Professional Documents
Culture Documents
Survey Questionnaire
Dear Sir/Madam
All the information collected will be kept confidential and used only for academic
purpose.
Thank you
Manohar Vincent Serrao
Research Scholar, MIM, Manipal University
Ph: 944848 2817 Email: manoharvserrao@gmail.com
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Instructions:
1) Tick (√) in the appropriate box or column given
2) Some of the questions in this questionnaire have more than two
options and the options you feel appropriate can be ticked
3) Please tick (√) all the questions
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Part I
BACKGROUND INFORMATION OF THE HOUSEHOLD
Tick (√) in the appropriate box or column given
Bangalore:
Belgaum:
Gulbarga:
Mysore:
Male adults
Female adults
Earning members
Total members
4) What is the category of livelihood activity that the household is dependent on?
Farmer:
Tenant cultivator:
Agricultural labour:
Construction labour:
Employment in manufacturing sector:
Employment in service sector:
Government employment:
Employment under government welfare schemes:
Other (Specify):
Household: A 'household' is usually a group of persons who normally live together and
take their meals from a common kitchen unless the exigencies of work prevent any of them
from doing so.
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8) Does the household own vehicles’? If yes, mention the type of the
Yes: No:
vehicles
Two wheelers:
Three wheelers:
Four wheelers:
Other (Specify):
BPL/APL card: Below Poverty Line Card/Above Poverty Line cards issued to households by the
government to indicate economic disadvantage and to identify individuals and households in
need of government assistance and aid.
PAN: Permanent Income Tax Account Number
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13) Kindly mention the social group that your household belongs to :
Scheduled Caste:
Scheduled Tribe:
General Category:
Other (Specify):
14) Kindly mention the approximate total value of assets of your household:
Less than Rs 1, 00,000:
Rs 1, 00,000 to 2, 00,000:
Rs 2, 00,000 and above:
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Part II
NATURE AND EXTENT OF FINANCIAL INCLUSION
17)Do the members in your household have access to financial services in their
daily livelihood and business activities?
Yes: No: If yes
19) From how many years approximately, have the members in your household
accessed the financial services from formal financial network?
Less than a year:
1 to 3 years:
3 to 5 years:
5 years and above:
Formal financial network: Group of financial institutions licensed by the Central Bank to provide financial
services based on legal infrastructure and provides recourse to the lenders and protection to the depositors.
Informal financial network: Group of financial institutions and individuals who provide financial services
outside the structure of government regulation supervision
Financial services: Financial products provided by the formal financial network , including credit, deposit,
payment, insurance, financial advice and other risk management services.
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20)Are the members in your household aware of the fact that they can open a
bank account with zero balance and without any initial charges?
Yes: No: If yes
a) Is there any such account opened in the name of your household members?
Yes: No:
22)Kindly mention the purpose for which bank account is opened in the name of
your household member:
Number of accounts
Category 1 2 6 & above
3 4 5
Male
Female
23)Do the members in your household have insurance cover for the risk they
face in their daily livelihood and business activities?
Yes: No: If Yes
a) Kindly mention the type of insurance cover accessed by the members in
your household:
Life Insurance:
Asset Insurance:
Livestock Insurance:
Vehicle Insurance:
Crop Insurance:
Health Insurance:
24)Do the earning members in your household have the habit of saving money
regularly from their income?
Yes: No: If Yes
a)Kindly mention the type of savings product accessed by the
household members:
Recurring Deposits in post office: Kisan Vikas Certificate:
Savings Bank Account: Postal Savings:
Pigmy Bank:
National Savings Certificate:
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25) Have the members in your household availed loan from formal financial institutions to
meet household financial emergencies?
Yes: No: If Yes
a) Mention the source from where the loan is availed:
Religious functions/Marriages:
To establish small businesses:
Education:
To conduct agricultural activity:
For health emergencies: Any Other:
To purchase gold and assets: (Specify)
To repay old loans:
For housing:
26)Do the members in your household use General purpose credit card /Kisan
credit card/Debit card for agricultural and other purchases?
Yes: No:
27) Was there any need in your household recently or in the past five years to
remit money regularly or occasionally?
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28)Other than insurance, do the members in your household have any alternative
risk management method for the risk they face in their daily life?
Yes: N o: If yes
NGO: Non Governmental Organization, legally constituted by natural or legal persons, that
operates independently of any government.
