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Clf Vo Shg Template -Form Fill
Identification Information
Q01
District Name
Q02
District Code
Q03
Block Name
Q04
Block Code
Q05
Cluster Level Federation Name
Q06
Cluster Level Federation Unique ID
Survey Information
A01
Name of the respondents
A02
Designation of the respondent
President
Vice-President
Secretary
Treasurer
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)
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)
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
Start time of the interview
A05_6
End time of the interview
A05_7
GPS coordinates
CLF basic demographic profiling
B01
What is the name of this CLF?
B02
What is the date of formation of this CLF?
B03
How many VOs are a member of this CLF?
B04
How many VOs have joined CLF after its formation?
B05
How many VOs have left the CLF after the formation?
B06
Is this CLF registered?
Yes
No
B07
What is the date of registration of this CLF?
B08
Has the office of CLF been established?
Yes
No
B09
Date of establishment of the office?
B10
What is the target number of households to form SHG under this CLF?
B11
How many households have already formed SHG?
B12
How many SHGs are under this CLF?
B13
Out of the total SHGs, how many of them are currently functional?
B14
How many SHGs have a saving bank account opened?
B15
How many SHGs do not have a saving bank account opened?
Role of CLF in Promoting Farm-based Livelihoods
C01
Does your CLF promote livelihood activities?
Yes
No
C02
Which livelihood activities does your CLF promote among its members?
Farm based livelihood
Bee Keeping
Milk production
Goatry
Poultry
If other (Specify___)
C03
How many members of households associated with your CLF are involved in these livelihood activities?
C03A
How many households practice multiple livelihood options under this CLF?
C04
How many SHG members own land?
C05
How many SHG members have leased in land?
C06
How many SHG members have leased out land?
C07
How many SHG members are landless agricultural laborer?
C08
How many SHG members irrigate their land?
C09
How many SHG members have access to electricity?
C10
What is the average duration of electricity availability in a day?
C11
Does your CLF provide financial assistance for taking up livelihood activity?
Yes
No
C11A
How much loan have you given to SHGs via VOs in the last financial year 20-21?
C11B
How much is the average amount of loan recovered?
C11C
How much is the average default rate?
C12
How many PG/ PC is created by CLF till the last month?
C13
How many PG/ PC are functional under this CLF till the last month?
C14
How many PG/ PC is planned for this year as per the annual action plan?
C15
What were all facilities accessible to member households in farm livelihoods?
Farm inputs
Machineries
Technology
If other (Specify___)
Livelihood Activities undertaken by SHGs/ VO/ CLF
D01
What are different livelihood activities taken up by SHG/ VO/ CLF?
D02
Is there any PG formed?
D03
How many PGs are formed under this SHG/ VO/ CLF?
D04
Is there any FPO formed?
Yes
No
D05
What crops are grown under the FPO?
D06
What are the new crops that are grown or planned to be grown?
D07
What is the existing value chain for selling these crops? Whom do they sell? Do they sell to the nearby villages, blocks, or district or states as well? Please elaborate
D08
What is the price do you receive for your commodity?
D09
Which are the nearest roads from this SHG/ VO/ CLF?
D10
Where do they procure their inputs from and at what price?
D11
What is the USP/ uniqueness of their produce? Please mention in detail
D12
Are you aware of produce of the other FPOs?
Yes
No
D13
Is there any other crops are gaining importance in the market?
Yes
No
D14
What could be the future opportunities/commodities that you would want to produce?
D15
Which major crops/commodities have gained scale or popularity in the last 5 years and why?
D16
How does the future look for these commodities? What could be done to improve these crops?
D17
What kind of support (Technical, Financial, social etc.) do you need from BRLPS?
D18
Do you think an FPO would help in any way? If yes then how?
