Please Wait...
Clf Template 3 -Form Fill
Identification Information
Q01
District Name
Q02
District Code
Q03
District Status
NRETP
BTDP
Q04
Block Name
Q05
Block Code
Q06
Model Cluster Level Federation Name
Q07
Model Cluster Level Federation Unique ID
Survey Information
A01
Name of the respondents
A02
Designation of the respondent
President
Vice-President
Secretary
Treasurer
Bookkeeper
Community Cadre
Cluster Facilitator
If others (specify____)
A03
FIRST VISIT
A03_1
Interviewer name
A03_2
Interviewed code
A03_3
Date of the interview
A03_4
Result of the interview
Interview complete
Visit rescheduled
Interview incomplete
Refused
Respondent is out of station for extended period
Respondent is temporarily away
Other (specify)
A03_5
Record time when you start the interview
A03_6
Record time when you end the interview
A04
SECOND VISIT
A04_1
Interviewer name
A04_2
Interviewed code
A04_3
Date of the interview
A04_4
Result of the interview
Interview complete
Visit rescheduled
Interview incomplete
Refused
Respondent is out of station for extended period
Respondent is temporarily away
Other (specify)
A04_5
Record time when you start the interview
A04_6
Record time when you end the interview
A05
THIRD VISIT
A05_1
Interviewer name
A05_2
Interviewed code
A05_3
Date of the interview
A05_4
Result of the interview
Interview complete
Visit rescheduled
Interview incomplete
Refused
Respondent is out of station for extended period
Respondent is temporarily away
Other (specify)
A05_5
Record time when you start the interview
A05_6
Record time when you end the interview
M-CLF Formation, Training, and Capacity Building
B01
What is the name of this M-CLF?
B02
What is the date of formation of this M-CLF?
B03
How many VOs are a member of this M-CLF?
B04
How many VOs had left the M-CLF since formation?
B05
Is this M-CLF registered?
Yes
No
B06
What is the reason for delay in the registration process of M-CLF?
Error in documentation work
Problem due to presence of already registered nodal VOs under the CLF
Others, specify ()
B07
What is the date of registration of this M-CLF?
B08
Does this CLF receive the registration certificate?
Yes
No
B09
Does this CLF display the registration certificate in their office premises?
Yes
No
B10
Has the office of M-CLF been established?
Yes
No
B11
Date of establishment of the office?
B12
Why the office M-CLF not established yet?
B13
Is the office of M-CLF functional?
Yes
No
B14
Why the office of M-CLF not functional?
Operational Guidelines of M-CLF
C01
Does this M-CLF have operational guidelines?
Yes
No
C02
Do these operational guidelines clearly define the roles and responsibilities of the office bearer of your M-CLF and their subcommittees?
Yes
No
C03
Are these guidelines available in the public domain?
Displayed in the M-CLF office
Printed on M-CLF records
Not displayed anywhere
If others (specify____)
C04
Does the M-CLF review its operational guidelines?
Yes
No
C05
When was the last time your M-CLF had reviewed its operational guidelines?
C06
Does your M-CLF prepare an annual action plan?
Yes
No
C07
When was the last time this M-CLF prepared annual action plan?
C08
Who prepares the annual action plan of M-CLF?
BOD
Master bookkeeper
Office Bearers of M-CLF
Any member of M-CLF
Area Coordinator
Cluster Facilitator
Group meeting with OB, CF, BOD
If others, Please specify(____)
C09
What all information do you include in the annual action plan?
C10
What is the reason for not preparing the Annual Action Plans?
C11
Does this M-CLF prepare annual budgets?
Yes
No
C12
What is the reason for not preparing the Annual budgets?
C13
When was the last time when this budget was prepared by M-CLF?
C14
Who is responsible for preparing annual budgets for this M-CLF?
Master Bookkeeper
Office Bearers of M-CLF
Area Coordinator
M-CLF Facilitator
M-CLF Manager
BOD
Do Not Know
If others, Please Specify()
Leadership
D01
Position currently held by this office bearer
President
Vice President
Secretary
Treasurer
Deputy Secretary
D02
Name of the office bearer
D03
Age of this Office bearer
D04
Religion of this office-bearer
Hinduism
Islam
Christianity
Jainism
Sikh
Buddhism
D05
Social category of this office bearer
SC
ST
OBC
General
If other(Specify___)
D06
In which year were you appointed for this position?
D07
Is your appointment fresh or repeated?