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Part III
SOCIO-ECONOMIC IMPACT OF ACCESS TO FORMAL FINANCIAL
SERVICES
Strongly agree:
Agree:
Not sure:
Disagree: If you agree
Strongly disagree:
a) Mention the level of income of the household before and after availing
financial services:
Level of income (per month) Before availing After availing
Less than Rs 5,000: financial services financial services
Rs 5,000 to Rs 10,000:
Rs 10,000 to Rs 15,000:
Rs 15,000 to Rs 20,000:
Rs 1,00,000 to 2,00,000:
Material Changes: Changes in access and control over material resources of household in the
level of income, expenditure, assets etc.
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Strongly agree:
Agree:
Not sure:
Disagree: If you agree
Strongly disagree:
Income:
Productive assets:
Ownership of property:
35) “After availing bank loans and other formal financial services, my household
members are better equipped with resources to satisfy their needs in daily
life.”
Strongly agree:
Agree:
Not sure:
Disagree: If you agree
Strongly disagree:
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36)“After availing bank loan and other formal financial services, my household
members’ earning capacity has gone up.”
Strongly agree:
Agree:
Not sure:
Disagree: If you agree
Strongly disagree:
a) Mention the category in which earning capacity has gone up:
Category Before availing After availing financial
Increase in the number of financial services services
earning members:
Members engaged in new/
37) “It is due to the bank loans that my household got better dwelling conditions.”
Tiled:
Concrete roof :
Other (Specify):
Thatched: Roof of the house with dry vegetation such as straw, water reed s, sedge rushes and heather,
so as to shed water away from the inner roof.
Tiled: Roof of the house covered with tiles mainly to keep rain water out. Tiles are traditionally made
from locally available materials such as clay or slate. Modern materials such as concrete and plastic
are also used.
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Daily wages:
Labourer in manufacturing:
Self employment:
Employment in service
sector:
39)Is there any additional land purchased or assets created in your household
after availing loan from formal financial institutions?
Yes: No: If yes
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Type of crop
Span of time Food crop Commercial crop
Before availing financial
services
41)“It is because of accessing credit and other financial services from formal
financial institutions that the consumption expenditure of the household has
gone up.”
Strongly Agree: Agree: Not sure: Disagree:
Strongly disagree: If you agree
Rs 1000 to Rs 5000
Rs 5000 to Rs 10000
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42)“After availing loan and other formal financial services, the literacy level of
the members in my household has gone up.”
Strongly agree: Agree: Not sure:
Disagree: Strongly disagree:
43) “It is because of availing bank credit from formal financial network and the
additional income generated out of it, that we are able to send our children to
school and there are more number of children going to school or continuing
education in our household.”
Strongly agree: Agree: Not sure: Disagree:
Strongly disagree:
44)“It is because of the access to basic banking facilities and the educational
loans availed through formal financial network that the members in my
household joined higher or professional education.”
Cognitive Changes: Changes in level of knowledge, skills and awareness of the members
of the household due to access to financial services in a wider environment
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46)“It is because of the credit availed through formal financial network and the
additional income generated out of it, that there is more economic freedom
and awareness in the members of my household.”
Strongly agree: Agree: Not sure: Disagree:
Strongly disagree: If you agree
a) Mention the type of economic freedom enjoyed :
b) Mention the kind of awareness that the members of the household attained:
Awareness of non-traditional type of work:
Awareness of political opportunities:
Awareness of fundamental rights of citizens:
Awareness of legal rights:
Any other (Specify):
c) Mention the various health facilities that your household members are
aware of:
Government health schemes:
About medical insurance:
Treatment facilities for illness available in
government and private hospitals:
About primary health care centres:
Any other Specify:
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47)“Due to the loan and other financial facilities availed through formal
financial network members of our household feel self esteemed and self
confident in their day today life”
Strongly agree: Agree: Not sure:
Disagree: Strongly disagree: If you agree
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51)“After availing loan and other formal banking services, there has been an
increase in the bargaining power of the members in our household.”
Strongly agree: Agree: Not sure:
Disagree: Strongly disagree:
a) Mention the activity in which bargaining power has been enhanced:
While purchasing household goods and services:
Within the family while making family decisions:
In asking higher salary or wages from employers:
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Thank You
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