1
SUSENAS
VSEN96.M
REPUBLIC OF INDONESIA
CENTRAL BUREAU OF STATISTICS
1996 NATIONAL SOCIO-ECONOMIC SURVEY
CONSUMPTION / HOUSEHOLD EXPENDITURES INFORMATION
CONFINDENTIAL
I. LOCATION IDENTIFICATION
01
Province
02
03
04
05
District/Municipality*)
Sub-District
Village / village unit *)
Area type
06
07
08
09
10
11
Enumeration area number
Segments group number
Segment number
Sample code number
Sample serial number of household
Village classification
12
13
14
Household head name
Number of household members
Address
(name of road /alley, home number,
RT/RW)
01
02
Urban
Rural
-1
-2
03
04
05
06
Tertinggal
tdk tertinggal
Filled in by
editor
Filled in by
editor
II. ENUMERATION PARTICULARS
Name and employment identity
number of enumerator
Enumerator ‘s Status
Province KS staff
District/municipality
KS staff
Mantis
Partner
Date of enumeration
Enumerator’s signature
Name and employment identity
number of supervisor
Supervisor’s Status
Province KS staff
District/municipality
KS staff
Mantis
07
Date of supervision
08
Supervisor’s signature
1
2
3
4
1
2
3
2
3
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTION DURING PREVIOUS WEEK
Purchase
Private production,
(cash/owed)
given, etc.
Standard unit Total
Value
Total
Value
NO
Details
(1)
001
002
003
004
005
006
007
008
009
010
011
012
(2)
A. Cereals
Local rice
High quality rice’s
Imported rice
Glutinous rice
Wet corn with skin
Dry corn with skin
Dry-shelled corn
Rice flour
Corn flour (maizena)
Wheat flour
Other ……………….
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
013
014
015
016
017
018
B. Tuber
Cassava
Sweet potato
Potato
Taro
Dried cassava
Kg
Kg
Kg
Kg
Kg
Kg
(3)
(0,00)
(4)
(Rp)
(5)
(0,00)
(6)
(Rp)
(7)
Total of consumption’s
Total
(4) + (6)
(0,00)
(8)
Value
(5) + (7)
(Rp)
(9)
4
5
NO
(1)
019
020
021
022
023
024
025
026
027
028
029
030
031
032
033
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Cassava flour (Tapioca)
Kg
Dried-cassava flour
Kg
Sago (not made from cassava,
Kg
example: Ambon Sago)
Other: ……………….
Kg
C. Fish
1] Fresh fish
Yellow tail fish
Tuna
“Tenggiri” /Spanish mackerel
“Selar” /mackerel
“Kembung” fish
“Teri”
“Bandeng” milkfish
“Gabus” fish
Tilapia fish
Gold fish
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
6
7
NO
(1)
034
035
036
037
038
039
040
041
042
043
044
045
046
047
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Lele” fish (catfish)
“Kakap” fish
Kg
Other ……………….
Kg
2] Shrimp and other fresh animal’s
Kg
water
Shrimp/Dried shrimps
Kg
Squid
Kg
Crab
Kg
Shell/snail
Kg
Other ……………….
Kg
3] Preserved fish
Kg
“Kembung” fish
Ounce
“Tenggiri” fish
Ounce
Tuna fish
Ounce
“Teri”
Ounce
“Selar” fish
Ounce
“Sepat” fish
Ounce
8
9
NO
(1)
048
049
050
051
052
053
054
055
056
057
058
059
060
061
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Bandeng” fish
Ounce
“Gabus” fish
Ounce
Canned fish
Ounce
Other ……………….
Ounce
4] Shrimp and other preserved water
animals
Shrimp (Dried shrimp)
Ounce
Squid
Ounce
Other ……………….
Ounce
D. Meat
1] Fresh meat
Beef
Kg
Buffalo
Kg
Goat
Kg
Pork
Kg
Purebred chicken
Kg
Free range chicken
Kg
10
11
NO
(1)
062
063
064
065
066
067
068
069
070
071
072
073
074
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Other poultry meats …………..
Other meats ………………..
Kg
2] Preserved meats
Kg
Dried meat
Kg
Dried shredded meat
Ounce
Meat in a can
Kg
Other ……………….
Kg
3] Other
Kg
Liver
Kg
‘Innards’ (other than liver)
Kg
“Tetelan” (bones with a bit of
Kg
adhering meat)
Bones
Kg
Other ……………….
