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Process Monitoring Template 17 -Form Fill
General Information
Q01
State Name
Q02
State Code
Q03
District Name
Q04
District Code
Q05
Block Name
Q06
Block Code
Q07
Enterprise Name
Q08
Enterprise Identification Code
Q09
Interviewer name
Q10
Interviewer code
Q11
Interview code
Q12
Date of the interview
Q13
Record time when you start the interview
Q14
Record time when you end the interview
Q15
GPS coordinates
Personal Information
A01
Name of the respondent
A02
Contact number of the respondent
A03
What is your religion?
Hindu
Muslim
Christian
Sikh
Other (Specify)
A04
What is your caste category?
Scheduled Caste
Scheduled Tribe
Other Backward Caste/Class
General
Other (Specify)
A05
What is your marital status?
Married
Unmarried or single
Widowed
Divorced or separated
Others (Specify)
A06
Gender of the respondent
Male
Female
Others
A07
What is your educational qualification?
No formal education
Signature literate
Completed Primary education
Completed secondary education
Completed higher secondary education
Completed graduate level
Completed post-graduation or above
Others (Specify) (text response)
A08
What are the livelihood activities in which you/ your family members are involved?
Agriculture/cultivation on own/ leased-in/ shared land
Animal husbandry
Fishing
Agriculture labor
Non-agri labor, unskilled (coolie, etc.)
Non-agri labor, skilled (mason, carpenter etc.)
MGNREGS labor
Enterprise/business /shops (beauty parlour, cosmetic shops, bangle shops etc.)
Salaried Govt. job (government teachers, clerks etc.)
Salaried private job (salesman, tuition teacher etc.)
JEEViKA Cadre
Other’s Specify
A09
What is your total monthly household income (from all the livelihood sources)?
A10
What is your monthly income from the enterprise?
A11
Are you the owner of the enterprise?
Yes
No
A12
If not, what is your role in the enterprise?
Business Partner/Financer
Full-time employee
SHG member (SHG-owned enterprise)
Other (Specify)
A13
Is the owner an SHG member?
Yes
No
A14
If no, is someone from your family an SHG member
Yes
No
A15
What is the name of the SHG?
A16
What is your relationship with the SHG members?
Husband
Unmarried son
Unmarried daughter
Unmarried brother
Unmarried sister
Parents
Others
Details of the enterprise
B01
Name of enterprise
B02
When was this enterprise started?
B03
Is this enterprise started with the support of OSF
Yes, started under OSF
No, enterprise was already operational
B04
What is the enterprise ownership type?
Individual
Group
B05
Who formed/ started this enterprise?
Started by the present owner/owners
Family business with joint ownership held by members of a single household
Bought from the previous owner
Formed through association with SHG
Formed under an NGO/ Foundation
Formed through PG, PC, Farmer groups, VOs, etc. (Cooperative/ collective)
Others (Specify), text response
Don’t know
B06
Is your enterprise registered?
Yes, registered
Not registered
Not aware
Other (Specify)
B07
Why is the enterprise not registered?
B08
Which sector does your enterprise operate in?
Manufacturing
Trading
Service
B09
What are the services/ products that your enterprise produces?
Grocery Shop
Bangle/ Cosmetic shops/ Salon
Sawmill/ furniture shop / Bamboo work/ handicrafts
Cybercafe/ Photostat shop/ Mobile repair shops/ TV Repair Shops/ Other Repair Shop
Tailoring shop/ garment shops
Food processing unit/ Spice mills
Services (physiotherapy, cooking, trained attendants, restaurant/ eatery etc.)
Producer company
Others, specify
B10
Please explain the business operations in detail
B11
What are the customer bases for this enterprise?
Local/community
Block-level
District level
State-level
National
International
B12
Who assisted in setting up this business?
Cluster Level Federations (CLFs)
CMRC
Village Organizations (VOs)
Producer Groups (PGs) or Producer Organizations (POs)
Self- established
Don’t know
Others (Specify)
B13
Usually, who is engaged in the enterprise?
Male family members
Female family members
Male employees (besides household members)
Female employees (besides household members)
SHG members
Others (Specify)
B14
How many family members are engaged full-time?
