household questionnaire - united nations questionnaire (en... · follow instructions from manual on...

STRICTLY CONFIDENTIAL

2. SECOND STAGE-STRATUM:(1= THREE OR MORE ADULT MEMBERS HHOLDS, 2= REMAINING HHOLDS)

4. NAME OF PRIMARY RESPONDENT

5. PERSON ID CODE OF PRIMARY RESPONDENT

6. NAME OF PRIMARY RESPONDENT'S SPOUSE (IF APPLICABLE)

7. PERSON ID CODE OF PRIMARY RESPONDENT'S SPOUSE (IF APPLICABLE)

8. MAIN LANGUAGE SPOKEN AT HOME:

9. LANGUAGE OF INTERVIEW:

10. TOTAL NUMBER OF INDIVIDUAL QUESTIONNAIRES ATTACHED:

PUT A CROSS (X) IN BLANK BOXES. NO BOX SHOULD BE LEFT BLANK. PERSON

NO. 1

PERSON

NO. 2

PERSON

NO. 3

11. PERSON ID CODES OF RESPONDENTS TO THE INDIVIDUAL QUESTIONNAIRES:

12. MANNER IN WHICH INDIVIDUAL INTERVIEWS CONDUCTED

NAME

See Codesheet

See Codesheet

EDGE PILOT SURVEY ON MEASURING ASSET OWNERSHIP AND

ENTREPRENEURSHIP FROM A GENDER PERSPECTIVE

HOUSEHOLD QUESTIONNAIRE

1. ENUMERATION AREA:

3. HOUSEHOLD SERIAL NO.:

CODE

1. CODE OF ENUMERATOR:

3. DATE OF INTERVIEW START (DD/MM/YYYY):

4. TIME OF INTERVIEW START (HH:MM):

TABLE OF CONTENTS

PAGE

3 MODULE 2A: HOUSEHOLD ROSTER 22

6 MODULE 2B: HOUSEHOLD DWELLING CHARACTERISTICS 31 MODULE 8: OTHER REAL ESTATE

8 MODULE 3: DWELLING 35 MODULE 9: CONSUMER DURABLES

10 MODULE 4: AGRICULTURAL LAND 36 MODULE 10: FINANCIAL ASSETS

18 MODULE 5: LIVESTOCK 38 MODULE 11: LIABILITIES

19 MODULE 6A: LARGE AGRICULTURAL EQUIPMENT 39 MODULE 12: VALUABLES

40 MODULE 13: END OF QUESTIONNAIRE

Read the following statement of purpose confidently, and then give time for the respondent to ask questions.

The [NSO] is conducting a survey of households across Georgia to better understand asset ownership and entrepreneurship in the country.

The findings from the survey will provide important information to the Government for developing policies and programs to improve the lives of men and women in

Georgia.

Your household was selected as one of those to which the survey questions will be asked. You were not selected for any specific reason. Rather, your household was

selected randomly from a list of all households in this village.

All information your household provides is strictly confidential. It will not be shared with any other government agency, and it will only be used for statistical purposes by

the [NSO] or under its supervision. To ensure that the most accurate information is collected, it is very important that we interview the specific household member selected

for the interview and that we interview him or her alone, without family or neighbours present. If, during the interview, any family members or neighbours come within

hearing distance of the interview, please ask them kindly to come back later after the interview has been completed.

Please spare some time to answer the questions. We thank you in advance for your time.

MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS

MODULE 1B: STAFF DETAILS

9. REMARKS BY SUPERVISOR

8. REMARKS BY ENUMERATOR

2. NAME OF ENUMERATOR:

5. CODE OF SUPERVISOR:

6. NAME OF SUPERVISOR:

:(INTERVIEWER ►MODULE 2A)

(SUPERVISOR ►Q9)

7. HOUSEHOLD QUESTIONNAIRES INSPECTION BY SUPERVISOR

DATE (DD/MM/YYYY):

/ /

/ /

/ /

/ /

MODULE 2A: HOUSEHOLD ROSTER MODULE 2A: HOUSEHOLD ROSTER (CONTINUED) MODULE 2A: HOUSEHOLD ROSTER (CONTINUED)

201. 202. 204. 205. 206. 207. 208. 209. 210. 211. 212. 213. 214. 215. 216. 217. 218.

SEX What is [NAME]’s ethnic

group?

ENUMERATOR:

IS [NAME] AGED

10 YEARS AND

OLDER?

ENUMERATOR:

IS [NAME]

AGED 15

YEARS AND

OLDER?

Is [NAME], in his/her primary work? READ ALL

CATEGORIES.

In addition [to this

primary status in

employment], is

[NAME] owning and

operating a non-

agricultural enterprise in

subsidiary capacity?

DD MM YYYY

01 01 01

02 02 02

03 03 03

04 04 04

05 05 05

06 06 06

07 07 07

08 08 08

09 09 09

10 10 10

11 11 11

12 12 12

13 13 13

14 14 14

15 15 15

Is [NAME’S]

spouse/partner a

member of this

household?

What is [NAME]'s marital status?COPY THE

ID CODE OF

THE

SPOUSE /

PARTNER.

YEARPERSON ID

FOR SPOUSE

P

E

R

S

O

N

I

D

C

O

D

E

203.

RELATIONSHIP TO HEAD OF

HOUSEHOLD:

NAME What religion, if any, does

[NAME] practice?

P

E

R

S

O

N

I

D

C

O

D

E

# OF YRS

How old is

[NAME] in

completed

years?

What is [NAME’S] date of birth?

P

E

R

S

O

N

I

D

C

O

D

E

In what kind of status of employment did [NAME] spend most of

his/her time in any economic activity in the last 7 days?

In what year

did [NAME]

marry or form a

consensual

union with

[NAME]'s

spouse /

partner?

RECORD 98

IF DO NOT

KNOW

What is the highest level of education attained by

[NAME] ?

In what kind of status of employment did [NAME] spend most of

his/her time in any economic activity in the last 12 months?

TO MAKE A COMPREHENSIVE LIST

OF MEMBERS OF THE HOUSEHOLD,

USE THE FOLLOWING PROBE

QUESTIONS TO THE PRIMARY

RESPONDENT:

1. Record the name of the

head of the household first.

2. Next, write down names of

all the head of the

household's immediate family

who have lived and eaten

their meals together here

for at least six of the 12

months preceeding the

interview.

3. Then ask names of other

persons related to the head

of the household or any

other household member that

have been living and eating

their meals in this

household for at least 6 out

of the past 12 months.

4. Ask about newly married

individuals, infants less

than 6 months and others who

even though have not lived

and eaten in the household

in the past 6 months are

expected to live permanently

in the household. Include

their names in the roster.

5. Ask about other non

relatives who have been

living and eating their

meals in this household for

at least 6 out of the past

12 months or are expected to

live in this household.

Include their names in the

roster.

6. Do not include those

individuals who have left

the household permanently or

died in the last 12 months.

FILL OUT QUESTIONS 201-203

FIRST AND THEN ADMINISTER

THE OTHER QUESTIONS ROW-WISE

TO THE PRIMARY RESPONDENT.

OTHER MEMBERS CAN HELP THE

PRIMARY RESPONDENT WITH

SPECIFIC QUESTIONS.

YES..1

NO...2 ►212

M....1

F....2

A SOLE DIRECTOR OF ONE'S OWN

LIMITED-LIABILITY ENTERPRISE......1

A PARTNER/ASSOCIATE IN ONE'S

OWN LIMITED-LIABILITY ENTERPRISE..2

RUNNING ALONE ONE'S OWN

ENTERPRISE (NON LLE)..............3

A PARTNER IN AN ENTERPRISE (NON

LLE)..............................4

OTHER (DESCRIBE ACTIVITY)........96

LIST HOUSEHOLD HEAD ON LINE 1.

THEN MAKE A COMPLETE LIST OF

INDIVIDUALS BOTH RELATIVES AND NON-

RELATIVES) WHO HAVE LIVED AND HAD

MEALS TOGETHER FOR AT LEAST 6 OF THE

12 MONTHS PRECEDING THE INTERVIEW.

ALSO INCLUDE INFANTS LESS THAN 6

MONTHS OLD, NEWLY MARRIED LIVING IN

THE HOUSEHOLD FOR LESS THAN 6 MONTHS,

OTHER PERSONS LIVING TOGETHER FOR LESS

THAN 6 MONTHS BUT WHO ARE EXPECTED TO

LIVE IN THE HOUSEHOLD PERMANENTLY.

