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Vo Template 2 -Form Fill

Identification Information
Q01

State code

Q02

State name

Q03

District Name

Q04

District Code

Q05

Block Name

Q06

Block Code

Q07

Village Name

Q08

Village Code

Q09

VO Name

Q10

VO Code

Q11

Type of sample

Survey Information
A01

Name of the respondents

A02

Designation of the respondent

A03

Respondent’s phone number

A04

Respondent identification code

A05

FIRST 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

A06

SECOND VISIT

A06_1

Interviewer name

A06_2

Interviewed code

A06_3

Date of the interview

A06_4

Result of the interview

A06_5

Record time when you start the interview

A06_6

Record time when you end the interview

A07

THIRD VISIT

A07_1

Interviewer name

A07_2

Interviewed code

A07_3

Date of the interview

A07_4

Result of the interview

A07_5

Record time when you start the interview

A07_6

Record time when you end the interview

VO Information
B01

What is the name of this VO?

B02

What is the date of formation of this VO?

B03

What is the total number of SHGs that are part of this VO

B04

Number of SHG members covered by VO.

B05

How many SHGs had Joined after the formation of VO?

B06

How many SHGs had been dropped out of the formation of VO?

B07

Reason for dropping out?

B07A

Elaborate the reason

B08

How many New SHGs are eligible to join the VO?

B09

Please give the number of SHGs joined after Aug 2022 till the date of survey

B10

Does the VO charge membership fee by member SHGs?

B11

What is the membership fee paid by member SHGs?

B12

What is the yearly membership renewal fee paid by member SHGs? (If any, put zero if no renewal fee is charged)

B13

Number of SHGs who had not submitted membership/renewal fee? (Put zero if no such SHG)

B14

Does the CLF review the VOs accounts ?

B15

If yes what is the frequency of review

B16

When was the review done last time ?

B17

What has been the primary function of this VO?

Leadership
C01

How many members are there in the VO-

C02

How many belong to SC/ST?

C03

How many are from PVTG? (Note : Take an approximate number if not exact)-

C04

Do you have bye-laws/guidelines?

C05

Why does not this VO has a bye-laws/guidelines?

C06

Does the VO rotate its OBs?

C07

Why has not the VO rotated OBs yet?

C08

Are all the OBs rotated?

C09

What is the interval for rotation?

C10

Name of the office bearer

C11

Age of this office bearer

C12

Social category of this office bearer

C13

Position currently held by this office bearer

C14

For how many terms can one hold this position?

C15

Is the current position a paid position?

C16

Education level of this office bearer

C17

Type of ration card the office bearer has.

C18

Did the office bearers receive trainings ?

C19

How many OBs received training ?

C20

On what topics OBs have received training?

C20_1

VO concept and management

C20_2

Leadership training

C20_3

Training on books of account

C20_4

Financial management of VO

C20_5

Cadre selection and management

C20_6

Convergence

C20_7

Livelihood training

C20_8

Gender Training

C20_9

PRI roles and responsibilities

C20_10

FNHW training

C20_11

Village Poverty Reduction Plan

C21

Does OBs need refresher trainings?

C22

On what topics refresher training is required?

C23

Is there any mechanism to provide training to new office bearers?

C24

Please select the topics for which the trainings have been received

C24_1

VO concept and management

C24_2

Leadership training

C24_3

Training on books of accounts

C24_4

Financial management of VO

C24_5

Cadre selection and management

C24_6

Convergence

C24_7

Livelihood training

C24_8

Gender training

C24_9

PRI roles and responsibilities training

C24_10

FNHW training

Governing Body/ Executive Committee (EC) and General Body (GB)
D01

What is the norm for conducting GB meetings of this VO?

D02

Provide details of last 3 General Body Meetings

D02A

Meeting 1

D02A_1

Did it conduct ?

D02A_2

date

D02A_3

No. of Members present.

D02B

Meeting 2

D02B_1

Did it conduct ?

