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Shg Template 3 -Form Fill

Village Information
Q01

State Name

Q02

State Code

Q03

District Name

Q04

District Code

Q05

Block Name

Q06

Block Code

Q07

Gram Panchayat Name

Q08

Gram Panchayat Code

Q09

Village Name

Q10

Village Code

Q11

Name of the Cluster level federation

Q12

Name of the village organisation

Q13

Village Unique ID

Survey Information
A01

Name of the respondents

A02

Respondent identification code

A03

FIRST VISIT

A03_1

Interviewer name

A03_2

Interviewed code

A03_3

Date of the interview

A03_4

Result of the interview

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

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

A05_5

Record time when you start the interview

A05_6

Record time when you end the interview

Basic Information of the member & group
B01

Name of the SHG

B02

What is your age? (in completed years)

B03

What is your highest educational qualification?

B04

What is your marital status?

B05

Do you hold any key position in the village?

B06

What is your main economic activity?

B07

When was your SHG formed?

B08

Is your SHG formed under the SRLM?

B09

Which organization helped in the formation of this SHG?

B10

How many members are there in your SHG for 2022-23

B11

Please tell us the caste composition of your SHG in the current period 2022-23 ?

B12

How many members in your SHG in the current period 2022-23 belong to Particularly Vulnerable Tribal Groups (PVTGs)?

B13

What is the average age of the members of this SHG? Ask minimum age

B14

What is the maximum age of the SHG members?

B15

Are the SHG meetings held weekly?

B16

If not, how frequently are the meetings of the SHGs conducted?

B17

Has there been a change in the frequency of SHG meetings?

B18

What is the reason for shift in frequency of meetings?

B19

When did the frequency of meetings change?

B20

What are the topics discussed in the meetings ?

B21

On average, what is the attendance record in the meetings that happened in the last three months?

B21_1

Month 1

B21_2

Month 2

B21_3

Month 3

B22

Reasons for absence of members

B23

Is there any rotation of OBs?

B24

How often has the group leadership been rotated?

B25

When did the SHG become part of the VO fold?

B26

Has this SHG/ representative of this SHG attended the meetings at the VO/CLF level for 2022-2023?

B27

What is your opinion on the time spent on the meetings at both VO and CLF levels?

B28

What areas do the group feel the SHGs are helpful for women?

B29

According to the group, what are the key barriers to becoming members of SHG?

B30

What can be done to mitigate these challenges?

B31

Has your SHG ever received any help and support from the CLF/ VO linked with the SHG?

B32

How did the CLF/ VO help and/or support your SHG?

B33

How frequently have your SHG been helped or supported by the CLF/ VO?

B34

Are you aware of Lakhpati Mahila Kisan initiative?

B35

Has this SHG identified members for Lakhpati Mahila Kisan initiative?

B36

How many members of your SHG have been identified for the Lakhpati Mahila Kisan Initiative?

B37

Which are the activities promoted by the SHG under Lakpathi Mahila Kisan Initiative?

B38

How many SHG members are engaged in

B38_1

One livelihood activity

B38_2

Two livelihood activities

B38_3

More than two livelihood activities

B39

Do you prepare monthly progress report?

B40

If No, what are the reasons for not preparing Monthly Progress Report?

B41

Has the grading been done for SHG?

B42

If No, what are the reasons for grading not been conducted?

B43

If Yes, who conduct the grading?

B44

What is the frequency of grading?

B45

What is the grade that your SHG have received ?

Financial Performance
C01

What is the total fund that was available with the SHG in the last three months (from (January 2023-March 2023)?

C02

How much money has been disbursed by the SHG in the last three months (January 2023-March 2023)

C03

Does the SHG have a bank account?

C04

If not, what are the reasons for not having a bank account?

C05

Has the group designated any member who will be operating the account?

C06

If yes, please specify the designation of the SHG member

C07

Can you briefly tell us about the formalities your SHG had to fulfill to open an account?