New Appointment
Re-appointment
D08
Do you receive any honorarium for this position?
Yes
No
D09
Education level of this office-bearer
Primary
Middle
Secondary
Senior secondary
Certificate/Diploma course
Graduate
Postgraduate
Signature Literate
D10
What type of ration card does the member’s household have?
Orange (APL)
Yellow (BPL)
White (Annual Income > Rs 1 Lakh)
Annapurna (Age above 65 years)
Antodaya Anna Yojana (AAY)
Priority Household (PHH)
Do not have any ration card
Do not know
If Other, please specify
D11
Is the office bearer disabled?
Yes
No
BOD/ RGB/ General Body
E01
When was the present Board of Directors (BOD) of the M-CLF constituted?
E02
How frequently do the BOD of this M-CLF meet?
Fortnightly
Monthly
Quarterly
Need based meeting
If others (specify___)
E03
How many were BOD meetings held in the last 12 months? (From July 2021 to June 2022)
E04
How many BOD have consecutively not attended last three meetings?
E05
Can you please tell me if the last four RGB meetings were conducted?
E05_1
Meeting 1
Yes
No
E05_2
Meeting 2
Yes
No
E05_3
Meeting 3
Yes
No
E05_4
Meeting 4
Yes
No
E06
Why were the meetings not held?
Office bearers were not available
There was a function (marriage, festival, etc.) in the village
Not aware of conducting meeting
If others (specify___)
E07
How many members VO were part of this M-CLF in the following months?
E07_1
44713
E07_2
44682
E07_3
44652
E07_4
44621
E08
How many VO-RGB members were absent continuously from last four meetings?
E09
What topics were discussed in the last 4 meetings of the RGB
Issues related to savings & loan
Maintenance of records
Disbursement of CIF
Schedule and loan repayment terms
Grading of VO and SHG
Promotion/ Status of PG
Promotion/ Status of RRM
Promotion/ Status DKR
Issues related to VHSND
Issues related to Community Cadre
Quality of services provided by ASHA/AWW
Sanitation issues
Convergence with welfare schemes
Gender issues
Symptoms and preventive measures for CORONA (COVID-19)
Performance of Sub-committees
If others (Specify___)
E10
Does this M-CLF conduct Annual General Meeting (AGM)?
Yes
No
E11
When was the last Annual General Meeting (AGM) conducted?
E12
How many members were present at the last AGM?
E13
What were the issues raised/ discussed in the AGM?
Issues related to savings & loan
maintenance of records
Disbursement of CIF
Schedule and loan repayment terms
Grading of VO and SHG
Promotion/ Status of PG/ PC
Promotion/ Status of RRM
Promotion/ Status DKR
Issues related to VHSND
Issues related to Community Cadre
Quality of services provided by ASHA/AWW
Sanitation issues
Convergence with welfare schemes
Gender issues
Symptoms and preventive measures for CORONA (COVID-19)
Future Plans of M-CLF
If others (Specify___)
E14
What is the reason for not conducting Annual general meeting?
Meeting Regularity and Attendance of RGB in Last six Months/Meetings
F01
Date of Meeting
F02
Total Number of VOs
F03
Number of VOs present
F04
Presence of BRLPS Staff (CC/ AC/ M-CLF Manager/ BPM etc)
Yes
No
F05
Presence of Master Bookkeeper
Yes
No
F06
Cadre
Yes
No
F07
Livelihood Specialist
Yes
No
Sub-Committees
G01
Has the M-CLF formed different sub-committees for managing various roles and responsibilities of the M-CLF?
Yes
No
G01A
What are the reasons for not forming any sub-committee in the M-CLF?
G02
When was this committee formed?
G02_1
Social Action Committee
G02_2
Social Audit and Property Evaluation Committee
G02_3
Monitoring & capacity building Committee for VO
G02_4
Loan Repayment committee
G02_5
Procurement Committee
G03
How many members are there on the committee currently?
G03_1
Social Action Committee
G03_2
Social Audit and Property Evaluation Committee
G03_3
Monitoring & capacity building Committee for VO
G03_4
Loan Repayment committee
G03_5
Procurement Committee
G04
How many times did this committee meet in the last 12 months?
G04_1
Social Action Committee
G04_2
Social Audit and Property Evaluation Committee
G04_3
Monitoring & capacity building Committee for VO
G04_4
Loan Repayment committee
G04_5
Procurement Committee
G05
Were orientation of sub-committee members was done?
