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Household Template New 48 -Form Fill

Household Identification
Q01

State
Q01A

Code
Q02

District
Q02A

Code
Q03

Block
Q03A

Code
Q04

EA/PSU

Q04A

Code
Q05

Household number
Q06

Language of interview
Q07

Household Head Phone Num
Q08

HH Type
Q09

Interview Details

Q10A

Enumerator Name
Q10B

Enumerator ID
Q11A

Supervisor Name
Q11B

Supervisor ID
Q12

Date of Interview DD/MM/YY
Household Profile
A01

Complete Name of the respondent

A02

Respondent’s age
A03

What is the sex of respondent?

A04

What is your religion?

A05

Do you belong to a scheduled caste, scheduled tribe, other backward class or general class?

A06

Please specify the category you fall in?

A07

Name
A08

Age in completed years (Years)
A09

Gender
A10

Marital status
A11

Primary occupation
A12

Highest education completed
A13

If going to school/college, then in which class?
A14

Type of school/college
A15

Is the name of the chief wage earner given in the rooster above?
A16

Select the code from HH ID of chief wage earner?
Household Characteristics
B01

What is the type of house?
B02

How many rooms in this house are used for sleeping?
B03

What is the ownership status of the house you are currently staying in?

B04

Do you have any agricultural Land?
B05

If yes, then please give details of your total cultivated land?

B05A

Irrigated agricultural land

B05A1

Owned and cultivated by family
B05A1_1

Unit

B05A2

Owned but leased out to others

B05A2_1

Unit

B05A3

Not owned by family but leased in from someone else

B05A3_1

Unit

B05B

Non-irrigated agricultural land

B05B1

Owned and cultivated by family
B05B1_1

Unit

B05B2

Owned but leased out to others

B05B2_1

Unit

B05B3

Not owned by family but leased in from someone else

B05B3_1

Unit

B05C

Orchard

B05C1

Owned and cultivated by family
B05C1_1

Unit

B05C2

Owned but leased out to others

B05C2_1

Unit

B05C3

Not owned by family but leased in from someone else

B05C3_1

Unit

B06

Do you have electricity at your home?
B07

How many bulbs/tube lights do you have at home
B08

How many fans (table and ceiling fans) do you have at your home?
B09

If the product is available in the household check the box

B09_1

Ceiling /table fan

B09_2

Color Tv

B09_3

Refrigerator

B09_4

Washing Machine

B09_5

Desktop/Laptop

B09_6

Air Conditioner

B09_7

Air cooler

B09_8

Iron

B09_9

Electric Kettle

B09_10

Mixer Grinder

B09_11

LPG Stove

B09_12

Four-Wheeler

B09_13

Two-Wheeler

B10

Are you able to use it freely without worrying about electricity (hours and voltage)?

B10_1

Ceiling /table fan

B10_2

Color Tv

B10_3

Refrigerator

B10_4

Washing Machine

B10_5

Desktop/Laptop

B10_6

Air Conditioner

B10_7

Air cooler

B10_8

Iron

B10_9

Electric Kettle

B10_10

Mixer Grinder

B10_11

LPG Stove

B10_12

Four-Wheeler

B10_13

Two-Wheeler

B11

Are you planning to buy this in the next one year?

B11_1

Ceiling /table fan

B11_2

Color Tv

B11_3

Refrigerator

B11_4

Washing Machine

B11_5

Desktop/Laptop

B11_6

Air Conditioner

B11_7

Air cooler

B11_8

Iron

B11_9

Electric Kettle

B11_10

Mixer Grinder

B11_11

LPG Stove

B11_12

Four-Wheeler

B11_13

Two-Wheeler

B12

What is the primary reason you don’t want to buy this?

B12_1

Ceiling /table fan

B12_2

Color Tv

B12_3

Refrigerator

B12_4

Washing Machine

B12_5

Desktop/Laptop

B12_6

Air Conditioner

B12_7

Air cooler

B12_8

Iron

B12_9

Electric Kettle

B12_10

Mixer Grinder

B12_11

LPG Stove

B12_12

Four-Wheeler

B12_13

Two-Wheeler

B13

Does this Household have a home-based enterprise?
B14

Does availability to electricity plays an important role in running the home-based enterprise?

B15

Does the current electricity supply comfortably meet the demand of your enterprise?
B16

Will availability of additional hours of electricity significantly increase your income from the home-based enterprise?
B17

What is the key advantage of additional hours of electricity in your home-based enterprise?

Electricity Access
C01

What are the sources of electricity supply of your household?
C02

How are you billed for electricity?
C03

How much were you billed (total from all sources) for electricity in each of the last three months?

C03_1

Last bill
C03_2

2nd last bill
C03_3

3rd last bill
C04

On average, how many hours of electricity is available in 24 hours from the national grid?