C08

Has the SHG taken any loan from the bank?

C09

How many bank loans have been taken by this SHG after its formation (ongoing and closed)?

C10

Has the SHG heard about collateral free loans?

C11

How many bank loans availed by this SHG after its formation are collateral-free loans?

C12

What was the total amount of collateral-free loans demanded by the SHG?

C13

What was the total amount of other (with submission of collateral) bank loans amount demanded by the SHG?

C14

What was the total sanctioned loan amount (Collateral free loans), including interest?

C15

What is the average interest rateof the collateral-free bank loans availed by this SHG?

C16

What was the total sanctioned loan amount for other loans (with collateral submission), including interest?

C17

What is the average interest rate of bank loans with collateral availed by this SHG?

C18

What has been the total repayment of the bank loan (collateral free) till March 2023 2022?

C18_1

Principal

C18_2

Interest

C19

What has been the total repayment of the bank loan (with collateral) till March 2023?

C19_1

Principal

C19_2

Interest

C20

How much time, on average, does it take for the bank loan to be approved?

C21

Does the SHG have a micro-credit plan (MCP) in place?

C22

Have you submitted the MCP to any higher-level federation/bank as of now?

C23

Please specify the organization

C24

Why is the MCP not getting prepared?

C25

As per the norms of the SHG, what minimum weekly savings should each SHG member contribute?

C26

Autogenerate expected savings from 1st Jan 2023 to 31st March 2023

C27

What has been the total savings of the group from 1st Jan 2023 to 31st March 2023

C28

Record reasons if the gap between 516-515 is more than 20%

C29

How much money has been disbursed by the SHG in the last three months (from Jan 2023- March 2023)

C30

What has been the total borrowing of the group from Jan 2023 – March 2023

C31

How many members asked for a loan in the last three months? (Jan 2023 – March 2023)

C32

How many members have been sanctioned the loan in the last 3 months? (Jan 2023 – March 2023)

C33

Has the SHG funded any interest-free loans to its members in the last three months? Jan 2023 – March 2023

C34

How many members have accessed interest-free loans from your SHG in the last three months?

C35

Do you think providing interest-free loans has helped improve the penetration of funds within the SHG?

C36

How did the SHG members utilize the interest-free loans they availed in the last 3 months? Jan 2023 – March 2023

C37

Can you categorize the individual loans by their amount in the last three months? (Including all)

C37_1

Less than 1000: ___

C37_2

1000-2500:____

C37_3

2500-5000:____

C37_4

5000-10000:___

C37_5

10000-20000: ___

C37_6

20000+: ______

C38

How long (in terms of days) does it take for a member to receive the loan within SHG after they apply?

C39

Do the members of this SHG follow on-time repayment of the loans they availed?

C40

Can you please specify the number of members giving partial amounts or no amount.

C41

What do you think are the potential reasons for low repayment?

C42

What was the expected total repayment, including interest, from Jan 2023 – March 2023

C43

What have been the loan's total repayments, including interest from Jan 2023 – March 2023

C44

Did the SHG receive any revolving funds?

C45

From where you received the RF?

C46

What has been the total amount of Revolving fund that the SHG received?

C47

What was the amount of Revolving Fund repaid by this SHG members to SHG?

C48

Did you receive CIF?

C49

From where you received the CIF?

C50

What has been the total amount of Community Investment Fund that the SHG received in 2022-23??

C51

What was the amount of Community Investment Fund repaid by this SHG in 2022 – 23??

C52

How did the SHG/SHG members utilize the Community Investment Fund they received in 2022-23?

C53

Did the SHG receive any vulnerability reduction fund?

C54

What has been the total Vulnerability Reduction Fund the SHG has received? (2022-23)

C55

What was the amount of the Vulnerability Reduction Fund repaid by this SHG in 2022-23?

C56

Did the SHG receive any Livelihood/Layering Fund?

