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Bc Sakhi Template 1 -Form Fill

Village Information
Q01

State Name

Q02

State Code

Q03

District Name

Q04

District Code

Q05

Block Name

Q06

Block Code

Q07

Gram Panchayat Name

Q08

Gram Panchayat Code

Q09

Village Name

Q10

Village Code

Q11

Village Unique ID

Survey Information
A01

Name of the respondents

A02

Respondent identification code

A03

FIRST VISIT

A03_1

Interviewer name

A03_2

Interviewed code

A03_3

Date of the interview

A03_4

Result of the interview

A03_5

Record time when you start the interview

A03_6

Record time when you end the interview

A04

SECOND 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

A04_6

Record time when you end the interview

A05

THIRD 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

Basic Information
B01

What is the name of your SHG?

B02

What is your age?

B03

What is your educational qualification?

B04

What is your marital status?

B05

Month/Year of Joining as BC agent?

B06

What is the primary activity of the the household?

B07

What is the secondary activity of the the household?

Identification/ Selection of BCAs
C01

How did you come to know the BC work/activity

C02

Who influenced you to become a BC Sakhi?

C03

What was the process adopted to select a BC agent? (Multiple choice)

C04

Have you had any experience working as a CRP/Bookkeeper/Trainer?

C05

Please provide details of prior experience.

C06

What motivated you to become a BC Sakhi?

C07

Can you tell us the major roles and responsibilities you must undertake as BC Sakhi?

Training and Capacity Building
D01

Did you receive any training for carrying out your roles and responsibilities as a BCA before initiating work?

D02

How many days of training did you receive?

D03

What all is taught in training (Multiple Choice)

D04

Did you find the training helpful?

D05

What were the main issues with the training sessions?

D06

Did you take an exam after being trained?

D07

If yes, did you receive a certificate?

D08

From where did you receive the certificate?

D09

After you started working as BCA, were you ever given another training?

D10

After how many days/months were you given the refresher training?

D11

What was taught in the refresher training

D12

If not, do you feel the need for refresher training?

D13

If yes, what areas would you like a refresher training on? (multiple choice)

D14

Do you think there has been a change in yourself after becoming a BC Sakhi?

D15

If yes, please elaborate

Functioning and Operations
E01

Which model of service do you follow?

E02

Please provide the name of the bank you work with

E03

Have you started the dual authentication/ verification process for SHG members who do not have an account in the same bank as the one you are associated with?

E04

If not, what are the barriers that are hindering the process of starting dual authentication?

E05

Please tick the following based on the availability of the following listed item at the outlet of Bank Sakhi

E06

During selection and recruitment, are you operating from the allocated place(kiosk)?

E07

How many days a week do you work as a BC Sakhi?

E08

How many hours do you work per day as a BC Sakhi?

E09

Which of the following hardware/ services are available at your outlet?

E10

Please provide the number of villages you provide your services to.

E11

Please provide the approx. number of households you provide your services.

E12

Number of SHGs in your service area

E13

How many of these SHGs have ever got their transactions done by you (i.e., through BC Sakhi)

E14

Number of VOs in your service area

E15

Number of CLFs in your service area

E16

How would you define your customer segment? (Multiple Choice)

E17

What kind of services do you provide to the eligible beneficiaries?

E18A

How many transactions did you carry out in the last three months?

E18A1

44682

E18A2

44713

E18A3

44743

E18B

What was your total value of transaction that took place in the last three months?

E18B1

44682

E18B2

44713

E18B3

44743

E18C

In the last three months, out of all the transactions made by you, how many of the transactions fall under each category?

E18C1

44682

E18C2

44713

E18C3

44743

E19

How many of those transactions were made for women?

E20

How many transactions were made for the elderly?

E21

What are the top 5 services availed by men?

E22

What are the top 5 services availed by women?

E23

Do you think you have been able to help or provide support to other women in society?

E24

If yes, how?

E25

Are you aware that SHG/VO/CLF transactions could be conducted through the BC platform?

E26

Have you ever conducted SHG/VO/CLF transactions?

E27

How many SHGs have which have conducted at least one transaction in the last three months

E28

Total value of SHG transactions done in the last three months

E29

How many VOs have conducted at least one transaction in the last three months?

E30

Total value of VO transactions done in the last three months.

E31

How many CLFs have conducted at least one transaction in the last three months?

E32

Total value of CLF transactions done in the last three months

E33

What are the reasons you feel are responsible for such a low number of SHG/VOs/CLFs routing their transactions through you?

E34

Why don’t you conduct SHG transactions?

E35

What assistance do you need to initiate transactions of SHGs/VOs/CLFs at the BC point?

E36

Has the BC Sakhi felt any constraints?

E37

Do you have someone who can help you with things if you cannot cover the required activities?

E38

If yes, can you specify who the people helping you out are?

Process of Fund flow
F01

What is your main source of investment?

F02

How much did you invest to initiate the activity (INR)?

F03

Of the total investment, how much invest towards equipment

F04

Of the total investment, how much invest towards the OD limit?

F05

What is the frequency with which you get your commission?

F06

What are the modalities of receiving the commission?

F07

How do you receive the commission?

F08

On average, what is the range of commissions you receive in a month?

F09

In which account have you received this amount?

F10

Have you received any incentives or bonuses for the services you have provided?

Detail of expenses
G01

Sources of Revenue

G01_1

Revenue from commissions

G01_2

Assistance provided by the SRLMs

G01_3

Assistance from Banks/NABARD

G01_4

Other sources of Revenue

G02

What is expenditure incurred by the Bank Sakhi under the following heads

G02A

Establishment Cost

G02A1

Laptop/ PC / Tablet

G02A2

Printer cum scanner

G02A3

Pin Pad Device/ Micro ATM

G02A4

Biometric device

G02A5

Internet Connection

G02A6

Power Backup

G02A7

Miscellaneous

G02A8

Overdraft amount (Note to the enumerator: The overdraft allows the account holder to continue withdrawing money even when the account has no funds in it or insufficient funds to cover the amount of withdrawal)

G02B

Total Establishment Cost

G02B1

Operational Expenses

G02B2

Rent of Premises

G02B3

Electricity

G02B4

Monthly Internet Charges

G02B5

Travel Expenses

G02B6

Stationary and miscellaneous expenses