Crop patterns
E01
Crop Code
Paddy
Wheat
Maize
Millet
Sorghum
Barley
Oat
Groundnut
Mustard
Rapeseed
Nizer
Sunflower
Soyabean
Linseed
Til
Pigeonpea
Blackgram
Chickpea
Greengram
Horsegram
Lentil
Lathyrus(Cheakling pea)
Potato
Tomato
Cabbage
Cauliflower
Chilli
Capsicum
Spongegourd
Bittergourd
Bottlegourd
Spinegourd
Snakegourd
Pointed gourd
Ridge gourd
Leafy vegetable
Sweet Potato
Brinjal
Cucumber
french bean
Green pea
Broccoli
Radish
Carrot
Coriander
Ladiesfinger
Coccinia (kundru)
Elephant foot yam
Colocasia (Kacchu)
Aru
Flat bean ( Saim)
Drumstick
Beet root
Pupmkin
Cowpea
Bean
Kakri
Ashgourd
Guava
Mango
Lemon/Lime
Orange
Papaya
Water Melon
Litchi
Apple
Berries
Banana
Sugarcane
Beal(woodapple)
Pomelo
Pomegranate
Pineapple
Onion
Garlic
Turmeric
Ginger
Tobacco
Jute
Dhaincha
Makhana
water chestnut
Bamboo
Marigold
Cotton
Arrrow root
Yambean
Tamrind
Coconut
Lemon grass
Eucalyptus
Supari
Jackfruit
Jamun
E02
How much of the agricultural land was used in the cultivation of this crop?
E03
What is the total quantity produced? (Quantity in KG.)
E04
How much did you sell?
E05
What was the average market rate you got for this crop? (price per kg)
E06
Where do you normally sell the crop?
Local market in the village
Middlemen
Retail market in block town
Wholesale market
Did not sell
Farmer Producer Company
Others (specify)
E07
What was/would be the income from the sale of the crop?
Value chain linkages with institutions and markets
F01
Agricultural Institutions or Markets
Biggest outward mandi
Biggest inward mandi
Cold storage – government
Cold storage – private
Warehouse – government
Warehouse – private
Food processing units
Milk cooperative
Agri processing clusters
FPO/ FPC/ Agro-based cooperatives
Krishi Vigyaan Kendra (KVK)
CBOs
No of CNOs in the block
F02
Financial institutions or markets
Banks (private/public/cooperative)
Credit societies
Micro finance institutions
Other financial institutions
Micro livelihood plan/ Joint liability group
F03
Road Infrastructure
National Highway
State Highway
Pucca Road to District Headquarters
Dirt road
F04
Mode of Transport
Railway Station
Bus Stand
Transport depot to access trucks
Vendors renting out tractors
F05
If it is present in District?
Yes
No
F06
Number of such facilities/infrastructure present in the block
F07
Location of these facilities /Infrastructure in the block
F08
What kind of value addition is done in this facility/ infrastructure?
F09
What cost is incurred For value addition?
F10
Which is the nearest market they are connected to?
F11
If no, distance from the nearest one
Suggestions from Cluster Level Federation / Village Organization
G01
Do you think the Promotion of FPO in your block will help the Farmers?
Yes
No
G02
What are the suggestions according to you that can help farmers in your block?
Diversify into products or services which are currently not catered in the existing market
Greater access to a better customer base or geographic region
Improved quality of products
Availability of low-cost raw materials
Availability of high-quality inputs and machinery
Access to urban and semi-urban markets
Better credit period from suppliers
Development of cluster markets
Diversify into other businesses from the existing FPOs/enterprises
Others (specify)
G03
What additional support do you think is needed from the Government for the expansion of FPO?
Easy access to markets
Easy availability of loans from banks
Improved condition of roads
Improved condition of mandis and APMCs
Better warehouses and storage space
Access to better input and raw materials
Others (specify)
G04
What support do you think is needed from BRLPS for the expansion of FPO?
Training Support
Financial grant
Support in development of financial plan
Providing market linkage
Access to modern technology and practices
Others (specify)
G05
What are the biggest challenges hindering the promotion of FPOs?
Inadequate access to funds
Loss of demand for the products/services
Impact of COVID-19 lockdown in reducing the stream of revenue
High cost of production
Lack of access to latest production technologies
Rate control by vendors/ companies
Others (specify)
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