C04_1

Summer
C04_2

Winter
C05

On an average, how many hours of electricity does your HH get in in 24 hours from the all the sources of electricity combined (including backup sources)?

C05A

Summer
C05B

Winter
C06

On average how many hours of electricity is available in your household during evening hours (from 6:00 pm to 10:00 pm) from the national grid, during the following seasons?

C06A

Summer
C06B

Winter
C07

On average how many hours of electricity is available in your household during evening hours (from 6:00 pm to 10:00 pm) from all sources combined, during the following seasons?

C07A

Summer
C07B

Winter
C08

In total how many working mobile phones are present in your HH
C09

Now we would like to ask about the energy backup devices that are available at your home. Please note that back up sources are used when electricity supply is not available from primary sources of electricity . Simpa device is not to be included in this list

C10

Presence

C10_1

Invertor with battery

C10_2

Invertor without battery

C10_3

Battery

C10_4

Generator

C10_5

Solar based lighting system
C11

What is the brand of this product?

C11_1

Invertor with battery

C11_2

Invertor without battery

C11_3

Battery

C11_4

Generator

C11_5

Solar based lighting system
C12

How satisfied are you with this back up source?

C12_1

Invertor with battery

C12_2

Invertor without battery

C12_3

Battery

C12_4

Generator

C12_5

Solar based lighting system
C13

Purchase cost?

C13_1

Invertor with battery

C13_2

Invertor without battery

C13_3

Battery

C13_4

Generator

C13_5

Solar based lighting system
C14

Monthly expense in running the same

C14_1

Invertor with battery

C14_2

Invertor without battery

C14_3

Battery

C14_4

Generator

C14_5

Solar based lighting system
C15

In summers, how frequently do you need to use this in a week?

C15_1

Invertor with battery

C15_2

Invertor without battery

C15_3

Battery

C15_4

Generator

C15_5

Solar based lighting system
C16

On average how many hours per day do you need to use this backup source?

C16_1

Invertor with battery

C16_2

Invertor without battery

C16_3

Battery

C16_4

Generator

C16_5

Solar based lighting system
C17

Do you use this fuel source?

C17_1

Candle
C17_2

Kerosene
C17_3

LPG for lighting
C18

Monthly expense

C18_1

Candle
C18_2

Kerosene
C18_3

LPG for lighting
C19

Apart from above which of these small backup sources for lighting do you have at home? (select all which applies)
C20

Select the applainces which you would definitely want to be connected with electricity back up and rank them in order of priority?

C20_1

Bulb/CFL/Tube
C20_2

Ceiling /table
C20_3

Color Tv

C20_4

Refrigerator

C20_5

Washing Machine
C20_6

Desktop/Laptop

C20_7

Air Conditioner

C20_8

Air cooler

C20_9

Iron

C20_10

Electric Kettle
C20_11

Mixer Grinder

C21

Now we will be reading out a few statements one by one. We would like you to listen to each one carefully and decide whether what is being said applies to you and your family as well. If it does, then tell us to what extent you agree with the statements and if they don’t, then tell how much you disagree. Not applicable will be coded if the statement is not applicable to the respondent, i.e. the situation being stated does not apply to your household.

C21_1

We get enough hours of electricity to keep all the mobile phones in the HH charged
C21_2

Children have faced health-related issues because they had to use fuel-based lighting solutions (candle/kerosene lamp etc.) for their studies
C21_3

My children find it difficult to study at night because of frequent power cuts
C21_4

Dinner is usually cooked before sunset because of frequent power cuts at night
C21_5

I cannot use some of my electric appliances due to voltage fluctuation issues
C21_6

I am concerned about my high grid electricity bill

C21_7

I get sufficient electricity from my back up source whenever required

C21_8

In summers I really must spend more than usual for backup sources of electricity, as electricity supply from grid connection is not sufficient

C21_9

Increase in availability of reliable power will help me to increase my household income

C21_10

I am aware about solar energy system

C21_11

We face many sleepless nights during summer, as the fan/cooler stop working because of frequent power cuts
C21_12

Our quality of life can considerably improve if our electricity availability gets improved

C21_13

I would be willing to consider purchasing any product that gives me better electricity supply for longer hours
C21_14

I would be open to consider HH level solar energy solution provided I can afford it

C21_15

Considering what I pay for electricity, I am very happy with the quality (hours and voltage) of electricity supply I get at home all around the year
Financial Profile (Income, savings, loans, & expenses)
D01

Does the HH have any Bank/Post office Saving account?
D02

What is the total number of accounts your HH has?
D03

Do you have an Aadhar card?
D04

Did your HH earn any income from this source in the last 12 months?

