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Household Listing Template 7 -Form Fill

Interviewer Information
Q01

Code of the Interviewer

Q02

Name of the Interviewer

Q03

Start Time

Q04

End Time

Q05

GPS coordinates

Household Information
A01

State Code

A02

District Code

A03

District Name

A04

Block Name

A05

Village code

A06

Village name

A07

Segment number

A08

Structure number

A09

Household number

A10

Type of village

A11

Name of Household Head

A12

Phone number of the respondent

A13

Gender of the household head

A14

Is anyone in the household involved in Project Unnat Kheti?

A15

No. of members in the household

A16

Caste of the head of the household

A17

Education level of the household head

A18

Does the household have a ration card?

A19

What was the primary source of income for the household in 2020?

A20

What was the primary source of livelihood for the household (Livelihood source where maximum number of HH members are employed) in 2020?

A21

Will you be available after 3-4 weeks for a detailed survey regarding your household's agricultural practices?

A22

Can we collect a soil sample from your field in the next two weeks?

A23

Can we collect a soil sample from your field after two years (in 2024)?

Agriculture/livestock rearing engagement Information
B01

Was the household involved in Agriculture in 2020?

B02

How much agricultural land did the household own/lease-in in 2020?

B03

What was the primary crop grown by the household in different seasons in 2020?

B03A

Rabi 2019-2020

B03B

Kharif 2020

B03C

Zaid 2020

B04

Was the household involved in livestock rearing/poultry farming in 2020?

B04A

Cow/Buffalo/ Oxen

B04B

Goats/Pigs

B04C

Poultry birds (Hens, Ducks etc.)

B05

Was anyone in your household a member of SHGs, VO, CLF (cluster level forum), FPOs, FPCs, etc. in 2020?

B06

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