YES..1

NO...2

►NEXT

PERSON, IF

LAST ► 219

YES..1

NO...2

►NEXT

PERSON,

IF LAST

► 219

NEVER MARRIED......1 ► 212

DIVORCED...........2 ► 212

SEPARATED..........3 ► 212

WIDOWED............4 ► 212

RELIGIOUS MARRIAGE.5

CIVIL MARRIAGE.....6

COHABITATING WITH

PARTNER............7

CHECK

WITH

Q204

CHECK

WITH

Q204

HEAD...........................1

SPOUSE.........................2

SON/DAUGHTER...................3

SISTER/BROTHER.................4

GRANDCHILD.....................5

FATHER/MOTHER..................6

SON/DAUGHTER IN LAW............7

BROTHER/SISTER IN LAW..........8

FATHER/MOTHER IN LAW...........9

OTHER RELATIVE(SPECIFY).......10

OTHER NON RELATIVE(SPECIFY)...11

HIRED/EMPLOYEE...............................1

EMPLOYER (FARMER WITH HIRED

WORKERS).....................................2

EMPLOYER (ENTREPRENEUR IN NON-AGRICULTURE WITH

HIRED WORKERS)...............................3

OWN ACCOUNT WORKER IN THEIR OWN PEASANT

FARM.........................................4

OWN ACCOUT WORKER(EXCEPT THOSE EMPLOYED IN THEIR

OWN PEASANT FARM)......................5

MEMBER OF A PRODUCERS' COOPERATIVE...........6

CONTRIBUTING FAMILY WORKER...................7

NOT CLASSIFIED BY EMPLOYMENT STATUS..........8

NOT ENGAGED IN ECONOMIC ACTIVITY (Those

who have worked for less than one month

during the last 12 months)...................9

YES......1

NO.......2

ORTHODOX........1

CATHOLIC........2

ARMENIAN

APOSTOLIC.......3

JUDAISM.........4

MUSLIM..........5

OTHER(SPECIFY).96

NONE............6

REFUSE TO ANSWER.........97

GEORGIAN..........1

AZERI.............2

ABKHAZIAN.........3

GREEK.............4

OSSETIAN..........5

RUSSIAN...........6

ARMENIAN..........7

UKRAINIAN.........8

OTHER (SPECIFY)..96

REFUSE TO ANSWER............97

HIRED/EMPLOYEE...........................1 ►218

EMPLOYER (FARMER WITH HIRED WORKERS).....2 ►218

EMPLOYER (ENTREPRENEUR IN NON-AGRICULTURE

WITH HIRED WORKERS)......................3 ►219

OWN ACCOUNT WORKER IN THEIR OWN PEASANT

FARM.....................................4 ►218

OWN ACCOUNT WORKER(EXCEPT THOSE EMPLOYED IN THEIR

OWN PEASANT FARM)..................5

MEMBER OF PRODUCERS' COOPERATIVE.........6 ►218 CONTRIBUTING FAMILY WORKER...............7 ►218

NOT CLASSIFIED BY EMPLOYMENT STATUS......8 ►218

NOT ENGAGED IN ECONOMIC ACTIVITY (Those

who have worked for less than one hour

during the last 7 days)..................9 ►219

ILLITERATE..........................1

DO NOT HAVE PRIMARY EDUCATION

BUT CAN READ AND WRITE..............2

KINDERGARTEN........................3

PRIMARY EDUCATION...................4

LOWER SECONDARY EDUCATION...........5

UPPER SECONDARY EDUCATION...........6

VOCATIONAL PROGRAM..................7

SECONDARY PROFESSIONAL PROGRAM......8

HIGHER PROFESSIONAL PROGRAM.........9

BACHELOR OR EQUIVALENT.............10

MASTER OR EQUIVALENT...............11

DOCTOR OR EQUIVALENT...............12

OTHER..............................96

MODULE 2B: HOUSEHOLD DWELLING CHARACTERISTICS

219. 220. 221. 222. 223. 224.

What type of material is mainly used for

construction of the wall of this dwelling?

What type of material is mainly used

for construction of the floor?

What is your household's main

source of electricity?

`

PUT A CROSS (X) IN BLANK BOXES. NO BOX SHOULD BE LEFT BLANK.

a) ID OF PRIMARY RESPONDENT c) ID OF 3RD RESPONDENT

227. ENUMERATOR: RECORD END TIME FOR HOUSEHOLD INTERVIEW (HH: MM).

What is the main source of drinking water in your household?

END OF HOUSEHOLD QUESTIONNAIRE

b) ID OF SPOUSE OF PRIMARY

RESPONDENT / 2ND

RESPONDENT

226. ENUMERATOR: RECORD THE PERSON ID CODE OF INDIVIDUALS OR HOUSEHOLD MEMBERS CHOSEN FOR THE INDIVIDUAL QUESTIONNAIRE. FOLLOW INSTRUCTIONS FROM MANUAL ON SELECTION OF INDIVIDUAL QUESTIONNAIRE RESPONDENTS.

225. ENUMERATOR: RECORD PERSON ID CODE OF MEMBER WHO SERVED AS THE RESPONDENT FOR HOUSEHOLD QUESTIONNAIRE.

What type of material is

mainly used for construction of

the roof of this household's

dwelling?

What type of toilet is mainly used in your household?

NON-AGRICULTURE..1

TIN.................1

SCHIST/TILE.........2

CONCRETE............3

METAL TILE..........4

OTHER, SPECIFY.....96

DON’T KNOW.........98

STONE, BRICK, BLOCK..........1

WOOD.........................2

CONCRETE SLABS...............3

GROUND, MUD, ADOBE...........4

MIXED........................5

OTHER, SPECIFY..............96

DON’T KNOW..................98

STONE, BRICK, CONCRETE....1

WOOD......................2

PARQUET...................3

LAMINATE..................4

GROUND....................5

OTHER, SPECIFY...........96

DON’T KNOW...............98

:

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ELECTRICITY FROM

POWER SUPPLIER.......1

GENERATOR............2

INVERTER.............3

SOLAR PANEL..........4

OTHER, SPECIFY.......96

NONE.................5

THE WATER SUPPLY SYSTEM INSTALLED IN THE DWELLING..1

THE WATER SYSTEM TAP IN THE YARD OR VICINITY.......2

THE WELL IN THE YARD OR VICINITY...................3

NATURAL SPRING IN THE YARD OR VICINITY.............4

A RIVER, LAKE, SPRING, CHANNEL.....................5

BOUGHT WATER.......................................6

OTHER(SPECIFY)....................................96

OWN FLUSH TOILET CONNECTED TO THE SEWERAGE SYSTEM...1

SHARED FLUSH TOILET CONNECTED TO THE SEWERAGE

SYSTEM..............................................2

A FLUSH LATRINE DOES NOT CONNECTED TO THE SEWERAGE SYSTEM

(CONNECTED TO THE RIVER, CHANNEL, RAVINE,

ETC.)...............................................3

PIT LATRINE (PERIODICALLY CLEANED OR BURIED AFTER

FILLING)............................................4

OTHER, SPECIFY.....................................96

STRICTLY CONFIDENTIAL

2. SECOND STAGE-STRATUM:(1= THREE OR MORE ADULT MEMBERS HHOLDS, 2= REMAINING HHOLDS)

6. DATE OF INTERVIEW (DD/MM/YYYY)

7. TIME OF INTERVIEW START (HH:MM):

8. CODE OF ENUMERATOR:

9. NAME OF ENUMERATOR:

10. CODE OF SUPERVISOR:

11. NAME OF SUPERVISOR:

13. COMMENTS FROM SUPERVISOR

______________________________________________________________________________________

12. INDIVIDUAL QUESTIONNAIRES INSPECTION BY SUPERVISOR DATE

(DD/MM/YYYY):

4. PERSON ID CODE OF CHOSEN RESPONDENT:

If the respondent is different from the one completing the Household Questionnaire, please read the statement of purpose

confidently given in Module 1B, and then give time for the respondent to ask questions, before soliciting information.

:

THIS SURVEY IS BEING CONDUCTED BY GEOSTAT.

3. HOUSEHOLD SERIAL NO.:

5. NAME OF CHOSEN RESPONDENT:

1. ENUMERATION AREA:

EDGE PILOT SURVEY ON MEASURING ASSET OWNERSHIP AND

ENTREPRENEURSHIP FROM A GENDER PERSPECTIVE

INDIVIDUAL QUESTIONNAIRENAME CODE

/ /

304. 305.

ID YEAR ID YEAR ID YEAR ID YEAR ID YEAR ID MOA ID MOA ID MOA ID MOA ID MOA

In what year was the dwelling or plot of land on which the household dwelling is located acquired by the

owner(s)?

IF >1 OWNER, ALLOW >1 RESPONSE. RECORD 98 IF DO NOT KNOW.

How did the owner(s) acquire the dwelling or the plot of land on which the household dwelling is located?

Indicate the mode of acquisition (MOA). IF >1 OWNER, ALLOW > 1 RESPONSE.

ID ID ID ID ID

What is the present ownership status of this dwelling?What type of dwelling is this?

301. 302.

MODULE 3: DWELLING

303.

Who are the adult owners of this household dwelling?

LIST ALL ADULTS FROM THE HOUSEHOLD. IF OWNED BY ALL ADULT HOUSEHOLD MEMBERS THEN

FILL IN THE IDs OF ALL ADULT HOUSEHOLD MEMBERS. IF SOMEONE FROM OUTSIDE OF THE

HOUSEHOLD JOINTLY OWNS THE DWELLING, ENTER CODE '99, IN ADDITION TO ID(S) OF

HOUSEHOLD MEMBER(S).

