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Clf Template 5 -Form Fill

Identification Information
Q01

District Name
Q02

District Code
Q03

Block Name
Q04

Block Code
Q05

Gram Panchayat Name
Q06

Gram Panchayat Code
Q07

Village Name
Q08

Village Code
Q09

Cluster Level Federation Name
Q10

Cluster Level Federation Unique ID
Survey Information
A01

Name of the respondents
A02

Designation of the respondent
A03

Respondent identification code
A04

FIRST 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
A05

SECOND 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
A06

THIRD 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
CLFFormation, Training and Capacity Building
B01

What is the name of this CLF?
B02

What is the date of formation of this CLF?

B03

How many VOs are member of this CLF?
B04

Is this CLF registered?
B05

What is the date of registration of this CLF?
B06

In the last one year, has the accounts of this CLF been audited by an external agency (Chartered Accountant)?
B07

What is the status of training?

B07_1

Exposure Visit of functional CLF
B07_2

CLF Concept and Functioning (CLFM-1)
B07_3

CLF Books Keeping (CBKM1)
B07_4

Refresher CBKM1
B07_5

Roles of CLF Sub-Committee
B07_6

Procurement Sub-Committee
B07_7

Fund management
B07_8

MCP/MIP Preparation/Facilitation and Appraisal
B07_9

Leadership/Group management
B07_10

Grading of VO
B07_11

Livelihood and Income Generation
B07_12

Cadre Review
B07_13

Convergence
B07_14

Other
B08

Date

B08_1

Exposure Visit of functional CLF
B08_2

CLF Concept and Functioning (CLFM-1)
B08_3

CLF Books Keeping (CBKM1)
B08_4

Refresher CBKM1
B08_5

Roles of CLF Sub-Committee
B08_6

Procurement Sub-Committee
B08_7

Fund management
B08_8

MCP/MIP Preparation/Facilitation and Appraisal
B08_9

Leadership/Group management
B08_10

Grading of VO
B08_11

Livelihood and Income Generation
B08_12

Cadre Review
B08_13

Convergence
B08_14

Other
B09

Duration(In Days)

B09_1

Exposure Visit of functional CLF
B09_2

CLF Concept and Functioning (CLFM-1)
B09_3

CLF Books Keeping (CBKM1)
B09_4

Refresher CBKM1
B09_5

Roles of CLF Sub-Committee
B09_6

Procurement Sub-Committee
B09_7

Fund management
B09_8

MCP/MIP Preparation/Facilitation and Appraisal
B09_9

Leadership/Group management
B09_10

Grading of VO
B09_11

Livelihood and Income Generation
B09_12

Cadre Review
B09_13

Convergence
B09_14

Other
B10

Who facilitated the training?
B11

Where was training conducted?

B12

Was training material provided?
B13

To whom the training was imparted?
B14

Was the training useful and content relevant?
B15

Do you recall the training content?
B16

Is the training session noted in book of records?
Operational Guidelines of CLF
C01

Does the CLF have operational guidelines?
C02

Do these operational guidelines clearly define roles and responsibilities of office bearers of your CLF and their sub commities?

C03

Are these guidelinesavailable in public domain?
C04

Does the CLF review its operational guidelines?
C05

When was the last time your CLF had reviewed its operational guidelines?
C06

Does your CLF prepare an annual action plan?
C07

What are the key priorities of the annual action plan?
Leadership
D01

Name of the office bearer
D02

Age of this Office bearer
D03

Religion of this office bearer
D04

Social category of this office bearer
D05

Position currently held by this office bearer
D06

How many times has the position rotated since the formation of CLF?
D07

In which year did the last rotation in position take place?
D08

Is the current position a paid position?
D09

Education level of this office bearer
D10

What type of ration card does the member’s household have?
Governing Body/ Executive Committee (EC)
E01

When was the present Executive Committee (EC) of the CLF constituted?
E02

How frequently do the Governing Body/ Executive Committee of this CLF meet?

E03

How many EC meetings were held in the last 12 months?
E04

Can you please tell me if the last four meetings were conducted?

E04_1

Meeting 1
E04_2

Meeting 2
E04_3

Meeting 3
E04_4

Meeting 4
E05

Why were the meetings not held?
E06

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

E06_1

Meeting 1
E06_2

Meeting 2
E06_3

Meeting 3
E06_4

Meeting 4
E07

Was any penalty levied on any of the EC member who did not attend the EC meeting?
E08

What topics were discussed in the last 4 meetings of the EC

E08_1

Meeting 1
E08_2

Meeting 2
E08_3

Meeting 3
E08_4

Meeting 4
Sub-Committees
F01

Has the CLF formed different sub-committees for managing various roles and responsibilities of the CLF?
F02

When was this committee formed?