D02B_2

date

D02B_3

No. of Members present.

D02C

Meeting 3

D02C_1

Did it conduct ?

D02C_2

date

D02C_3

No. of Members present.

D03

How many SHGs had not participated in each of the last two GB meetings?

D04

When was the present Executive Committee (EC) of the VO constituted?

D05

What is the norm for conducting EC meetings of this VO?

D06

How many EC members are currently elected ?

D07

How many EC meetings were held in the last 12 months? (2022)

D08

Provide details of last 3 meetings of Executive Committee

D08A

Meeting 1

D09A_1

Did it conduct ?

D09A_2

date

D09A_3

No. of Members present.

D08B

Meeting 2

D08B_1

Did it conduct ?

D08B_2

date

D08B_3

No. of Members present.

D08C

Meeting 3

D08C_1

Did it conduct ?

D08C_2

date

D08C_3

No. of Members present.

D09

Why were the meetings not held?

D10

How many EC members were absent in each of the last three consecutive meetings?

D11

No. of SHGs and no. of meetings failed to attend meetings consecutively.

D11A

Meeting 1

D11A_1

No. of SHG

D11A_2

No. of meetings

D11B

Meeting 2

D11B_1

No. of SHG

D11B_2

No. of meetings

D11C

Meeting 3

D11C_1

No. of SHG

D11C_2

No. of meetings

D12

Does the VO levy penalty if EC members are absent?

D13

What was the penalty levied if any of the EC members did not attend the EC meeting? (Note : Ask the amount levied per meeting, per member)

D14

How many meetings did Community Mobilizer had attended in the last 6 months? (Oct 23- March 24)

D15

How many meetings are attended by project staff in the last 6 months? (Oct 23- March 24)

D16

What are the major topics discussed in the EC meetings ?

D16_1

Meeting 1

D16_2

Meeting 2

D16_3

Meeting 3

D16_4

Meeting 4

D17

Has the VO observed any change in its functioning because of the presence of M-CLF?

D18

If yes, can you tell briefly what are the areas that you have felt the difference?

D19

Has the VO received adequate support from the M-CLF?

D20

If yes, what kind of support has been catered to the VO?

D21

Has the VO formed different sub-committees for managing various roles and responsibilities of the VO?

D22

COMMITTEE TYPE

D22_1

Social Action Committee

D22_2

Livelihood committee

D22_3

Monitoring Committee

D22_4

Asset Verification Committee

D22_5

Bank Linkage Committee

D23

When was this committee formed?

D23_1

Social Action Committee

D23_2

Livelihood committee

D23_3

Monitoring Committee

D23_4

Asset Verification Committee

D23_5

Bank Linkage Committee

D24

How many times did this committee meet in the last 12 months?(April 2023- March 2023)

D24_1

Social Action Committee

D24_2

Livelihood committee

D24_3

Monitoring Committee

D24_4

Asset Verification Committee

D24_5

Bank Linkage Committee

D25

Key roles and responsibilities of the committee

D25_1

Social Action Committee

D25_2

Livelihood committee

D25_3

Monitoring Committee

D25_4

Asset Verification Committee

D25_5

Bank Linkage Committee

D26

What are the trainings received by this committee to perform its duties?

D26_1

Social Action Committee

D26_2

Livelihood committee

D26_3

Monitoring Committee

D26_4

Asset Verification Committee

D26_5

Bank Linkage Committee

D27

How would you rate the effectiveness of this committee?

D27_1

Social Action Committee

D27_2

Livelihood committee

D27_3

Monitoring Committee

D27_4

Asset Verification Committee

D27_5

Bank Linkage Committee

D28

Was the AGM conducted in this VO?

D28A

2022-23

D28B

2023-24

D29

Was the notice for AGBM served to all the members?

D30

Was it displayed in Notice Board of VO’s office?

D31

Has the attendance of members been recorded?

D32

Have the minutes of meeting been captured and signed by the Chairperson?

