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Shg Template 4 -Form Fill

Interview Details
Q01

GPS Coordinates   

Q02

State / Union Territory 

Q03

District Name 

Q04

Mandal/Block Name  

Q05

GP Name   

Q06

Village name   

Q07

Project code  

Q08

Name of Implementing Agency

Q09

Interviewer code   

Q10

Interviewer Name   

Q11

Supervisor Name   

Q12

Date of Interview   

Q13

Interview Start Time   

Q14

Interview End Time   

Respondent profile
A01

Name of the respondent 

A02

Respondent’s phone number 

A03

What is your age? (in completed years) 

A04

How many members are there in your household? 

A05

What is the highest level of education that you have completed?  

A06

Which ID is used to verify the identity of the respondent? 

A07

Please specify which card you have. 

A08

What is your social category? 

A09

What is your household’s main source of income?  

A10

What is your annual income range? 

A11

Which state/UT were you born in? 

A12

Where did you live before you moved here? 

A13

How long have you been living in your current Village/Town/City of residence? 

Livelihood
B01

Are you part of a Self-Help Group, supported by ITC?

B02

What are the sources of income in your household?

B03

From which occupation does your household earn maximum money?

B04

What is your primary occupation?

B05

How much income does your household earn annually in total (inclusive of all earnings from all sources)

B06

How much income do you earn annually in total? (Earning of beneficiary only)

B07

Would you say your family income has improved past two years?

Training and Capacity Building
C01

Did you and other SHG members receive any training?

C02

Which organization provided trainings to the SHG?

C03

Which trainings were provided to you and SHG members?

C04

Did you learn essential skills through these trainings?

C05

Do you require more trainings?

C06

If yes, in which area do you require additional training?

Savings
D01

Do you have any savings?

D02

Why don’t you save?

D03

How do you save?

D04

At what intervals do you save?

D05

What is the purpose of your savings?

Loans
E01

Have you taken a loan from the SHG?

E02

For what purpose did you take the loan?

E03

What amount loan did you take?

Social Security Scheme linkage
F01

What all government schemes are you availing?

F02

To what extent did the SHG help you avail these schemes?

SHG Leader
G01

Are you the Leader of a Self-Help Group?

G02

When did you become the leader of the SHG?

G03

What encouraged you to be the leader of the SHG?

G04

What vision do you have for your SHG?

G05

Are SHG members aware of the importance of savings?

G06

What proportion of SHG members actively save?

G07

How do SHG members prefer to save money?

G08

What is the saving corpus currently?

G09

Where is the money kept?

G10

Who maintains the SHG books?

G11

Is this corpus increasing month-on-month?

G12

Does the SHG lend money to members?

G13

Does your SHG have any entrepreneurial venture?

G14

Who helped you set up a business?

G15

What entrepreneurial venture does your SHG have?

Self Help Group Members
H01

When did you become a member of self-help group (SHG)?

H02

Who encouraged you to become a SHG member?

H03

How many members are in your SHG?

H04

What all roles exist within your SHG?

H05

What is your role within the SHG?

H06

How is the SHG leader selected?

H07

What is the role of SHG leader?

H08

What is the role of members in the SHG?

Support from Self Help Group to Members
I01

Has the SHG been able to support in your livelihood/income generation?

I02

Why has the SHG not been able to support in livelihood/income generation?

I03

In what areas has the SHG supported you?

I04

What business do you own?

I05

How has the SHG supported you?

I06

Has your business income increased after joining SHG?

I07

If Yes, then how have you spent the income from your business?