aware of integrated nutrient management?

D25

Do you adopt the following practices as part of integrated nutrient management?

D26

How much area did you cultivate under intercropping in the last 12 months?

D27

Which crop combinations do you cultivate in intercropping?

D28

What do you do with the crop residue from your farm?

Marketing of produce
E01

Where do you sell your agricultural produce?

E02

How much distance do you have to travel on average to reach the market where you mostly sell your agricultural produce?

E03

On average how much time does it take for you to travel to the market where you mostly sell your produce?

E04

What is the mode of transport that you mostly use to travel to sell your produce?

E05

Do you mostly sell your produce separately or sell it after aggregating it with other farmers ?

E06

Do you think you have adequate space to store your crops ?

E07

Do you store the produce after harvesting?

E08

Crop Stored

E09

Number of days stored in last 12 months

E10

Where was it stored?

E11

Distance of storage facility from farm

E12

Are you aware about pledge loan scheme?

E13

Have you taken any pledge loan ?

E14

What is the reason for not availing pledge loan scheme?

E15

From where you have taken pledge loan ?

E16

How much loan have you taken as pledge loan ?

E17

Do you sell the produce directly after harvesting or do you engage in any value addition activity ?

E18

What type of value addition do you do in your produce before selling it ?

E19

What type of value-added product do you prepare?

E20

Do you have access to cold storage facility in your area?

E21

Do you have access to grading and sorting facility in your area?

Agriculture Allied activities and its income
F01

Any CASH income from this source OR production for own consumption in past 12 months?

F01_1

Milk (dairy, sheep, goat, etc.)

F01_2

Egg (poultry, ducks, etc.) (no.)

F01_3

Live animals (e.g., cattle, sheep, goat, pig, poultry & ducks, etc.)

F01_4

Wool (sheep, goat, etc.) (kg)

F01_5

Fish (kg)

F01_6

Honey (kg)

F01_7

Manure / Vermicompost

F01_8

Fodder

F01_9

Sericulture

F01_10

NFTP

F01_11

Nursery

F01_12

Seed Production

F01_13

Other(specify)

F02

Total revenue from this activity in past 12 months (INR)

F02_1

Milk (dairy, sheep, goat, etc.)

F02_2

Egg (poultry, ducks, etc.) (no.)

F02_3

Live animals (e.g., cattle, sheep, goat, pig, poultry & ducks, etc.)

F02_4

Wool (sheep, goat, etc.) (kg)

F02_5

Fish (kg)

F02_6

Honey (kg)

F02_7

Manure / Vermicompost

F02_8

Fodder

F02_9

Sericulture

F02_10

NFTP

F02_11

Nursery

F02_12

Seed Production

F02_13

Other(specify)

F03

Total costs on this activity in past 12 months (INR)

F03_1

Milk (dairy, sheep, goat, etc.)

F03_2

Egg (poultry, ducks, etc.) (no.)

F03_3

Live animals (e.g., cattle, sheep, goat, pig, poultry & ducks, etc.)

F03_4

Wool (sheep, goat, etc.) (kg)

F03_5

Fish (kg)

F03_6

Honey (kg)

F03_7

Manure / Vermicompost

F03_8

Fodder

F03_9

Sericulture

F03_10

NFTP

F03_11

Nursery

F03_12

Seed Production

F03_13

Other(specify)

F04

Now we would like to ask your family income in the last 12 months from sources other than farming and farming allied activities

F04_1

Agriculture Labour

F04_2

MNREGA

F04_3

Other Labour

F04_4

Salary

F04_5

Business/Own enterprise(shops/skilled work etc)

F04_6

Remittance

Training and Adoption of Climate resilient technologies
G01

Did you receive any training or participate in any demonstration on this technology before 2018?

G01_1

Contour cultivation

G01_2

Cultivation by broad bed furrow (BBF) method

G01_3

Intercropping

G01_4

Use of improved seed Varieties

G01_5

Seed treatment

G01_6

Integrated Nutrient Management

G01_7

Integrated Pest Management

G01_8

Furrow opening

G01_9

Foliar spray of 2% Urea at flowering and 2% DAP at boll development

G01_10

Protective irrigation through farm pond

G01_11

Conservation tillage

G01_12

Incorporation of biomass

G01_13

Mulching

G01_14

Cultivation of citrus crops on broad ridges

G01_15

Canopy management in fruit Crops

G01_16

Shade net

G01_17

Polyhouse

G01_18

Poly tunnel

G01_19

Rainwater Harvesting

G01_20

Rearing of Small ruminants

G01_21

Backyard poultry

G01_22

Sericulture

G01_23

Apiculture

G01_24

Inland fisheries

G01_25

Land preparation

G01_26

Use of machinery or agriculture tools in farming

G02

Did you adopt this technology at your farm in the last 1 year?