PRIVATE HOUSE ....................1

FLAT IN A BLOCK OF FLATS..........2

ROOM OR ROOMS OF MAIN HOUSE.......3

OTHER (SPECIFY)..................96

OWNED BY SOMEONE IN HOUSEHOLD..1

RENTED.........................2 ►315

RENTED IN EXCHANGE OF INTEREST-FREE LOAN

..........................3 ►315

FREE...........................4 ►315

OTHER (SPECIFY)...............96 ►315

DON'T KNOW....................98 ►315

PURCHASED...............................................1

INHERITED AFTER THE DEATH OF NATAL FAMILY MEMBER........2

INHERITED AFTER THE DEATH OF MARITAL FAMILY MEMBER......3

ACQUIRED DUE TO MARITAL LAW.............................4

ALLOCATED/GIFT FROM HOUSEHOLD MEMBER....................5

ALLOCATED/GIFT FROM NON-HOUSEHOLD MEMBER................6

GOVERNMENT PROGRAM......................................7

ENCROACHMENT............................................8

OTHER(SPECIFY).........................................96

DON'T KNOW.............................................98

THE IDs IN 303 AND 304 SHOULD CORRESPOND AND BE WRITTEN IN THE SAME

ORDER.

THE IDs IN 303 AND 305 SHOULD CORRESPOND AND BE WRITTEN IN THE SAME ORDER.

MODULE 3: DWELLING (CONTINUED)

306. 307.

Is there an ownership document for the dwelling or plot of land

on which the household dwelling is located?

ID ID ID ID ID

Whose names are listed as owners on the ownership document for the dwelling or plot of land on which the

household dwelling is located?

LIST ALL ADULTS FROM THE HOUSEHOLD. IF SOMEONE FROM OUTSIDE OF THE HOUSEHOLD IS

LISTED AS AN OWNER ON THE DOCUMENT, ENTER CODE '99', IN ADDITION TO ID(S) OF

HOUSEHOLD MEMBER(S). RECORD 98 IF DO NOT KNOW.

A TITLE DEED...........1

LOCAL REGISTER BOOK....2

A PURCHASE AGREEMENT...3

NONE.................. 4 ►308

OTHER (SPECIFY).......96

DON'T KNOW............98 ►308

MODULE 3: DWELLING (CONTINUED)

315.

For questions 308 - 309

308.

310. 311. 312. 313. 314.

309.

Who would be involved in the decision to bequeath this dwelling or

plot of land on which your household dwelling exists?

ID ID IDID

Do dwelling owners sell

dwellings in or around this

community?

Are you informed

regarding the value of

recent dwelling sales

transactions?

ID

GEL

(FOR CODE 1 - PRIVATE

HOUSE in Q301 and

CODES '97' OR '98' IN

Q312) What would it cost

to construct this dwelling

today including the cost of

the plot of land on which

the dwelling (PRIVATE

HOUSE) is located?ESTIMATE VALUE IN

GEL.RECORD 97 IF

REFUSE TO ANSWER.

RECORD 98 IF DO NOT

KNOW.

GEL

ID ID ID ID

If this dwelling and the plot of

land on which it is located were

to be sold today, how much

could be received for it?

ESTIMATE VALUE IN GEL.

RECORD 97 IF REFUSE TO

ANSWER. RECORD 98 IF DO

NOT KNOW.

IF CODE 97 OR 98 IN Q312 ►

313

IF THE ESTIMATED VALUE OF

ASSET IS OBTAINED

IN Q312 ► 314

CODE FOR ABILITY OF RESPONDENT TO BE INTERVIEWED

ALONE.

(Reasons interview not administered with the respondent(s)

alone should be explained in the remarks)

ID

If this dwelling were to be sold today, who

would decide how the money is used?

LIST ALL ADULTS FROM THE

HOUSEHOLD. ADD ADDITIONAL SPACE

FOR LISTING IDs, IF REQUIRED. IF

SOMEONE FROM OUTSIDE OF THE

HOUSEHOLD WOULD DECIDE, ENTER

CODE "99", IN ADDITION TO ID(S) OF


ID ID ID

ID

ID

LIST ALL ADULTS FROM THE HOUSEHOLD. ADD ADDITIONAL SPACE FOR LISTING IDs, IF REQUIRED. IF SOMEONE

FROM OUTSIDE OF THE HOUSEHOLD HAS THIS RIGHT, ENTER CODE "99", IN ADDITION TO ID(S) OF HOUSEHOLD

MEMBER(S).

If this dwelling or plot of land on which your household

dwelling exists were to be sold, who would be involved in

the decision to sell?

YES, DWELLING OWNERS

SELL............1

NO SALES

TRANSACTIONS....2 ►312

DO NOT KNOW....98 ►312

INFORMED OF

TRANSACTIONS.....1

NOT INFORMED OF

TRANSACTIONS.....2

RESPONSE CODES:

ALONE.......................................1

WITH ADULT FEMALES PRESENT..................2

WITH ADULT MALES PRESENT....................3

WITH ADULTS MIXED SEX PRESENT...............4

WITH CHILDREN PRESENT.......................5

WITH ADULTS MIXED SEX AND CHILDREN PRESENT..6

MODULE 4: AGRICULTURAL LAND MODULE 4: AGRICULTURAL LAND (CONTINUED) MODULE 4: AGRICULTURAL LAND (CONTINUED) MODULE 4: AGRICULTURAL LAND (CONTINUED)

402. 404. 405. 406. 407. 408. 409. 410. 411. 412. 413.

PARCEL NAME & DESCRIPTION

(LIST FROM LARGEST TO

SMALLEST PARCEL).

What is the area of this

[PARCEL]?

ENUMERATOR: ASK THE

RESPONDENT TO

ESTIMATE THE AREA IN

HECTARES.

RECORD 98 IF DO NOT

KNOW.

Is this [PARCEL] the same

piece of land on which the

dwelling is located?

What is/was the primary use of this [PARCEL] in

the most recent cropping season?

Code AREA IN HECTARES 1ST 2ND 3RD 4TH 5TH ID ID ID ID ID ID ID ID ID ID ID YEAR ID YEAR ID YEAR ID YEAR ID YEAR ID MOA ID MOA ID MOA ID MOA ID MOA ID ID ID ID ID

P01

P02

P03

P04

P05

P06

P07

P08

P09

P10

401. Do you or any member of your household currently OWN any agricultural parcels exclusively or jointly with someone else ?

The parcels may include those that are cultivated by your household, currently fallow, rented out or given away for nothing in return on a temporary basis. DO

NOT include those held only through use/access rights.

Whose names are listed as owners on the ownership document for this [PARCEL]?

LIST ALL ADULT OWNERS FROM THE HOUSEHOLD ROSTER. IF SOMEONE FROM

OUTSIDE OF THE HOUSEHOLD IS LISTED AS AN OWNER ON THE DOCUMENT,

ENTER CODE '99', IN ADDITION TO ID(S) OF HOUSEHOLD MEMBER(S). RECORD

98 IF DO NOT KNOW.

Is there an ownership document for this [PARCEL]?Who are the adult owners of this [PARCEL]?

LIST ALL ADULT OWNERS FROM THE

HOUSEHOLD ROSTER. IF SOMEONE

FROM OUTSIDE OF THE HOUSEHOLD

JOINTLY OWNS THE PARCEL, ENTER

CODE '99', IN ADDITION TO ID(S) OF


P

A

R

C

E

L

I

D

In what year was this [PARCEL] acquired by the owner(s)?

IF >1 OWNER, ALLOW >1 RESPONSE. RECORD 98 IF DO NOT KNOW.

How did the owner(s) acquire this [PARCEL]? Indicate the mode of acquisition (MOA). IF

> 1 OWNER, ALLOW > 1 RESPONSE.

What crops are (were) cultivated on this

[PARCEL] during the most recent cropping

season ?

SEE TRAINING MANUAL FOR CROP

CODES. LIST ALL CROPS, STARTING

WITH THE CROP WITH THE LARGEST

AREA UNDER CULTIVATION.

Who decided on the primary use of this

[PARCEL] in the most recent cropping

season?

LIST ALL ADULTS FROM THE HOUSEHOLD

ROSTER. IF SOMEONE FROM OUTSIDE

OF THE HOUSEHOLD IS A DECISION-

MAKER, ENTER CODE '99', IN ADDITION

TO ID(S) OF HOUSEHOLD MEMBER(S).

Where is this [PARCEL] located?

403.

YES..........1

NO...........2 ► 423

DON'T KNOW..98 ► 423

YES..1 ► NEXT PARCEL,

IF LAST ► 423

NO...2

RENTED OUT...................1 ► 408

GIVEN OUT (FREE).............2 ► 408

LAND UNDER ANNUAL CROPS......3

LAND UNDER PERMANENT CROPS...4

FALLOW.......................5 ► 408

NATURAL MEADOWS..............6 ► 408

NATURAL PASTURES.............7 ► 408

LAND UNDER YARDS AND BUILDINGS

(INCLUDING GREENHOUSES)......8 ► 408

WOODLAND/FOREST..............9 ► 408

AREA UNDER WATER/SWAMP......10 ► 408

OTHER LAND (SPECIFY)........96 ► 408

DO NOT KNOW.................98 ► 408

A TITLE DEED..........1

LOCAL REGISTER BOOK...2

A PURCHASE AGREEMENT..3

NONE................. 4 ► 414

OTHER (SPECIFY)......96

DON'T KNOW...........98 ► 414

Please write:

Name of district and

Name of settlement

(town/village)

THE IDs IN 409 AND 410 SHOULD CORRESPOND AND BE

WRITTEN IN THE SAME ORDER.



