Questionnaire for Bank Survey

Questionnaire to Evaluate the Financial Need of Men/Women

Code of Respondent:________ Source Of Credit:

(1) ________________

(2) ________________

(3) ________________

SECTION 1

Information about Respondent and Family

1 Name of the respondent

2 Gender (i) Male (ii) Female

3 Age

4 Marital Status

5 Qualification

6 Position in Family (i) Head

(ii) Member

7 If married, No of children (i) Male Adult_______

(ii) Female Adult________

(iii) Children below 10______

8 School Going Children (i) Male____________

(ii) Female___________

(iii) Total____________

9 Address

10 Rural/Urban/Semi Urban

SECTION 2

Information about Credit and Business

1 Nature of business

2 Month and year of starting the business/Earning activity?

3 Source of initial investment.

4 Your earlier business Experience?

5 Month and year of borrowing?

6 Purpose of borrowing?

7 Amount of credit?

8 Is the amount of credit sufficient?

9 Time period of loan?

10 Rate of interest when borrowed?

11 Is the rate of interest reasonable? (i) Yes(ii) No

12 If yes, would you like to borrow at higher rate of interest?

13 Where was loan utilized?

(eg. Purchase of raw material, purchase of machinery, paid rent of land, purchase of livestock etc) (i) ___________________

(ii) ___________________

(iii) ___________________

14 Was loan repaid in time?

15 If repayment was delayed, what was the cause of delay?

16 Source of repayment. (i) Income from business

(ii) Other_________

17 Do you intend to re-borrow after repaying the existing loan?

18 Reason for re-borrowing.

19 If you have already re-borrowed, no of times re-borrowed?

20 Total persons employed in the business before utilizing credit?

21 Total persons employed in the business after utilizing credit.

22 Has credit improved your business/Earning (i) Yes(ii) No

23 If yes, how long did it take to improve your business/Earning?

24 If yes, how much business income has increased due to credit?

25 Was increase in income temporary or permanent?

26 If income has not increased, what are the reasons? (i) ________________________

(ii) ________________________

(iii) ________________________

(iv) ________________________

27 Will you suggest other people to borrow from Microfinance Institutions? (i) Yes(ii) No

28 If no, give reasons (i) _________________________

(ii) _________________________

(iii) _________________________

(iv) _________________________

SECTION 3

Information about Income and saving

1 Position of respondent in home (i) Husband

(ii) Wife

(iii) Other___________