Please Wait...
End Users Template 3 -Form Fill
Geographical Information
Q01
State Name
Q02
District Name
Q03
District Code
Q04
Block Code
Q05
Village Name
Q06
Enumerator code
Q07
Date of Interview
Respondent Information
A01
Full Name of the Respondent
A02
Phone Number/ Mobile Number
A03
Sex of the respondent
Female
Male
Others
A04
What is the highest standard or class you have completed?
Graduate or above
12th
10th
8th
Never attended school
Don’t remember
A05
Are you part of any farmer group?
Yes
No
A06
Which of the organizations are you part of?
SHG
FPO
Farmer Cooperative
Others
Stability and Adaptive capacity
B01
What is the primary source of income for the household?
Self‐employed in agriculture/ fishery/ orchard/ animal husbandry
Self‐employed in non‐agriculture (Owning a shop for sale of products eg: Grocery, Sanitary wares)
Regular salaried/wage employee in government/private sector
Casual wage labor in public works (e.g., MGNREGA)
Casual labor in agriculture
Casual labor in non‐agriculture other than public works
Traditional service occupation (Cobbler, Dhobi, Barber)
Others (Specify)
B02
What is the current household annual income?
B03
Has there been any change in the income you earned in the last one year?
Increased
Remained the same
Decreased
Don’t remember
B03A
What is the average annual income from this activity at present?
B03A_1
Cultivation of Main crops
B03A_2
Cultivation of other crops
B03A_3
Livestock rearing
B03A_4
Non-farm activities (running a small business, self-employment, buy-and-sell)
B03A_5
Wage & salaried work (agri based)
B03A_6
Wage & salaried work (non-agri based)
B03A_7
Aquaculture (fishpond, etc.)
B03A_8
Apiary
B03A_9
Sale of farmyard manure and organic inputs such as jeevamrit, amrit pani, etc.
B03A_10
Renting out of implements, machinery, and bullocks
B03A_11
Others (specify)
B04
Has there been any change in your household expenditure in the last one year?
Increased
Remained the same
Decreased
Don’t remember
B05
How many members of your household are currently employed?
Agricultural and Allied Practices
C01
Do you have any agricultural land?
Yes, Owned land
Yes, Leased land
Yes, both owned and leased
No
C02
How much land do you own/Lease?
C02A
Unit
Decimal
Biswa
Katha
Bigha
Acre
Hectare
Killa
Guntha
C03
What is the proportion of land occupied for farming purposes?
80-100%
60-80%
40-60%
20-40%
0-20%
C04
What kind of Agriculture and Allied activities are you engaged in?
Cultivation of crops
Animal Husbandry/Livestock
Both
C06
What is the duration of your crop cycle?
0-3 months
3-6 months
6-9 months
9-12 months
more than 12 months
C07
What was the total yield during last crop harvest? (in Kgs)
C08
How much did you sell from the total harvest? (in Kgs)
C09
Where did you sell your crop?
Other farmers in locality
Local weekly market (haat)
KVK / Government outlets
Market in nearby town
Local cooperatives (FPC, FPO, PACS)
Market in block
market in district
dealer purchases directly from field
Other (specify)
C10
What was the price per Kg/Quintal/ton at which you sold this crop?
C11
How much income did you earn from selling this produce in the last cycle? (In INR)
Access and Availability of Services
D01
Do you have access to warehouses?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
D02
Do you have access to transport services to get the produce to the market?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
D03
Do you have access to the online market?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
D04
What are the animal husbandry activities that you do? (Multiple Response)
Poultry
Goatry
Fisheries
Pig
Dairy
Others
D05
Do you sell livestock or livestock produce?
Yes
No
D06
Where do you sell your livestock produce?
Other farmers in locality
Local weekly market (haat),
KVK / Government outlets,
Market in nearby town,
Local cooperatives (FPC, FPO, PACS),
Market in block,
market in district,
dealer purchases directly from field,
Other (specify),
Don’t know/ remember
D07
How much income did you receive in the last cycle after selling your produce from allied activities? (INR)
D08
Why did you not sell livestock or livestock produce? (Multiple Response)
Did not have enough produce to sell
Did not receive a good price
Don’t know where to sell
Others
Access to Information and Agricultural Services
E01
Do you have access to sources for agricultural information?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
E01A
What is the source of your agriculture information?