C57

What has the total amount of Livelihoods/Layering Fund the SHG has received? (2022-23)

C58

What amount of Livelihood/Layering funds were repaid by this SHG in 2022-23?

C59

Has the SHG taken any loan from the CLF/VOs in 2022-23? (Other than VRF, CIF, Livelihood/layering funds)

C60

What is the amount of the loan (besides VRF, CIF, and Livelihood/layering funds) taken by the SHG from the CLF/VO in 2022-23?

C61

What is the average annual interest charged by CLF/VO on loans to your SHG?

C62

What have been the expected total repayments of the loan from the SHGs to the CLF/VO during 2022-23?

C63

What have been the total repayments of the loan from the SHGs to the CLF/VO’s during 2021-22?

C64

What percentage of SHG members are dependent on other informal sources for credit?

C65

Who all helped the SHG in getting through the bank formalities?

C66

Has any of the SHG members made any investments in the last year?

C67

How influential are your family's female members in the decision-making process related to savings, investments, and loans?

C68

What are the top purposes for which these members usually take these loans? 

C69

Now I will ask about the loan disbursement and repayment in the last 3 months

C70A

44927

C70A_1

Total loan amount demanded (in INR)

C70A_2

Total loan amount disbursed (in INR)

C70A_3

Total loan outstanding (in INR)

C70A_4

Expected payment of Principal amount (in INR)

C70A_5

Expected payment of Interest amount (in INR)

C70A_6

Actual collection of Principal amounts (in INR)

C70A_7

Actual collection of Interest amount (in INR)

C70A_8

Closing Balance (Cash in Hand) (in Rs)

C70A_9

Closing Balance (Cash in Bank) (in Rs)

C70A_10

Total Amount overdue for more than 30 days (only principal)

C70A_11

Total Amount overdue for more than 90 days (only principal)

C70B

44958

C70B_1

Total loan amount demanded (in INR)

C70B_2

Total loan amount disbursed (in INR)

C70B_3

Total loan outstanding (in INR)

C70B_4

Expected payment of Principal amount (in INR)

C70B_5

Expected payment of Interest amount (in INR)

C70B_6

Actual collection of Principal amounts (in INR)

C70B_7

Actual collection of Interest amount (in INR)

C70B_8

Closing Balance (Cash in Hand) (in Rs)

C70B_9

Closing Balance (Cash in Bank) (in Rs)

C70B_10

Total Amount overdue for more than 30 days (only principal)

C70B_11

Total Amount overdue for more than 90 days (only principal)

C70C

44986

C70_1

Total loan amount demanded (in INR)

C70_2

Total loan amount disbursed (in INR)

C70_3

Total loan outstanding (in INR)

C70_4

Expected payment of Principal amount (in INR)

C70_5

Expected payment of Interest amount (in INR)

C70_6

Actual collection of Principal amounts (in INR)

C70_7

Actual collection of Interest amount (in INR)

C70_8

Closing Balance (Cash in Hand) (in Rs)

C70_9

Closing Balance (Cash in Bank) (in Rs)

C70_10

Total Amount overdue for more than 30 days (only principal)

C70_11

Total Amount overdue for more than 90 days (only principal)

C71

Income and expenditure of SHGs

C71_1

Expenditure of SHG (INR): Remuneration of cadres

C71_2

Expenditure of SHG (INR): Penalty paid to higher level federations

C71_3

Expenditure of SHG (INR): Travel expenses

C71_4

Expenditure of SHG (INR): other miscellaneous expenses

C71_5

Income of the SHG (INR): Grants from SRLM

C71_6

Income of the SHG (INR): Grants from VO/CLF

C71_7

Income of the SHG (INR): Interest income from the loan to members

C71_8

Income of the SHG (INR): Interest income from the funds in the bank

C71_9

Income of the SHG (INR): Fines and penalties from SHG members

C71_10

Income of the SHG (INR): Other income

Books or Records
D01

Available

D01_1

Attendance register

D01_2

Saving ledger

D01_3

Loan ledger

D01_4

Cash book

D01_5

Individual passbook

D01_6

General ledger

D01_7

Membership register

D02

Updated till the month of survey

D02_1

Attendance register

D02_2

Saving ledger

D02_3

Loan ledger

D02_4

Cash book

D02_5

Individual passbook

D02_6

General ledger

D02_7

Membership register

Insurance
E01

Are the members of your group aware of any available insurance products?