F02_1

Social Action Committee
F02_2

MIP Approval/ Livelihoods Committee
F02_3

Education Committee
F02_4

VOMonitoringCommittee
F02_5

Bank Linkage and Training Committee
F02_6

Procurement Committee
F02_7

Social Audit Committee
F02_8

If others(specify____)
F03

How many members are there in the committee currently?

F03_1

Social Action Committee
F03_2

MIP Approval/ Livelihoods Committee
F03_3

Education Committee
F03_4

VOMonitoringCommittee
F03_5

Bank Linkage and Training Committee
F03_6

Procurement Committee
F03_7

Social Audit Committee
F03_8

If others(specify____)
F04

How many times did this committee meet in the last 12 months?

F04_1

Social Action Committee
F04_2

MIP Approval/ Livelihoods Committee
F04_3

Education Committee
F04_4

VOMonitoringCommittee
F04_5

Bank Linkage and Training Committee
F04_6

Procurement Committee
F04_7

Social Audit Committee
F04_8

If others(specify____)
F05

Key roles and responsibilities of the committee
F06

What are the trainings received by this committee to perform its duties?
F07

How would you rate the effectiveness of this committee?
F08

Does this CLF conduct review meetings for sub-committies?
F09

How frequently review meetings are conducted?
F10

How many review meetings were conducted in past 12 months?
F11

What different processes were reviewed in these meetings?
Review and Monitoring
G01

How often does the CLF review the activities of the member VOs?
G02

What VO activities are reviewed by the CLF?
G03

What kind of support does this CLF provide to the member VOs?

G04

Does this CLFprepare monthly progress report (maasiknivedika)?
G05

What major points are covered in monthly progress report?
G06

Does this CLF generate action plans?
G07

When was the last time when this report submitted to CLF?
G08

Does this CLF conduct grading of VO?
G09

How many VOs have been graded till now by this CLF?
G10

How many meetings CLF conduct for reviewing adoption of Dashsutri by VO?

G11

What kind of services does VO provide to member SHGs?
G12

How frequently General Body Meetings (GBMs) are conducted?
G13

When was the last Annual General Meeting (AGM) conducted?
Maintenance of Records
H01

Check if following book of records is available or not?

H01_1

Membership Register
H01_2

Meetings Register
H01_3

Minutes Book
H01_4

Savings Register
H01_5

General Ledger
H01_6

Daily Expenses Register
H01_7

Cash Book
H01_8

Loan Register
H01_9

Receipt Book
H01_10

Voucher Book
H01_11

Stock register
H01_12

Financial statements
H01_13

CLF Passbook
H01_14

Cheque Issue Register
H01_15

CLF DCB Register
H01_16

Others (specify)
H02

Check if book of records is updated or not?

H02_1

Membership Register
H02_2

Meetings Register
H02_3

Minutes Book
H02_4

Savings Register
H02_5

General Ledger
H02_6

Daily Expenses Register
H02_7

Cash Book
H02_8

Loan Register
H02_9

Receipt Book
H02_10

Voucher Book
H02_11

Stock register
H02_12

Financial statements
H02_13

CLF Passbook
H02_14

Cheque Issue Register
H02_15

CLF DCB Register
H02_16

Others (specify)
H03

Please record date last updated

H03_1

Membership Register
H03_2

Meetings Register
H03_3

Minutes Book
H03_4

Savings Register
H03_5

General Ledger
H03_6

Daily Expenses Register
H03_7

Cash Book
H03_8

Loan Register
H03_9

Receipt Book
H03_10

Voucher Book
H03_11

Stock register
H03_12

Financial statements
H03_13

CLF Passbook
H03_14

Cheque Issue Register
H03_15

CLF DCB Register
H03_16

Others (specify)
H04

Please specify reason for not updating book of records

H04_1

Membership Register
H04_2

Meetings Register
H04_3

Minutes Book
H04_4

Savings Register
H04_5

General Ledger
H04_6

Daily Expenses Register
H04_7

Cash Book
H04_8

Loan Register
H04_9

Receipt Book
H04_10

Voucher Book
H04_11

Stock register
H04_12

Financial statements
H04_13

CLF Passbook
H04_14

Cheque Issue Register
H04_15

CLF DCB Register
H04_16

Others (specify)
Financial Management
I01

Opening of CLF Bank Account

I01A

Whether the signature of CLF President, Secretary, and Treasurer are taken for opening the bank account?

