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Micro Enterprise Template 4 -Form Fill

Information
Q01

Name of the State

Q02

Name of the District

Q03

Name of the Block

Q04

Name of Panchayat

Q05

Name of the Village (PSU)

Q06

Village Census Code

Q07

Whether ME is a SPRD customer or not?

Q08

ME Structure No.

Q09

Address

Q10

Investigator Name

Q11

Investigator Code

Q12

Start Time

Q13

End Time

Q14

Interviewer’s Visits - 1

Q14_1

Date

Q14_2

Result

Q15

Interviewer’s Visits - 2

Q15_1

Date

Q15_2

Result

Q16

Interviewer’s Visits - 3

Q16_1

Date

Q16_2

Result

Entrepreneur Profile
A01

Name of the respondent

A02

Age of the respondent/owner

A03

Is the owner male or female?

A04

Are you the owner of the enterprise?

A05

Name of the owner

A06

What is the religion of the owner?

A07

Does the owner belong to a scheduled caste, scheduled tribe, other backward class or general class?

A08

What is the year of formation of the enterprise?

A09

What is the type of enterprise?

A10

What kind of services do you provide through your enterprise?

A11

On a regular basis, how many people are engaged in the enterprise?

A12

Do you also hire seasonal labour?

A13

In which month do you engage seasonal labour and how many?

Electricity Connection
B01

Do you have government grid connection in your enterprise?

B02

How many hours of electricity supply do you get from the government grid?

ELECTRICITY SOURCES & USAGE
C01

What are the sources of energy used in the enterprise?

C01A

Before 2015

C01A_1

Primary source

C01A_2

Other sources

C01B

Current

C01B_1

Primary source

C01B_2

Other sources

C02

What is/was the daily hours of supply of each of the sources of electricity?

C02A

Before 2015

C02A_1

Grid Electricity

C02A_2

Solar panel at home

C02A_3

Diesel generator

C02B

Current

C02B_1

Grid Electricity

C02B_2

Solar panel at home

C02B_3

Diesel generator

C03

What are the appliances used in the enterprise?

C03A

Before 2015

C03A_1

LED bulb

C03A_2

CFL bulb

C03A_3

Incandescent bulb

C03A_4

T. V

C03A_5

Radio/Music player

C03A_6

Fan

C03A_7

AC/Air cooler

C03A_8

Mobile charging point

C03A_9

Computer/Laptop

C03A_10

Enrolment device

C03A_11

Printer

C03A_12

Sewing machine

C03A_13

Chiller/Refrigerator

C03A_14

Mixer/Grinder

C03A_15

Metal welder/cutter

C03A_16

Rice huller

C03A_17

Atta chakki

C03A_18

Chura mill

C03A_19

Daal Mill

C03A_20

RO plant Filter

C03A_21

Oil expeller

C03A_22

Hair trimmer

C03A_23

Soldering machine

C03A_24

Wood planer

C03B

Current

C03B_1

LED bulb

C03B_2

CFL bulb

C03B_3

Incandescent bulb

C03B_4

T. V

C03B_5

Radio/Music player

C03B_6

Fan

C03B_7

AC/Air cooler

C03B_8

Mobile charging point

C03B_9

Computer/Laptop

C03B_10

Enrolment device

C03B_11

Printer

C03B_12

Sewing machine

C03B_13

Chiller/Refrigerator

C03B_14

Mixer/Grinder

C03B_15

Metal welder/cutter

C03B_16

Rice huller

C03B_17

Atta chakki

C03B_18

Chura mill

C03B_19

Daal Mill

C03B_20

RO plant Filter

C03B_21

Oil expeller

C03B_22

Hair trimmer

C03B_23

Soldering machine

C03B_24

Wood planer

C04

What was the daily electricity requirement of each appliance and how many hours can you use it for?