D33

Whether the following issues discussed during the last AGM meetings?

D33_1

Financial status of VO and Repayment from SHGs

D33_2

Monthly Progress Report and Grading of the SHGs

D33_3

Status and Promotion of PGs

D33_4

Identification of Defaulter SHG or SHG at risk of default

D33_5

Action plan for loan recovery

D33_6

Identification of most poor families in the village

D33_7

Identification of training and financial help to sustain/promote livelihood activities

D33_8

Performance of Community cadre i.e., CM, bookkeeper, BS/BC etc.

D33_9

Health and nutrition-related issues – the importance of balanced diet, child and maternal health, health services in the village

D33_10

Sanitation related issues- the importance of cleanliness, sanitation practices, availability of clean drinking water, construction of toilets etc.

D33_11

Education in the village- school enrolment, availability of the teaching staff etc.

D33_12

Involvement in Panchayati Raj Institutions – Participation in Gram Sabha (General)

D33_13

Active Participation in Government Schemes- by facilitating members to access Govt. Welfare/ Development Schemes/Programs (e.g., MGNREGS, PDS, etc.

D33_14

Discussion on last month meeting minutes

D33_15

Discussion on Household Livelihoods

D33_16

Gender Issues

D33_17

Social issues

Review and Monitoring
E01

How often does the VO review the activities of the member SHGs?

E02

What SHG activities are reviewed by the VO?

E03

How many SHGs have been graded by the VO?

E04

What is the frequency of grading conducted by VO?

E05

How many SHGs linked with this VO are in the graded category as used by CLF to grade the associated SHGs?

E05_1

Grade A

E05_2

Grade B

E05_3

Grade C

E05_4

Grade D

E06

Why the other SHGs are not graded by the VO?

E07

What is the reason for SHGs being graded D according to you?

E08

What is being done for SHGs which are performing poorly?

E09

What kind of support does this VO provide to the member SHGs?

E10

Did VO had conducted Training for SHGs?

E11

What training did VO had provided to the SHGs? please specify the number of SHGs that were given the training

E11_1

Panch Sutra

E11_2

Micro Credit

E11_3

Bookkeeping

E11_4

Concept of VO

E11_5

Conflict Management

E11_6

Livelihood Promotion

E11A

please specify the number of SHGs that were given the training

E11A_1

Panch Sutra

E11A_2

Micro Credit

E11A_3

Bookkeeping

E11A_4

Concept of VO

E11A_5

Conflict Management

E11A_6

Livelihood Promotion

E12

Who all are supported in training ?

E13

No of the groups started livelihood activities? (Note: Ask approx if not exact)

E14

Types of Activities

E15

Has the VO started any new initiatives ?

E16

If yes, what are the initiatives that have been undertaken by VO?

E17

What has been the impact of the initiatives and how has it helped the members?

E18

Please let us know if there has been any innovative measures taken up by the VO?

E19

Which of the following staff are working on VO payroll? (Multiple response)

E20

Can you tell us a description of the roles and responsibilities of the staff?

Maintenance of Records
F01

Whether the record is introduced in the VO?

F01_1

Membership Register

F01_2

Meetings Register

F01_3

Minutes Book

F01_4

Savings Register

F01_5

General Ledger

F01_6

Daily Expenses Register

F01_7

Cash Book

F01_8

Loan Register

F01_9

Receipt Book

F01_10

Voucher Book

F01_11

Stock register

F01_12

Financial statements

F01_13

VO Passbook

F01_14

Cheque Issue Register

F01_15

VO DCB Register

F02

Please record the date last updated

F02_1

Membership Register

F02_2

Meetings Register

F02_3

Minutes Book

F02_4

Savings Register

F02_5

General Ledger

F02_6

Daily Expenses Register

F02_7

Cash Book

F02_8

Loan Register

F02_9

Receipt Book

F02_10

Voucher Book

F02_11

Stock register

F02_12

Financial statements

F02_13

VO Passbook

F02_14

Cheque Issue Register

F02_15

VO DCB Register

Financial Management
G01

Did you receive the fund?