I01B

Type of CLF bank account
I01C

How many bank accountsare opened and linked with your CLF?
I02

Authorization for operating the CLF Bank Account

I02A

Do all three signatories viz. the CLF President, Secretary, and Treasurer mandatorily authorize all bank transactions?
I02B

Are all deposit and withdrawal slips, NEFT, RTGS receipts, etc. mandatorily signed by all three signatories?

I03

Custody of cheques and its transactions

I03A

Are all cheques kept in a safe lock (with two keys) in the CLF office only?
I03B

Is one key for the safe lock kept with the CLF secretary and the other with CLF treasurer/ manager?
I03C

Are any cheques kept in the personal custody of CLF president, secretary, treasurer, accountant, manager, or member?

I03D

If “Yes” in 703.C, was a criminal case filed against the person?

I03E

Are all cheque transactions recorded in the appropriate book of records that are maintained in the CLF office?

I03F

Do CLF President, Secretary, and Treasurersign the advance or blank cheques?
I04

Office expense

I04A

Are all office expenses carried out according to rules and regulations set by the Mission guidelines?
I05

Guidelines for funds received from various sources

I05A

From how many sources has your CLF received fundsin the form of CIF, Start-up-Cost, Livelihoods Fund, etc.?
I05B

Whether this fund is managed and utilized according to set guidelines of MSRLM?

I05C

Are discrepancies in management and utilization of this fund resolved through filing a criminal case against those involved?
I05D

What are the lending norms set by CLFs for onward lending VO/ SHG/ PG/ PE?

I05E

Is there timely flow of funds among CBOs i.e. from higher federations (CLFs) to lower (VOs/ SHGs/ PG/ PE)?
I05F

If not, what are the reasons for same and how to improve?

I05G

What are the ways to reduce the cash transaction amongst CLF-VO-SHG-Member and vice-versa?
I05H

Is promotion of digital transaction a good alternative to cash transaction?
I06

Settlement of bills

I06A

Are all bills scrutinized thoroughly for CLF name, date of transaction, item name, quantity, rate, total amount, signature, and authorization of the vendor who raised the bill?
I06B

Does the authorized person of CLF deny settlement of cash memo, proforma bills, etc.?

I06C

Does your CLF raise vouchers for the bills that are to be settled?

I06D

Are the vouchers placed for approval from authorized persons of the CLF?
I06E

Arethe bills settled only on the final approval of vouchers from CLF authorized persons?
I07

Method for settlement of bills

I07A

Are all bills settled through either through RTGS or NEFT or Crossed Cheques only?
I07B

While transacting through the crossed check, is it ensured that the authorized persons of CLF check the name of the party, details of the amount entered in both figures and words, apply transparent cello tape on the entered amount, cross the cheque or use ‘accounts payee only’ stamp to mark, all authorized signatories have signed the cheque in CLF office only, noted the details of cheques in checkbook and book of records and then issued the cheque?

I07C

After clearance of the cheque in the bank, is it ensured that the vendor sign on the receipt register?
I07D

In case of the transaction through RTGS/ NEFT, is it ensured that the authorized persons of CLF note all the details in the RTGS/ NEFT registers available in the CLF office?
I08

Maintaining the Books of Records in CLF office

I08A

Are all transactions which are entered in books of records/ registers signed byCLF President, Secretary, and Treasurer?
I08B

In every CLF meeting, are the members of CLF allowed to access and scrutinize the books of records?
I09

Bank reconciliation

I09A

Does CLF Accountant carry out the task ofBank Reconciliation every month?
I09B

Is Bank Reconciliationfile prepared and presented to CLF President, Secretary, and treasurer everymonth?
I09C

Is the file signed by CLF Accountant, Manager, CLF President, Secretary, and treasurer?
I09D

Is bank statement for every month attached toMonth Wise Bank Statement File?
I09E

Are the deposits and withdrawals noted in the bank statements scrutinized regularly on a weekly or monthly basis?
I10

Guidelines for issuing an advance amount

I10A

How much amount the CLF accountant/ Manager are eligible to receive for office expense?
I10B

Under which heads of office expense is this amount utilized?
I10C

In order to receive the new advance, what proportion of the existing advance amount must be utilized?
I10D

Before issuing the advance amount, are all approvals according to the set guidelines of CLF taken?