G02_1

Contour cultivation

G02_2

Cultivation by broad bed furrow (BBF) method

G02_3

Intercropping

G02_4

Use of improved seed Varieties

G02_5

Seed treatment

G02_6

Integrated Nutrient Management

G02_7

Integrated Pest Management

G02_8

Furrow opening

G02_9

Foliar spray of 2% Urea at flowering and 2% DAP at boll development

G02_10

Protective irrigation through farm pond

G02_11

Conservation tillage

G02_12

Incorporation of biomass

G02_13

Mulching

G02_14

Cultivation of citrus crops on broad ridges

G02_15

Canopy management in fruit Crops

G02_16

Shade net

G02_17

Polyhouse

G02_18

Poly tunnel

G02_19

Rainwater Harvesting

G02_20

Rearing of Small ruminants

G02_21

Backyard poultry

G02_22

Sericulture

G02_23

Apiculture

G02_24

Inland fisheries

G02_25

Land preparation

G02_26

Use of machinery or agriculture tools in farming

Exposure to climate vulnerability and risk mitigation mechanism adopted
H01

Did you face any climate vulnerability (less rainfall, high temperature, dry spell, unseasonal rainfall) in the last one year ?

H02

What type of vulnerability did you face?

H03

What technology did you adopt to curb the adverse effect of climate (less rainfall, high temperature, dry spell, unseasonal rainfall) in the last one year ?

H04

Do you think the above adopted technologies in the last one year have been helpful in reducing the impact of climate vulnerability (less rainfall, high temperature) ?

H05

Had you used any digital solution related to agriculture before one year i.e. before June 2018

H06

What type digital solution related to agriculture had you or your family used before June 2018 ?

H07

Did you use any technology-related source of Information for agriculture before June 2018?

H08

Had you received any agriculture or climate related advisory before June 2018 ?

H09

What type of agriculture or climate related advisory have you received before June 2018 ?

H09_1

Crop Prices

H09_2

Crop Planning /Advisory

H09_3

Weather Forecast

H09_4

Pest/Disease Management

H09A

Source of Information

H09A_1

Crop Prices

H09A_2

Crop Planning /Advisory

H09A_3

Weather Forecast

H09A_4

Pest/Disease Management

H09B

Frequency

H09B_1

Crop Prices

H09B_2

Crop Planning /Advisory

H09B_3

Weather Forecast

H09B_4

Pest/Disease Management

H09C

Cost Incurred (per each time)

H09C_1

Crop Prices

H09C_2

Crop Planning /Advisory

H09C_3

Weather Forecast

H09C_4

Pest/Disease Management

Access to credit
I01

Have you or family taken any loan/credit before June 2018?

I02

What is the source from which you have taken credit?

I03

What were the reason because of which you have taken this loan?

I04

In case loan is taken for agriculture, what was the specific reason to avail credit ?

I05

What amount of credit did you avail before June 2018 and at what annual interest rate?

I06

What amount of loan have you taken specifically for investing in agriculture(this includes purchase land, equipment, machinery, livestock, Creating storage facilities etc)?

I07

Have you received benefit of debt waiver scheme?

I08

Do you have to face issues while getting access to credit for your farming?

I09

What issues do you have to face?

I10

What is the key reason that you did not avail any credit for your farming?

I11

Do you have crop insurance?

I12

For which crop have you taken crop insurance?

I13

From where you have taken this crop insurance (before June 2018)?

I14

Have you availed benefits from crop insurance ?

HH Characteristics
J01

Does your family own this house?

J02

What is the type of your house?

J03

How many rooms are there in your house?

J04

What is the main source of drinking water for members in the house?

J05

Is the water available throughout the year

J06

During which months do you experience scarcity of water?

J07

What is type of toilet facility available in your house?

J08

What is the main source of lighting in your house?

J09

What is the main type of fuel does your HH use for cooking?

J10

Does your HH own the following? (Items in the list should be in working condition)

J10_1

Electricity connection

J10_2

Pressure cooker

J10_3

Mixer/grinder

J10_4

Motorcycle/scooter

J10_5

Car/Jeep

J10_6

Tractor and/ or other agricultural equipment (incl. power tiller)

J10_7

Bicycle

J10_8

Animal-drawn cart

J10_9

Chair

J10_10

Table

J10_11

Cot/ Bed

J10_12

Mattress

J10_13

Clock or watch

J10_14

Electric fan

J10_15

Water pump

J10_16

Thresher

J10_17

Radio/Transistor

J10_18

Sewing machine

J10_19

Refrigerator

J10_20

Color television

J10_21

Telephone

J10_22

Computer

J10_23

Cell Phone

J11

Do you have this farm machinery or equipments available in your house

J11_1

Laser land leveler

J11_2

Wooden plank

J11_3

Rotavator

J11_4

Tractor

J11_5

Disc harrow

J11_6

Cultivator

J11_7

Zero till drill/DSR machine

J11_8

Hoe

J11_9

Wooden plough

J11_10

Iron plough

J11_11

Planter

J11_12

Ox plough cart

J11_13

Happy seeder

J11_14

Irrigation pump

J11_15

Generator

J11_16

Power weeder

J11_17

Power sprayer

J11_18

Mini harvester

J11_19

Combine harvester

J11_20

Thresher

J11_21

Straw baler

J11_22

Broadcast seeder

J12

Does your HH own the following animals?

J12_1

Cows

J12_2

Buffalos

J12_3

Bullocks

J12_4

Sheep

J12_5

Goats

J12_6

Piggery

J12_7

Ducks

J12_8

Poultry

J12_9

Fishery (acres)

J12_10

Beekeeping

J12_11

Other livestock

J13

Number of animals owned

J13_1

Cows

J13_2

Buffalos

J13_3

Bullocks

J13_4

Sheep

J13_5

Goats

J13_6

Piggery

J13_7

Ducks

J13_8

Poultry

J13_9

Fishery (acres)

J13_10

Beekeeping

J13_11

Other livestock