SAMPLE GRP: S1 S2 S3
S4
ZONE: A B C
Listing HH No: EL
Person: P
SHENO: E
HOUSEHOLD SAVINGS AND MOBILE PHONE USAGE RESEARCH PROJECT
ROUND 1 (NOVEMBER/DECEMBER 2010)
Respondent’s
...........................................................................................................................................................
ON
Name(with initials)
Gender
1. Male
2. Female
GN
...........................................................................................................................................................
HAD1 Home Address
...........................................................................................................................................................
HAD2 Address
...........................................................................................................................................................
HAD3 Address
Telephone No.
HTN
TN1 Land
TN2 Mobile
By what name are you commonly known in this area? ...........................................................................................
CN
Language
1. Sinhala
2. Tamil
3. English (Mark the language in which the survey was conducted)
LN
Economic Activity
1. Agricultural crops or Livestock related self employment 2. Other self employment
(mark
all
that
EA
3. Wage work 4. Casual/temporary work
5. Not engaged in any economic activity
apply) (MA)
IF SELF EMPLOYED:
Business Name
...........................................................................................................................................................
BM
...........................................................................................................................................................
Nature of Business (If agricultural crops, specify crop types. If livestock, specify animal types)
BN
1. Manufacturing 2. Services 3. Retail/Sales
Business
1. Male
2. Female
3. Husband and wife jointly owned
4. Other
BGN
Ownership
Business Address
...........................................................................................................................................................
BAD1
Address
...........................................................................................................................................................
BAD2
Address
...........................................................................................................................................................
BAD3
Business Tel No.
Mobile
BTN
TN1 Land
TN2
IF WAGE WORKER:
Job Sector
...........................................................................................................................................................
WS
Nature of Job
...........................................................................................................................................................
WN
USE CODES AND NAMES
Province
Div. Secretariat
PR
DS
District
GN Division Name
DI
GN
Town
GN Division No.
TO
GN
INTERVIEWER”S RECORDS
Interviewer ‘s Name :
Number :
Gender: 1.Male 2.Female
Date and Time of the Interview. Use 24 hour system for time
First Interview
Date
Time
From:
To:
Second Interview
Date
Time
From:
To:
I certify that all the information contained in this document was obtained as accurately as possible from the respondent to questions
asked according to given instructions.
.............................................................
Interviewer Signature
RECORD OF PROCESS
Yes
Name
Signature
Date : YYYY / MM / DD
Field Scrutinized
1
---------------------/---------/-------Qnr Checking
1
---------------------/---------/-------Coding
1
---------------------/---------/-------Data Entry
1
---------------------/---------/-------Cleaning
1
---------------------/---------/-------SKETCH OF LOCATION OF HOME / BUSINESS (with sufficient details for supervisor to locate place)
1
SECTION 1: PERSONAL AND BUSINESS INFORMATION
We are interested in knowing some personal and business activity related information. Please give us answers to the
following questions.
1.1.
Are you currently engaged in any economic activity from which you earn income?
1. Yes
2. No
If S4, then Go to 1.7. If S1 or S2 or S3, end interview.
1.2.
Which of these best describes your main economic activity? (S.A.)
1. Employee receiving wages / salary
2. Daily paid / casual worker / in temporary employment
3. Agricultural crops or livestock related self employment
4. Other self employment
5. Other (describe) ________________________________________
1.3.
Apart from your main economic activity, are you engaged in any other economic activity?
1. Yes
Go to 1.4
2. No
Go to instructions after 1.4
1.4.
Which of these best describes your secondary economic activity? (S.A.)
1. Employee receiving wages / salary
2. Daily paid / casual worker / in temporary employment
3. Agricultural crops or livestock related self employment
4. Other self employment
5. Other (describe) __________________________________________
Interviewer: For those involved in agricultural crops or livestock related self employment activities (i.e.
response to question 1.2 or question 1.4 is 3) then ask question 1.5 and question 1.6. For others, skip to
question 1.7.
1.5.
Which of the following types of agricultural crop/livestock activities are you involved in? (MA)
1. Rice
2. Other grain (eg. corn, maize)
3. Vegetables
4. Fruits
5. Tea/Coffee
6. Coconut
7. Livestock
8. Spices
9. Other (specify) _________________________
1.6.
How often do you receive income from these agricultural crop/livestock self employment activities? (MA)
1. At least weekly
2. At least every two weeks
3. At least monthly
4. Less frequently than monthly
Personal Information
1.7.
What is your age?
1.8.
Gender
1. Male
2. Female
1.9.
Marital Status
1. Single/Never Married
2. Married
3. Widowed
4. Divorced
5. Separated
Years _____________
2
1.10.
What ethnic group do you belong to ?
1. Sinhalese
2. Sri Lankan Tamil
3. Indian Tamil
4. Sri Lankan Moor
5. Burgher
6. Malay
7. Other (Specify)______________________
1.11.
What religious group do you belong to?
1. Buddhist
2. Hindu
3. Islam
4. Roman Catholic
5. Other Christian
6. Other ( Specify)_____________________
1.12.
Which languages do you speak at home?
a. Sinhala
b. English
c. Tamil
1. Yes
1
1
1
2. No
2
2
2
(Interviewer: Speak means the ability to discuss about their family)
1.13.
What is the highest level of education that you have completed? (use the codes below)
______________
Codes for education levels
1=Completed Year 1, 2=Completed Year 2/Grade 1, 3=Completed Year 3/Grade 2, 4=Completed Year 4/Grade 3,
5=Completed Year 5/Grade 4 , 6=Completed Year 6/Grade 5, 7=Completed Year 7/Grade 6, 8=Completed Year
8/Grade 7, 9=Completed Year 9/Grade 8, 10=Completed Year 10/Grade 9, 11=Completed Year 11/G.C.E.
(Ordinary Level)/NCGE, 12=Completed Year 12/Grade 11, 13=Completed Year 13/G.C.E. (Advanced Level)/
HNCE, 14=Completed some years at university, 15=Completed university degree, 16=Postgraduate work,
17=Technical College , 18=Not gone to school/Entered Year 1 only.
Interviewer: If answer to Qn. 1.13 is 14-17, then ask Qn. 1.14. If not (i.e. 1-13 or 18), then go to next section.
1.14.
Then how many years of formal education have you had?
Yrs
______
SECTION H: HOUSEHOLD ROSTER
Interviewer: Ask this Section from all respondents.
I would like to know some details about your family members.
H.1.
What is your relationship to the head of household? (Use codes below)
Relationship to Head:
1=Head, 2=Wife/Husband, 3=Son/Daughter, 4=Son-in-law/Daughter-in-law, 5=Grandchild/Great Grandchild,
6=Parent of head or spouse, 7=Other relative, 8=Domestic employee, 9=Non-relative
Name all persons who usually live in this household, including individuals temporarily living elsewhere or
temporarily working in another location. Include the respondent’s details also. Also include those in overseas
employment or armed forces. Include the household members according to the relationship. E.g.: first Head of
household, second wife/husband etc.
3
H.3
Gender
1=M
2=F
H.4
Relationship
to
household
head
[Use H.1
Codes]
Code
1 2
Code
1
2
1
2
1 2 3 4 5
3
1
2
1 2 3 4 5
4
1
2
1 2 3 4 5
5
1
2
1 2 3 4 5
6
1
2
1 2 3 4 5
7
1
2
1 2 3 4 5
8
1
2
1 2 3 4 5
9
1
2
1 2 3 4 5
10
1
2
1 2 3 4 5
11
1
2
1 2 3 4 5
12
1
2
1 2 3 4 5
Household Member ID
H.2
Name
H.5
Age
H.6
Marital
Status
1=Never
Married
2=Married
3=Widowed
4=Divorced
5=Separated
Year
H.7
What
main
activity is
he/she(na
me)
involved
in at the
present
[See
activities
codes
below]
Code
H.8
If
employed
, how
many
hours
does this
person
work in a
normal
week?
