Questionnaire for Beneficiaries

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Questionnaire for Beneficiaries

(To be filled by Evaluation Team)

YYYY

Time

Name of Project –

Name of State -

District:

Block: -

Village:

Beneficiary Profile

Name of Beneficiary-

Category-

Mobile Number –

Social Category

Land Holding Categories

Land Information (Acre)

Source of Irrigation:

Before 5 Year

Recent

Tubewell

Well

Pond

Canal

Other (Please Specity)

Community Institution

Are you a member of Producer Group –

Are you a member of Producer Company –

Are you a shareholder of Producer Company –

Are you an Agri-entrepreneur –

Are you a member of the Water user Group –

Did you participate in Gram Sabha –

Capacity Building

Have you received training in any of the following themes-

Community Institution – (PG, FPC)

Agriculture

Horticulture

Livestock

Non-pesticide Management

Non-Timber Forest Produce (NTFP)

MGNREGA

Collective Marketing (Collection, Buyer Negotiation and Selling)

Value addition

Clear selection

Agriculture

Do you practice synchronize farming –

How many winners/ High Value crop you have identified

Do you have seed bank in your village

Yes

Before 5 Yeaars

Recent

If yes, have you sold purchased seed from the seed bank

3. Livestock Intervention

Do you practice livestock rearing –

Whether you have received livestock -

Fisheries

Do you practice Fisheries–

Collective Marketing

Are you doing collective marketing –

Do you have a collection/Aggregationcenter at village –

Are you able to bargain for a better price –

Are you selling the produce in farm gate–

Do you know the current market/ mandi rate of your commodities

Have you got market service

How many markets you can access

Local

District

State Capital

Inter-state

Clear selection

Value addition practices you follow

Grading

Sorting

Aggregation

Storage

Packaging

NTFP Collection Centre

Clear selection

Income Analysis

Current Income from all sources

Annual average Income increase in the percentage

Rights and Entitlement Support Received through project facilitation

MGNREGA (Job Card, Work Received)

PM AwasYojna

Swachh Bharat Mission

Ujjwala

Ayushman Bharat

Aadhaar Card

Ration Card

Widow Pension Scheme

Old Age Pension

Especially abled Pension

PM FasalBimaYojna

Kisan Credit Card

Clear selection

MGNREGA Support

What kind of support did you receive from MGNREGA

Yes

Labour Work

Asset Created

Both

None

Clear selection

If yes mention the below details in the following table:

Asset Created

Type of Individual Asset

Type of Community Asset

Have you participated in the DPR preparation process

Is this planning in the ridge-to-valleyapproach

Food Security

Food Security at household Before 5 Years

Food Security at household now

Migration

Did any of the family member migrate for work before 5 Years- Y/N ,If yes, where did they migrate

For how long you migrated before 5 years

Did any of the family members migrate for work in recent years- Y/N,If yes, where did they migrate

For how long have you migrated in recent years

Gender

Were you involved in decision-making at the household level before 5 years

Marriage

Education

Financial decision (Buying Assets)

Other, please specify

None

Clear selection

Are you involved in decision-making at the household level now

Marriage

Education

Financial decision (Buying Assets)

Other, please specify

None

Clear selection

Submit

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