Yes
No
G06
Does sub-committee members aware about their key roles and responsibilities of the committee?
Yes
No
G07
How would you rate the effectiveness of this committee?
very effective
effective
not effective
no response
G08
Does this M-CLF conduct review meetings for sub-committees?
Yes
No
G09
What is the reason for not conducting review meeting of sub-committies?
G10
How frequently are review meetings conducted?
Monthly
Bimonthly
Quarterly
Bi- Annually
Annually
G11
How many review meetings were conducted in the past 12 months? (July 2021 to June 2022)
Review and Monitoring
H01
What is the target number of households to form SHG under this M-CLF?
H02
How many households are already part of SHGs?
H03
How many SHGs are linked this M-CLF?
H04
Out of the total SHGs, how many of them are currently functional?
H05
How many SHGs have less than 10 members?
H06
How many SHGs do not have OB members selected?
H07
Please provide the number of SHG whose office bearers have received training on M-CLF concept.
H08
How many SHGs profile linked to this M-CLF is updated on MIS (SHG Profile entry)?
H09
How many members of SHGs records linked to this M-CLF is updated on MIS?
H10
How many SHGs received Community Investment Money (CIM/ Dari Baksa)?
H11
How many SHGs have a saving bank account opened?
H12
How many SHGs do not have a saving bank account opened?
H13
How many SHGs received all Modular Trainings?
H14
Do all the SHGs have Community Mobiliser (CM) appointed under this M-CLF?
Yes
No
H15
How many SHGs are left to get a Community Mobiliser (CM)?
H16
Does the Community Mobiliser (CM) of all SHGs received training?
Yes
No
H17
How have many SHGs’ members Aadhar seeding completed so far?
H18
How many SHGs maintain the book of records?
H19
How many SHGs have received the Revolving Fund (RF)?
H20
How many SHGs have availed the Initial Capitalization Fund (ICF) from VO?
H21
How many SHGs have their loan account/ Cash Credit Linkage (1st Bank linkage)?
H22
How many SHGs have received bank loans?
H23
Is there a possibility to form more VOs under this M-CLF?
Yes
No
H24
Does all VOs are mapped under this M-CLF?
Yes
No
H25
How many VOs records are updated on MIS?
H26
How many VOs have their saving bank account opened?
H27
Does BOD for all the VOs has been selected?
Yes
No
H28
How many VOs are yet to select their BOD members?
H29
Does OB for all the VOs has been selected?
Yes
No
H30
How many VOs are yet to select their OB members?
H31
Does BOD/ OB of VOs under this M-CLF has received training?
Yes
No
H32
How many VOs have bookkeepers appointed under this M-CLF?
H33
How many of the Bookkeepers of VOs have received training?
H34
Do all VOs under this M-CLF have received Modular training?
Yes
No
H35
How many VOs under this M-CLF have sub-committees formed?
H36
Did the members of sub-committees of VOs were oriented?
Yes
No
H37
How many VOs under this M-CLF received HRF?
H38
How many VOs under this M-CLF received FSF?
H39
How many VOs update the records of the transactions performed in the MIS?
H40
How frequently are the VOs updating MIS?
Weekly
Fortnightly
Monthly
Once in two months
No predetermined frequency
Do not update
H41
How many VOs maintain the book of records under this M-CLF?
H42
How many VOs books of records were audited in the financial year 2021-2022?
H43
How many VOs are yet to purchase items through Community Investment Money (CIM/ dari baksa fund)?
H44
How often does the M-CLF review the activities of the member VOs?
Weekly
Fortnightly
Monthly
Once in two months
No predetermined frequency
Do not update
H45
What are all the activities of VO reviewed by the M-CLF?
Books of records /Quality of bookkeeping
Micro credit plan
Utilization of the CIF
Democratic financial transaction in VO
Financial transaction between VO and M-CLF
Social Issues
VO Bank-Linkage
Promotion of livelihood activities by VO
If others (Specify__)
H46
What kind of support does this M-CLF provide to the member VOs?
Providing handholding support in maintenance of records
Providing support in maintaining financial discipline
Providing support in identification of livelihood activities
Providing information on flagship government schemes
Facilitating market linkages
If others (Specify__)
H47
Does this M-CLF prepare and submit Mashik Prativedan to BPIU?
Yes
No
H47A
What is the reason for not preparing mashik Prativedan?
H47B
What is the grade of M-CLF awarded by BPIU?
