Please Wait...

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

A03

FIRST VISIT

A03_1

Interviewer name

A03_2

Interviewed code

A03_3

Date of the interview

A03_4

Result of 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

A05

THIRD VISIT

A05_1

Interviewer name

A05_2

Interviewed code

A05_3

Date of the interview

A05_4

Result of the interview

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?

B07

What is the date of registration of this CLF?

B08

Has the office of CLF been established?

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?

C02

Which livelihood activities does your CLF promote among its members?

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?

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?

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?

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?

D13

Is there any other crops are gaining importance in the market?

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

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?

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

F02

Financial institutions or markets

F03

Road Infrastructure

F04

Mode of Transport

F05

If it is present in District?

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?

G02

What are the suggestions according to you that can help farmers in your block?

G03

What additional support do you think is needed from the Government for the expansion of FPO?

G04

What support do you think is needed from BRLPS for the expansion of FPO?

G05

What are the biggest challenges hindering the promotion of FPOs?