B14A
No. of days of employment (in a month)
B14A_1
Male
B14A_2
Female
B14A_3
Male child
B14A_4
Female child
B14B
Remuneration
B14B_1
Male
monthly
weekly
daily
per piece
B14B_2
Female
monthly
weekly
daily
per piece
B14B_3
Male child
monthly
weekly
daily
per piece
B14B_4
Female child
monthly
weekly
daily
per piece
B14C
Amount
B14C_1
Male
B14C_2
Female
B14C_3
Male child
B14C_4
Female child
B15
How many members are employed full-time in the enterprise (other than family members)?
B15A
No. of days of employment (in a month)
B15A_1
Male
B15A_2
Female
B15A_3
Male child
B15A_4
Female child
B15B
Remuneration
B15B_1
Male
monthly
weekly
daily
per piece
B15B_2
Female
monthly
weekly
daily
per piece
B15B_3
Male child
monthly
weekly
daily
per piece
B15B_4
Female child
monthly
weekly
daily
per piece
B15C
Amount
B15C_1
Male
B15C_2
Female
B15C_3
Male child
B15C_4
Female child
B16
How many members are employed part-time in the enterprise (other than family members)?
B17
Do you also hire seasonal labour?
Yes
No
B18
What is the reason for not hiring seasonal labour?
We do not need it
The remuneration cannot be paid through our earnings
We are at an early stage right now
Others, specify
B19
In which month do you engage seasonal labour?
January
February
March
April
May
June
July
August
September
October
November
December
B20
Daily, how many hours is the enterprise operational?
B21
How many days in a month is your enterprise operational on average?
B22
How many customers do you get daily on average?
Less than 3
Less than 5 more than 3
Less than 10 more than 5
Less than 15 more than 10
Less than 25 more than 15
Less than 30 more than 25
Less than 50 More than 30
More than 50
B23
What are the challenges faced in enterprise operations?
Inadequate availability of electricity
Limited availability of clean water
Competition from national/international companies
Low availability of skilled and semi-skilled labor
Inadequate availability of pucca roads
Limited options of transportation
Inadequate availability of high-quality inputs and machinery
More cost of transportation
Inadequate availability of loans
Less credit period from suppliers
Others (Specify)
Don’t know
B24
Where is the business located?
Within the household (in the living area)
In the household (outside the living area) premise
Market/Commercial area
Farmland
Other fixed places
Mobile location
B25
Does the owner or owners own the location or space occupied by the business or activity?
Yes
No
B26
Does this business or activity pay any rent for the location or space it occupies?
Yes
No
B27
What is the monthly rent paid for the office/ enterprise space?
Training received by entrepreneur
C01
Did you receive any Entrepreneur Development training or orientation before/ after starting up the business?
Yes
No
C02
What were some of the topics covered in the training?
Business operations
Financial management
Book-keeping
Packaging
Marketing
Storage
Banking processes
Market linkage
Use of technology
Others, specify
C03
What are the topics where you think training would have helped in developing your business?
Business operations
Financial management
Book-keeping
Packaging
Marketing
Storage
Banking processes
Market linkage
Use of technology
Others, specify
C04
If no, do you feel there is a need for refresher trainings?
Yes
No
C05
What are the topics on which refresher training is required?
Business operations
Financial management
Book-keeping
Packaging
Marketing
Storage
Banking processes
Market linkage
Use of technology
Others, specify
Enterprise- expenditure, profits and book of records
D01
What is the average monthly cost of operations/ expenditure?
D01_1
Raw material
D01_2
Wages
D01_3
Rent
D01_4
Electricity
D01_5
Transportation
D02
What is the total monthly expenditure incurred on the operations?
D03
What is the total monthly expenditure incurred on the operations during peak season?
D04
On average, how many months in a year you realise this peak expenditure season (festivals, wedding etc)?
D05
What is the total monthly revenue generated?
D05A
Before support from OSF
D05A_1
Normal season
D05A_2
Peak Season
D05B
After support from OSF
D05B_1
Normal season
D05B_2
Peak Season
D06
On average, how many months in a year you realise this peak revenue season (festivals, wedding etc)?
D07
Please provide the overall revenue and expenditure details for the last 3 months-
D07A
Feb’23
D07A_1
Revenue
D07A_2
Expenditur e
D07A_3
Profit
D07B
Mar’23
D07B_1
Revenue
D07B_2
Expenditur e
D07B_3
Profit
D07C
Apr’23
D07C_1
Revenue
D07C_2
Expenditur e
D07C_3
Profit
D08
What is the average monthly profit from this enterprise?
