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Micro Enterprise Template 5 -Form Fill
Information
Q01
Name of the State
Q02
Name of the District
Q03
Name of the Block
Q04
Name of Panchayat
Q05
Name of the Village (PSU)
Q06
Type of Village
Project
Comparison
Q07
Micro-enterprise number
Q08
Name of micro-enterprise owner
Q09
Address of Household
Q10
Address of micro-enterprise
Q11
Type of user
User group (with MLINDA connection)
Non-user group (without MLINDA connection)
Q12A
Interviewer’s Visits - 1
Q12A_1
Date
Q12A_2
Result
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
Q12B
Interviewer’s Visits - 2
Q12B_1
Date
Q12B_2
Result
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
Q12C
Interviewer’s Visits - 3
Q12C_1
Date
Q12C_2
Result
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
Enterprise PROFILE
A01
Name of the respondent/entrepreneur
A02
What is the sex of respondent?
Male
Female
Transgender
A03
What is the religion of your respondent?
Hindu
Muslim
Christian
Sikh
Buddhist/Neo-Buddhist
Jain
Jewish
Parsi/Zoroastrian
Sarna
Other (Specify)
A04
Do you belong to a scheduled caste, scheduled tribe, other backward class or general class?
Scheduled Caste
Scheduled Tribe
Other Backward Class
General
Other (Specify)
A05
Whether your enterprise is women owned enterprise?
Yes
No
A06
What is the date of formation of the enterprise?
A07
What is the category of enterprise?
Irrigation Pump
Flour Mill
Rice Huller
Daal Mill
Chaura Mill
Ice Factory
Shop
Poultry
Computer Center
Shopkeeper (Chiller)
Sweet shop
Medical store
Oil processing mill
Brick factory
Computer/Xerox shop
Computer coaching centre
Mobile repair shops/ TV repair shops/ other repair shop
Saloons (barber shops)
RO water filter plant RO
Saw Mill
Photo Studio
Tailoring/sewing
Others (Specify)
A08
On an average, for how many hours do you run the enterprise in a day?
A09
Is this enterprise your primary source of income?
Yes
No
A10
How many people are engaged in your enterprise?
A11
In which months is the enterprise operational?
January
February
March
April
May
June
July
August
September
October
November
December
A12
How many other enterprises of similar nature are present in your village?
FUEL USE
B01
What is the average daily requirement of electricity in your enterprise? (in hours per day)
B02
What is the average daily supply of electricity in your enterprise? (in hours per day)
B03
Do you use the following appliances in your enterprise
B03_1
Bulb
Yes
No
B03_2
Fan
Yes
No
B03_3
T.V
Yes
No
B03_4
Rice Huller
Yes
No
B03_5
Flour Mill
Yes
No
B03_6
Chiller/Refrigerator
Yes
No
B03_7
Computer
Yes
No
B03_8
Photo copy machine
Yes
No
B03_9
Sewing Machine
Yes
No
B03_10
Oil expeller
Yes
No
B03_11
Cutting machines
Yes
No
B04
What is the main source of electricity that you use for operating this appliance?
B04_1
Bulb
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_2
Fan
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_3
T.V
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_4
Rice Huller
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_5
Flour Mill
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_6
Chiller/Refrigerator
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_7
Computer
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_8
Photo copy machine
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_9
Sewing Machine
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_10
Oil expeller
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B04_11
Cutting machines
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05
In case the main source fails, what do you use to operate the appliance?
B05_1
Bulb
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_2
Fan
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_3
T.V
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_4
Rice Huller
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_5
Flour Mill
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_6
Chiller/Refrigerator
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_7
Computer
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_8
Photo copy machine
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_9
Sewing Machine
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_10
Oil expeller
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B05_11
Cutting machines
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B06
On an average, how many hours in a day is this appliance operated?
B06_1
Bulb
B06_2
Fan
B06_3
T.V
B06_4
Rice Huller
B06_5
Flour Mill
B06_6
Chiller/Refrigerator
B06_7
Computer
B06_8
Photo copy machine
B06_9
Sewing Machine
B06_10
Oil expeller
B06_11
Cutting machines
B08
What is the source of lighting in your enterprise?
Kerosene Lamp
Gas Lamp
Rechargeable Solar lamp
No lighting source
Others (Specify)
B09
In case of non-availability of major source of electricity, what do you do?
Resort to other renewable sources of energy (Bio-gas, Bio-mass pellets etc.)
Close the enterprise till fuel supply is restored
Resort to other non-renewable sources of energy (Diesel, Kerosene etc.)
Others(Specify)
B10
Do you face any of the following issues with respect to the electricity connection or the available source of energy?
B10_1
Light Fluctuation
Never
Yes, Sometimes
Yes, Frequently
Always
B10_2
Low Voltage
Never
Yes, Sometimes
Yes, Frequently
Always
B10_3
Disruption in Supply (Irregular Supply)
Never
Yes, Sometimes
Yes, Frequently
Always
B10_4
Bad or poor supply during Rainy season or during bad weather
Never
Yes, Sometimes
Yes, Frequently
Always
B10_5
Meter Availability (No meter is there and they want one)
Never
Yes, Sometimes
Yes, Frequently
Always
B10_6
Difficult to contact in case of issues
Never
Yes, Sometimes
Yes, Frequently
Always
COST OF PRODUCTION AND REVENUE
C01
What has been the initial investment in the enterprise?