Kg
E. Egg and milk
Kg
Egg of purebred chicken
Kg
12
13
NO
(1)
075
076
077
078
079
080
081
082
083
084
085
086
087
088
089
090
*) box
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Egg of free range chicken
Pieces
Duck egg
Pieces
Quail egg
Pieces
Other eggs
Pieces
Salted egg
Pieces
Pure milk
Liter
Factiry-processed liquid milk
250ml *)
Sweetened condensed milk
397gr **)
Powder milk
Kg
Baby powder milk
400gr ***)
Cheese
Ounce
Other dairy product: …………….
Ounce
F. Vegetables
Spinach
Kg
Water Spinach
Kg
Cabbage
Kg
14
15
NO
(1)
091
092
093
094
095
096
097
098
099
100
101
102
103
104
105
106
107
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Chinese cabbage (“petsai”)
Kg
Mustard greens
Kg
Green bean
Kg
Long beans
Kg
Tomato
Ounce
Carrot
Kg
Cucumber
Kg
Leaves of cassava
Kg
Eggplant
Kg
Soya bean sprouts
Kg
Squash
Kg
Baby corn
Ounce
Vegetables soup/stir-fried
Package
vegetables
“Sayur asam” (sour soup)
Package
Young jack fruit
Kg
Unripe papaya
Kg
Mushroom
Ounce
16
17
NO
(1)
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Petai” (beans with pungent odor)
Kg
“Jengkol” (Phithecolobium)
Kg
Shallot
Ounce
Garlic
Ounce
Red pepper
Ounce
Green pepper
Ounce
Small chili
Ounce
Vegetables in a can
Kg
Other ……………..
Kg
G. Pulses
Peanut with skin
Kg
Peanut without skin
Kg
Soy bean
Kg
Mung bean
Kg
Cashew nut
Ounce
Other peanuts
Kg
(………………..)
18
19
(1)
124
125
126
127
128
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Tofu
Kg
Tempe
Kg
Fermented soy bean sauce
Ounce
Oncom
Ounce
Other ………………….
Ounce
129
130
131
132
133
134
135
136
137
138
139
H. Fruits
Orange
Mango
Apple
Avocado
“Rambutan”
Lanzon
Durian
Snake fruit
Pineapple
Banana
NO
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
20
21
NO
(1)
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
King “Raja” banana
Kg
Other banana
Kg
……………………
Kg
Papaya
Kg
“Jambu” (rose-apple)
Kg
“Sawo” (Sapodilla)
Star fruits
“Kedondong”
Kg
Watermelon
Kg
Melon
Kg
Jack fruit
Kg
Tomato
Kg
Fruits in a can
Kg
Other ………………..
Kg
I. Oil and fat
Kg
Coconut oil
Liter
Corn oil
Liter
22
23
NO
(1)
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Other cooking oil:
Liter
Coconut
pieces
Margarine
Ounce
Other
……………………..
J. Beverages ingredients
Granulated sugar
Ounce
Palm sugar
Ounce
Tea
Ounce
Powdered coffee
Ounce
Coffee bean
Ounce
Cocoa powder
Ounce
Syrup (fruit syrup concentrate for
620ml
drink)
Other ……………….
K. Spices
Salt
Ounce
Candlenut
Ounce
24
25
NO
(1)
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Coriander/caraway seed
Ounce
Pepper
Ounce
Tamarind
Ounce
Nutmeg
Ounce
Clove
Ounce
Fish paste
Ounce
Soy sauce
10 ml
Monosodium glutamate
Gram
“Sambal” (chili sauce) /tomato
140 ml
sauce
Prepared spices
Ounce
Other spices
…………………….
L. Other consumption
Fish/shrimp crakcers
Ounce
Emping chip
Ounce
Wet noodle
Kg
Instant noodle
80 gr
26
27
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
NO
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
188 Rrice noodle
Ounce
189 Macaroni/ dried noodle
Ounce
190 Jelly
Pack (7 gr)*)
191 Baby porridge (packaged)
150 gr
192 Other
………………………..
193 M. Prepared foods & drinks
194 Bread
Small pack
195 Sweet bread/other bread
Piece
196 Cookies/Biscuit/’semprong’
Ounce
197 Cake
Piece
198 Fried food
Piece
199 Mungbean porridge
Bowl
200 Gado-gado/’ketoprak/’pecel’
Plate
201 Rice and side dishes (nasi rames)
Plate
202 Fried rice
Plate
203 Rice
Plate
*) Small pack
28
29
NO
(1)
204
205
206
207
208
209
210
211
212
213
214
215
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Bowl
“Lontong” (ice steamed in a banana
leaf)/ Ketupat sayur (rice cake with
vegetables)
“Soto”/curry/ soup/”rawon”/mince
Bowl
“Sate”/”Tongseng” (goat stir-fry)
Plate
Meat ball noodle/boiled
Bowl
noodle/fried noodle
Instant noodle
Bowl
Snack for kids/fish or shrimp
Ounce
crackers/chips
Fish (fried, baked, etc)
Piece
Chicken/meat (fried, baked, etc)
Piece
Ice cream
Small bowl
Other ice ……………
Glass
Other prepared food ……………..
