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Enterprise Template 1 -Form Fill
VILLAGE PROFILE
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
Name of household head
Q08
Address of Household
Q09
Interviewer’s Visits
Q10
Date
Q11
Result
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
Q12
Supervisor
Enterprise PROFILE
A01
Name of the respondent/ entrepreneur
A02
What is the sex of respondent?
Male
Female
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)
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?
Male
Female
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
Yes
No
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 source of electricity that you use for operating this appliance?
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?
Govt. Grid
Diesel Generator (Owned)
Diesel Generator (Supplier)
Solar Panel (Owned)
Mini-grid in village
Don’t use electricity
B06
What is the source of lighting in your enterprise?
Kerosene Lamp
Gas Lamp
Rechargeable Solar lamp
No lighting source
Others (Specify)
B07
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)
B08
Do you face any of the following issues with respect to the electricity connection or the available source of energy?
Never
Yes, Sometimes
Yes, Frequently
Always
B08_1
Light Fluctuation
Never
Yes, Sometimes
Yes, Frequently
Always
B08_2
Disruption in Supply (Irregular Supply)
Never
Yes, Sometimes
Yes, Frequently
Always
B08_3
Bad or poor supply during Rainy season or during bad weather
Never
Yes, Sometimes
Yes, Frequently
Always
B08_4
Meter Availability (No meter is there and they want one)
Never
Yes, Sometimes
Yes, Frequently
Always
B08_5
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
MFI
Others specify
C05
What was the monthly rate of interest for the loan?
COST OF PRODUCTION AND MONTHLY REVENUE
D01
What is the average monthly expenditure for the enterprise on:
D01A
Labour
D01B
Repairs and Maintenance
D01C
Other Inputs (Purchase of something for the enterprise)
D02A
On an average, how much do you spend on fuel and lighting for the enterprise in one month?
D02A1
Firewood (kg)
D02A2
Grid electricity ( unit)
D02A3
Kerosene
D02A4
LPG
D02A5
Coal
D02A6
petrol (litre) [including conveyance]
D02A7
diesel (litre) [including conveyance]
D02A8
Solar Power
D02A9
Mini-grid
D02B
Quantity
D02B1
Firewood (kg)
D02B2
Grid electricity ( unit)
D02B3
Kerosene
D02B4
LPG
D02B5
Coal
D02B6
petrol (litre) [including conveyance]
D02B7
diesel (litre) [including conveyance]
D02B8
Solar Power
D02B9
Mini-grid
D02C
What was the price for per unit of the item?
D02C1
Firewood (kg)
D02C2
Grid electricity ( unit)
D02C3
Kerosene
D02C4
LPG
D02C5
Coal
D02C6
petrol (litre) [including conveyance]
D02C7
diesel (litre) [including conveyance]
D02C8
Solar Power
D02C9
Mini-grid
D02D
Average Total Amount( in Rs)
D03
On an average, how much do you earn from this enterprise in a month?
D04
Of the total sales, how much do you earn from sale of your products to customers outside this village?
D05
What is the value of current unsold stock with you?
EXPANSION OF ENTERPRISE
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