H.9
If employed,
how much
does he/she
earn in a
normal
month?
H.10
What is the
highest level
of education
he/she has
obtained?
[Use Qn.
1.13 Codes]
Hours
Rupees
Years
1 2 3 4 5
Code for H.7 activities involved: 1=salaried/wage employee, 2=agricultural crops/livestock related self employment,
3=employer, 4=unpaid family worker, 5=expecting a job (unemployment), 6=student, 7=housekeeping, 8=retired (pension),
9=economically inactive, 10=non-schooling kid, 11=other non-economic activities, 12=overseas worker, 13=other self
employment activities.
(Interviewer: Ask Qn. H.8. and Qn. H.9. only if, the answer for Qn. H.7 is 1,2,3,4, 12 or 13. If not, keep blank. If the
answer for Qn. H.7 is 4, ask only Qn. H.8 and keep Qn. H.9 blank.)
H.11. Interviewer: Please indicate the row ID in above table corresponding to the respondent
4
SECTION 2: AGRICULTURAL LAND
If you or members of your household engage in agricultural crop production as self employment, then I would like to ask you some questions about land used for that purpose.
2.1
During the past 2 years, have you or any member of the household used land for agricultural crop production self employment activity at any time? (Interviewer: If
agricultural crop production activity is undertaken ONLY for home consumption then this is not considered as self employment activity)
1. Yes
2. No
Skip to Section 4
2.2.
How much land do you currently use for agricultural production?
Note: 1 acre = 160 perches. If other measure (bushels, laas, pal) is used, convert to perches.
Perches ______________
2.3.
How much is the approximate market value of that land? (For rented lands, get the value, not the rental)
Rs._______________
2.4.
2.5.
Over the past 12 months (from 2009 November to 2010 October) what is the approximate total market value of the harvest of crops products cultivated in that plot of
land?
Rs._______________
Over the past 12 months, how much did you receive from the sale of crops produced on this land?
Rs._______________
2.6.
Over the past 12 months, what is the approximate market value of crops produced on this land which you consumed in the household?
2.7.
Over the past 12 months, what is the approximate market value of crops produced on this land which you distributed among others without selling? Rs.______________
2.8.
Now think about the expenses associated with the agricultural crop production we have just discussed. During the last year, please tell me what were the following
expenses for each category of crop.
Type of Crop
1. Rice
2. Cereals
3. Vegetables
4. Fruits
5. Tea,
Coffee
6. Coconuts
7. Spices
8. Other
2.8. Did you
produce any crop
of this type?
1.Yes 2. No
(If No, go to next
row)
1
1
1
1
1
2
2
2
2
2
1
1
1
2
2
2
Rs._______________
a. Hired
labor
b. Seeds
c. Fertilizer
and manure
d. Chemicals
(e.g. pesticides)
e. Transport
(tractor)
f. Water
g. Hire of machines
and equipments /
animals
h. Other
i. Total
Expenses
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
2.9.
During the past 12 months (i.e. November 2009 – October 2010), how much income/profit did the household earn, after paying all expenses, from these agricultural crop
production self employment activities?
Rs _________________
5
6
SECTION 4: LIVESTOCK INFORMATION
4.1
Do you or any member of the household engage in livestock related self employment activity? (eg. Large
animals such as cattle, small animals such as chickens) (Interviewer: If livestock activity is undertaken
ONLY for home consumption then this is not considered as self employment activity)
1. Yes
2. No
Skip to Section 5
I would like to ask some information about the livestock which you or your household members own and used for self
employment activity:
Type of livestock
1.Cattle
2.Buffalo
3.Swine
4.Goats
5.Chicken
6.Other
(Specify:___________)
4.2. Do you/ HH
members own and use
this type of livestock
for self employment
activity? (If No, go to
next row)
Y=1
N=2
1
2
1
2
1
2
1
2
1
2
1
4.3. How many
animals do you/ HH
members own?
No.
4.4. If you were
to sell one today,
how much would
you receive from
the sale?
Rs
2
Now I would like to ask you about income earned from sale of animals and sale of livestock products, or consumption
of products from the livestock.
Type of livestock
4.5 Do you sell any of
these animals or the
output from the this type
of livestock
1=Yes
2=No
(If No, go to next row)
1 2
1 2
1 2
1 2
1 2
1 2
4.6 What do
you sell?
(Name) (e.g.
milk, eggs)
meat )
4.7 How often
do you make
sales? (See
codes)
4.8 During the
past year, how
much have you
received from
selling this
output? (Rs.)
4.9.During the past 12
months, if you used
this output for house
hold consumption,
what is its market
value? (Rs.)
1.Cattle
2.Buffalo
3.Swine
4.Goats
5.Chicken
6.Other (Specify:
_______)
Codes for 4.7- 1=Once a year, 2=Monthly, 3=Every 2 weeks, 4=weekly, 5=several times per week (Interviewer: If more than one kind
of output is sold from one type of livestock, use the most frequent time interval)
4.10.
I would like to ask you about expenses associated with maintaining livestock owned by you or members of your
household. How much have you spent on each of the following items?
Expenditure Item
a. Expenditure (Rs.)
1. Hired labor
2. Animal Feed
3. Veterinary services
4. Other expenses
5. Total Expenses
4.11.
During the past 12 months (i.e. November 2009 – October 2010), how much income/profit did the household
earn, after paying all expenses, from these livestock related self employment activities? Rs ____________
7
SECTION 5: AGRICULTURAL ASSETS OTHER THAN LAND AND ANIMALS
Interviewer: Ask this section only if the respondent or other HH member undertakes agricultural crop
production or livestock related self employment activity. If not, skip this section.
Show the Card
5.1
Now I am going to ask you about the characteristics of any utensils, tools, machinery and equipment, vehicles
and other property currently used in agricultural crop production or livestock related self employment activity
by you or any household member. Please tell me the approximate value of your assets in each of the following
categories. Think of the value as how much it would cost you to replace the assets with ones in similar
condition.
(a) Value if
(b) Rental value if rented (Rs)
Item
owned (Rs.)
monthly
per season
1. Tools and utensils (Spades, rakes, etc.)
2. Heavy Machinery and Equipment (eg. Combined
thresher, tractors, etc.)
3. Light Machinery and Equipment (eg. pumps)
4. Vehicles used in the business
5. Site (including land and buildings used for
storage) – not already included in Section 2
6. Investment in wells and other water sources
7. Other physical assets (excluding inventories)
8. Total value of business assets and rentals
5.2.
Do you currently have any stock of raw materials used in this agricultural crop production or livestock related
business? (e.g. fertilizers, seeds, animal feed)?
1. Yes
Go to Qn. 5.2a
2. No
Go to Qn. 5.3
5.2a.
If yes, at market prices what is the value of these inputs?
5.3.
Do you currently have any stock of output from this agricultural crop production or livestock related business
which is not yet sold? (Do not include the value of unharvested crops or live animals).
1. Yes
Go to Qn. 5.3a
2. No
Go to next section
5.3a.
If yes, at market prices what is the value of these outputs?