Soft drink with CO2 (soda)
200 ml *)
Beverages without CO2:
216 Packaging water
217 Packaging tea
*) Small Glass Bottle
**) Small Plastic Bottle
***) “Tea bottle” packaging
500 ml **)
200 ml ***)
30
31
III. 1. FOOD, DRINK, AND TOBACCO CONSUMPTIONS DURING PREVIOUS WEEK
Purchase
Private production,
Total of consumption’s
(cash/owed)
given, etc.
NO
Details
Standard unit Total
Value
Value
Total
Value
Total
(5) + (7)
(4) + (6)
(Rp)
(0,00)
(0,00)
(Rp)
(0,00)
(Rp)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
218 Packaged fruit juice
200 ml*
219 Health drink/energy drinks
Bottle **
(100 ml)
220 Other drinks (coffee, milk coffee,
Glass
tea, chocolate milk)
221 N. Alcoholic drinks
222 Beer
620 ml
223 Wine
620 ml
224 Other alcoholic drinks ……….
620 ml
………………..
225 O. Tobacco and betel
226 Filtered clove cigarette
10 pieces
227 Unfiltered clove cigarette
10 pieces
228 White tobacco cigarette
10 pieces
229 Tobacco
Ounce
230 Betel leaves/areca nut
231 Other …………………..
• * Boxed packaging
• ** Small bottle
32
33
NO
(1)
232
233
III. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
A. Housing and Household facility
The house of living is:
Owned property/free of rent 1
Lease
2
Rent
3
Installment payment
Official house
Other
4
5
6
234
If the house is own property/free of rent, estimated monthly rent: Rp. ………………….
235
If the house is leased:
a. Lease agreement: ……………….year
b. Lease value: Rp. …………………..
c. Average monthly lease value:
Rp. …………
236
If the house is rented, monthly rent value:
237
If the status of dwelling is installment, official and others, average monthly rent value:
Rp. ……………
Maintenance costs (paint, plastering, painting the wall, replacing roof tiles, broken glass, hinge, etc, including
wages for workers)
238
239
Electricity:
Used electricity (quantity):
240
241
Rp. ………….
a. A month ago: …….………..kwh/watt *)
b. 12 months ago: …………….kwh/watt *)
Fill in by
CBS
Value:
Telephone :
34
35
NO
(1)
242
III. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
Water (“PAM” = Municipal Water Corporation / from water vendor/ purchased)
Quantity:
243
244
Value:
LPG (Liquid Propane Gas)
Quantity:
245
246
a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
Value:
Kerosene
Quantity:
249
250
a. A month ago: ……………………kg
b. 12 months ago: ………………….kg
Value
City Gas
Quantity:
247
248
a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
Value
Generator
a. Type and number of fuel used:
Gasoline
Diesel
251
1
2
Kerosene
3
A month ago: ……………..liter
12 months ago: ……………liter
Value
36
37
III. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
NO
(1)
252
b. Lubricants:
Quantity:
253
254
255
a. A month ago: ……………………liter
b. 12 months ago: ………………….liter
Value:
c. Maintenance and repair
Charcoal
Quantity:
a. A month ago: ……………………kg
b. 12 months ago: ………………….kg
256
257
Value
Firewood and other fuel
258
Others (flashlight, storage battery, matches, mosquito repellent, lamp, air freshener, Liquid floor cleaner, etc)
259
Goods and Services
260
Bath soap, toothpaste, toothbrush, and shampoo
261
Cosmetics (perfume, pomade, deodorant, powder, lipstick, comb, etc), and sanitary napkin
262
Treatments for skin, face, nails, hair (cut, curl, cream bath, etc)
38
39
III. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
NO
(1)
Health
263
264
265
266
267
268
269
270
271
272
273
a. Government’s hospital
b. Private’s hospital
c. Doctor’s practice
d. Puskesmas (Integrated Health Center)
e. Supporting Puskesmas
f. Clinic/”Mother and Child’s Clinic”/ BP (infirmary)
g. Posyandu (Integrated Health Services Post)/Cader
h. Midwife/paramedic/practicing nurses
i. Traditional healer/Shinshe (Chinese traditional healer)
j. Purchased medication with doctor’s prescription
k. Own treatment/purchased medicine without doctor’s prescription/purchased medicinal herbs
Other health:
274
275
276
277
278
a. Pregnancy examination cost
b. Delivery cost
c. Immunization cost for children under 5 years
d. Check-up and contraceptive costs
Health treatment (vitamin, herbs, massage, fitness, etc)
School & courses expenses
279
280
281
282
283
284
a. Donation for school development (school enrollment fee)
b. School tuition (SPP) and BP3/POMG contribution
c. Other school contributions (vocational skills, additional lesson, exams, etc.)