Grade A
Grade B
Grade C
H48
Who prepares the Mashik Prativedan for this M-CLF?
Master Bookkeeper
Office Bearers of M-CLF
Area Coordinator
M-CLF Facilitator
M-CLF Manager
Do Not Know
If others, Please Specify()
H49
In which month last Mashik Prativedan was Submitted?
H50
Please provide us the status of the last 4 Mashik Prativedan submitted to BPIU
H50_1
44713
Yes
No
H50_2
44682
Yes
No
H50_3
44652
Yes
No
H50_4
44621
Yes
No
H51
Does this M-CLF conduct grading of VO?
Yes
No
H52
How many VOs of this M-CLF are under following grades?
H52_1
Grade A
H52_2
Grade B
H52_3
Grade C
H53
Who conducts the grading process of VO in M-M-CLF?
Master Bookkeeper
M-CLF Facilitator
Office bearer of M-CLF
External agency
BRLPS staff
Do not know
If others, Please specify (____)
H54
What is the reason for not conducting grading of VOs?
Maintenance of Record
I01
Check if the following book of records is available or not?
I01_1
Cash Book
Yes
No
I01_2
General Ledger
Yes
No
I01_3
Minutes Book
Yes
No
I01_4
Loan Register
Yes
No
I01_5
Stock register
Yes
No
I01_6
Cheque Issue Register
Yes
No
I01_7
Membership Register
Yes
No
I01_8
Receipt Book
Yes
No
I01_9
Voucher Book
Yes
No
I01_10
Cadre Selection Register
Yes
No
I01_11
Savings Register
Yes
No
I01_12
Daily Expenses Register
Yes
No
I02
Check if the book of records is updated or not?
I02_1
Cash Book
Updated till last meeting
Partly updated
Incomplete
I02_2
General Ledger
Updated till last meeting
Partly updated
Incomplete
I02_3
Minutes Book
Updated till last meeting
Partly updated
Incomplete
I02_4
Loan Register
Updated till last meeting
Partly updated
Incomplete
I02_5
Stock register
Updated till last meeting
Partly updated
Incomplete
I02_6
Cheque Issue Register
Updated till last meeting
Partly updated
Incomplete
I02_7
Membership Register
Updated till last meeting
Partly updated
Incomplete
I02_8
Receipt Book
Updated till last meeting
Partly updated
Incomplete
I02_9
Voucher Book
Updated till last meeting
Partly updated
Incomplete
I02_10
Cadre Selection Register
Updated till last meeting
Partly updated
Incomplete
I02_11
Savings Register
Updated till last meeting
Partly updated
Incomplete
I02_12
Daily Expenses Register
Updated till last meeting
Partly updated
Incomplete
I03
Please record the date last updated
I03_1
Cash Book
I03_2
General Ledger
I03_3
Minutes Book
I03_4
Loan Register
I03_5
Stock register
I03_6
Cheque Issue Register
I03_7
Membership Register
I03_8
Receipt Book
I03_9
Voucher Book
I03_10
Cadre Selection Register
I03_11
Savings Register
I03_12
Daily Expenses Register
I04
Please specify the reason for not updating the book of records
I04_1
Cash Book
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_2
General Ledger
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_3
Minutes Book
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_4
Loan Register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_5
Stock register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_6
Cheque Issue Register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_7
Membership Register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_8
Receipt Book
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_9
Voucher Book
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_10
Cadre Selection Register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_11
Savings Register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I04_12
Daily Expenses Register
Bookkeeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to M-CLF
Book format has changed, and training is yet to be given
BookKeeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
I05
Is financial statement of previous financial year available in the M-CLF office?
Yes
No
I06
Is Passbook of M-CLF bank account available in the M-CLF office?
Yes
No
I07
Is passbook updated for all the transactions conducted till the date of survey?
Yes
No
I08
What is the reason for not updating the passbook frequently?
I09
Does this M-CLF maintain Cadre Payment register?
Yes
No
Financial Management
J01
Opening of M-CLF Bank Account
J01_1
Is the bank account of M-CLF opened?
Yes
No
J01_2
How many bank accounts are opened and linked with your M-CLF?
J01_3
Type of M-CLF bank account
Savings
Current
J01_4
When was the bank account opened for this M-CLF?
J01_5
Whether the signature of the M-CLF President, Secretary, and Treasurer are taken for opening the bank account?