Rs ____________
Rs ____________
SECTION 6: OTHER SELF EMPLOYMENT ACTIVITY RELATED INFORMATION
Interviewer: Ask this section only if the respondent is engaged in any other (non agricultural crops production /
non livestock) self employment activity. (i.e. answered 4 to Qn 1.2 or 1.4). If not, skip this section. If involved in
two other self employment activities (i.e. answered 4 to both Qn 1.2 and Qn 1.4) then ask this section with
reference to the main other self employment activity.
I would like to know some information about your other (non agricultural crop production/non livestock) self
employment activity.
6.1.
What is the nature of your business or what does your activity consist of??
(Interviewer: describe and use code ISIC-R3)
1. Respondent’s answer : ______________________________________________
2. Description of ISIC : ______________________________________________
6.2.
How many hours a week do you personally spend working in the business ?
a. Hours last week (Days* hours)
b. Hours in a normal week
8
6.3.
Is your business and home both situated at the same location? If not is it situated in another location? (SA)
1. In the household
2. Business is in a separate building but in the same land of the owner’s household
3. Business is in a different location but in the same GN division
4. Business is located in a different GN division but in the same DS division
5. Business is located in the same DS division but in the same district
6. Business is located in a different but neighbouring district
7. Business is located in a different non-neighbouring district
8. Other (Specify: _____________________________)
6.4
What is the type of site where your business operates? (SA)
1. Improvised site on public spaces
2. Permanent or semi-permanent site on public spaces
3. Improvised or travelling site in a marketplace
4. Site that is part of a permanent market
5. Traveling door to door or on the street
6. Merchandise, prepared food or services offered on motorcycle, bicycle, vehicle, truck etc.
7. Transporting people or merchandise without a site: three wheeler, bus, truck, etc
8. At customer’s residence
9. At your residence without special installations
10. At your residence with special installations
11. Commercial site (grocery, hardware, etc.)
12. Service site (dry cleaning, restaurant, office, etc.)
13. Production shop (bakery, printing, etc.)
14. Repair service shop (mechanic, electrician, etc.)
15. Guest house, hotel, inn, etc
16. Transporting people or merchandise with site
17. Other type of site: (specify)...........................................................
If answer is 1-10 then go to Qn. 6.4a; if answer is 11-16 then go to Qn. 6.5; if answer is 17, ask only the
relevant names for 6.4a
6.4a.
Please indicate whether your business operates in a permanent place or in a flexible location (mobile
business)
1. Fixed location
Go to Qn. 6.5
2. Flexible locations
Go to Qn. 6.6
6.5.
Is this site your or your house hold members own property/ rented/ borrowed?
1. Your/your house hold own property
2. Rented/Leased
3. Borrowed
4. Other (specify).........................
6.6
Did you start the business from scratch or was it inherited or purchased from your parents or someone else?
1. I started the business from scratch
Go to Qn. 6.9
2. I purchased or inherited the business
Go to Qn. 6.7
6.7
If you did not start the business from scratch, was it:
1. Inherited from your parents?
2. Inherited from another family member?
3. Owned from marriage
4. Purchased from a family member?
5. Purchased from someone outside the family?
6. Other (Specify __________________________
6.8
When did you undertake/ accept/ take over the activities/ ownership/ management of this business? (If don’t
know mention it)
6.8m. Month:____________ 6.8y. Year: ___________
99. Don’t know
9
6.9.
When did this business begin operations?
6.9m. Month:____________ 6.9y. Year: ___________
99. Don’t know
6.10.
What type of accounts do you keep for income, expenses, assets etc. of your business?
1. Through formal accounting (using the services of a professional within the firm)
2. Through formal accounting (using the services of a professional outside the firm. eg. book keeping)
3. Personal record keeping or other records
4. Does not do any accounting
5. Other: (specify) ____________________
6.11.
How many total employees work in your enterprise? (Including yourself and all permanent /temporary workers)
_________
6.12.
Tell me how many of the following types of workers you have in your business [Do not count yourself in any
of these categories]
Employee category
Number
1. Wage or Salaried Workers/ Permanent
2. Casual or Daily paid Workers/Temporary
3. Partners
4. Unpaid workers (eg. unpaid family members)
5. Total number of workers (sum of 1-4)
(Interviewer: Ask each category separately. Examine 1-4 total.)
999. Don’t know/ can’t say/ refuse to answer
SECTION 7: ASSETS, INCOME, EXPENSES AND PROFIT OF OTHER SELF EMPLOYMENT ACTIVITY
Interviewer: Ask this section only if the respondent is engaged in any other (non agricultural crops production /
non livestock) self employment activity. (i.e. answered 4 to Qn. 1.2 or 1.4). If not, skip this section. If involved in
two other self employment activities (i.e. answered 4 to both Qn. 1.2 and Qn. 1.4) then ask this section with
reference to the main other self employment activity.
I would like to know some information about assets, income and expenses of your other (non agricultural crop
production/non livestock) self employment activity.
Show the card
7.1.
Now I am going to ask you about the characteristics of any utensils, tools, machinery and equipment, vehicles
and other property currently used in your business or activity. Please tell me the approximate value of your
assets in each of the following categories. Think of the value as how much it would cost you to replace the
assets with ones in similar condition
a. Value if owned b. Monthly rental value
Item
(Rs.)
if rented (Rs.)
1. Tools and utensils (eg. Instruments, containers)
2. Machinery and Equipment (eg. gas cookers, ovens
fridges)
3. Furniture
4. Vehicles used in the business
5. Site (including land and buildings)
6. Other physical assets (excluding inventories)
7. Total value of assets (1-6 items) in business
7.2.
Do you have any inventories in stock, products for sale, raw materials, products in production, spare parts, or
other such materials currently held at your business?
1. Yes
Go to Qn. 7.2a
2. No
Go to Qn. 7.3
10
7.2a
At market prices, what is the value you calculate of your current inventories?
Rs : __________
Show the card
7.3
Business Expenses During the last month
Please report the amount you have spent on each of the following categories of business expenses during the
last month (October 2010)
(Interviewer: include only business and not household expenses; do not include wages the owner pays
himself as an expense)
Item
Cost (Rs.)
a. Purchase of materials and items for resale
b. Purchase of electricity, water, gas and fuel
c. Interest paid on loans
d. Wages and salaries for employees
e. Rent for land or buildings
f. Taxes
g. Other expenses (including equipment rental, telephone, transportation)
h. Total expenses in October 2010
7.4
Can you tell me the total monthly sales of your business in the last month from all sources, including
manufacturing, trade and services?
Rs : ____________
7.4a.
Which of the following methods do customers use to pay for goods / services? (MA)
1. Cash
2. Check
3. On credit
4. Electronic cards (such as Debit Cards)
5. Other (specify) _______________
7.5.
Can you tell me the total daily/weekly/monthly/annual revenues of your business from all sources?
Interviewer: Use daily/weekly/monthly revenues to estimate annual revenue. It is expected to estimate
“d” column by using one of the a, b, c columns.
Revenue (Rs)
Year
a. Daily
b. Weekly
c. Monthly
d. Annual
1. 2009
2. 2008
3. 2007
999. Don’t know/ Don’t remember (If no answer given at all for Qn. 7.5, then skip to Qn. 7.7)
7.6.
7.7.
Interviewer: Answer Qn. 7.6 based on observation.
Were written records consulted in responding to the above question? Or by memory?
1. Written records
2. Memory
What was the total income the business earned during October after paying all expenses including wages of
employees, but not including any income you paid yourself. That is, what were the profits of your business
during October? (Note: If you paid yourself a salary, add that back into your profits.)