d. Textbooks/photocopy of textbooks
e. Stationeries (calculator, compass, etc)
f. Course fee
40
41
NO
(1)
285
III. 2. EXPENDITURE FOR NON-FOOD CATEGORY LAST MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
Newspapers, magazines, books, and stationery (excluding school and course needs) including rent of
magazines/literatures
286
Post, Telegram, public phone, and postal materials, including pager fee
287
Motor vehicle fuels used for household needs (not for business/work)
288
a. Gasoline
Quantity: (1) A month ago: ………………………….liter
(2) 12 months ago: ………………………..liter
Value:
289
290
b. Solar fuel
Quantity: (1) A month ago: ………………………….liter
(2) 12 months ago: ………………………..liter
Value:
292
293
c. Lubricant oil
Quantity: (1) A month ago: ………………………….liter
(2) 12 months ago: ………………………..liter
Value:
Maintenance and repairs of motor vehicle
294
Costs of transportation (bus, train, airline, ship, ‘becak’, parking fee, toll fee, etc)
295
296
Hotel, motel, cinema, theatre, sport, decoder, and other recreations, (excluding transportation cost and purchase
of goods for recreation)
Servant and driver (wages or salary)
297
Other goods (tissue, camphor, banana leaves, coconut leaves, ‘sate’ stick, etc)
298
Other services (Identity card, Driver license, birth certificate, photo copy,
291
42
43
NO
(1)
299
300
301
III. 2. EXPENDITURE FOR NON FOOD CATEGORY LAST MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
C. Clothes, Footwear, and Head gear
302
Ready made men’s wear (Blazer, long-sleeved shirt, Jacket, sarong, pants, T-shirt, underwear, etc)
Ready made women’s wear (Gown, long fabric, blouse, nightgown, sweater, skirt, sarong, shawl, cloth girdle,
underwear, etc)
Ready made children’s wear (clothes, pants, sweater, shirts, under wear, baby napkin, etc)
303
Materials/fabrics for men, women, and children (wool, polyester, cotton, silk, etc)
304
Cost for tailoring, clothes repair, thread and other sewing needs
305
Footwear for men (shoes, sandal, sock, etc)
306
Footwear for women
307
Footwear for children
308
Head gear for man, woman and children (hat, ‘kopiah” =rimless cap, veil, etc)
309
Laundry-soap (in bar form)
310
Powder soap and cream soap
311
Others (towel, belt, shoe polish, tie, laundry, etc)
44
45
III. 2. EXPENDITURE FOR NON FOOD CATEGORY LAST MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
NO
(1)
312
D. Durable goods
313
314
Furniture ( table, chair, bed, wardrobe, cabinet, shelving, mirror, food cabinet, baby bed, etc)
Household equipment (sewing machine, refrigerator, fan, washing machine, air conditionner, etc)
315
Household furnishings (mattress, pillow, table cloth, bed sheet, mirror, pillow sheet, blanket, plaited mat,
curtain, carpet, etc)
Household utensils (Iron, broom, scissors, knife, machete, saw, vacuum cleaner, etc)
316
317
319
Kitchen/eating utensils (plate rack, stove, cooking pan, pan, pail, wok, spoon, thermos bottle, plate, glass, and
other utensils made of glass, ceramic, melamine, and plastic; mixer, blender, microwave, oven, etc)
Decorative goods (wall decoration, aquarium, decoration goods made of ceramic, porcelain, onyx, marble,
wood, etc)
Repaired of household furniture, furnishings and equipment
320
Watch, clock, camera, glasses, and their repair
321
Umbrella, bag, luggage, and their repair
322
Expensive jewelers (gold, diamond, pearl, etc) and their repair
323
Children’s toy and their repair
324
Television, video, radio, cassette, radio cassette, guitar, piano/organ, computer, and their repair
325
Sport utensils (chess, racket, ball, net, bet, stick, etc) and their repair
326
Vehicle (bicycle, motor cycle, car, etc) and their repair
327
Pets and plants including maintenance
328