Yes
No
J02
Authorization for operating the M-CLF Bank Account
J02_1
Does two or three signatories, viz. the M-CLF President, Secretary, and Treasurer, mandatorily authorize all bank transactions?
Yes
No
J02_2
Does all deposit and withdrawal slips, NEFT, RTGS receipts, etc., mandatorily signed by two or three signatories?
Yes
No
J03
Custody of cheques and their transactions
J03_1
Are all cheques kept in a safe lock (with two keys) in the M-CLF office only?
Yes
No
J03_2
Is one key for the safe lock kept with the M-CLF secretary and the other with the M-CLF treasurer/ manager?
Yes
No
J03_3
Are any cheques kept in the personal custody of the M-CLF president, secretary, treasurer, master bookkeeper, manager, or member?
Yes
No
J03_4
If “Yes” in J03_4, was a criminal case filed against the person?
Yes
No
J03_5
Are all cheque transactions recorded in the appropriate book of records that are maintained in the M-CLF office?
Yes
No
J03_6
Do M-CLF President, Secretary, and Treasurer sign the advance or blank cheques?
Yes
No
J04
Office expense
J04_1
Are all office expenses carried out according to rules and regulations set by the Mission guidelines?
Yes
No
J05
Guidelines for funds received from various sources
J05_1
Does this M-CLF receive any fund in the name of NRETP?
Yes
No
J05_2
Whether this fund is managed and utilized according to the set guidelines of BRLPS (JEEViKA)?
Yes
No
J05_3
Are discrepancies in Management and utilization of this fund resolved through filing a criminal case against those involved?
Yes
No
J05_4
What are the lending norms set by M-CLFs for onward lending VO/ SHG/ PG/ PC?
Loan management system in place
Updated Book of Records
percentage of SC/STs in SHG/VOs more than or equal to 60%
Repayment history of the VO/SHG
Categorization of SHG/VO is Grade A
Idle funds
outstanding amount of VO/SHG
discussion based on business model/ plan for PGs/PCs
Fulfillment of panchsutra norms
Regular rotation of office bearers as per norms
Linked VO and SHGs promoting convergence activities
If Other, please specify: ________
J05_5
Is there a timely flow of funds among CBOs, i.e., from higher federations (M-CLFs) to lower (VOs/ SHGs/ PG/ PC)?
Yes
No
J05_6
How many days does it take to transfer the required fund since the day request has been received from VO/ SHG/ PG/PC?
J06
Cash transactions and Promotion of Digital/ Cashless transactions
J06_1
What is the mode of transaction that happens between M-CLF/ VO/ SHG?
Cash
Account Transfer/ Online transfer/ digital transactions
J06_2
Are cash transactions allowed under your M-CLF?
Yes
No
J06_3
Are you aware that the occurrence of cash transactions, if any, will be considered as serious financial lapses, and necessary actions will follow?
Yes
No
J06_4
What type of transactions are done through account transfer/ online transfer/ digital transactions?
J06_5
Can you suggest some ways to reduce the cash transaction amongst M-CLF/ VO/ SHG-Member and vice-versa?
J06_6
Is the promotion of digital transactions a good alternative to cash transactions?
Yes
No
J06_7
What are the reason according you that make digital transactions more beneficial?
J07
Settlement of bills
J07_1
Are all bills scrutinized thoroughly for M-CLF name, date of transaction, item name, quantity, rate, total amount, signature, and authorization of the vendor who raised the bill?
Yes
No
J07_2
Does your M-CLF raise vouchers for the bills that are to be settled?
Yes
No
J07_3
Are the vouchers placed for approval from authorized persons of the M-CLF?
Yes
No
J07_4
Are the bills settled only on the final approval of vouchers from M-CLF authorized persons?
Yes
No
J08
Method for settlement of bills
J08_1
Are all bills settled through either RTGS or NEFT or Crossed Cheques only?
Yes
No
J08_2
While transacting through the crossed check, is it ensured that the authorized persons of M-CLF check the name of the party, details of the amount entered in both figures and words, apply transparent cello tape on the entered amount, cross the cheque, or use ‘accounts payee only’ stamp to mark, all authorized signatories have signed the cheque in M-CLF office only, noted the details of cheques in chequebook and book of records and then issued the cheque?
Yes
No
J08_3
After clearance of the cheque in the bank, is it ensured that the vendor sign on the receipt register?
Yes
No
J08_4
In case of the transaction through RTGS/ NEFT, is it ensured that the authorized persons of M-CLF note all the details in the RTGS/ NEFT registers available in the M-CLF office?