Rs _____________
SECTION W: WAGE WORK
Interviewer: Ask this section only if the respondent is engaged in any wage work or casual work. (i.e. answered 1
or 2 to Qn. 1.2 or 1.4). If not, skip this section. If involved in two different wage/causal work activities (i.e.
answered 1 or 2 to both Qn. 1.2 and Qn. 1.4) then ask this section with reference to the main wage/casual work
activity.
Job Related Information
I would like to get some information about your work.
11
W.1.
Could you describe the kind of industry/sector that you are employed in?
1. Respondent’s description :______________________________________________
2. Description of ISIC
:______________________________________________
(Interviewer: describe and use code ISIC-R3)
W.2.
Could you describe the kind of occupation that you are engaged in?
1. Respondent’s description : ______________________________________________
2. Description of ISOC
: ______________________________________________
Interviewer : Describe and use the codes of ISOC-88
W.3.
How frequently do you get your wage/salary? Is it daily, weekly or monthly?
1. Daily
2. Weekly
3. Every two weeks
4. Monthly
5. On commission basis only
6. Other (specify) ___________________
W.4.
Are you a permanent, temporary or contract basis employee?
1. Permanent employment / written contract, for indefinite time
2. Contract employment / written contract, for fixed time
3. Temporary worker / non-written contract
4. No contract at all
5. Other (specify) ___________________
W.5.
Please tell me which kind of sector/economic activity you are engaged in?:
1. Government employee
2. Private employee
3. Non governmental organization employee
4. Other (specify) ________________________
W.6
What is this firm’s current legal status or ownership? (SA)
1. Sole proprietorship
2. Partnership
3. Private limited liability company
4. Public limited liability company
5. Government company
6. State Corporations and Statutory Bodies
7. Government department / ministry / central or provincial government institution
8. Co-operative establishment
9. Clubs and Associations
10. Other (specify)______________
11. Don’t know/Can’t say/reject
W.6a. Does the job operate in a fixed place or is it in a flexible location (mobile business)?
1. Fixed location/same place
Go to Qn. W.7
2. Flexible location/mobile business
Go to Qn. W.13
W.7.
How many people work in your firm of employment? ( all paid and unpaid workers including you and the
owner of the firm)
1. 4 or less than 4 workers
2. 5-9 workers
3. 10-25 workers
4. 26-250 workers
5. More than 250
W.8.
How far is your workplace located from home?
1. Within 500 meters of your home
2. 500 meters – 1 km distance from home
3. In the same G.N. but more than 1 km from home
12
4. In the same D.S. but different G.N. (more than 1 km)
5. In the same district but different D.S. (more than 1 km)
6. In the same province but different district (more than 1 km)
7. Different province (more than 1 km)
W.9.
Which kind of local authority type does your place of work belong to?
1. Municipal Council
2. Urban Council
3. Pradeshiya Sabha
4. Don’t know/can’t say
Interviewer: If answer to W.6 is 1 or 2 or 3, then ask W.10; If not, skip to W.12
W.10. Is the owner of the business a relative of yours?
1. Yes
Go to Qn. W.11
2. No
Go to Qn. W.12
W.11. If yes, is the owner of the firm/business:
1. Parent
2. Sibling
3. Parent or sibling by marriage
4. Other relative
W.12. Have you been registered for Employee Provident Fund/Employees Trust Fund (EPF/ETF) or Widows and
Orphans Fund?
1. Yes
2. No
W.13. How many hours a week do you work in your main job?
a. Hours last week ( Days*hours)
b. Hours in a normal week ( Days*hours)
W.14. How many days a week do you work in your main job?
a. Days last week
b. Days in a normal week
W.15
How much did you earn in this job as basic salary during October 2010? (include only basic salary without
over times, bonuses, commissions etc.)
Rs: ________________
W.16
In addition to this basic payment, how much did you receive in the form of overtime, food, bonuses, travel,
commissions or other payments from your wage job in October 2010?
Rs: ________________
W.16a. in which following way are you paid?
1. In cash
2. By check
3. By electronic deposit (eg. direct deposit)
4. Other (specify) _________________
W.17. When did you begin working in this place of work in this occupation?
W.17m Month: ___________________
W.17y Year: ___________________
W.18
In addition to this job, do you have another wage job?
1. Yes
Go to Qn. W.19
2. No
Go to next Section
W.19. How many hours per week do you normally work in this other wage job?
Hrs: ___________
W.20
Rs : ____________
How much do you earn per week in this other wage job?
13
SECTION 8: HOUSEHOLD ASSETS AND INFORMAL FINANCIAL TRANSACTIONS
Interviewer: Ask this Section from ALL respondents.
8.1.
Does your household have a land line telephone (Including wireless/CDMA)?
1. Yes
2. No
8.2.
Does anyone (including you) living in the household have a cellular phone?
1. Yes
2. No
8.3.
Do the members of this household own any of the following items? (MA)
1. Iron and heaters
2. Refrigerator or freezer
3. Fans
4. Sewing machines
5. Radio, cassette/CD/record players
6. Television sets, Video players, VCD/DVD players
7. Motorcycles, scooters, three-wheelers
8. Motor cars, vans, Lorries, tractors etc.
9. Oven
10. Gas or electric cooker / Stove
11. Gold Jewelry
8.4
During the past 12 months, please tell me if you have given out loans to any of the following:
Person
(a) Have you given such a loan? (b) Amount
outstanding (Rs.)
1. Yes
2. No
If NO, go to next row
1. Your parents
1
2
2. Your spouse’s parents
1
2
3. Your siblings
1
2
4. Your spouse’s siblings
1
2
5. Your adult children
1
2
6. Your grandparents
1
2
7. Other relatives
1
2
8. Friends
1
2
9. Neighbours
1
2
10. Fellow Seetu members
1
2
11. Other (specify) __________________
1
2
Total
8.5
Interviewer: If not given out any loans, then skip to Qn. 8.6
Of the loans you have given over the past 12 months (regardless of whether they have been repaid or not), could
you please provide information on the four largest loans?
a. Person
d. Amount
b. Amount (Rs)
c. Purpose
(see codes)
Repaid
1.
2.
3.
4.
Recipient Codes: 1=parents; 2=spouse’s parents; 3=siblings; 4=spouse’s siblings; 5=adult children;
6=grandparents; 7=other relatives; 8=friends; 9=neighbours; 10=fellow seetu members; 11=other
14
8.6
During the past 12 months, please tell me if you have taken out any loans from any of the following:
Person
1. Your parents
2. Your spouse’s parents
3. Your siblings
4. Your spouse’s siblings
5. Your adult children
6. Your grandparents
7. Other relatives
8. Friends
9. Neighbours
10. Fellow Seetu members
11. Other (specify) __________________
(a) Have you taken such a loan?
1. Yes
2. No
If NO, go to next row
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
Total
(b) Amount
outstanding (Rs.)
Interviewer: If not taken out any loans, then skip to Qn. 8.8
8.7.
Of the loans you have received over the past 12 months (regardless of whether they have been repaid or not),
could you please provide information on the four largest loans?
(a) Person
(d) Amount
(b) Amount (Rs)
(c) Purpose
(see codes)
Repaid
1.
2.
3.
4.
Source Codes: 1=parents; 2=spouse’s parents; 3=siblings; 4=spouse’s siblings; 5=adult children;
6=grandparents; 7=other relatives; 8=friends; 9=neighbours; 10=fellow seetu members; 11=other
8.8.