D04_1

From sale of agriculture/horticulture produce

D04_2

From wage labour

D04_3

From salaries

D04_4

From business/retail sales

D04_5

From rent

D04_6

From remittances

D04A

What was the annual income from this activity? (Amount in Rupees )

D04A_1

From sale of agriculture/horticulture produce

D04A_2

From wage labour

D04A_3

From salaries

D04A_4

From business/retail sales

D04A_5

From rent

D04A_6

From remittances

D05

How much were you able to save during the last one year after meeting all your household expenses, including committed repayment of loans, committed investments in business, agriculture, and regular medical expenses?

D06

How have you been saving your money?
D07

From which of the following sources, have you or any other member of your family ever taken a loan?

D08

Does your household have any outstanding debt that you are repaying currently?
D09

What is the total value of outstanding loan of your household as of today?
D10

What was the purpose for which you had taken this loan?
D11

Is some part of this debt inherited?

D12

Is there any asset (home, land, jewellery, etc.) that is currently under mortgage because it has been used as collateral for securing any loan in the past?)
Simpa Users-Happy Bucket
E01

Category of Customer
E02

Which Product do you have from SIMPA?
E03

Have you taken the product on cash payment or on lease /EMI based payment?
E04

How many months ago did you purchase/Lease the product?
E05

How did you come to know about the SIMPA product for the first time?
E06

What were the different options which you had considered (to improve your electricity supply) before buying this SIMPA product?

E07

How much would you say was the influence of SIMPA representatives (RSA/CRA/Urja Mitra) in convincing you to purchase the product?
E08

A person might get interested and consider buying a SIMPA product after hearing about it from a relative, or after he notices his neighbor purchase it (E10), but he only decides to purchase it once the demonstration is given by the SIMPA staff (E11).

E09

A person was interested in such product after his child complained regarding need of reliable electricity for evening study, and he got more intrigued when his neighbor purchased it. In this case 2 options will be marked in E10. But he finally purchased it because his children’s study was very dear to him, thus marking the same in E11.

E10

What the key reasons because of which you decided to consider spending money on an alternative energy source?
E11

What was the most influential factors which persuaded you to purchase this product?
E12

Now please tell us about your satisfaction level on these various parameters of the SIMPA product that you are using

E12_1

Overall quality of the SIMPA product

E12_2

Hours of electricity backup available from the SIMPA product once it is full charged

E12_3

Stability of voltage of electricity available from the product

E12_4

Service of the product from SIMPA
E12_5

Servicing time (response time in case of issue in product)

E12_6

Hours taken to get full charge

E13

Statements

E13_1

Compared to the time I didn’t had SIMPA solar product, my total spend on electricity has Increased, Decreased, or No change

E13_2

Compared to the time I didn’t had SIMPA solar product, the number of hours of electricity I get has Increased, Decreased, or No change
E13_3

Compared to the time I didn’t had SIMPA solar product, the hours of light availability for my children’s study time has increased, decreased, or no change
E13_4

Compared to the time I didn’t had SIMPA solar product, the flexibility to do household chores after sunset has improved, worsened, or No change
E13_5

Compared to the time I didn’t had SIMPA solar product, the sleep quality at night has improved, worsened, or No change
E14

Please answer the following in reference to SIMPA product

E14_1

I am satisfied with the correctness information provided during sales pitch by sales person
E14_2

I am very satisfied with the ease of usage of the product
E14_3

Considering what in paid for the product/pay in EMI, I am very satisfied with the hours of electricity I get
E14_4

The maintenance requirement for the product is very low

E14_5

I use the product on the regular basis
E14_6

I am very happy with the decision to buy this product
E14_7

I will certainly recommend this product to my friends

Simpa User: Hard Bucket
F01

Which is the most important reason you stopped paying EMI for the product?
F02

What changed from the time you purchased the product?
F03

Did you try to contact the customer service?
F04

What happened when you tried to contact them
F05

How many EMIs did you pay before deciding to stop the payment?
F06

Would you have kept the products it if the EMI was lower?
F07

At what EMI would you have continued with the payments?
Potential Customers
G00

Exposure to product architecture before exposure to price

G01

Will you be willing to consider spending some time to learn about some of the solar products developed for household usage?

G02

Which of the following products are you likely to be interested in purchasing?
G03

What is the primary reason that you don’t want to purchase any of these products?
G03A

How much would you be willing to pay upfront if you could get a product which fulfills yours need as answered in last question?
G04

After exposure to pricing

G05

Now that you know the prices of each product, which of the following are you likely to be interested in purchasing?
G06

After exposure to EMI option

G07

Now that you know that easy financing is available, which of the following are you likely to be interested in purchasing?
G08

Why are you not interested to purchase any of these products?
G09

Which other back up source will you be interested to buy?

G10

What is the reason for preferring this back up source?
G11

What are the key reasons because of which you want interested to buy this product