G02

Total fund received.

G03

Last time received.

G04

Total SHGs that took loan.

G05

Amount disbursed.

G06

Amount repaid.

G07

Amount repaid by VOs to higher federation.

G08

Name of the SHG that are part of the VO

G09

No of times the SHG has received loan from VO

G10

Total loan amount received from VO (Amount)

G11

Last loan received from VO (Amount)

G12

Date on which last loan received

G13

Duration for which the loan was taken

G14

Loan outstanding amount as on March 31st 2023.

G15

How many tranches of VRF have you received till now

G16

Have the SHGs under your ambit received the CIF?

G17

If yes, please give the number of SHGs that received CIF

G18

Total Loan is given by VO Corpus Fund (VRF)from Jan 2024-March 2024

G19

Total repayment on the VO Corpus fund (VRF)from Jan 2024-March 2024

G20

Total loan outstanding of CLF loan on VO from Jan 2024-March 2024

G21

Interest charged by CLF on loans to VO

G22

Total Outstanding of VO loan on SHG Jan 2024-March 2024

G23

Interest charged by VO on loans to SHGs

G24

Cash in Bank Jan 2024-March 2024

G25

Total number of SHG defaulted the VO loan (CIF/ VRF)

G26

Total No of SHG with the potential of loan default/week repayment ratio

G27

What action was taken by the VO against loan defaulter SHGs?

G28

Has the VO received any interest-free loan from CLF in the last three months? (Jan 2024-March 2024)

G29

Has the VO funded any interest-free loan to any SHG in the last three months? (Jan 2024-March 2024)

G30

How many SHGs have accessed interest free loans from your VO in the last three months? (Jan 2024-March 2024)

G31

Number of SHG had raised the demand for a loan last three month (Jan 2024-March 2024)

G32

Number of loan Demands accepted by VO for last three months (Jan 2024-March 2024)

G33

If there were any rejections, please elaborate the reasons

G34

Total loan of demand raised by VO to CLF in last three months (Amount) (Jan 2024-March 2024)

G35

Total Loan received by VO in last three months (Amount) (Jan 2024-March 2024)

G36

Amount due from SHGs in the last three months (Jan 2024-March 2024)

G37

Amount collected from SHGs in the last three months (Jan 2024-March 2024)

G38

Note the Demand Collection Balance (DCB) from the bookkeeper. (Jan 2024-March 2024)

G39

What is the expenditure incurred by the VO under the following heads?

G39_1

Payment of staff (cadre)

G39_2

Training expenses (Amount for trainings if any conducted in this timeline)

G39_3

Purchase of fixed assets (ag. Purchase/ Construction of VO office - furniture, almirah etc.)

G39_4

Miscellaneous expenses (e.g. Printing of brochures, purchase of stationery etc.)

G40

What is the amount received by the VO under the following heads?

G40_1

Membership fees (subscription fee) deposited by SHGs (Total)

G40_2

Interest received on loans

G41

Total profit/surplus accumulated by the VO

G42

Opening balance

G43

Closing balance

G44

Particulars

G44A

FY 2021-22 (INR)

G44A_1

Net savings

G44A_2

Fixed deposits made by VO

G44A_3

CIF outstanding

G44A_4

CEF outstanding

G44A_5

PG loan outstanding

G44A_6

Other loans outstanding (loans given from other grants

G44A_7

Net profit or loss

G44A_8

Cash in hand

G44A_9

Cash at bank

G44B

FY 2022-23 (INR)

G44B_1

Net savings

G44B_2

Fixed deposits made by VO

G44B_3

CIF outstanding

G44B_4

CEF outstanding

G44B_5

PG loan outstanding

G44B_6

Other loans outstanding (loans given from other grants

G44B_7

Net profit or loss

G44B_8

Cash in hand

G44B_9

Cash at bank

G44C

FY 2023-24 (INR)

G44C_1

Net savings

G44C_2

Fixed deposits made by VO

G44C_3

CIF outstanding

G44C_4

CEF outstanding

G44C_5

PG loan outstanding

G44C_6

Other loans outstanding (loans given from other grants

G44C_7

Net profit or loss

G44C_8

Cash in hand

G44C_9

Cash at bank

G45

Expenditure (recurring) including statement of advances during the year

G45A

FY 2021-22 (INR)

G45A_1

Remuneration to VO staff

G45A_2

Office rent, water, electricity, telephone, communication, internet, etc.