Krishi Vigyan Kendra
Mobile Applications (YouTube, WhatsApp)
Farmer magazines
Internet through phones and laptop
Farmer interest Groups (FPO)
Panchayat
Agriculture research institutes
Radio
Other large farmers in the village
Others specify
E02
Do you have access to sources for agricultural credit?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
E02A
What are your sources of agriculture credit ?
Local Money lender
Formal Banks
Cooperative society
Farmer Producer Company
Self-Help Group
Regional Rural Banks
Kisaan Credit Card
Family and Friends
Others specify
E03
Do you have access to sources for fair prices of produce?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
E03A
What is the source of information for fair price?
Farmer Interest groups (FPO, Cooperative society)
TV channels
Mobile applications
Large/Progressive farmers
Retailers
Creditors
Others specify
E04
Do you have access to reliable power supply?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
E05
Do you have access to small credit for agriculture needs?
Yes, Available and using
Yes, Available but not using
No, Not Available
Don’t know
FPO information
F01
Are you a member of the FPO?
Yes
No
F01A
How long have you been associated with the FPO?
6 months
12 months
18 months
others (specify)
F02
Are you one of the board members of the FPO?
Yes
No
F03
Do you contribute to the decision-making of the activities of the FPO?
Yes
No
F04
Do you actively participate in the activities of the FPO?
Yes
No
F05
What are the activities of the FPO?
Aggregation of Produce
Access to Inputs (Farm, seeds, fertilizers, etc)
Access to Inputs (Non-Farm)
Primary processing (Grading, Sorting)
Value addition (Secondary processing, (packaging, Branding)
Trading (Aggregation of crops and sale of the crops)
Warehousing
Micro-finance
Marketing (Sale of value-addition products)
Farm advisory
Others, Specify
F06
Why do you not participate in the activities of the FPO?
Better terms outside the FPO
Favor the board members
Discriminatory policy
Do not attend meetings
Do not require the services
Others, Specify
F07
Do you benefit from the activities of the FPO?
Yes
No
F08
What are your perceived benefits of the FPO?
Better price realization
Leasing farm equipment
Access to inputs
Market Linkage
Farm/Non-farm advisory
Access to credit capital
Processing
Transportation
Storage facilities
Others, Specify
Renewable Energy Information
G01
What is the primary source of energy for this machinery and equipment?
G01_1
Solar
Yes, Available and using
Yes, Available but not accessible
No, Not Available
G01_2
Wind
Yes, Available and using
Yes, Available but not accessible
No, Not Available
G01_3
Biogas
Yes, Available and using
Yes, Available but not accessible
No, Not Available
G01_4
Grid electricity
Yes, Available and using
Yes, Available but not accessible
No, Not Available
G01_5
Petrol/diesel
Yes, Available and using
Yes, Available but not accessible
No, Not Available
G01A
For what purpose do you use solar?
Irrigation pumps
Cold storage
Implements (Tractor/thresher/transplanter/ harvesting/post-harvest implements)
Others, Specify
G01B
Why are you not using solar/biomass/, biogas?
Non-functional
No access
Don’t know about it
Don’t know where to source it from
Expensive to purchase/install
Don’t know how to operate
Maintenance is difficult
Doesn’t generate enough energy to meet the need
weather condition not favourable
others (specify)
G02
How did you come to know about energy resources?
Enterprise
Govt. Schemes
Extension Workers
Online Advisory (WhatsApp, YouTube)
Other CBOs/ Farmer Groups
FPO/Cooperatives
Others, Specify
G03
According to you what are the perceived benefits of using renewable energy?
Cost savings
continuous supply of power
Easy management
Reduces pollution
Self-reliance
Others Specify-----------
G04
What kind of support did you receive from the enterprise while adopting renewable energy?