PURCHASED...............................................1







ENCROACHMENT............................................8

OTHER(SPECIFY).........................................96

DON'T KNOW.............................................98

MODULE 4: AGRICULTURAL LAND (CONTINUED) MODULE 4: AGRICULTURAL LAND (CONTINUED) MODULE 4: AGRICULTURAL LAND (CONTINUED)

414. 415. 416. 417. 418. 419. 420. 421. 422. 423

If this parcel were to be

sold today, how much

could be received for it?

P01 P01 P01

P02 P02 P02

P03 P03 P03

P04 P04 P04

P05 P05 P05

P06 P06 P06

P07 P07 P07

P08 P08 P08

P09 P09 P09

P10 P10 P10

ID

If this [PARCEL] were to be sold, who would be involved in

the decision to sell?

LIST ALL ADULTS FROM THE HOUSEHOLD ROSTER. IF

SOMEONE FROM OUTSIDE OF THE HOUSEHOLD

WOULD BE INVOLVED IN THE DECISION TO SELL,

ENTER CODE '99', IN ADDITION TO ID(S) OF


If this [PARCEL] were to be sold today, who would

decide how the money is used?


ROSTER. IF SOMEONE FROM OUTSIDE OF

THE HOUSEHOLD WOULD DECIDE, ENTER



ID

P

A

R

C

E

L

I

D

ID ID ID ID

ESTIMATE VALUE IN

GEL. RECORD 97 IF

REFUSE TO ANSWER.

RECORD 98 IF DO NOT

KNOW.

P

A

R

C

E

L

I

D

ID ID ID ID

Are you informed


recent land sales

transactions?

Do land owners sell out any land in or

around the community where the land is

located?

Who would be involved in the decision to bequeath

this [PARCEL]?



THE HOUSEHOLD WOULD BE INVOLVED IN

THE DECISION TO BEQUEATH, ENTER CODE

'99', IN ADDITION TO ID(S) OF HOUSEHOLD

MEMBER(S).

CODE FOR ABILITY OF

RESPONDENT TO BE

INTERVIEWED ALONE.


alone should be explained in the remarks)GEL ID ID ID

Are there any household

members aged 18 and

above that do not know

about your ownership of

this [PARCEL] ?

Which household member

aged 18 and above does not

know about your ownership of

this [PARCEL]?

LIST UP TO 3 FROM

HOUSEHOLD ROSTER.

ID ID IDID

P

A

R

C

E

L

I

D

ID

ENUMERATOR: IS

RESPONDENT ONE

OF THE OWNERS OF

[PARCEL]?

RESPONSE CODES:

ALONE.......................................1






YES, LAND OWNERS

SELL.............1

NO LAND

TRANSACTIONS.....2 ►418

DO NOT KNOW.....98 ►418

INFORMED OF

TRANSACTIONS.....1

NOT INFORMED OF

TRANSACTIONS.....2

YES........1

NO...... 2 ►

NEXT PARCEL, IF

LAST ► 423

YES.....1

NO..... 2 ►

NEXT PARCEL, IF

LAST ► 423

CHECK IN

ACCORDANCE

TO Q409

MODULE 5: LIVESTOCK

501.

LIVESTOCK

NAME

ID ID ID ID ID

501 Bovines

502 Buffaloes

503 Sheep

504 Goats

505 Pigs

506 Horses

507 Asses and mules

508 Rabits

509 Beehives

510 Poultry (all types)

CODE FOR ABILITY OF RESPONDENT

TO BE INTERVIEWED ALONE.



L

I

V

E

S

T

O

C

K

C

O

D

E

Does any member of your

household own any [LIVESTOCK]

either exclusively or jointly with

someone else? READ ALL

CATEGORIES

502.

Who are the adult owners of at least one of this

[LIVESTOCK]?

LIST ALL ADULT OWNERS FROM THE

HOUSEHOLD. IF SOMEONE FROM OUTSIDE

OF THE HOUSEHOLD JOINTLY OWNS THE

LIVESTOCK, ENTER CODE '99', IN ADDITION


503.

YES.........1

NO..........2 ►NEXT ITEM,

IF LAST► 503

DON'T KNOW..98 ►NEXT ITEM,

IF LAST► 503

RESPONSE CODES:

ALONE.......................................1






Y

MODULE 6A: LARGE AGRICULTURAL EQUIPMENT

602.

AE1

AE2

AE3

AE4

AE5

AE6

601. Do you or any member of your household own any large agricultural equipment, exclusively or jointly with someone else, including tractors, ploughs, ox-

ploughs, trailers or other types?

ID YEAR

604.

In what year was this [AGRICULTURAL EQUIPMENT] acquired by the owner(s)?" IF >1

OWNER, ALLOW >1 RESPONSE. RECORD 98 IF DO NOT KNOW.

ID YEAR YEARID YEAR ID YEARID

E

Q

U

I

P

M

E

N

T

C

O

D

E

603.

Who are the adult owners of this [AGRICULTURAL

EQUIPMENT]?

LIST ALL ADULT OWNERS FROM THE HOUSEHOLD

ROSTER. IF SOMEONE FROM OUTSIDE OF THE

HOUSEHOLD JOINTLY OWNS THE AGRICULTURAL

EQUIPMENT, ENTER CODE '99', IN ADDITION TO ID(S) OF


ID ID ID ID ID

Please list each piece of large agricultural equipment

that someone in your household owns in order of most

recently purchased. READ LIST

NAME CODE

YES...........1

NO............2 ►615

DON'T KNOW...98 ►615

HAND TRACTOR (MOTOR CULTIVATOR).......1

MINI TRACTOR..........................2

OTHER TRACTORS (18 HP AND MORE).......3

PLOUGH................................4

OX-PLOUGH.............................5

TRAILER...............................6

OTHER(SPECIFY).......................96

IF MORE THAN ONE OF THE SAME EQUIPMENT,

LIST IN DECREASING ORDER, FROM MOST

RECENT TO OLDEST YEAR OF ACQUISITION BY

THE HOUSEHOLD AND GIVE THE EQUIPMENT'S

DIFFERENT NAMES. EXAMPLE: JOHN'S TRACTOR

1, MYRA'S TRACTOR 2, ...

THE IDs IN 603 AND 604 SHOULD CORRESPOND AND BE WRITTEN IN

THE SAME ORDER.

MODULE 6A: LARGE AGRICULTURAL EQUIPMENT

606.

AE1

AE2

AE3

AE4

AE5

AE6

If this [AGRICULTURAL EQUIPMENT] were to be sold, who would

be involved in the decision to sell?

ID ID ID ID ID


SOMEONE FROM OUTSIDE OF THE HOUSEHOLD HAS THIS

RIGHT, ENTER CODE '99', IN ADDITION TO ID(S) OF


E

Q

U

I

P

M

E

N

T

C

O

D

E

605.

How did the owner(s) of this [AGRICULTURAL EQUIPMENT] acquire it? Indicate the mode of acquisition (MOA). IF >1

OWNER, ALLOW >1 RESPONSE.

ID ID MOA ID MOAMOA ID MOA ID MOA

THE IDs IN 603 AND 605 SHOULD CORRESPOND AND BE WRITTEN IN THE SAME

ORDER.

PURCHASED...............................................1







ENCROACHMENT............................................8

OTHER(SPECIFY).........................................96

DON'T KNOW.............................................98

MODULE 6A: LARGE AGRICULTURAL EQUIPMENT (CONTINUED)

607. 608. 609. 610. 612. 613. 614. 615.

ID ID ID ID IDGEL

ID ID ID ID ID ID ID ID

AE1

AE2

AE3

AE4

AE5

AE6

E

Q

U

I

P

M

E

N

T

C

O

D

E

Are there any

household

members aged 18

and above do not

know about your

ownership of this

[AGRICULTURAL

EQUIPMENT] ?

Which household member

aged 18 and above does

not know about your

ownership of this

[AGRICULTURAL

EQUIPMENT]?

ENUMERATOR: IS

RESPONDENT OWNER

OF [EQUIPMENT]?

Who would be involved in the decision

to bequeath this [AGRICULTURAL

EQUIPMENT]?

611.

Do individuals sell out any

[AGRICULTURAL EQUIPMENT]

in or around this community?

Are you informed


recent [AGRICULTURAL

EQUIPMENT] sales

transactions?

If this

[AGRICULTURAL

EQUIPMENT] were

to be sold today,

what would be the

total price received,

given the age and

state of the

equipment?

ESTIMATE IN GEL.