G45A_3

Stationary purchased

G45A_4

Travel expenses

G45A_5

Bank/ commission charges

G45A_6

Other expenditures (if available mention expenditure incurred on training separately in remarks screen)

G45A_7

Subscription/Fee to paid higher level federations

G45B

FY 2022-23 (INR)

G45B_1

Remuneration to VO staff

G45B_2

Office rent, water, electricity, telephone, communication, internet, etc.

G45B_3

Stationary purchased

G45B_4

Travel expenses

G45B_5

Bank/ commission charges

G45B_6

Other expenditures (if available mention expenditure incurred on training separately in remarks screen)

G45B_7

Subscription/Fee to paid higher level federations

G45C

FY 2023-24 (INR)

G45C_1

Remuneration to VO staff

G45C_2

Office rent, water, electricity, telephone, communication, internet, etc.

G45C_3

Stationary purchased

G45C_4

Travel expenses

G45C_5

Bank/ commission charges

G45C_6

Other expenditures (if available mention expenditure incurred on training separately in remarks screen)

G45C_7

Subscription/Fee to paid higher level federations

G46

Loan loss/ write off bad debts

G47

Service charges paid to member organizations

G48

Total expenditure

G49

Excess of income over expenditure (if income is more than expenditure) is the balance figure

G50

Income receipts during the said period

G50_1

Bank Interest received

G50_2

Penalty collected

G50_3

Resource fee/ institutional charges received

G50_4

CIF interest on loans collected from member organizations

G50_5

CEF interest on loans received

G50_6

Interests received from loans given from other grants

G50_7

Recurring subscription fee received from member organizations

G50_8

Membership fee received from member organizations

G50_9

Admission/registration fees received from member organizations

G50_10

Service Fee received

G50_11

Other income

G50_12

Income from other grants

G51

Total income

G52

Excess of expenditure over income (if expenditure is more than income) is the balancing figure

G53

Total loan amount demanded (in INR)

G53_1

Month 1

G53_2

Month 2

G53_3

Month 3

G54

Total loan amount disbursed (in INR)

G54_1

Month 1

G54_2

Month 2

G54_3

Month 3

G55

Total loan outstanding (in INR)

G55_1

Month 1

G55_2

Month 2

G55_3

Month 3

G56

Expected payment of Principal amount (in INR)

G56_1

Month 1

G56_2

Month 2

G56_3

Month 3

G57

Expected payment of Interest amount (in INR)

G57_1

Month 1

G57_2

Month 2

G57_3

Month 3

G58

Actual collection of Principal amount (in INR)

G58_1

Month 1

G58_2

Month 2

G58_3

Month 3

G59

Actual collection of Interest amount (in INR)

G59_1

Month 1

G59_2

Month 2

G59_3

Month 3

G60

Closing Balance (Cash in Hand) (in Rs)

G60_1

Month 1

G60_2

Month 2

G60_3

Month 3

G61

Closing Balance (Cash in Bank) (in Rs)

G61_1

Month 1

G61_2

Month 2

G61_3

Month 3

G62

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

G62_1

Month 1

G62_2

Month 2

G62_3

Month 3

G63

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

G63_1

Month 1

G63_2

Month 2

G63_3

Month 3

Custom Hiring Centres
H01

Is there a functional CHC in your area?

H02

How many farmers are members of the CHC?

H03

Is there a membership fee to join the CHC?