E02

Which of the following schemes are the members aware of?

E03

Are you aware of insurance schemes?

E04

What are the main sources from which you got awareness about various Insurance?

E05

Have you provided awareness about insurance products to other members of your village?

E06

How many members in your group have insurance?

E07

Can you tell us briefly about the process they followed to get insured?

E08

Can you tell us the top two forms of insurance that most ofthe group members have availed of?

E09

Can you tell us how most members pay the premium amount?

E10

What is the average amount paid by the group as the premium for the insurance they have taken?

E11

Did any group members claim under the insurance schemes in the last year?

E12

If such situation has arrived for claiming insurance? Whether claim was submitted?

E13

What is the average time usually taken to avail claim benefits for insurance policies by any group member?

E14

What was the claim amount that was received?

E15

If they haven’t received any claim, what were the reasons for not getting the claim amount?

E16

Can you tell us for how long, on average, the group members had this insurance?

E17

According to the group, what are the major facilitators and challenges for people to buy insurance?

E18

What steps do you think can be taken to mitigate the challenges?

E19

Is the SHG aware of what is an insurance settlement process?

E20

Who informed the group about the processes of insurance settlement?

E21

What are the reasons that the group members have not taken insurance?

E22

How influential are the female members of the family in the process of buying insurance?

Pension
F01

Are you and other group members aware of pension schemes?

F02

How many members in your group are aware of pension schemes?

F03

What mediums did you and other group members use to learn about the pension schemes?

F04

Have you provided awareness to other women regarding the various pension scheme?

F05

How many office bearers of the SHG are enrolled in the contributory pension scheme?

F06

How many SHG members are enrolled in the contributory pension scheme present?

F07

What aremost of these members' contributions towards the pension scheme?

F08

How many office bearers of this SHG have taken a pension scheme (exclude contributory pension scheme)?

F09

What is the kind in which the eligible beneficiaries receive the payment?

F10

What factors led you or the other group members to subscribe to a pension scheme?

F11

Can you briefly tell us about the understanding of the people who have taken the pension and their purpose fortaking the pension scheme?

F12

What are the reasons that some members may not have bought any pension plan?

F13

According to the group, what promotes more people in the nearby neighborhood to buy pension plans?

F14

According toSHG, what challenges restrict more people in your neighborhood from buying pension plans?

F15

What steps can be taken to mitigate these challenges?

F16

Scheme

F16A

Number of eligible members

F16A_1

Old Age Pension

F16A_2

Widow Pension

F16A_3

Disability Pension

F16A_4

Atal Pension Yojana

F16A_5

National Pension Scheme

F16A_6

Jeevan Akshay Policy

F16B

Members that have taken

F16B_1

Old Age Pension

F16B_2

Widow Pension

F16B_3

Disability Pension

F16B_4

Atal Pension Yojana

F16B_5

National Pension Scheme

F16B_6

Jeevan Akshay Policy

F16C

Why the members have not taken up?

F16C_1

Old Age Pension

F16C_2

Widow Pension

F16C_3

Disability Pension

F16C_4

Atal Pension Yojana

F16C_5

National Pension Scheme

F16C_6

Jeevan Akshay Policy

F17

The loan distribution among members

F17_1

Name of the member

F17_2

No of times received loan from SHG

F17_3

Total loan received from SHG (Amount)

F17_4

Last loan received from SHG (Amount)

F17_5

Date on which last loan received

F17_6

Duration for which the loan was taken

F17_7

Loan outstanding amount as on …/…/…(current date)

SHG Transactions through BC Sakhi
G01

How do you conduct financial transactions within your group? (Multiple Choice)

G02

Have you heard about the BC Sakhi intervention?