Suppose you needed Rs 10,000 for a medical emergency and you do not have this amount of cash in hand. In
such a situation, from whom could you borrow the money? (MA)
1. Your parents
2. Your spouse
3. Your spouse’s parents
4. Your siblings
5. Your adult children
6. Your spouse’s siblings
7. Your grandparents
8. Other relatives
9. Friends
10. Neighbours
11. Fellow seetu members
12. Other (specify)____________________
13. There is no one
8.9.
Now suppose instead you had a really profitable investment activity you could undertake. You are also quite
certain that you would make a nice profit. But you don't have the Rs 10,000 in capital to invest. In such a
situation, from whom could you borrow the money? (MA)
1. Your parents
2. Your spouse
3. Your spouse’s parents
4. Your siblings
15
5. Your adult children
6. Your spouse’s siblings
7. Your grandparents
8. Other relatives
9. Friends
10. Neighbours
11. Fellow seetu members
12. Other (specify)____________________
13. There is no one
8.10.
Do you participate in any seetus?
1. Yes
Go to Qn. 8.11
2. No
Go to next Section
8.11.
How many seetus do you participate in?
8.12.
We would like to get some information about the seetus that you participate in. Lets start with the seetu into
which you contribute the most amount.
8.12a. How often
8.12b. How 8.12c
8.12d
8.12e
8.12f. How many
do you contribute much worth What do
How
What do
members of this
money or goods to of goods or you
many
you
seeetu live in the
this seetu?
money do
contribute members receive
following distances
you
to the
does this from this
from your home?
Seetu
contribute
seetu?
seetu
seetu?
each time?
1=money
have?
1=money
2=goods
2=goods
Within
More than
Code
Rs.
1 2
No.
____________
1 km
1. Highest amount
1 2 3 4 5
1 2
1
seetu
________
2. Second highest
1 2 3 4 5
1 2
1
seetu
________
3. Third highest
1 2 3 4 5
1 2
1
seetu
________
Codes for 8.12a: 1=daily, 2= weekly, 3= monthly, 4= every two months,5.other (specify)
1 km
2
2
2
8.13.
In the seetus that you participate in, is there a number order in which money is received?
1. Yes
Go to Qn. 8.14
2. No
Go to next Section
8.14.
If yes, in the past 12 months, have you exchanged positions/numbers with any other seetu member?
1. Yes
Go to Qn. 8.15
2. No
Go to next Section
8.15
If yes, did you obtain an earlier or later position/number? Did you pay/receive money for this exchange of
positions? (MA)
1. Earlier number/position
Rs. _____________
2. Later number/position
Rs. _____________
16
SECTION 9: FINANCIAL HISTORY AND MOBILE PHONE USAGE
Interviewer: Ask this Section from ALL respondents.
9.1
Please tell me about the formal savings products that you use
Savings institution
1. Private Bank (eg.
Sampath, Seylan)
2. Govt Bank (eg.
Peoples, BOC)
3. Microfinance
organization
(eg.SEEDS,
Cooperative Bank)
4. Development Banks
(eg. RDB)
5. National Savings
Bank (NSB)
6. Samurdhi Bank
7. Sanasa Bank
8. Development
project such as IDRP/
REAP/ ABG
9. Farmers’
organization
10. Other(specify)
...............
(a). Do you have
an account with
this bank or
institution?
1.Yes, have 1
Ac.
2. Yes, more
than 1 Ac.
3.No  Next
row
1
2
3
(b)
Which
year did
you
open the
account
?
(c) How frequently do
you use this account?
1. Daily
2. Weekly
3. Every other week
4. Monthly
5. Not in last month
6. Not in last 3 months
7. Other (specify) ______
(d)
What is
the
current
balance
in this
account
?
(e) How
much do
you
typically
deposit
into this
account at
any time?
(Rs)
(f).
What is the
MONTHLY or
ANNUAL interest
rate in % on this
account?
Monthly
(%)
Annual
(%)
1 2 3 4 5 6 7 ......
1
2
3
1 2 3 4 5 6 7 ......
1
2
3
1 2 3 4 5 6 7 ......
1
2
3
1 2 3 4 5 6 7 ......
1
2
3
1 2 3 4 5 6 7 ......
1
1
1
2
2
2
3
3
3
1 2 3 4 5 6 7 ......
1 2 3 4 5 6 7 ......
1 2 3 4 5 6 7 ......
1
2
3
1 2 3 4 5 6 7 ......
1
2
3
1 2 3 4 5 6 7 ......
Interviewer: If more than 1 account for a single institution type (i.e. answer is 2 for 9.1a), ask 9.1b for the oldest account,
9.1c for the most frequently used account, 9.1d for the sum of balances of all accounts, 9.1e for the most frequent account
into which deposits are made, and 9.1f for the account paying the highest interest.
9.2
Please tell me about the informal savings products/methods that you have used in the last two years. Consider
only the savings from your own earned income; not the assets that you have inherited from your parents or
family members.
Product/Method
1. Cash in hand
2. Seetu 1 (RoSCA)
3. Seetu 2 (RoSCA)
4. Seetu 3 (RoSCA)
5. Gold Jewellery
6. Inventories
7. Durable goods
(a) Do you save
this way?
1.Yes
2.No  Next
row
1
1
1
1
1
1
1
2
2
2
2
2
2
2
(b) Typical
amount
saved at one
time? (Rs.)
(c) Frequency of saving?
1. Daily
2. Weekly
3. Every 2 weeks
4. Monthly
5. Every 2 months
6. Less frequent than every 2 months
1
2
3 4 5
6
1
2
3 4 5
6
1
2
3 4 5
6
1
2
3 4 5
6
1
2
3 4 5
6
1
2
3 4 5
6
1
2
3 4 5
6
(d) Total
value of
savings?
(Rs.)
17
8. Land
9. Loans to others
1
1
2
2
1
1
2
2
3
3
4
4
5
5
6
6
9.3.
Have you ever applied for a loan?
1. Yes
Go to Qn. 9.4
2. No
Go to Qn. 9.5
9.4
Please tell me about any such loans that you have applied for or received from any of the following lenders:
Loan Institution
1. Private Bank (eg.
Sampath, Seylan)
2. Govt Bank (eg.
Peoples, BOC)
3. Microfinance
organization (eg.SEEDS,
Cooperative Bank)
4. Development Banks
(eg. Regional/ Uva Dev
Bank)
5. National Savings Bank
(NSB)
6. Samurdhi Bank
7. Sanasa Bank
8. Development project
such as IDRP/ REAP/
ABG
9. Farmers’ organization
10. Moneylender
11. Family and friends
(a)
Have
you applied
for a loan of
this type?
1.Yes
2.NoNext
row
(b)
What was the outcome of
this application?
1. Received loan
2. Still waiting for a
decision
3. rejected
4. other (specify)
If answer is 2,3 or 4 go
to next row
(c)
Do you still
owe part of
this loan?
1.Yes
2.No 
Next row
(d)
Have you at
any point
delayed
paying your
loan
installment?
1. Yes
2. No
1
2
1
2
3
4 ……
1
2
1
2
1
2
1
2
3
4 ……
1
2
1
2
1
2
1
2
3
4 ……
1
2
1
2
1
2
1
2
3
4 ……
1
2
1
2
1
2
1
2
3
4 ……
1
2
1
2
1
1
1
2
2
2
1
1
1
2
2
2
3
3
3
4 ……
4 ……
4 ……
1
1
1
2
2
2
1
1
1
2
2
2
1
1
1
2
2
2
1
1
1
2
2
2
3
3
3
4 ……
4 ……
4 ……
1
1
1
2
2
2
1
1
1
2
2
2
(e).