RECORD 97 IF

REFUSE TO

ANSWER. RECORD

98 IF DO NOT

KNOW.



FROM OUTSIDE OF THE

HOUSEHOLD HAS THIS RIGHT,

ENTER CODE '99', IN ADDITION TO

ID(S) OF HOUSEHOLD MEMBER(S).

If this [AGRICULTURAL

EQUIPMENT] were to be sold out

today, who would decide how the

money is used?


HOUSEHOLD. IF SOMEONE FROM

OUTSIDE OF THE HOUSEHOLD

WOULD DECIDE, ENTER CODE '99',

IN ADDITION TO ID(S) OF


CODE FOR ABILITY OF RESPONDENT TO BE INTERVIEWED

ALONE.

(Reasons interview not administered with the respondent(s) alone

should be explained in the remarks)

LIST UP TO 3 FROM THE

HOUSEHOLD ROSTER.YES,SELL.........1

NO TRANSACTIONS..2 ►610

DO NOT KNOW.....98 ►610

INFORMED OF

TRANSACTIONS.....1

NOT INFORMED OF

TRANSACTIONS.....2 YES...1

NO....2 ► NEXT ITEM, IF LAST ►615

YES.....1

NO..... 2 ►

NEXT ITEM, IF

LAST ► 615

CHECK IN

ACCORDANCE

TO Q603

RESPONSE CODES:

ALONE.......................................1






MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS

704 …offer any service or sold anything at a fixed or mobile location on a street, at home, or in a

market, including firewood, home-made charcoal, curios, construction timber, woodpoles, traditional

medicine, mats, bricks, cane furniture, weave baskets, thatch grass etc.?

708…own any other non-agricultural enterprise not mentioned above, even

if it is a small enterprise run from home or on a street?

703…own a trading enterprise at a fixed or mobile location on a street, at home, or in a market? 707…own a drinking place (ex. bar) or eating place (ex. restaurant)?

709. ENUMERATOR: IS THERE A "1" FOR ANY OF THE QUESTIONS

701 THROUGH 708?

701…own a non-agricultural manufacturing enterprise or provided a non-agricultural service from

home or a household-owned shop, as a carwash owner, metal worker, mechanic, carpenter, tailor,

barber, etc.?

705…own a professional office or offered professional services from home

as a doctor, accountant, lawyer, translator, private tutor, midwife, mason,

etc?

702…process and sell any agricultural by-products, including flour, starch, juice, beer, jam, oil, seed,

bran, wine etc.?

706…drive a household-owned taxi or pick-up truck to provide transportation

or moving services?

Does any member of your household currently engaged in any of the following activities with the main intention of earning income?

YES..1

NO...2 ► 748

YES...1

NO....2

YES...1

NO....2

YES...1

NO....2

YES...1

NO....2

YES...1

NO....2

YES...1

NO....2

YES...1

NO....2

YES...1

NO....2

MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS (CONTINUED) MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS (CONTINUED) MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS (CONTINUED) MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS (CONTINUED)

710. 711. 712. 713. 720. 721. 722. 724. 725. 726. 727. 728. 729. 730. 731. 732. 733. 734. 738. 739.

INDUSTRY

CODE # OF MONTHSID % ID % ID % ID % ID % ID TS ID TS ID TS ID TS ID TS ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID MOA ID MOA ID MOA ID MOA ID MOA ID YEAR ID YEAR ID YEAR ID YEAR ID YEAR

`NUMBER GEL GEL RESPONSE 1 RESPONSE 2 RESPONSE 3 RESPONSE 1 RESPONSE 2 RESPONSE 3 RESPONSE 1 RESPONSE 2 RESPONSE 3

E1

E2

E3

E4

E5

NAME AND ADRESS OF

[ENTERPRISE]

LIST ALL

ENTERPRISES OF ALL

HOUSEHOLD

MEMBERS

Which household member(s) have the

main responsibil ity for managing day-to-

day operations?

Who has the main responsibil ity for

managing day-to-day operations?

Who has the main financial control,

including the ability to sign loans, leases

and contracts?

LIST ALL ADULT HOUSEHOLD

MEMBERS. IN ADDITION TO ID(S) OF

HOUSEHOLD MEMBER(S), ENTER

CODE '99' IF NON-HOUSEHOLD OWNER

OR A HIRED MANAGER HAS THIS

RESPONSIBILITY. ENTER CODE '98'

FOR DO NOT KNOW.

Who has the main responsibil ity for

providing services and/or producing

goods?





OR A HIRED MANAGER HAS THE


FOR DO NOT KNOW.





OR A HIRED MANAGER HAS THIS


FOR DO NOT KNOW.

Is the [ENTERPRISE] your

desired size or did you wish to

grow it ?

What was the

approximate

monthly

turnover from

the

[ENTERPRISE]

(the total value

of sales of

goods or

services;

consider an

average over

the last three

operational

months)?

What was the

approximate total

monthly income

earned from the

[ENTERPRISE]

after paying all

expenses,

including wages

of employees, but

not including any

income paid to

yourself and other

owners (consider

average of last

three operational

months)?

723. 735. 736.

E

N

T

E

R

P

R

I

S

E

I

D

What was the main source of funding

used for purchasing or founding this

[ENTERPRISE]?

DO NOT READ LIST

716. 718.714. 717.

How many

months was

the enterprise

operational in

the last 12

months?

Who are the adult owners of this enterprise?


SOMEONE FROM OUTSIDE OF THE HOUSEHOLD IS AN

OWNER, ENTER CODE '99', IN ADDITION TO ID(S) OF


RECORD % OF OWNERSHIP FOR EACH JOINT OWNER.

RECORD 98 IF DO NOT KNOW.

LOCATION OF THE [ENTERPRISE] Please describe the kind of main

activ ity each enterprise is

engaged in.

715.

What was the average number of hours per week that each

owner spent managing or working on this [ENTERPRISE]

over the last operational month ?

719.

ENUMERATOR:

WAS THIS

ENTERPRISE

FOUNDED

(Q719, CODE 1)

OR PURCHASED

(CODE 2)?

In what year was this [ENTERPRISE] acquired by the owner(s)? IF >1 OWNERS,

ALLOW >1 RESPONSES. RECORD 98 IF DO NOT KNOW.

How was this [ENTERPRISE] acquired? IF >1 OWNER, ALLOW >1 RESPONSE. ENUMERATOR:

IS THE

RESPONDENT

AMONG THE

OWNERS OF

THE

ENTERPRISE

ACCORDING TO

QUESTION 714?

What factors would increase your happiness/satisfaction as

an entrepreneur?

RESPONSE 1 RESPONSE 2 RESPONSE 3

Over the past three

years, has the

number of paid

employees

increased,

decreased or

remained the

same?

Is this [ENTERPRISE] registered? How many paid

employees

does this

[ENTERPRISE]

currently

employ on a

continuous

basis,

excluding the

owner(s)?

During the past twelve months, what

was the primary source of funding

used to finance expansion and capital

improvements or to face unexpected

expenses for this [ENTERPRISE]?

DO NOT READ LIST

What was the main reason your enterprise

did not apply for a line of credit or a

loan? DO NOT READ LIST

Was the loan

application

accepted? (IF

RESPONDENT

APPLIED FOR

MORE THAN ONE

LOAN IN THE

LAST 12

MONTHS, REFER

TO THE MOST

RECENT LOAN IN

THE SAME TIME

PERIOD).

What is the main motivation for running/operating this [ENTERPRISE] (pick the

main reason)? DO NOT READ LIST.SELECT UP TO THREE RESPONSES. DO NOT

READ LIST.

737.

Have you ever taken part in any course or training

activity, whether formal or informal, on how to start an

enterprise, such as training on how to develop a

business plan, assess market opportunities, identify

and access start-up capital, develop business

networks, etc.? SELECT UP TO THREE RESPONSES.

During the last twelve

months, did the

[ENTERPRISE] apply

for loans or l ine(s) of

credit?

What type of records or accounts this

[ENTERPRISE] maintained?

What factors have constrained the business owner’s ability

to increase the size of the [ENTERPRISE] to the desired

size? SELECT UP TO THREE RESPONSES. DO NOT

READ LIST

Various people may give you advice on

managing your enterprise. From whom do you

regularly (once or more per month) receive

advice for managing your [ENTERPRISE]?