C02
Did you take any loan for the enterprise?
Yes
No
C03
How much loan did you take for the enterprise?
C04
What was the source of the loan for the enterprise?
Bank / Commercial Lender
Money Lender
Friends/Relative
SHG Loan
MFI
Others specify
C05
What was the monthly rate of interest for the loan?
C06
What is the average monthly expenditure for the enterprise on
C06_1
Labour
C06_2
Rent for the enterprise
C06_3
Transportation cost
C06_4
Repairs and Maintenance
C06_5
Other Inputs/capital investment (Purchase of something for the enterprise)
C07
On an average, how much do you spend on fuel and lighting for the enterprise in one month?
C07A
Quantity
C07A_1
Firewood (kg)
C07A_2
Grid electricity ( unit)
C07A_3
Kerosene
C07A_4
LPG
C07A_5
Coal
C07A_6
petrol (litre) [including conveyance]
C07A_7
diesel (litre) [including conveyance]
C07A_8
Solar Power
C07A_9
Mini-grid
C07B
What was the price for per unit of the item?
C07B_1
Firewood (kg)
C07B_2
Grid electricity ( unit)
C07B_3
Kerosene
C07B_4
LPG
C07B_5
Coal
C07B_6
petrol (litre) [including conveyance]
C07B_7
diesel (litre) [including conveyance]
C07B_8
Solar Power
C07B_9
Mini-grid
C07C
Average Total Amount( in Rs)
C07C_1
Firewood (kg)
C07C_2
Grid electricity ( unit)
C07C_3
Kerosene
C07C_4
LPG
C07C_5
Coal
C07C_6
petrol (litre) [including conveyance]
C07C_7
diesel (litre) [including conveyance]
C07C_8
Solar Power
C07C_9
Mini-grid
C08
On an average, how much do you earn from this enterprise in a month?
C09
Of the total sales, how much do you earn from sale of your products to customers outside this village?
C10
What is the value of current unsold stock with you?
EXPANSION OF ENTERPRISE
D01
Is your enterprise able to fulfil the demands of its customers?
Yes
No
D02
Do you plan to expand your current enterprise?
Yes
No
D03
What are the reasons for not expanding?
Financial Issues
Lack of electricity
Lack of raw materials
Lack of technical skills
Lack of potential market
Others (Specify)
D04
Have you received any skill development training for better development of your enterprise?
Yes
No
D05
What all trainings have you undergone?
Operation Handling
Book Keeping
Marketing
Technical training
Others (Specify)
D06
Do you require any training to develop your skills for running the enterprise?
Yes
No
D07
If yes, what kind of training do you require?
Operation Handling
Book Keeping
Marketing
Technical training
Others (Specify)
D08
Have you received any support in establishing backward linkages for running your enterprise?
Yes
No
D09
What kind of backward linkage support have you received for your enterprise?
Linking with the raw material supplier
Linking with source of financing
Others (Specify)
D10
Do you require any support in establishing backward linkages for running your enterprise?
Yes
No
D11
What kind of backward linkage support do you require for your enterprise?
Linking with the raw material supplier
Linking with source of financing
Others (Specify)
D12
Have you received any support in establishing forward linkage for running your enterprise?
Yes
No
D13
If, yes What kind of forward linkage support have you received? (Multiple Response)
Helped in networking
Established new clients
Others (Specify)
D14
Do you require any support in establishing forward linkages for running your enterprise?
Yes
No
D15
What kind of forward linkage support do you require for your enterprise?
Helped in networking
Established new clients
Others (Specify)
Satisfaction Level Test
E01
On a scale of 5, how satisfied are you with the following:
E01_1
Price of electricity
Highly Satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Highly Dissatisfied
E01_2
Quality of light
Highly Satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Highly Dissatisfied
E01_3
Regularity
Highly Satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Highly Dissatisfied
E02
Are you aware of MLINDA connections available in your village?
Yes
No
E03
Did you ever avail an MLINDA connection?
Yes
No
E04
What package did you avail?
1 LED bulb+ 1 Mobile charging point
2 LED bulb+ 1 Mobile charging point
Fixed package for operating appliance
Metered connection
Other (Specify)
E05
Why did you discontinue with the connection?
Proved to be too costly
Supply hours were less
Supply hours did not meet requirements
Voltage fluctuations in supply
Irregular supply
Difficult to report problems
Poor response to filed complaints
Other (Specify)
E06
What are the reasons for not opting the connection under MLINDA?
Don’t feel the need of electricity
Already have a grid connection
Registration fees for MLINDA is too much
Monthly rent is high
Have not been able to get in touch with the person responsible for providing the connection
Others (Specify)
E07
Would you like to have a connection under MLINDA?
Yes
No
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