C04A

Before 2015

C04A_1

LED bulb

C04A_2

CFL bulb

C04A_3

Incandescent bulb

C04A_4

T. V

C04A_5

Radio/Music player

C04A_6

Fan

C04A_7

AC/Air cooler

C04A_8

Mobile charging point

C04A_9

Computer/Laptop

C04A_10

Enrolment device

C04A_11

Printer

C04A_12

Sewing machine

C04A_13

Chiller/Refrigerator

C04A_14

Mixer/Grinder

C04A_15

Metal welder/cutter

C04A_16

Rice huller

C04A_17

Atta chakki

C04A_18

Chura mill

C04A_19

Daal Mill

C04A_20

RO plant Filter

C04A_21

Oil expeller

C04A_22

Hair trimmer

C04A_23

Soldering machine

C04A_24

Wood planer

C04B

Current

C04B_1

LED bulb

C04B_2

CFL bulb

C04B_3

Incandescent bulb

C04B_4

T. V

C04B_5

Radio/Music player

C04B_6

Fan

C04B_7

AC/Air cooler

C04B_8

Mobile charging point

C04B_9

Computer/Laptop

C04B_10

Enrolment device

C04B_11

Printer

C04B_12

Sewing machine

C04B_13

Chiller/Refrigerator

C04B_14

Mixer/Grinder

C04B_15

Metal welder/cutter

C04B_16

Rice huller

C04B_17

Atta chakki

C04B_18

Chura mill

C04B_19

Daal Mill

C04B_20

RO plant Filter

C04B_21

Oil expeller

C04B_22

Hair trimmer

C04B_23

Soldering machine

C04B_24

Wood planer

ENTERPRISE ECONOMICS
D01

What has been the initial investment in the enterprise?

D02

What was the source of investment?

D03

If loan was taken, then how much loan was taken and what is the annual interest on loan (in %)?

D04

Does any female member of your family also support you in your business?

D04A

Before 2015

D04B

Current

D05

What is level of involvement of female family members in the activities?

D05_1

In deciding the product to be sold/service to be provided

D05_2

In deciding the amount of investment

D05_3

In deciding from which market raw materials need to be procured

D05_4

In deciding the pricing of the product/service

D05_5

In deciding the market where the final product is to be sold

D05_6

In deciding if and when additional loan needs to be taken

D05_7

Looking after the daily operations of the enterprise

D06

From where do you procure your raw material?

D06A

Before 2015

D06B

Current

D07

What is the average monthly expenditure for the enterprises?

D07A

Before 2015

D07A_1

Labour

D07A_2

Rent

D07A_3

Repairs and Maintenance

D07A_4

Raw materials (Purchase of inputs for the enterprise)

D07A_5

Electricity taken from grid

D07A_6

Electricity taken from diesel generator (owned/supplier)

D07A_7

Expense on running diesel generator engine

D07A_8

Transportation

D07B

Current

D07B_1

Labour

D07B_2

Rent

D07B_3

Repairs and Maintenance

D07B_4

Raw materials (Purchase of inputs for the enterprise)

D07B_5

Electricity taken from grid

D07B_6

Electricity taken from diesel generator (owned/supplier)

D07B_7

Expense on running diesel generator engine

D07B_8

Transportation

D08

Did/Do you use kerosene for lighting in your enterprise

D08A

Before 2015

D08B

Current

D09

What was/is the quantity of kerosene used by you, monthly, for lighting purposes?

D09A

Before 2015

D09B

Current

D10

What was/ is unit price of kerosene?

D10A

Before 2015

D10B

Current

D11

On an average, how much do you earn from this enterprise in a month?

D11A

Before 2015

D11B

Current

D12

What is the unit selling price for your product?

D12A

Before 2015

D12A_1

Flour Mill

D12A_2

Rice Huller

D12A_3

Oil expeller

D12A_4

Daal Mill

D12A_5

Chaura Mill

D12A_6

Ice Factory

D12A_7

Brick factory

D12A_8

Welding units

D12A_9

Saw Mill/ Carpenter unit

D12A_10

Poultry units

D12A_11

Computer Center

D12A_12

Computer Coaching centre

D12A_13

Photo Copy Shop

D12A_14

Photo Studio

D12A_15

Tailoring/sewing

D12A_16

Saloons (barber shops)

D12B

Current

D12B_1

Flour Mill

D12B_2

Rice Huller

D12B_3

Oil expeller

D12B_4

Daal Mill

D12B_5

Chaura Mill

D12B_6

Ice Factory

D12B_7

Brick factory

D12B_8

Welding units

D12B_9

Saw Mill/ Carpenter unit

D12B_10

Poultry units

D12B_11

Computer Center

D12B_12

Computer Coaching centre

D12B_13

Photo Copy Shop

D12B_14

Photo Studio

D12B_15

Tailoring/sewing

D12B_16

Saloons (barber shops)

D13

Where do you utilize your savings?