Govt. Subsidy
Discounts from the enterprise
Bank Loans
Technical/Advisory Support
Others, Specify
AgTech Information
H01
Are you availing of any agriculture-related services using digital technology?
Yes
No
H02
What is the medium of service provision/ communication?
Mobile Application
Online services
WhatsApp
Community based information platform at FPO/FPC
Others, Specify
H03
By using a digital medium, has the service provider mapped your profile/details to an AgTech platform? (For example, the service provider has records of your landholding size, income, crops grown, price earned, etc.)
Yes
No
H04
In your opinion, what are the benefits of using a digital medium?
Advisory services on crop health, weather
Information on subsidies/govt. schemes
Purchase of inputs
Providing better reach to market
Improving pricing for produce
Access to Financial Institutions
Monitoring of purchased product/ Service
Others, Specify
Food Loss Information
I01
Have you faced food/crop losses during your experience in performing agriculture activities?
Yes
No
I02
What proportion of the crops were affected? (Multiple Response)
I02A
Quantity Produced
I02A_1
Fruits & Vegetables
I02A_2
Cash crops (cotton, sugarcane, Jute, Oilseeds
I02A_3
Paddy
I02A_4
Wheat
I02A_5
Maize
I02A_6
Millets
I02A_7
Others
I02B
Quantity lost
I02B_1
Fruits & Vegetables
I02B_2
Cash crops (cotton, sugarcane, Jute, Oilseeds
I02B_3
Paddy
I02B_4
Wheat
I02B_5
Maize
I02B_6
Millets
I02B_7
Others
I03
At what stage did the food/crop loss occur? (Multiple Response)
Cultivation/Production
post-production
I04
What were the reasons for food loss at the cultivation stage?
Pest infection
Climate induced loss (Drought/ Floods/Variability in rainfall)
Others, Specify
I04A
What were the reasons for crop loss at the post-production stage?
No Storage facility
Lack of appropriate storage facility
In-transit losses
Lack of primary processing facilities
inappropriate harvesting techniques
Others, Specify
I05
Have you adopted any risk mitigation mechanism to prevent food loss?
Yes
No
I06
What is the risk mitigation solution you have opted for?
Tied up with a storage/warehouse provider
Have tie-up with market players
Purchased/leased a mini storage
Others, Specify
I07
What are the benefits of a storage facility?
Mitigates against price fluctuations
Quality maintenance that minimizes decay
Mitigates risks against weather variability and seasonality
Value-added services
Extended shelf-life
Improved farm income
Climate Smart Agriculture
J01
What method of irrigation do you use?
Surface (Flooded) irrigation
Drip irrigation
Sprinkler
J02
Do you have access to micro-irrigation practices (sprinkler and drip)
Yes, Available and Accessible
Yes, Available but not accessible
No, Not Available
J03
How have the uses of organic matter changed in last 1 year?
Increased
same/no change
decreased
J04
What did you do to control pests?
Did not do anything
Used chemical pesticides and fungicides
Used bio-inputs (specify)
Manually removed them
Other (specify)
Don’t know/ remember
J05
How have the uses of botanicals, green manure, and biological pest control changed in last 1 year ?
Increased
same/no change
decreased
never used
J06
Do you practice crop rotation?
Yes
No
J07
Do you have access to soil health card ?
Yes
No
J08
Do you follow the prescribed ratio of NPK (Nitrogen, phosphorous, potassium)?
Yes
No
J09
Do you produce renewable energy on agricultural land (Solar, Wind turbines, Biofuels)?
Yes
No
J10
Do you have access to agriculture advisory services?
Yes, Available and Accessible
Yes, Available but not accessible
No, Not Available
J11
Do you have access to information on local weather?
Yes, Available and Accessible
Yes, Available but not accessible
No, Not Available
J12
Do you have access to digital sensors for crop monitoring?
Yes, Available and Accessible
Yes, Available but not accessible
No, Not Available
J13
Can you elaborate on how you have benefitted by using the services of this enterprise?
Dear user, please upgrade your plan to access this feature
See Plans
Please Wait