SELECT UP TO THREE RESPONSES. DO

NOT READ LIST

OWN/HOUSEHOLD'S SAVINGS......1

FRIENDS/RELATIVES............2

PRIVATE MONEY LENDER.........3

COMMERCIAL/DEVELOPMENT BANK..4

DEPOSIT TAKING

MICROFINANCE INSTITUTIONS....5

CREDIT INSTITUTIONS..........6

TRADER/SHOP KEEPER...........7

NGO..........................8

GOVERNMENT...................9

OTHER (SPECIFY).............96

DON'T KNOW..................98

GOVERNMENT.......................1

NOT REGISTERED...................2

REGISTRATION IN PROCESS..........3

OTHERS(SPECIFY).................96

DON'T KNOW......................98

REFUSES TO RESPOND..............97

DIDN'T EXPAND ENTERPRISE, MAKE

CAPITAL IMPROVEMENTS OR FACE

UNEXPECTED EXPENSES..........1

OWN/HOUSEHOLD'S SAVINGS......2




DEPOSIT TAKING


CREDIT INSTITUTIONS..........7 TRADER/SHOP KEEPER...........8

NGO........................ .9

GOVERNMENT..................10


DON'T KNOW..................98

INCREASED.....1

DECREASED.....2

REMAINED

THE SAME......3

DON'T KNOW...98

DID NOT MAKE EFFORTS TO GROW IT.........1

LACK OF DEMAND..........................2

LACK OF INPUTS..........................3

LACK OF FINANCE.........................4

IRREGULARLY PROVIDED WITH ELECTRICITY

AND PHONE SERVICE.......................5

LACK OF TRAINED EMPLOYEES...............6

COST OF HIRING NEW EMPLOYEES............7

LEGAL REGULATIONS.......................8

POOR QUALITY ROADS......................9

LACK OF MARKET INFORMATION.............10

HIGH TAX RATES.........................11

LACK OF CLEAR OWNDERSHIP OF LAND.......12

HIGH CRIME RATES.......................13

ECONOMIC POLICY UNCERTAINTY............14

CORRUPTION.............................15

LACK OF TIME TO WORK ON THE BUSINESS

DUE TO HOUSEHOLD CHORES ...............16

OTHER (SPECIFY)........................96

TO FILL A NEED SEEN IN THE MARKET FOR AN ENTIRELY NEW

PRODUCT/SERVICE OR FOR AN IMPROVEMENT IN AN EXISTING

PRODUCT/SERVICE.............................................1

BECAUSE THE OWNER IDENTIFIED A VERY PROFITABLE AREA FOR

ENTERPRISE (LOW WAGES, CHEAP INPUTS, NEW FASHION)...........2

TO MAKE MORE MONEY..........................................3

TO GAIN GREATER FLEXIBILITY, CONTROL OF TIME................4

TO FULFILL A DREAM, REALIZE A PASSION.......................5

TO SUPPLEMENT THE FAMILY INCOME.............................6

BECAUSE IT IS THE FAMILY ENTERPRISE(IT IS WHAT IS EXPECTED).7

TO MAKE A POSITIVE CONTRIBUTION TO LIFE IN THE COMMUNITY....8

BECAUSE THE OWNER DID NOT HAVE ANY OTHER CHOICE/

LOST JOB, LAID OFF/TO FEED FAMILY...........................9

OWNER INHERITED THE ENTERPRISE FROM ANOTHER PERSON.........10

OTHER (SPECIFY)............................................96

DON'T KNOW.................................................98

TIME SPENT (TS)

NONE.............1

LESS THAN 20.....2

20-39 HOURS......3

40 HOURS.........4

41-59 HOURS......5

60 HRS AND MORE..6

DON'T KNOW......98

YES..1 ►731

NO...2 ►731

NO NEED FOR A LOAN-ENTERPRISE

HAS SUFFICIENT CAPITAL..........1

APPLICATION PROCEDURES FOR LOANS

OR LINE OF CREDIT ARE COMPLEX...2

INTEREST RATES ARE NOT

FAVOURABLE......................3

COLLATERAL REQUIREMENTS FOR LOANS

OR LINE OF CREDIT ARE

UNATTAINABLE....................4

SIZE OF LOAN AND MATURITY ARE INSUFFICIENT....................5

DID NOT THINK IT WOULD BE

APPROVED........................6

OTHER (SPECIFY)................96

ENTERPRISE IS THE SIZE

I PREFER............1 ►736

I WANTED TO GROW THE

ENTERPRISE..........2

AS PART OF MY REGULAR EDUCATION AT

SCHOOL.................................1

AT MY INITIATIVE.......................2

AS A CONDITION FOR RECEIVING A LOAN/FOR

PARTICIPATING IN A PROGRAM.............3

TRAINING FROM GOVERNMENT...............4

TRAINING BY NGO........................5

OTHER (SPECIFY).......................96

NO.....................................6

SPOUSE/PARTNER...................1

OTHER FAMILY MEMBERS/

RELATIVES........................2

FRIENDS..........................3

A PUBLIC ADVISING SERVICE (BANK,

LAWYER, ACCOUNTANT)..............4

OTHER(SPECIFY)..................96

NONE.............................5

MORE MONEY AT THE END OF THE MONTH FOR ME

AND MY FAMILY.............................1

MORE SUPPORT FROM MY SPOUSE/PARTNER/FAMILY

AND COMMUNITY.............................2

HAVING MORE TIME TO SPEND WITH MY FAMILY..3

HAVING LESS PROBLEMS COMPLYING WITH PUBLIC

REGULATIONS/SPEND LESS TIME TO FILL

PAPERWORK, GET AUTHORIZATIONS AND PAY

TAXES.....................................4

FEELING LESS CONCERNED ABOUT MY PERSONAL

SECURITY AND THE SECURITY OF MY ASSETS....5

HAVING CAPABLE AND MOTIVATED HELP (FROM MY

PAID AND UNPAID EMPLOYEES)................6

NOTHING, I AM FULLY SATISFIED WITH MY WORK

AS ENTERPRISE OWNER... ...................7

OTHER (SPECIFY)..........................96

YES....1

NO.....2 ►740

NO WRITTEN ACCOUNT KEPT.......1

INFORMAL RECORDS FOR

PERSONAL USE..................2

SIMPLIFIED ACCOUNTING FORMAT

REQUIRED FOR TAX PAYMENT......3

DETAILED FORMAL ACCOUNT

(BALANCE SHEET AND INCOME

STATEMENTS)....................4

DON'T KNOW...................98

REFUSES TO RESPOND...........97

YES....1

NO.....2 ►723

THE IDs IN 714 AND 715 SHOULD CORRESPOND

AND BE WRITTEN IN THE SAME ORDER.

THE IDs IN 714 AND 719 SHOULD CORRESPOND AND BE WRITTEN IN THE

SAME ORDER.

YES.........1

NO..........2 ►730

FOUNDED.................................................1

PURCHASED...............................................2







ENCROACHMENT............................................9

OTHER(SPECIFY).........................................96

DON'T KNOW.............................................98

THE IDs IN 714 AND 723 SHOULD CORRESPOND AND BE WRITTEN IN THE

SAME ORDER. FIXED PREMISES

AT HOME WITH NO SPECIAL WORK SPACE...1

AT HOME WITH WORK SPACE

INSIDE/ATTACHED TO THE HOME..........2

BUSINESS PREMISES WITH FIXED

LOCATION INDEPENDENT FROM HOME.......3

HOME OR WORKPLACE OF THE CLIENT......4

CONSTRUCTION SITE....................5

MARKET, BAZAAR STALL, TRADE FAIR.....6

STREET PAVEMENT OR HIGHWAY

WITH FIXED POST......................7

NO FIXED PREMISES

TRANSPORT VEHICLE....................8

NO FIXED LOCATION....................9

(e.g. mobile, door-to-door; street w/o

fixed post)

OTHER(SPECIFY).......................96

(in completed

months)

IF LESS THAN A MONTH,

ENTER '00' AND PUT

APPROPRIATE REMARKS

MODULE 7: NON-AGRICULTURAL ENTERPRISES AND ENTERPRISE ASSETS (CONTINUED)

743. 744. 745. 746. 747. 748.

Equipment/

Machinery/

Furniture

Stocks of

Materials

Equipment/

Machinery/

Furniture

Stocks of

MaterialsID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID

E1

E2

E3

E4

E5

ENUMERATOR: IS

RESPONDENT THE

OWNER/ONE OF THE

OWNERS OF THE

[ENTERPRISE]?

Are there any

household

members aged

of 18 and

above that do

not know about

your ownership

of this

[ENTERPRISE

] ?

Which household

member aged 18 and

above does not know


this [ENTERPRISE]?

LIST UP TO 3 FROM

HOUSEHOLD ROSTER

Who would be involved in the decision to

bequeath this [ENTERPRISE]?

LIST ALL ADULTS FROM



HAS RIGHT TO BEQUEATH, ENTER



741. 742.740.

Does the [ENTERPRISE]

currently own any of the

following assets?

IF THE RESPONSE IS

"NO" OR "DO NOT KNOW"

FOR BOTH EQUIPMENT/

MACHINERY/FURNITURE

AND STOCKS OF

MATERIALS, SKIP TO 745.

How much would be

received for all of this

[ENTERPRISE ASSET]

if it were sold today

(please estimate total

value per type of asset)?

ESTIMATE IN LOCAL

CURRENCY. RECORD

97 IF REFUSE TO

ANSWER. RECORD 98

IF DO NOT KNOW.

E

N

T

E

R

P

R

I

S

E

I

D

CODE FOR ABILITY OF

RESPONDENT TO BE

INTERVIEWED ALONE.



If this [ENTERPRISE] were to be sold,

which member(s) of this household would

be involved in the decision to sell?

If this [ENTERPRISE] were to be sold,

who would be involved in the decision to

sell?