What is
the
amount
owing?
(Rs)
(f).
What is the
MONTHLY or
ANNUAL interest rate
in % on this loan?
(a)
Annu
al
intere
st rate
(%)
(b)
Mont
hly
install
ment
(Rs.)
(c)
Loan
period
Years
9.5.
Suppose you have Rs. 100 in a savings account and the interest rate was 2% per year. After 5 years, how much
do you think you would have in the account if you left the money to grow: more than Rs. 102, exactly Rs. 102,
less than Rs. 102? (SA)
1. More than Rs. 102
2. Exactly Rs. 102
3. Less than Rs. 102
4. Don’t know
5. Refused to answer
9.6.
Imagine that the interest rate on your savings account was 1% per year and inflation was 2% per year. After 1
year, would you be able to buy more than, exactly the same as, or less than today with the money in this
account? (SA)
1. More than today
2. Exactly the same as today
3. Less than today
4. Don’t know
5. Refuse to answer
18
9.7.
In your day to day life, consider the payments that you make in a regular pattern (eg. House Rent, Rent for
Business premises, Electricity bill, Bank Loan etc). Of these, consider the 4 largest amount bills or payments
that you make regularly. Consider only payments made by yourself, not other members of the household.
(a). Payment Category
(b). Amount
(c). Payment Frequency (d). Amount still owed
(Rs)
(Rs)
(Look at the codes
(Look at the codes
below)
below)
1.
2.
3.
4.
Payment Category codes: 1=residential rent, 2=business rent, 3=electricity, 4=water, 5=money lender loan
repayment, 6=bank loan, 7=microcredit loan, 8=Telephone bill, 9=school payment, 10=insurance payment,
11=instalment payment for durable goods, 12=other (specify)
Payment Frequency codes: 1=Daily, 2=Weekly, 3=Every 2 weeks, 4=Monthly, 5=Every 2 months, 6=Less
frequent than every 2 months.
9.8.
Have you at any point delayed paying a loan instalment?
1. Yes
2. No
9.9.
Have you at any point delayed making a bill payment (eg. residential rent, business rent, electricity bill, bank
loans) ?
1. Yes
2. No
9.10.
What was the total income of your household for the last month, including income from all sources? (Note: the
income from the business is only the profits earned)
Rs._____________
Mobile Phone Usage
9.11. How often do you use a mobile phone to receive or make calls?
1. Daily
2. Weekly
3. Occasionally, but less than once per week
4. Never
9.12.
How often do you use a mobile phone to send or receive text messages?
1. Daily
Go to Qn. 9.12a
2. Weekly
Go to Qn. 9.13
3. Occasionally, but less than once per week
Go to Qn. 9.13
4. Never
Go to Qn. 9.13
9.12a
How many text messages (SMS) would you estimate you send on average in a day?
No of texts _______
9.13.
Have you ever added or changed a SIM card in a phone?
1. Yes
2. No
9.14.
How many SIM cards do you have in your current phone?
9.15.
What is your assessment of the quality of cellular reception (signals) in the place you live? (On any network)
1. Excellent
2. Good
3. Somewhat ok
4. Poor
5. Not at all
No. of SIMs _______
19
Interviewer: If the place of work is the same as the home, skip to Qn. 9.17
9.16
If the place you live is different than the place you work, what is your assessment of the quality of cellular
reception (signals) in the place that you work? (On any network)
1. Excellent
2. Good
3. Somewhat ok
4. Poor
5. Not at all
9.17
How often do you add money to your phone network? (eg. using Reload, topup cards, paying bills etc)?
1. Daily
2. Weekly
3. Occasionally, but less than once per week
4. Paying off monthly bill
5. Never
9.18.
What is the approximate distance from your home to the nearest mobile phone topup card / reload agent?
1. less than 100 m
2. 100 – 200 m
3. 200 – 500 m
4. 500 m – 1000 m (1 km)
5. 1 – 3 km
6. 3 – 5 km
7. more than 5 km
9.19.
Assume that you needed to purchase topup card or reload for your mobile phone. How much time would it take
for you to go from your home to the agent, complete the transaction, and return back to your home?
Minutes ______
9.20.
If you had a technical problem with your cell phone, who would you mainly ask for help?
1. I can fix most technical problems myself
2. A relative
3. A neighbour or friend
4. A local cell phone retailer/repair workshop
5. A local reload/topup card agent
6. I would purchase a new phone
7. Other (specify) ________________
8. Not applicable
9.21.
How often do you change your ringtone?
1. Weekly
2. Monthly
3. Occasionally, but less than once per month
4. I have changed my ringtone only once
5. I have never changed my ringtone
6. Not applicable
9.22.
What are the other services that you, yourself, obtain via your mobile phone? (MA)
1. Phone Camera
2. Internet access
3. Phone Games
4. Phone Video
5. Listen to Phone Radio
6. Phone TV
7. Phone MP3/MP4/3Gp (songs)
8. Phone calculator
9. Phone Alarm / Reminder
10. Multimedia Message Services (MMS)
20
11. Data exchange services (eg. Bluetooth)
12. Phone Torch
13. Phone Dictionary
14. Phone Clock
15. Phone Calendar
16. Other (specify) __________________
17. Not applicable
Use of Bank Services
9.23. How often do you use an ATM card to withdraw money from a bank?
1. Weekly
2. Monthly
3. Less than monthly, but at least once per year
4. Less often than once per year
5. Have never used these services
9.24.
How often do you use internet banking services?
1. Weekly
2. Monthly
3. Less than monthly, but at least once per year
4. Less often than once per year
5. Have never used these services
9.25.
How often do you send or receive money by electronic methods (eg. wire transfer services operated by banks,
international networks such as Western Union)?
1. Weekly
2. Monthly
3. Less than monthly, but at least once per year
4. Less often than once per year
5. Have never used these services
9.26.
In the past year, have you sent or received remittances to/from family members living elsewhere in Sri Lanka or
abroad? (Not as loans but as transfers from income earning family members to dependent family members for
home consumption or investment purposes)
1. Have sent money
2. Have received money
3. Have sent and received money
4. Have neither sent nor received money
9.27.
Think about the bank located nearest to you. How much time would it take you to travel to this bank?
Minutes _______
9.28.
How much time would you spend at this bank making a deposit?
Minutes _______
9.29.
How much would it cost you to travel to the bank? (If you would walk, then say 0)
Rs ____________
9.30.
Would you feel safe travelling to the bank with Rs 10,000 to deposit?
1. Yes
2. No
9.31.
Many people say that the difficulty of doing regular cash deposits at a bank is due to the time and cost (such as
travel cost) involved and the inconvenience. In order to make this task easier some countries operate a system
where savings can be done through the mobile phone network. For example, using top up cards to deposit
money into a bank account via the mobile phone instead of mobile phone time. This method is particularly
useful when making small value deposits. If such a service was available without any additional fee involved,
would you be willing to use such a service?
1. Yes
2. No
Go to next section
21
9.32.
In many countries a fee is charged for the use of this service. So in order to deposit Rs 100, one might have to
incur a fee of about Rs 5-20. Despite the fee, customers are still willing to use this service due to saving in time
and cost and the convenience of being able to deposit money at any time. If you were being charged a fee for
this service, what is the maximum fee that you would be willing to bear in order to deposit Rs 100?
Rs ____________
SECTION 10: NUMERACY, LITERACY & RAVEN
Interviewer: Ask this Section from ALL respondents.