I10E

Is there any instance when both the CLF accountant and manager have received the advance amount at the same time?
I10F

Is the advance amount utilized within a month?
I10G

If “No” in 710.E, isthe interest amount at the pre-defined rate levied on the person who holds the amount?
I10H

Is there any instance when the CLF President, Secretary, and Treasurer have received the advance amount?
I11

Cash Transaction

I11A

Are the cash transactions allowed under your CLF?
I11B

Are you aware that the occurrence of cash transactions, if any, will be considered as serious financial lapses, and necessary actions will follow?
I12

Statutory Audit

I12A

Are statutory audits for CLF done?

I12B

If “Yes” in 712.A, are audit reports available?

I12C

Are there any objections reported in the audit reports?

I12D

If yes, are the objections low, moderate, or high risks?
I13

What is expenditure incurred by the CLF under the following heads

I13A

Payment of staff (cadre)

I13B

Training expenses
I13C

Purchase of fixed assets (ag. Purchase/ Construction of CLF office, furnitures, almirah etc.)
I13D

Miscellaneous expenses (eg. Printing of brochures, purchase of stationary
I13E

Other expenses (specify)
I14

What is the amount received by the CLF under the following heads

I14A

Membership fees (subscription fee) deposited by VOs
I14B

Interest received on loans
I14C

Earnings from other sources (specify)

I15

Total profit/surplus accumulated by the CLF
I16

Opening balance
I17

Closing balance
Cadre Management
J01

Community cadre engaged with the CLF
J02

Name of this community cadre?
J03

Gender of this community cadre?
J04

Age in years completed
J05

Social category of this community cadre?
J06

Religion of the community cadre?
J07

Education level of this community cadre?
J08

Since when the community cadre is working?
J09

What are the trainings received by the cadre?
Social Action and Convergence
K01

Did the cluster face any problem regarding ISSUE?

K01_1

SHG/VO related issues
K01_2

Health facilities related issues
K01_3

Social Issues
K01_4

Issues in availing benefits of welfare schemes
K02

Did this CLF take any action against ISSUE?

K02_1

SHG/VO related issues
K02_2

Health facilities related issues
K02_3

Social Issues
K02_4

Issues in availing benefits of welfare schemes
K03

Action/ Collective Action taken up

K03_1

SHG/VO related issues
K03_2

Health facilities related issues
K03_3

Social Issues
K03_4

Issues in availing benefits of welfare schemes
K04

Did this CLF collaborate with or seek help from other institutions for this activity?

K04_1

SHG/VO related issues
K04_2

Health facilities related issues
K04_3

Social Issues
K04_4

Issues in availing benefits of welfare schemes
K05

If yes, which institutions did this CLF collaborate or seek help from?

K05_1

SHG/VO related issues
K05_2

Health facilities related issues
K05_3

Social Issues
K05_4

Issues in availing benefits of welfare schemes
K06

Result

K06_1

SHG/VO related issues
K06_2

Health facilities related issues
K06_3

Social Issues
K06_4

Issues in availing benefits of welfare schemes
Role of CLF in Promoting Farm Livelihoods
L01

Does your CLF promote livelihood activities?
L02

Which livelihood activities does your CLF promote among its members?
L03

How many members households associated with your CLF are involved in these livelihood activities?
L04

What kind of support CLF provide to its member household?
L05

How do CLF decide on which livelihood activity a member household will work?
L06

Have your CLF conducted trainings to build capacity of member households for livelihood activities?
L07

Does your CLF provide financial assistance for taking up livelihood activity?
L08

Does a CLF member take up multiple livelihood activity?
L09

Does this CLF have livelihood sub-committee?
L10

Does this sub-committee conduct meetings?
L11

How frequently these meetings are conducted by sub-committees?
L12

What agendas were discussed in these meetings?
L13

How many members attend these meetings?
L14

How many meetings were conducted in past 12 months?
L15

Does CLF provide VGF to member VO and SHGs to carry farm livelihood activities?
L16

What are the criteria for distribution of VGF to member SHGs?
L17

Does this CLF engage CRPs in farm livelihood activities?
L18

Does this CLF provide Honorarium to the CRPs for the service provided by them?
L19

Does CLF review the work done by the CRPs?
L20

How frequently these review meetings are conducted?
L21

What activities of CRPs are reviewed in these meetings?
L22

Does this CLF maintain record of household engaged in farm livelihood activities?
L23

How many households practice multiple livelihoods options under this CLF?
L24

How much investment was made to generate livelihood opportunity?
L25

How much revenue was generated from these livelihood activities?
L26

What all facilities were accessible to member households in farm livelihoods?