HAS RIGHT TO SELL, ENTER CODE

'99', IN ADDITION TO ID(S) OF

HOUSEHOLD MEMBER(S),

If the [ENTERPRISE ASSETS] were to be

sold today, who would decide how the

money is used?



OUTSIDE OF THE HOUSEHOLD

WOULD DECIDE, ENTER CODE '99', IN

ADDITION TO ID(S) OF HOUSEHOLD

MEMBER(S),

YES...........1

NO............2 ►745

DON'T KNOW...98 ►745

RESPONSE CODES:

ALONE.......................................1






YES.....1

NO..... 2 ►NEXT

ENTERPRISE, IF

LAST ►748

CHECK IN

ACCORDANCE

TO Q714

YES..1

NO...2 ►

NEXT

ENTERPRISE,

IF LAST

►748

MODULE 8: OTHER REAL ESTATE MODULE 8: OTHER REAL ESTATE (CONTINUED) MODULE 8: OTHER REAL ESTATE (CONTINUED)

802. 803. 805. 806. 808. 809. 810. 812. 813.

Which non-

agricultural

enterprise ID is

this [REAL

ESTATE] used

for?

Is there an ownership document for this [REAL

ESTATE]?

CODE CODE

RE1

RE2

RE3

RE4

RE5

RE6

YEAR ID YEAR

801. Do you or any member of your household own any other real estate, exclusively or jointly with someone else, including other dwellings/buildings, flats, other real

estate, such as stores, owned by household enterprises, non-agricultural plots, either rural or urban?

In what year was the [REAL ESTATE] acquired by the owner(s)? IF >1 OWNER, ALLOW >1 RESPONSE.

RECORD 98 IF DO NOT KNOW.

YEAR ID YEARIDID YEAR ID

Please list each piece of other real

estate that someone in your household

owns. READ LIST

Where is this

[REAL ESTATE]

located?

ENUMERATOR

TO HELP

RESPONDENT

IDENTIFY

WHETHER

LOCATION IS

RURAL/

URBAN

What is this [REAL ESTATE]

used for?

811.

Whose names are listed as owners on the ownership

document for this [REAL ESTATE]?


ROSTER. IF SOMEONE FROM OUTSIDE OF THE

HOUSEHOLD IS LISTED AS OWNER, ENTER

CODE '99', IN ADDITION TO ID(S) OF HOUSEHOLD

MEMBER(S). RECORD 98 IF DO NOT KNOW.

ID ID ID ID IDID ID ID ID ID

LOCATION OF [REAL ESTATE]

804.

How did the owner(s) of this [REAL ESTATE] acquire it? Indicate the mode of acquisition (MOA). IF >1

OWNER, ALLOW >1 RESPONSE.

ID MOA ID MOA ID MOA ID MOA ID MOA

807.

Who is/are the adult owner(s) of this [REAL

ESTATE]?


ROSTER. IF JOINTLY OWNED BY SOMEONE

FROM OUTSIDE OF THE HOUSEHOLD, ENTER



ENTERPRISE ID

CODE

If this [REAL ESTATE] were to be sold, who

would be involved in the decision to sell?



THE HOUSEHOLD HAS THE RIGHT TO SELL,

ENTER CODE '99', IN ADDITION TO ID(S) OF


Who would be involved in the decision to

bequeath this [REAL ESTATE]?



THE HOUSEHOLD HAS THE RIGHT TO

BEQUEATH, ENTER CODE '99', IN ADDITION


ID ID ID ID ID ID ID ID ID ID

YES...........1

NO............2 ► 823

DON'T KNOW...98 ► 823

RURAL.....1

URBAN.....2

RENTED OUT......1 ►807

HOUSEHOLD NON-COMMERCIAL

USE.............2 ►807

HOUSEHOLD

COMMERCIAL USE..3

OTHER

(SPECIFY)......96 ►807

DON'T KNOW.....98 ►807

PRIVATE HOUSE ............1

FLAT IN A BLOCK OF FLATS..2

ROOM(S) IN A HOUSE........3

GO DOWN/BASEMENT..........4

STORE.....................5

OTHER BUILDING............6

NON-AGRICULTURAL LAND.....7

OTHER (SPECIFY)..........96



A TITLE DEED.............1

LOCAL REGISTER BOOK......2

A PURCHASE AGREEMENT.....3

NONE.................... 4 ► 812

OTHER (SPECIFY).........96

DON'T KNOW..............98 ►812

Please write:

Name of district and

Name of settlement

(town/village)

PURCHASED...............................................1







ENCROACHMENT............................................8

OTHER(SPECIFY).........................................96

DON'T KNOW.............................................98



MODULE 8: OTHER REAL ESTATE (CONTINUED)

814. 815. 816. 817. 818. 820. 821. 823.

Are you informed


recent [REAL ESTATE]

sales transactions?

ENUMERATOR:

IS THIS [REAL

ESTATE] CODE

1 Q802?

ENUMERATOR:

IS RESPONDENT

THE

OWNER/ONE OF

THE OWNERS

OF [REAL

ESTATE] ?

Are there any

household

members

aged of 18 and

above that do

not know

about your

ownership of

this [REAL

ESTATE] ?

CODE GEL GEL ID ID ID ID ID ID ID ID

RE1

RE2

RE3

RE4



819.

Do individuals sell any [REAL

ESTATE] in or around the

community where it is located?

If this [REAL ESTATE] were to be

sold today, who would decide how

the money is used?


HOUSEHOLD ROSTER. IF

SOMEONE FROM OUTSIDE OF

THE HOUSEHOLD WOULD

DECIDE, ENTER CODE '99', IN

ADDITION TO ID(S) OF


(FOR CODE 1

Q802 AND CODES

97 OR 98 IN Q816)

What would it cost

to construct this

[REAL ESTATE]

today, including the

cost of the plot of

land on which the

real estate is

located?

ESTIMATE VALUE

IN LOCAL

CURRENCY.

RECORD 97 IF

REFUSE TO

ANSWER.

RECORD 98 IF DO

NOT KNOW.

If this [REAL

ESTATE] were to

be sold today, how

much could be

received for it?

ESTIMATE VALUE

IN GEL. RECORD

97 IF REFUSE TO

ANSWER.

RECORD 98 IF

DO NOT KNOW.

IF CODE 97 OR 98

IN Q816 ► 817

IF THE ESTIMATED

VALUE OF ASSET

IS OBTAINED IN

Q816 ► 819

CODE FOR ABILITY OF RESPONDENT

TO BE INTERVIEWED ALONE.

822.

Which household

member aged of 18

and above does not

know about your

ownership of this

[REAL ESTATE]?

LIST UP TO 3 FROM

HOUSEHOLD

ROSTER

YES, INDIVIDUALS

SELL.............1

NO TRANSACTIONS..2 ►816

DO NOT KNOW.....98 ►816

INFORMED OF

TRANSACTIONS...1

NOT INFORMED OF

TRANSACTIONS...2

RESPONSE CODES:

ALONE.......................................1






YES..1

NO...2 ►

NEXT ITEM,

IF LAST

►823

YES..1

NO...2 ►

NEXT ITEM,

IF LAST

►823

CHECK IN

ACCORDANCE

TO Q807

YES..1

NO...2 ►819

MODULE 9: CONSUMER DURABLES

901. 903.

Do you or any member of your

household own any [CONSUMER

DURABLE], exclusively or jointly

with someone else? READ ALL

CATEGORIES

901 Refrigerator

902 Washing machine

903 Television

904 Computer (PC, Laptop, etc)

905 Electric/Gas Stove

906 Mobile phone

907 Bicycle

908 Motorcycle

909 Car, Pick-up Truck

910 Air conditioner

911 Piano, grand piano

912 Other (Specify)

D

U

R

A

B

L

E

C

O

D

E

D

U

R

A

B

L

E

N

A

M

E



CODE FOR ABILITY OF RESPONDENT TO BE

INTERVIEWED ALONE.

902.

ID ID ID ID ID

Who are the adult owners of at least one of this

[CONSUMER DURABLE]?

LIST ALL ADULTS FROM THE HOUSEHOLD. IF

JOINTLY OWNED BY SOMEONE FROM

OUTSIDE OF THE HOUSEHOLD, ENTER CODE

'99', IN ADDITION TO ID(S) OF HOUSEHOLD

MEMBER(S). YES..........1

NO...........2 ►NEXT ITEM,

IF LAST ►903

DON'T KNOW..98 ►NEXT ITEM,

IF LAST ►903

RESPONSE CODES:

ALONE.......................................1






YES...........1

MODULE 10: FINANCIAL ASSETS

1002. 1004. 1005. 1006. 1007.

ENUMERATOR: IS

RESPONDENT THE

OWNER/ONE OF

THE OWNERS OF

[FINANCIAL ASSET]

?

LOCAL CURRENCY

FA1

FA2

FA3

FA4

FA5

FA6

FA7

FA8

What is the current

value of the

[FINANCIAL

ASSET]?

ESTIMATE IN

LOCAL CURRENCY.

RECORD 97 IF

REFUSE TO

ANSWER. RECORD

98 IF DO NOT

KNOW.