Other durable goods (cradle, baby carriage, electricity installation, telephone, plumbing, pager, and their repair
318
46
47
(1)
329
III. 2. EXPENDITURE FOR NON FOOD CATEGORY PAST MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
(4)
Taxes and insurance:
330
331
Building and Land tax (PBB)
Radio & TV tax, and its type
332
Vehicle (motor and non motor) tax
333
Other taxes/levies (household contribution, garbage, security, cemetery, etc)
334
Accident & loss insurance
335
F. Festivities and ceremonies
336
337
Weeding (rentals for facilities and services, function hall rental, etc)
Circumcision, birthday
338
339
Religious holidays (“Idul Fitri” = holiday celebrating the end of fasting period, “Idul Adha”, Christmas, New
Year, “Waisak “= Budhist New Year, “Galungan” = Hindu Holy Day, expenses for going to Mecca for Haj
Other Traditional ceremonies (“selametan’, party, “sajen” = offerings, etc)
340
Funeral
NO
48
49
NO
(1)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
III. 3. AVERAGE MONTHLY HOUSEHOLD EXPENSES ( IN RUPIAH)
Type of expenses
During a week
(2)
Cereals (III.1 A)
Tuber (III. 1 B)
Fish (III. 1 C)
Meat (III. 1 D)
Egg and Milk (III. 1 E)
Vegetables (III. 1 F)
Pulses (III. 1 G)
Fruits (III. 1 H)
Oil and Fat (III. 1 I)
Drinks (III. 1 J)
Spices (III. 1 K)
Other consumables (III. 1 L)
Prepared foods and drinks (III. 1 M)
Alcoholic drink (III. 1 N)
Tobacco and betel (III. 1 O)
Sub Total (1 to 15)
Sub total (16) x 30
7
Housing and Household facility (III. 2 A)
Goods and Services (III. 2 B)
Clothes, Footwear, and Headgear (III. 2 C)
Durable goods (III. 2 D)
Tax and Insurance (III. 2 E)
Festivities and ceremonies (III. 2 F)
Average monthly expenses(17 to 23)
(3)
Average in a
month
(4)
During 12
months
(5)
50
51
IV. INCOME, REVENUE AND EXPENSES FOR NON FOOD CATEGORY DURING THE PAST 12 MONTHS
(IN RUPIAH)
1. Wages/salary received in cash and in kind
2. Income from agriculture business/activities
a. Food and non-food crops
b. Other farming activities(livestock, poultry, miscellaneous livestock, fishery, forestry)
3. Income from non agriculture business/activities
4. Income outside of wage/salary and business
a.
Estimated house rent
b. Other (pension, duty-binding scholarship/ scholarship, claimed life insurance, dividend, land lease, others)
5. Expenses and money transfers received
Expenses:
(transferred money, give donation, gift, bequest, and aid)
6. Other expenses and revenue
Expenses:
a. Purchased stock/bonds/gold/jewelry, immovable goods
including building renovation
Revenue:
(received money transfers, inheritance, donation, gift, aid)
Revenue:
a. Sold of bond/gold/jewelry/immovable goods, secondhand goods
b. Others (saving, paid of insurance, loans/paid back loans,
b. Others (withdrew savings, claimed other insurance,
down payment, paid “arisan” = social gathering
received “arisan”, received loans, panwed goods, etc
whose member contribute to and take turns sum of money,
etc)
7. Income/revenue of household
(Total of income/revenue, details 1 to 6 – total expenses, details 5 to 6)
8. Average income/revenue of household in a month (details 7 : 12)
52
53
V. HOUSEHOLD MEMBERS RICE CONSUMPTION FREQUENCY
AND NUMBER OF CLOTHES
Frequency of rice
Number of clothes owned at
eaten previous week time of enumeration
No
Name
Prepared Prepared Tops
Skirt/sho Dress
at home
food
rts/pants
(1) (2)
(3)
(4)
(5)
(6)
(7)
VI. LIVESTOCK AND POULTRY LISTING
1. Do you have livestock/poultry at time of enumeration?
Yes
1
No
2 → finished
2. If “yes” , number of livestock/poultry raised:
Type of livestock/poultry
(1)
01
02
03
04
05
06
07
08
09
10
11
12
male
(2)
female
(3)
Total
(4)
01. Dairy cow
02. Cow
03. Buffalo
04. Horse
05. Goat
06. Sheep
07. Pig
08. Free range chicken
09. Layer chicken
10. Broiler chicken
11. Ducks
54
55
VII. NOTE
56