10.1.
10.2.
Suppose someone was going to pay you Rs. 1500 1 month from now. He/she offers to pay you a lower amount
today. What amount today would make you just as happy as receiving Rs. 1500 in 1 month?
Interviewer: Probe: "You wouldn't be willing to take (Rs. 100 less)?”
Rs _____________
I would now like to ask you some questions involving numbers. Please answer as best as you can,
without using pencil or paper. No one is expected to be able to answer all of the questions.
Show Card
Look at the following series of numbers. Which number is missing from each of the following
sequences?
(a) 20 30 ___ 50 60
(b) 59 67 75 ___ 91
(c) 26 ___ 38 44 50
10.3a
Starting with the number 40, I would like you to count backwards toward 0, by 10. So, for example,
what is 40 minus 10? and that answer minus 10? and so forth.
1. 40
2. ______
3. ______
4. ______
5. ______
10.3b Now starting with the number 100, I would like you to count backwards by 7, until you reach 50. So,
for example, what is 100 minus 7? And that answer minus 7? And so forth.
Interviewer: Continue until the respondent passes the number 50, or for 2 minutes. Please note
down the responses and the time taken.
1. 100
2. ______
3. ______
4. ______
5. ______
6. ______
7. ______
8. ______
9. ______
Interviewer: mention the time and aids (if used) used to do this exercise
Time taken to reach below 50:
__________ min
__________ sec
Interviewer: Did the respondent use paper or any other aid?
1. Yes
2. No
10.4.
Suppose someone was going to pay you Rs. 10,000, 6 months from now. He/she offers to pay you a
lower amount in 5 months time. What amount received in 5 months time would make you just as
happy as receiving Rs. 10,000 in 6 months time?
Interviewer: Probe: "You wouldn't be willing to take (Rs. 100 less)?”
Rs _____________
10.5.
Raven Test
Show Card
I will show you a series of pictures. Each picture has figures in three rows and three columns. One
figure is missing. You should find the missing part required to complete a pattern from the figures
given below. You will be given 5 minutes. During that time, do as many as possible. Feel free to skip a
picture and come back later if you have extra time.
22
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Interviewer: The respondent needs 5 minutes of uninterrupted time. If he/she does get interrupted, take
the pictures back and return it to them for the remaining time.
10.6.
Suppose someone was going to pay you Rs. 1500, 6 months from now. He/she offers to pay you a lower
amount in 5 months time. What amount received in 5 months time would make you just as happy as receiving
Rs. 1500 in 6 months time?
Interviewer: Probe: "You wouldn't be willing to take (Rs. 100 less)?”
Rs _____________
10.7.
DIGIT-SPAN RECALL
Interviewer: Start with the card with 3 numbers marked on it, listed as card number 3. Tell the
enterprise owner the following:
Show the card
I am now going to show you a card with several numbers written on it. I will show you the card for 10 seconds.
I will then wait 10 seconds which you can use to remember those numbers, and ask you to repeat the numbers
back to me. For example, if I showed you this card:
[Interviewer: Pull out card with three digits 7-5-2 on it and show it to the owner.]
Then you would look at this card, remember the numbers, and after 10 seconds repeat back to me 7-5-2.
Okay, let's start with a card with 4 numbers on it.
Interviewer: Show them the card with 4 numbers on it for 10 seconds, then wait for 10 seconds, and ask
them to repeat the numbers back to you. If they get the numbers correct on the first attempt, mark 1 for
correct in the box and move onto the next card with 5 numbers on it. Otherwise, if they do not get the
numbers right, mark 2 for incorrect in the box, and move onto Qn. 10.8.
a. Card with 4 numbers
b. Card with 5 numbers
c. Card with 6 numbers
d. Card with 7 numbers
e. Card with 8 numbers
f. Card with 9 numbers
g. Card with 10 numbers
h. Card with 11 numbers
10.8.
1=correct
(If 1, go to the next card)
1
1
1
1
1
1
1
1
2=wrong
(If 2, go to Qn. 10.8)
2
2
2
2
2
2
2
2
Suppose someone was going to pay you Rs. 1500, 13 months from now. He/she offers to pay you a lower
amount in 12 months time. What amount received in 12 months time would make you just as happy as receiving
Rs. 1500 in 13 months time?
Interviewer: Probe: "You wouldn't be willing to take (Rs. 100 less)?”
Rs _____________
Show the Card
10.9. Now, I will show you a card with a short Sinhala sentence written in English on it. Please read the sentence written
on it.
Interviewer: Mark according to the reading skill of the respondent
1. Read in a very easy way
2. Read easily
3. Some words were difficult to read
4. Could not read at all
10.10. Generally speaking, would you say that most people can be trusted or that you need to be very careful in dealing
with people?
1. Most people can be trusted
2. You need to be very careful.
23
Show the Card
10.11. I would like to ask you how much you trust people from various groups. Could you tell me for each whether
you trust people from this group completely, somewhat, not very much, or not at all?
1= Trust completely, 2= Trust somewhat, 3 = Do not trust very much, 4= Do not trust at all.
Person Group
a. Your neighbours
b. People you meet for the first time
1
Trust
2
3
4
Show the Card
10.12. I am going to name a number of organizations. For each one, could you tell me how much confidence you have
in them: is it a great deal of confidence, quite a lot of confidence, not very much confidence, or none at all?
1 = A great deal, 2= Quite a lot, 3= Not very much, 4= None at all.
a. The press
1
2
3
4
b. The police
1
2
3
4
c. The court
1
2
3
4
d. Banks / financial institutions
1
2
3
4
e. The central government (eg. The president, cabinet ministers)
1
2
3
4
f. The provincial government (eg. Provincial ministers and parliamentarians)
1
2
3
4
g. The municipal council, urban council or Pradeshiya Saba
1
2
3
4
h. Mobile telephone operators (dialog, mobitel)
1
2
3
4
Show the Card
10.13. Are you generally a person who is fully prepared to take risks or do you try to avoid taking risks? Please tick a
box on the scale, where the value 0 means:"unwilling to take risks"-a very careful person and the value 10
means: "fully prepared to take risks"- a careless person. Which point describes you the best?
0
1
2
3
4
5
6
7
8
9
Unwilling to
take risks
10
Fully prepared
to take risks
Show the Card
10.14. Consider now your risk behavior regarding your savings and finances. Someone who takes a lot of risks may
not save very much or may not keep a careful account of what they spend. Someone who is very reluctant to
take risks may save a lot in case of emergencies and only buy things that the household absolutely needs, etc.
Are you generally a person who takes a lot of financial risks or do you try to avoid taking financial risks ?
Please tick a box on the scale, where the value 0 means:"unwilling to take risks" and the value 10 means: "fully
prepared to take risks."
The value 0 means:"unwilling to take risks"-very careful person and the value 10 means: "fully prepared to take
risks" – a careless person
0
Unwilling to
take risks
1
2
3
4
5
6
7
8
9
10
Fully prepared
to take risks
24
SECTION 11: HOUSEHOLD EXPENDITURE
Interviewer: Ask this Section from ALL respondents.
11.1
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
In the past month of October 2010, how much in total did your household (including yourself) spend on
each of the following?
Expenditure Category
Expense (Rs)
Food consumed at home
Food consumed outside the home (eg. restaurants, tea-shops, bought on street)
Non-durable household goods (eg. personal care products, soaps)
Recreation and entertainment (eg. movies, CD/VCD/DVD, trips)
Housing (rent, taxes, maintenance)
Fuel, light and water (eg. electricity bill, gas, firewood, kerosene, candles, matches)
Telephone (including land line and mobile)
Other household services (laundry, grinding, domestic servants)
Transport (including fuel for car/motor cycle, bus fares)
Schooling (include fees, books and other materials, uniforms, etc.)