Whose name is on the financial asset?

LIST ALL ADULTS FROM THE HOUSEHOLD ROSTER. IF THE NAME OF

SOMEONE FROM OUTSIDE OF THE HOUSEHOLD IS ON THE

ACCOUNT, ENTER '99', IN ADDITION TO ID(S) OF HOUSEHOLD

MEMBER(S). RECORD 98 IF DO NOT KNOW.

(IF CODE 1 IN

Q1005) Are there any

household members

aged 18 and above

that do not know

about your ownership

of this [FINANCIAL

ASSET] ?

IDID ID

1001. Do you or any member of your household own any financial asset, exclusively or

jointly with someone else, including saving bank accounts, microfinance accounts, equity

(stocks/shares), bonds, pension fund or other types?

Which household

member aged 18

and above does not

know about your

ownership of this

[FINANCIAL

ASSET]?

LIST UP TO 3 FROM

HOUSEHOLD

ROSTER.

A

S

S

E

T

C

O

D

E

1003.

Please list each financial asset

that someone in your household

owns. READ LIST

ID ID ID ID ID

YES...........1

NO............2 ►1008

DON'T KNOW...98 ►1008

SAVING BANK

ACCOUNT...............1

MICROFINANCE

ACCOUNT...............2

EQUITY

(STOCKS/SHARES).......3

BONDS.................4

PENSION FUND..........5

OTHER FINANCIAL

ASSETS(SPECIFY)......96

CHECK IN

ACCORDANCE

TO Q1003

YES.....1

NO......2 ► NEXT

ITEM, IF LAST

►1008

YES.....1

NO......2 ►

NEXT ITEM, IF LAST

►1008

MODULE 10: FINANCIAL ASSETS (CONTINUED)

1008.

1011. 1012. 1013. 1015.

ENUMERATOR: IS

RESPONDENT A

SOLE/JOINT

LENDER OF THE

MONEY?

Are there any

household

members aged 18

and above that do

not know about

your ownership of

this [MONEY] ?

WRITTEN DESCRIPTION CODE GEL

LN1

LN2

LN3

LN4

LN5

LN6


INTERVIEWED ALONE.



Does any person or any enterprise owe you or any

member of your household any money?

L

O

A

N

N

O

ID ID ID ID

1009.

Who was the money lent to?

1010.

Which member(s) of the household lent the

money?

LIST ALL ADULTS FROM THE HOUSEHOLD.

IF THE SOMEONE FROM OUTSIDE OF THE

HOUSEHOLD IS A JOINT LENDER OF THE

MONEY ALONG WITH A HOUSEHOLD

MEMBER, ENTER '99' FOR THE LENDER

OUTISDE THE HOUSEHOLD.

1014.

Which household

member aged 18 and

above does not know


this [MONEY]?

LIST UP TO 3 FROM

HOUSEHOLD ROSTER

ID

What is the

remaining amount

to be received on

the loan (principal +

interest)?

ESTIMATE IN GEL

ID ID ID

YES..........1

NO...........2 ► 1015

REFUSES TO

RESPOND.....97 ► 1015

DON'T KNOW..98 ► 1015

FAMILY AND/

OR HOUSEHOLD MEMBER. ...1

FRIEND/RELATIVE.........2

EMPLOYEE................3

CLIENT/CUSTOMER.........4

OTHER(SPECIFY).........96

REFUSES TO RESPOND.....97

DON'T KNOW.............98

RESPONSE CODES:

ALONE.......................................1






YES..1

NO...2 ► NEXT

ITEM, IF LAST

►1015

REFUSES TO

RESPOND.....97

DON'T KNOW..98

CHECK IN

ACCORDANCE

TO Q1010

YES.....1

NO......2 ► NEXT

ITEM, IF LAST

►1015

MODULE 11: LIABILITIES

1103. 1104. 1106.

WRITTEN DESCRIPTION CODE GEL

LN1

LN2

LN3

LN4

1107. 1108. 1109. 1110.

ENUMERATOR: IS RESPONDENT A

SOLE/JOINT BORROWER OF THIS

MONEY?

Are there any household members aged 18 and above that

do not know about your ownership of this [LOAN] ?

LN1

LN2

LN3

LN4

CODE FOR ABILITY OF RESPONDENT TO BE INTERVIEWED ALONE.

(Reasons interview not administered with the respondent(s) alone should be explained

in the remarks)

Which household member aged 18 and above

does not know about your ownership of this

[LOAN]? LIST UP TO 3 FROM HOUSEHOLD

ROSTER

IDID ID

L

O

A

N

N

O

What was main purpose for seeking the loan? DO NOT

READ LIST

ENUMERATOR: IF THE

LOAN WAS DRAWN FOR A

NON-AGRICULTURAL

ENTERPRISE, ENTER the

ENTERPRISE ID FROM

MODULE 7.

ENTERPRISE ID

L

O

A

N

N

O

1101. Do you or any member of your household owe money to anyone or any institution?

1102.

Who was the money borrowed from?

1105.

What is the remaining

amount to be repaid on the

loan (principal + interest)?

ESTIMATE IN

GEL.RECORD 97 IF

REFUSE TO ANSWER.

RECORD 98 IF DO NOT

KNOW.

ID ID

Who is/are the adult borrower(s) of the [MONEY]?

LIST ALL ADULTS FROM THE HOUSEHOLD ROSTER. IF THE

MONEY BORROWED JOINTLY WITH SOMEONE FROM OUTSIDE OF

THE HOUSEHOLD, ENTER '99', IN ADDITION TO ID(S) OF


ID IDID

YES...........1

NO............2 ► 1110

REFUSES TO

RESPOND......97 ► 1110

DON'T KNOW...98 ► 1110

FOR NON-AGRICULTURAL HOUSEHOLD ENTERPRISES

PURCHASE INPUTS/WORKING CAPITAL

FOR NON-AGRICULTURAL ENTERPRISES. 1

FOR HOUSEHOLD OR AGRICULTURAL ENTERPRISES

BUY LAND. . . . . . . . . ... . . 2 ►1105

BUY LIVESTOCK. . . . . . . ... . .3 ►1105

BUY AGRICULTURAL TOOLS AND

IMPLEMENTS. . . . . . . . . ... . 4 ►1105

BUY AGRICULTURAL INPUTS . . ... . 5 ►1105

BUYING HOUSE/PAY FOR BUILDING

MATERIALS/REPAIR

RENOVATION OF HOUSE. . . . . ... .6 ►1105

BUY CONSUMPTION

GOODS AND SERVICES. . . . . . ... 7 ►1105

TO PAY EDUCATION EXPENSES. . ... .8 ►1105

TO PAY HEALTH EXPENSES. . . . ... 9 ►1105

TO PAY FOR CEREMONIAL EXPENSES...10 ►1105

OTHER(SPECIFY). . . . . . . . ...96 ►1105

RESPONSE CODES:

ALONE.......................................1






YES..1

NO...2 ►NEXT ITEM, IF

LAST ►1110

CHECK IN

ACCORDANCE

TO Q1105

YES.....1

NO......2 ►NEXT ITEM,

IF LAST ►1110

ANOTHER HOUSEHOLD MEMBER.....1



EMPLOYER.....................4


DEPOSIT TAKING


COOPERATIVE CREDIT SOCIETIES

.............................7

TRADER/SHOP KEEPER...........8

NGO..........................9

GOVERNMENT..................10

PAWNSHOP....................11


MODULE 13: END OF QUESTIONNAIRE

1201. 1203.


INTERVIEWED ALONE.

1301. ENUMERATOR: INDICATE THE NUMBER OF CALL BACKS YOU MADE TO THE

HOUSEHOLD, IF ANY, IN ORDER TO INTERVIEW RESPONDENT:

1302. ENUMERATOR: RECORD END TIME FOR INDIVIDUAL INTERVIEW (HH : MM):

101 Jewelry

102 Semi-precious and

precious metals

1303. ENUMERATOR: RECORD END DATE FOR INDIVIDUAL INTERVIEW (DD/MM/YYYY)

103 Semi-precious and

precious stones

104 Paintings ANY FURTHER COMMENTS:

105 Other, Specify

V

A

L

U

A

B

L

E

C

O

D

E



Who in your household owns at least one

of this [VALUABLE]?


HOUSEHOLD. IF OWNED BY ALL

ADULT HOUSEHOLD MEMBERS THEN

FILL IN THE IDs OF ALL ADULT

HOUSEHOLD MEMBERS. ADD

ADDITIONAL SPACE FOR LISTING IDs

OF ADULT OWNERS, IF REQUIRED.

1202.

ID

MODULE 12: VALUABLES

Do you or any member of your

household own any [VALUABLE],

exclusively or jointly with someone else?

READ ALL CATEGORIES

ID ID ID

V

A

L

U

A

B

L

E

N

A

M

E YES............1

NO.............2 ► NEXT ITEM,

IF LAST ►1203

DON'T KNOW....98 ► NEXT ITEM,

IF LAST ►1203

RESPONSE CODES:

ALONE.......................................1






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