H04

If yes, what is the membership fee? (INR) (mention unit also)

H05

What are the services and activities conducted in your CHC

H06

Who all are eligible to avail the CHC services?

H07

Have the CHC services be of help to you and other farmers in your area?

H08

If yes, how has the CHC services been of help?

H09

Are there certain farmers who are eligible but not opting for CHC services?

H10

If yes, are there any barriers that disable them from taking advantage of CHC services?

H11

What is the potential area under cultivation where the CHC can rent out the implements?

H12

What is the total area serviced by this CHC?

H13

Which operations can be performed using the equipment available in the CHC?

H14

What are the various kinds of machinery available at the CHC?

H15

Did anyone from SRLM/project team ever take your suggestion on what kind of agricultural equipment to store in the CHC?

H16

On a scale of 1-5 how much do you agree to the statement that the CHC has the machinery for the crops commonly grown in the village?

H17

On a scale of 1-5, how much do you agree to the statement that the CHC has the machinery timely available when needed?

H18

On a scale of 1-5, how much do you agree to the statement that the CHC has the machinery which is user friendly? (i.e. easily movable, easy to handle)

H19

On a scale of 1-5, how much do you agree with the statement that the CHC have machinery which is well maintained and well lubricated? Please rate on a scale of 1 – 5

H20

How are the machinery priced vis-à-vis the market rates?

H21

Benefits CHCs have been giving

H22

Who owns the CHC?

H23

Who manages the day-to-day operations of the CHC?

H24

What are the day to day tasks performed by the CRP?

H25

What are the BORs maintained by the CRP at the CHC?

H26

Does the CRP receive an honorarium?

H27

What is the monthly/yearly honorarium of the CRP?

H28

Does the CRP/ VO livelihood sub-committee members receive trainings to run the CHC?

H29

Were you able to attend the trainings conducted?

H30

What all was covered in the trainings?

H31

At what frequency are these trainings conducted?

H32

On a scale of 1-5, how satisfied are you with the quality of trainings

H33

What can be done to improve the quality and accessibility of trainings offered?

H34

In what ways does the VO livelihood sub-committee support the CHC?

H35

Do you receive support from any other government schemes/programs to set up the CHC/ for subsidies on agricultural equipment?

H36

What are the processes followed to rent equipment?

H37

What is done in case equipment is not submitted on time/late payment?

H38A

How is the penalty decided?

H38B

Is there a grievance redressal system/mechanism at CHC?

H39

What is done to handle grievances with the CHC?

H40

What was the total CHC revenue for the previous financial year? (for FY 2023-2024)

H41

What is the net revenue deposited with the VO sub-committee for the previous financial year? (for FY 2023-2024)

H42

What is the total expenditure on repair and maintenance of equipment

H43

What was the total expenditure on procurement or replacement of new equipment (for FY 2023-2024)

H44

On a scale of 1-5, how would you rate your experience with the CHC?

H45

How do you think CHC services can improve?

Convergence
I01

Has the VO taken any steps to ensure that SHG members regularly attend VHSND, Gram Sabha meetings and GPDP planning process?

I02

If yes, please mention the steps undertaken

I03

In the last 6 months, in how many VO meetings were attended by AWW/Ashas/ANMs?

I04

What are the areas in which these workers provided awareness/information on?

I05

Has the VO members taken up any discussions/meetings to discuss the quality of VHND and ICDS services provided?

I06

Has the VO provided awareness to its members on roles and responsibilities of PRI, women sabhas, 73rd and 74th amendment and gram sabhas.

I07

If yes, how has the information helped the members

I08

In the last 6 months has the VO participated in activities alongwith PRIs?

I09

If yes, please mention the activities and meetings participated

I10

How does VO incorporate VPRP into its operations?

I11

What kind of social capital developed VO has developed over time?

I12

Does this VO have provided with training on gender module?

I13

What aspects of Gender has been incorporated in the functioning of VOs ? Please elaborate