G03

Is there a BC Sakhi operating in your area?

G04

Are you aware that you could conduct SHG transactions through the BC point?

G05

How did you learn about conducting SHG transactions through the BC point?

G06

Has the SHG ever conducted transactions through the BC point?

G07

What sort of transactions were carried out? (Multiple Choice)

G08

Is there a policy for transacting through the BC point?

G09

How many transactions did your SHG conduct through the BC point in the last 3 months?

G10

Why did you not conduct more transactions through the BC point

G11

What do you think are the advantages of conducting transactions through BC Sakhi? (open-ended)

G12

What are the disadvantages? (open-ended)

G13

Why didn’t you conduct SHG transactions through the BC point?

Agri-Nutri Gardens
H01

Are you aware about agri nutri-gardens?

H02

How did you come to know about the agri-nutri gardens?

H03

Have you, other SHG women/community members set up an agri-nutri garden?

H04

How many women are there in your SHG

H05

Amongst these, how many SHG women have set up an agri-nutri garden

H06

How many non-SHG women from the village have set up agri-nutri garden?

H07

How many women in your SHG are beneficiaries of the Integrated Child Development Scheme (ICDS)?

H08

What are the reasons women do not choose to set up an agri-nutri garden?

H09

What is the total land area under cultivation for agri-nutri garden for all the beneficiaries (both SHG and non-SHG members )?

H09A

Unit

H10

What is the total land are under cultivation for the agri-nutri garden for your SHG members?

H10A

Unit

H11

Did anyone assist you in setting up the agri-nutri garden?

H12

What help does the CRP offer to SHG members in setting up agri-nutri-gardens?

H13

What all does your agri-nutri garden have?

H14

Do you receive an all year roundsupply of agriculture seedlings?

H15

Are these seeds HYV seeds/ GM Seeds?

H16

Who supplied the seedlings?

H17

Do you receive an all year round supply of seedlings?

H18

Who supplied the seedlings?

H19

Do you receive an all year round supply of chicks?

H20

Who supplied the chicks?

H21

Did you receive help from MGNREGS to set up the Agri-Nutri Garden?

H22

In what ways does MGNREGS support you in setting up agri-nutri gardens

H23

How do women typically fund their agri-nutrition gardens?

H24

How many SHG members have taken loans from this SHG for setting up of agri-nutri garden?

H25

What is the total amount of loan taken by this SHG members from this SHG for the agri-nutri garden?

H26

How many SHG members have repaid the loans taken from this SHG for setting up of agri-nutri garden?

H27

What is the total amount of loan repaid by the SHG members who have taken loan for agri-nutri garden?

H28

Did the CRP(s) assist you in setting up agri-nutri gardens?

H29

Did you receive any training for setting up the agri nutria garden?

H30

What all subjects are covered in your training?

H31

Were exposure visits a part of your training?

H32

What is the frequency of trainings in a year?

H33

Does the cadres visit your field for monitoring the cultivation practices in the agri-nutri garden?

H34

On a scale of 1-5, please rate the existing trainings offered to you

H35

How can the trainings be improved to help you better assist mahila kisans in setting up nutri-gardens?

H36

How do agri-nutri gardens help you/ SHG women?

H37

How has the agri-nutri garden impacted your daily consumption of food and expenditure on food?

H38

What kind of additional support do you require to run agri-nutri gardens successfully?

H39

Do you/other SHG members sell the harvest from the agri-nutri garden in the market?

H40

Approximately, what proportion of the harvest from agri-nutri garden in the last season have been sold in the market?

H41

What are the reasons for the sale crops produced in the agri nutri garden in the market?