Yes
No
J09
Maintaining the Books of Records in M-CLF office
J09_1
Are all transactions which are entered in books of records/ registers signed by the President, Secretary, and Treasurer?
Yes
No
J09_2
In every M-CLF meeting, are the members of M-CLF allowed to access and scrutinize the books of records?
Yes
No
J10
Bank reconciliation
J10_1
Does M-CLF Master Bookkeeper carry out the task of Bank Reconciliation every month?
Yes
No
J10_2
Is the Bank Reconciliation file prepared and presented to M-CLF President, Secretary, and treasurer every month?
Yes
No
J10_3
Is the file signed by M-CLF Master Bookkeeper, Manager, M-CLF President, Secretary, and treasurer?
Yes
No
J10_4
Is the bank statement for every month attached to Month Wise Bank Statement File?
Yes
No
J10_5
Are the deposits and withdrawals noted in the bank statements scrutinized regularly on a weekly or monthly basis?
Yes
No
J11
Guidelines for issuing an advance amount
J11_1
How much amount the M-CLF Master Bookkeeper/ Manager is eligible to receive for office expense?
J11_2
Under which head of office expense is this amount utilized?
Expense on meetings
Expense on housekeeping
Expense on stationary
Miscellaneous expenses
If others, please specify
J11_3
To receive the new advance, what proportion of the existing advance amount must be utilized?
J11_4
Before issuing the advance amount, are all approvals according to the set guidelines of M-CLF taken?
Yes
No
J11_5
Is there any instance when both the M-CLF Master Bookkeeper and manager have received the advance amount at the same time?
Yes
No
J11_6
Is the advance amount utilized completely within a month?
Yes
No
J11_7
Is there any instance when the M-CLF President, Secretary, and Treasurer have received the advance amount?
Yes
No
J12
Statutory Audit
J12_1
Are statutory audits for M-CLF done?
Yes
No
J12_2
Are audit reports available?
Yes
No
J12_3
Are there any objections reported in the audit reports?
Yes
No
J12_4
If yes, are the objections raised were of low, moderate, or high risks?
Low risk
Moderate risk
High risk
J12_5
When was the last audit report was prepared?
J12_6
Is this audit report being available to all M-CLF members?
Yes
No
J13
Now I will ask you a few questions about the type of funds received
J13A
Did you receive the following funds?
J13A_1
Startup fund/ Establishment fund
Yes
No
J13A_2
ICF
Yes
No
J13A_3
Bank Loan
Yes
No
J13A_4
Viability Gap Funding (VGF)
Yes
No
J13A_5
Health Risk Fund
Yes
No
J13A_6
Livelihoods Funds/ Funds for PG
Yes
No
J13B
What is the amount of [fund] received by this CLF?
J13B_1
Startup fund/ Establishment fund
J13B_2
ICF
J13B_3
Bank Loan
J13B_4
Viability Gap Funding (VGF)
J13B_5
Health Risk Fund
J13B_6
Livelihoods Funds/ Funds for PG
J13C
What is the date of receiving the following funds?
J13C_1
Startup fund/ Establishment fund
J13C_2
ICF
J13C_3
Bank Loan
J13C_4
Viability Gap Funding (VGF)
J13C_5
Health Risk Fund
J13C_6
Livelihoods Funds/ Funds for PG
J14
Cash in hand
J15
Opening Balance (Cash in Bank)
J16
Closing balance
J17
Total amount Received from following sources
J17_1
Interest received from repayment received from VOs
J17_2
Interest received from bank
J17_3
How much amount received under membership fees from VOs?
J18
Total expenditure of M-CLF on the following:
J18_1
Payment of staff (cadre) through M-CLF
J18_2
Payment of staff (cadre) project
J18_3
Purchase of fixed assets (ag. Purchase/ Construction of M-CLF office, furniture, almirah, etc.)
J18_4
Rent and Maintenance
J18_5
Miscellaneous expenses (e.g., Printing of brochures, purchase of stationery, etc.)
J19
Expected Principal
J20
Expected Interest
J21
Actual Principal
J22
Actual Interest
Cadre Management
K01
Is this cadre appointed through this M-CLF?
K01_1
Bookkeeper
Yes
No
K01_2
Master Bookkeeper
Yes
No
K01_3
HNS-MRP
Yes
No
K01_4
SJY- MRP
Yes
No
K01_5
JRP
Yes
No
K01_6
Bank Mitra
Yes
No
K01_7
Cluster Facilitator (CF)
Yes
No
K01_8
CM through VOs
Yes
No
K01_9
MIS Operator
Yes
No
K02
How many persons are appointed in this position?