D09
How are the profits used?
Household expenses
Purchase of assets/ land
Repayment of loans
Re-investment in business
Savings
Starting new business
Others, specify
D10
Do you maintain book of records?
Yes
No
D11
If no, why do you not maintain book of records?
D12
What are the types of records that you maintain?
Day Book
Purchase book
Sales book
Expense book
Others, specify
D13
Are the above-mentioned books maintained in separate registers?
Maintain separate registers for each record
Maintain all records in one register
D14
Do you face any challenges in updating the book of records?
Yes
No
D15
If yes, what type of challenges do you face while maintaining book of records?
D16
Are the book of records reviewed?
Yes
No
D17
What is the frequency of review of book of records?
Weekly
Fortnightly
Monthly
Quarterly
Half-yearly
Annually
Other, specify
D18
Who reviews these books of records?
BDSP
OSF MC
Others, specify
D19
Do you receive any assistance from BDSPs in maintaining the Book of records?
Yes
No
D20
What type of assistance do you receive from BDSPs in maintenance of records?
D21
Do you find the assistance useful?
Yes
No
D22
What are the areas where you need assistance from BDSP?
Access to Funds
E01
When did you access to fund throgh OSF?
E02
What is the EMI/ repayment schedule for the loan availed under OSF/ CLF?
E03
How much amount have you requested under OSF?
E04
How much amount have you received through OSF?
E05
How many months of repayment schedule was done ?
E06
What is the type of your bank account?
Current Account
Savings Account
Other (Specify)
E07
What has been the initial investment in the enterprise when you started the business?
E08
How did you arrange for the initial investment?
E08A
Whether availed or not?
E08A_1
Savings
Yes
No
E08A_2
Loan from bank
Yes
No
E08A_3
Loan from MFI
Yes
No
E08A_4
Friends/ relatives
Yes
No
E08A_5
Moneylenders
Yes
No
E08A_6
SHGs/ CBOs
Yes
No
E08B
Amount
E08B_1
Savings
E08B_2
Loan from bank
E08B_3
Loan from MFI
E08B_4
Friends/ relatives
E08B_5
Moneylenders
E08B_6
SHGs/ CBOs
E09
Have you taken a loan for the development of your enterprise?
Yes
No
E10
Were you provided any assistance during application for loans?
Yes
No
E11
If no, what was the reason?
E12
When was your business plan approved?
E13
When was the fund disbursed for your enterprise?
E14
How much amount did you request from OSF?
E15
How much amount have you received from OSF?
E16
Loan repayment status for OSF loans
E16_1
Moratorium
E16_2
Repayment tenure
E16_3
EMI (amount)
E16_4
Amount to be repaid
E16_5
Actual amount repaid till April 2023
E17
Sources of loan after joining OSF
E17A
Was the loan availed from this source
E17A_1
Bank
Yes
No
E17A_2
MFIs
Yes
No
E17A_3
Friends/Relative
Yes
No
E17A_4
Informal moneylenders
Yes
No
E17A_5
SHG
Yes
No
E17A_6
VO/CLF
Yes
No
E17B
What was the loan amount?
E17B_1
Bank
E17B_2
MFIs
E17B_3
Friends/Relative
E17B_4
Informal moneylenders
E17B_5
SHG
E17B_6
VO/CLF
E17C
What was the rate of interest?
E17C_1
Bank
E17C_2
MFIs
E17C_3
Friends/Relative
E17C_4
Informal moneylenders
E17C_5
SHG
E17C_6
VO/CLF
E17D
What is the status of loan repayment?
E17D_1
Bank
Partial
Complete
Not started
Unaware
E17D_2
MFIs
Partial
Complete
Not started
Unaware
E17D_3
Friends/Relative
Partial
Complete
Not started
Unaware
E17D_4
Informal moneylenders
Partial
Complete
Not started
Unaware
E17D_5
SHG
Partial
Complete
Not started
Unaware
E17D_6
VO/CLF
Partial
Complete
Not started
Unaware
E17E
How do you repay the loan?