Health expenditures (medicine, doctor/consultant fees)
Clothing (including clothes, footwear)
Jewelry and watches (eg. beads, bangles, bracelets and necklaces)
Household furnishings (eg. furniture, curtains)
Electronic goods and household appliances
Repairs to house and land (including garden related)
Travel to visit friends or family
Expenses on smoking (eg. cigarette, beedi)
Consumption of alcoholic drinks (eg. liquor, beer)
Expenses on beauticultural needs (hair styling)
Religious activities
Horse race betting
Ceremonies related to family members and relatives (eg. weddings, funerals)
Social activities
Repayment of loans/interests
Consumption of betel (eg. betel leaves, arricanuts, tobacco)
Card playing for money
Lottery expenses
Books, newspapers and magazines
Other (specify): _____________________________
Total household expenditures for the last month
Now I want to ask you about the total income earned by your house hold, including yourself in the past
month of October 2010.
11.2.
Let’s first look at income earned (by you and your household members) in the past month of October
2010. Can you please tell me how much money you received from each of the following sources?
Source
1. In the past month of October 2010, how much income did your house hold earn
from economic activity? (eg. wages from work, earnings from business, income earned
from sales of agricultural crops)
2. In the past month of October 2010, how much money did you receive as remittances
from your relatives living in other areas of Sri Lanka(eg. children/siblings) and from
your friends?
3. In the past month of October 2010, how much money did you receive as remittances
from your relatives (eg. children/siblings) and from your friends residing in abroad
countries
4. In the past month of October 2010, how much money did you and your house hold
Income (Rs)
25
members receive from other sources (eg. government payment schemes such as
Samurdhi, seetus/loans, etc.)
Total
11.3.
Now I would like to ask you the incomes received and expenditure incurred by only yourself for the
past month of October 2010
First, we will discuss about your income for the last month. Please tell me how much you received
from each source below.
Source
1. In the past month of October 2010, how much income did you earn from economic
activity? (eg. wages from work, earnings from your business, money withdrawn from
your own bank account etc)
2. In the past month of October 2010, how much money did you receive from your
spouse or other household members? (eg. money given by HH members to purchase
things for the household, loans given by HH members, other remittances from foreign
countries)
3. In the past month of October 2010, how much money did you receive from persons
living outside the household or institutions? (eg. gifts or loans given by family
members outside the home, money received from seetus, other transfers etc)
4. Total
Amount (Rs)
11.3a. This means that you received a total amount of Rs (mention total amount in 11.3.4) during the past
month of October 2010. Does this sound correct?
1. Yes
2. No
Go to Qn. 11.4
Go to Qn. 11.3b
11.3b. If not, then what might be the correct amount of money received after including any other sources as
well?
Rs_______________
11.4.
Now I would like to ask you about money given to other people in the past month of October 2010.
Can you tell me how much money you gave to each of the following?
Type of expenditure
1. Money given to spouse (for expenditures, savings etc)
2. Money given to children (for transport to school, food etc)
3. Money given to other members of the household
4. Money given to members outside the household (eg. as gifts etc)
5. Other (specify) ____________________________
6. Total
Amount (Rs)
11.4a. This means that you gave a total amount of Rs (mention total amount in 11.4.6) during the past month
of October 2010. Does this sound correct?
1. Yes
2. No
Go to Qn. 11.5
Go to Qn. 11.4b
11.4b. If not, then what might be the correct amount of money given after including any other recipients as
well?
Rs _______________
11.5.
Interviewer: Subtract the total in 11.4.6 (if incorrect, then 11.4b) from the total in 11.3.4 (if incorrect,
11.3b) and write the answer here.
Rs _______________
26
11.6.
Then after deducting the total amount of money given to others from the total amount of money received, you
had Rs (mention total amount in 11.5) remaining for saving or spending in the past month of October 2010. Can
you tell me how much money you saved using the following methods?
Saving Method
Amount (Rs)
1. Saving in an institution such as a bank
2. Retain as cash in hand
3. Deposit in a seetu
4. Savings in another form (specify) ____________________________
5. Total
11.7.
Interviewer: Subtract the total in 11.6.5 from the total of 11.5 and write the answer here.
Rs _______________
11.8.
Then after deducting the total amount of money saved by you, you personally had Rs (mention total amount in
11.7) remaining for spending in the past month of October 2010. Can you tell me how much money you
personally spent on each of the following?
Expenditure Category
Expense (Rs)
1.
Food consumed at home
2.
Light food items consumed outside the home (eg. short eats, snacks, tea etc.)
3.
Other food consumed outside the home (at restaurants, hotels etc)
4.
Non-alcoholic beverages consumed outside the home (eg. soft drinks such as sprite,
coca cola etc)
5.
Bus fare
6.
Three wheelers / taxi fares
7.
Clothing (including clothes, footwear)
8.
Jewelry and watches (eg. beads, bangles, bracelets and necklaces)
9.
Telephone (including land line and mobile)
10. Cigarettes and Tobacco (including Beedi / Betel etc.)
11. Beer and other alcoholic beverages
12. Hair Cuts / Hair dressing
13. Personal care products (eg. perfumes, creams, shampoo etc.)
14. Religious activities (eg. visits to temple)
15. Parties and other celebrations
16. Betting at Horse Races / Turf Accountants
17. Travel to visit friends and family
18. Expenditure on weddings / funerals and other such family events
19. Social activities / festivals / ceremonies
20. House expenses(eg. rents)
21
Fuel, light and water (eg. electricity bill, gas, firewood, kerosene, candles, matches)
22. Other household services (laundry, grinding, domestic servants)
23. Schooling (include fees, books and other materials, uniforms, etc.)
24. Health expenditures (medicine, doctor/consultant fees)
25. Household furnishings (eg. furniture, curtains)
26. Electronic goods and household appliances
27. Repairs to house and land (including garden related)
28. Repayment of loans/interests
29. Consumption of betel (eg. betel leaves, arricanuts, tobacco)
30. Card playing for money
31.. Lottery expenses
32. Books, newspapers and magazines
33. Other (specify)_____________________
31. Total household expenditures for the last month
27
SECTION 16: INTERVIEWER IMPRESSIONS
Interviewer: Please answer the following questions after completing the interview without consulting the
respondent.
16.1
16.2
16.3
16.4
Who else other than the owner was present during the interview? (MA)
1. Nobody
2. The spouse
3. Other adult household member
4, Other adults from outside the household
5. A child 5 years of age or younger
6. A child older than 5 years of age
7. An employee
8. Other (specify) _____________
What is your impression of how well the respondent
understood the questions asked?
What is your impression of the seriousness with
which the respondent answered the questions?
What is your overall impression of the preciseness /
accuracy with which the questions were answered?
Excellent
Good
Not so
good
Very
bad
1
2
3
4
1
2
3
4
1
2
3
4
16.5
Which questions were most difficult or troubling for the respondent? (Mark section or question number)
______________________________________________________
16.6
Which questions were most difficult or troubling for you? (Mark section or question number)
______________________________________________________
16.7
Which questions interested the respondent the most? (Mark section or question number)
______________________________________________________
16.8
The Survey was conducted at
1. Home
2. Business site
3. Other (specify) _________________________
Thank the respondent and terminate interview
Additional Remarks:..
28