K02_1
Bookkeeper
K02_2
Master Bookkeeper
K02_3
HNS-MRP
K02_4
SJY- MRP
K02_5
JRP
K02_6
Bank Mitra
K02_7
Cluster Facilitator (CF)
K02_8
CM through VOs
K02_9
MIS Operator
K03
Is this cadre received training?
K03_1
Bookkeeper
Yes
No
K03_2
Master Bookkeeper
Yes
No
K03_3
HNS-MRP
Yes
No
K03_4
SJY- MRP
Yes
No
K03_5
JRP
Yes
No
K03_6
Bank Mitra
Yes
No
K03_7
Cluster Facilitator (CF)
Yes
No
K03_8
CM through VOs
Yes
No
K03_9
MIS Operator
Yes
No
K04
What is the reason for not receiving training?
K04_1
Bookkeeper
K04_2
Master Bookkeeper
K04_3
HNS-MRP
K04_4
SJY- MRP
K04_5
JRP
K04_6
Bank Mitra
K04_7
Cluster Facilitator (CF)
K04_8
CM through VOs
K04_9
MIS Operator
K05
How much amount does they receive as their honorarium monthly?
K05_1
Bookkeeper
K05_2
Master Bookkeeper
K05_3
HNS-MRP
K05_4
SJY- MRP
K05_5
JRP
K05_6
Bank Mitra
K05_7
Cluster Facilitator (CF)
K05_8
CM through VOs
K05_9
MIS Operator
K06
How does the M-CLF pay honorarium amount to the cadre?
K06_1
Bookkeeper
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_2
Master Bookkeeper
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_3
HNS-MRP
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_4
SJY- MRP
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_5
JRP
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_6
Bank Mitra
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_7
Cluster Facilitator (CF)
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_8
CM through VOs
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
K06_9
MIS Operator
From M-CLF fund
Paid through Project
Both through M-CLF and Project fund
Role of M-CLF in Promoting Livelihoods
L01
Does your M-CLF engaged in income generating livelihood activities?
Yes
No
L02
Which livelihood activities does your M-CLF promote among its members?
L02A
Is there any PG formed for following Livelihood activity?
L02A_1
Farm based livelihood
Yes
No
L02A_2
Bee Keeping
Yes
No
L02A_3
Rural Retail Mart
Yes
No
L02A_4
Didi Ki Rasoi
Yes
No
L02A_5
Tailoring / Mask making
Yes
No
L02A_6
Art & Craft
Yes
No
L02A_7
Milk production/ Dairy
Yes
No
L02A_8
Goatry
Yes
No
L02A_9
Poultry Murgi Palan
Yes
No
L02A_10
Painting
Yes
No
L02A_11
Aggarbatti making
Yes
No
L02B
Amount Invested
L02B_1
Farm based livelihood
L02B_2
Bee Keeping
L02B_3
Rural Retail Mart
L02B_4
Didi Ki Rasoi
L02B_5
Tailoring / Mask making
L02B_6
Art & Craft
L02B_7
Milk production/ Dairy
L02B_8
Goatry
L02B_9
Poultry Murgi Palan
L02B_10
Painting
L02B_11
Aggarbatti making
L02C
Profit generated
L02C_1
Farm based livelihood
L02C_2
Bee Keeping
L02C_3
Rural Retail Mart
L02C_4
Didi Ki Rasoi
L02C_5
Tailoring / Mask making
L02C_6
Art & Craft
L02C_7
Milk production/ Dairy
L02C_8
Goatry
L02C_9
Poultry Murgi Palan
L02C_10
Painting
L02C_11
Aggarbatti making
L03
How many members of households associated with your M-CLF are involved in these livelihood activities?
L04
What were all facilities accessible to member households in farm livelihoods?
Farm inputs/ fertilizers/ seeds
Machineries
Tractors
Tiller
If other (Specify___)
L05
Any Livelihood activity closed after Fund support had been stopped?
Yes
No
L06
If yes, Please specify the livelihood activity which was closed due to lack of financial support?
Farm based livelihood
Bee Keeping
RRM
DKR
Tailoring
Art & Craft
Milk production
Goatry
Poultry
If other (Specify___)
L07
How does M-CLF decide on which livelihood activity a member household will work?