E17E_1
Bank
EMI
Quarterly/half-yearly payments
Yearly payments
Share of profits
Others
E17E_2
MFIs
EMI
Quarterly/half-yearly payments
Yearly payments
Share of profits
Others
E17E_3
Friends/Relative
EMI
Quarterly/half-yearly payments
Yearly payments
Share of profits
Others
E17E_4
Informal moneylenders
EMI
Quarterly/half-yearly payments
Yearly payments
Share of profits
Others
E17E_5
SHG
EMI
Quarterly/half-yearly payments
Yearly payments
Share of profits
Others
E17E_6
VO/CLF
EMI
Quarterly/half-yearly payments
Yearly payments
Share of profits
Others
E18
Have you faced any challenges while repaying the loan?
Yes
No
E19
What were the challenges faced?
High interest rate
Lack of cash flow
Unforeseen expenses
High instalment amount
Others, specify
E20
Has a bank account been opened in the name of the enterprise?
Yes
No
E21
What is the distance to the bank from the enterprise (accessibility in case of services)?
E22
Which of these funds did you apply for?
E22A
Fund received
E22A_1
Loans through CLF
E22A_2
Loan from Bank
E22B
Amount received
E22B_1
Loans through CLF
E22B_2
Loan from Bank
E23
How useful was the loan assistance provided by CBO/ CLFs for the development of your enterprise?
Not at all useful
Not useful
Can’t say/neutral
Useful
Quite useful
Support fro m BDSPs
F01
Was the business plan prepared in the consultation with you?
Yes
No
F02
If given a copy of Business Plan, will that be helpful for you in operating and managing your finances and business?
Yes
No
F03
Did the BDSP assist you in preparing the business plan?
Yes
No
F04
When was your buisness proposal passed?
F05
When did you received the fund through OSF?
F06
What aspects are covered in the business plan?
F07
Did the BDSP help you in raising funds for your business?
Yes
No
F08
If no, how did you manage to raise funds for the enterprise?
F09
Have you planned expansion of your business?
Yes
No
F10
If no, why have you not planned to expand your business?
F11
What are your plans for expansion of your enterprise?
F12
Did the BDSP provide you support in setting up market linkages?
Yes
No
F13
If no, how did you manage market operations for your enterprise?
F14
Did you receive any assistance from BDSP for getting licenses and other regulatory documents (Udyog Aadhaar, PAN, GST etc.)?
Yes
No
F15
If no assistance was provided by BDSP, have you managed to get licenses on your own?
Yes
No
F16
What type of licenses/ regulatory documentation did the BDSP assist you with?
Udyog Aadhaar
FSSAI
PAN Card
GST
Others, specify
F17
Were you informed by the BDSP about other government schemes that could help you in the business?
Yes
No
F18
If yes, did you get benefit under any other government scheme?
Yes
No
F19
Do you have an insurance?
Yes
No
F20
If no, why did you not get an insurance?
F21
Which type of insurance do you have?
Personal (individual)
Personal (group)
Enterprise insurance
F22
Under which scheme have you enrolled for insurance?
PMJJBY
PMSBY
LIC
Insurance policies by Banks
Others, specify
F23
Did the BDSP provide you support in getting insurance?
Yes
No
F24
Do you pay service fee to the BDSP?
Yes
No
F25
Are you aware of any rate card for payment of service fees?
Yes
No
F26
If no, do you think rate card will help you in authenticating the service charge recommended by JEEViKA to BDSP?
Yes
No
F27
Did you receive any other support from BDSPs apart from finances to help in the business?
Business plan preparation
Market linkage
Registration support under UDYOG AADHAR
Backward Linkage
Others, specify
Expectations, Challenges and Way Forward
G01
What support do you require from OSFs/ JEEViKA to further improve your enterprise?
Funds
Training
Market Linkage
Packaging and Marketing
Others
G02
Have you taken any innovative initiative on yourself to attract more customers to your business? (Like, offering sale, advertisement, benefits etc.)
G03
What are your plans to further expand your business?
G04
What are the challenges that you see in expanding the business?
G05
According to you, what can be done to address these challenges?
G06
What were your expectations/ aspirations that were fulfilled through OSF?
G07
What were your expectations/ aspirations that were not fulfilled through OSF?
G08
What are your thoughts on the help and support you have received from JEEViKA during the whole process?
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