HOUSEHOLD SURVEY Date: Hamlet Name: Village Name: Block Name:

1. Livelihood Portfolio: 1.1 Household profile: Name of the Head of the household: Caste: SC/ST/OBC/Others

1.2 Occupation: primary_____________ secondary________________ 1.Agriculture 2.AH Dairy 3.AH Goat, Sheep, etc 4.Poultry, Duck Rearing, etc 5.Wage Earners 6.NTFPs 7.Artisans 8.Traders, Small Business, etc 9.Others like Govt. Service

1.3 Existing livelihood activities members engaged in: Activities Members Months engaged in Annual Income/yr.

2. Livelihood capacities: 2.1 skills and Knowledge: Agriculture Practice Yes / No Agriculture Practice Yes / No

Used hybrid seeds Used soil testing Used seedlings Used extension services Used pesticides Used farm equipment Used fertilizer Used irrigation Used farmyard manure Hired Labor Total Yes Response Total Yes Response Bee keeping: Yes/No Wether undergone any training/Traditionally praticising? Poultry: Yes/No Wether knows how to use vaccination and proper caring? NTFP storage and processing Knowledge: Any other specify

2.2. Credit Accessibility: sources of credit money lender traders-input and output banks/financial institutions co-operatives relatives and friends SHGs Any other specify 3. Livelihood Related Issues: Migration: Migration for Higher Income Opporunities No. of members, Days, Places, seasonality, Activities Involved. No. of times in a year. Amount (in Rs.) Reasons Challenges

Distress Migration No. of members, Days of Migration, Seasonality, Places, and Activities Involved.

Food Inscure months during last year(most to least):Nos. No. of months: 1 2 3 Coping mechanism-Past experience:

Reason

4. Access to market: Agriculture output Crops Productivity (Kg/acre) Price/kg Place of sale Problems (if any)