Based on the requirement by BRLPS (JEEViKA)
Discussion in SHG meeting
Assessing the skill set of members
Based on funds and resource available
If other (Specify___)
L08
Do your M-CLF facilitate trainings to build the capacity of member households for livelihood activities?
Yes
No
L09
Does your M-CLF provide financial assistance for taking up livelihood activity?
Yes
No
L10
Does this M-CLF engage CRPs/ cadres in promoting livelihood activities?
Yes
No
L11
Does this M-CLF provide an Honorarium to the CRPs/ cadres for the service provided by them?
Yes
No
L12
How many PG/ PC is created by M-CLF till June 2022 (Last month) ?
L13
How many PG/ PC are functional under this M-CLF till June 2022 (Last month) ?
L14
How many PG/ PC is planned for this year (2022-2023) as per the annual action plan?
L15
Is there any JRP working under the catchment of this M-CLF?
Yes
No
L16
Does unemployed youths were identified in the catchment of M-CLF through JRP?
Yes
No
L17
If yes, how many Youths were identified for training in last Financial year (1st April 2021 to 31st March 2022)?
L18
How many training sessions under DDUGKY/ RSETI were conducted for unemployed youths in last financial year (1st April 2021 to 31st March 2022)?
L19
How many youths were trained in last financial year (1st April 2021 to 31st March 2022)?
L20
Was placement provided to these trained youths in last financial year (1st April 2021 to 31st March 2022)?
Yes
No
L21
If yes, how many youths were placed in the last Financial year (1st April 2021 to 31st March 2022) ?
Response of M-CLF in combating CORONA (COVID-19)
M01
Has your M-CLF received any information/directives on CORONA (COVID-19)?
Yes
No
M02
Who has provided the information/directives?
BRLPS officials
ASHA
AWW
Gram Pradhan/sarpanch
Other(specify)
M03
What initiatives were taken up by the M-CLF during COVID 19?
M04
Whether this M-CLF was involved in mask making?
Yes
No
M05
What was the total income of M-CLF through mask making in last two years?
M06
What are the preventive measures M-CLF members are adopting while helping with the CORONA situation at the community level?
Wash hands frequently
Wash hands frequently with soap
Clean hands with sanitizer
Cover nose and mouth with handkerchief/ tissue/elbow while coughing or sneezing
Don't touch eyes, nose, or mouth
Don't be in close physical contact with anyone
Avoid crowded places
Be at least 1 meter away from everyone
Don't spit in public
Wear a mask if sick
Avoid physical contact with infected individuals
Avoid touching common surfaces, items or sharing plates/utensils
Avoid touching what sick persons have touched such as surfaces, items, plates/utensils
Keep cleaning common surfaces
Don't shake hands with others
Others (specify)
Don't Know
M07
Did the M-CLF faced any issue in access to funds provided by Jeevika during COVID?
Yes
No
M08
Was there any issue faced in communication with the BRLPS team due to COVID lockdown?
Yes
No
M09
Was there any issue faced in communication with the M-CLF members due to COVID lockdown?
Yes
No
M10
Does M-CLF members faced any issue in accessing basic amenities during lockdown?
Yes
No
M11
Does M-CLF played any role in sensitizing members to take the COVID-19 Vaccine?
Yes
No
M12
What all initiatives were taken to sensitize members to take the COVID-19 Vaccine?
M13
Are you aware of the number of SHG members under this M-CLF that have taken 1st dose of COVID-19 vaccination?
Yes
No
M14
Can you tell us the number of SHG members that have taken 1st dose of COVID-19 vaccination?
M15
Are you aware of the number of SHG members under this M-CLF that have also taken 2nd dose of COVID-19 vaccination?
Yes
No
M16
Can you tell us the number of SHG members that have also received the 2nd dose of COVID-19 vaccination?
M17
Overall, What changes have you observed in the functioning of this M-CLF in the last 12 months?
M18
What have been the changes in the linkages with VOs and SHGs by the M-CLF in the last 12 months?
M19
What have been the activities done by this M-CLF to promote livelihood activities in the last 12 months?
M20
Have they observed any changes in the repayment of loan availed by the VOs in the last 12 months? If yes, then explain?
M21
What have been the challenges and issues faced by this M-CLF in the last 12 months?
M22
Do you have any suggestions for better performance in the future? If yes, what are the suggestions?
Dear user, please upgrade your plan to access this feature
See Plans
Please Wait