D13A

Before 2015

D13B

current

D14

How many days in a month is your shop operational?

D14A

Before 2015

D14B

current

D15

How many customers do you get on a daily basis?

D15A

Before 2015

D15B

current

D16

What is output of the machine in 1 hour?

D16A

Before 2015

D16A_1

Rice huller

D16A_2

Atta chakki

D16A_3

Chura mill

D16A_4

Daal Mill

D16A_5

Oil expeller

D16A_6

Wood planer

D16B

current

D16B_1

Rice huller

D16B_2

Atta chakki

D16B_3

Chura mill

D16B_4

Daal Mill

D16B_5

Oil expeller

D16B_6

Wood planer

D17

Daily, how many hours do you keep your enterprise open?

D17A

Before 2015

D17B

current

USAGE OF ELECTRICITY & CHANGES
E01

When is the electricity available at your enterprise?

E01A

In the last 6 months have you changed or added any new electricity source in your enterprise?

E01B

What source have you shifted to?

E02

For which of the appliances is the new electricity source used?

E03

Which of these appliances have you purchased/added after getting connected to the new electricity source?

E04

If Yes, how much did you spend in the purchase of new machinery?

E04_1

LED bulb

E04_2

CFL bulb

E04_3

Incandescent bulb

E04_4

T. V

E04_5

Radio/Music player

E04_6

Fan

E04_7

AC/Air cooler

E04_8

Mobile charging point

E04_9

Computer/Laptop

E04_10

Enrolment device

E04_11

Printer

E04_12

Sewing machine

E04_13

Chiller/Refrigerator

E04_14

Mixer/Grinder

E04_15

Metal welder/cutter

E04_16

Rice huller

E04_17

Atta chakki

E04_18

Chura mill

E04_19

Daal Mill

E04_20

RO plant filter

E04_21

Oil expeller

E04_22

Hair trimmer

E04_23

Soldering machine

E04_24

Wood planer

E05

What was the purpose of buying this appliance?

E06

Are you planning to invest in a new electrical appliance?

E07

What appliance are you planning to invest in?

E08

Have you started a new line of business in the last six months?

E09

Has there been any change in your working efficiency in the last six months?

E10

How has the efficiency changed?

E11

Do you feel carrying out your business operations has changed in the last six months ?

E12

How has carrying out business operations changed?

E13

In the last six months, who has been your primary customer?

E14

Has the customer base increased in the last six months?

E15

How has the customer base increased?

EXPANSION PLANS
F01

Do you plan to expand your enterprise?

F02

What are the reasons for not expanding?

F03

How do you plan to expand your business?

F04

What support will be required to make your expansion plan successful?

ELECTRICITY QUALITY and SATISFACTION
G01

Do you face any of the following issues with respect to electricity from your primary source?

G01_1

Light Fluctuation

G01_2

Low Voltage

G01_3

Disruption in Supply (Irregular Supply)

G01_4

Bad or poor supply during Rainy season or during bad weather

G01_5

Meter Availability/ Tariff (There is no meter and they want one)

G01_6

Difficult to contact someone to report problems

G02

Rate your satisfaction on the following parameters for electricity from your primary source

G02_1

Hours of electricity supply under the package you have taken

G02_2

Consistency in terms of voltage

G02_3

Schedule of electricity supply

G02_4

Quality of service provided by service providers such as maintenance

G02_5

Accuracy of billing

G02_6

Tariff

G02_7

Timeliness in addressing complaints

Impact of Street lighting
H01

Are there street-lights in your village?

H02

Since when are the streetlights functional?

H03

What is the source of electricity for these streetlights?

H04

Do you perceive any benefit from street-light for your enterprise?

H05

How is it beneficial for the enterprise?

H06

Why is it not beneficial for your enterprise?

H07

Do you feel overall mobility and safety has improved in your village after street lights?