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SURVEY ON FINANCIAL INCLUSION (QUESTIONNAIRE)

Place of Survey: _______________ Date: _____ __

Name: ______________________ Age: ______ _______ 

Gender: M/F Occupation: ____ __________  No. of family memer!: ___ adult! ___ c"ildren

A. SAVINGS:1. Is your household h!"#$ o#e %#& ''ou#

# $e! # No

*. No. o+ ''ou#s "# your household: # % # & # ' # ( # More t"an (

,. -h"'h ye o+ ''ou# do you h!e# Saving! )an* a/c # +urrent a/c# ,ecurring Depo!it a/c # Fi-ed Depo!it a/c# f ot"er! 0plea!e !pecify1 ___________________________ 

/. Is he %#& ''ou# 0"h 'heue %oo& # $e! # No

2. -h 0ere he reso#s h your household oe#ed he ''ou## 2o receive Govt. payment! from N,3GP# 2o receive Govt. payment! from !c"eme! ot"er t"an N,3GP# For receiving remittance!

# For !aving money# 2o re4ue!t a loan# f ot"er! 0plea!e !pecify1 ___________________________ 

3. -ho heled you oe# he ''ou## 5illage Panc"ayat Official! # )an* Official!# Neig"or # Friend!/,elative!# f ot"er! 0plea!e !pecify1 ___________________________ 

4. 5o0 +reue#ly do you s!e "# your ''ou## don6t !ave / never # At lea!t once a mont"# 7e!! t"an once a mont"# put in money a! and 8"en can# "ave paid money in ut not in pa!t %& mont"!# "ave not added money !ince account 8a! opened# f ot"er! 0plea!e !pecify1 __________________________ 9&

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6. Reso#s +or #o h!"#$ %#& ''ou#:# "ave no money/little money to put in# No an* in t"i! area# No point enefit! received in ca!"# No point paid in ca!"

# +oncerned t"ere may e too many c"arge!# 2ried to open ut 8a! refu!ed# 7engt"y proce!!e!# Not important to me# Anticipated re;ection# f ot"er! 0plea!e !pecify1 _____________________________ 

7. Reso#s +or %e"#$ re+used %#& ''ou#:# No D# Previou! ad credit "i!tory# No ;o unemployed

# o you h!e #y $r"e!#'es "# your ;#o # )an*! # ,elative! # Friend!  # Moneylender!  # f ot"er! 0plea!e !pecify1 _________________________ 

9'

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1/. I+ %orro0ed +ro %#&s 0h"'h o+ he +ollo0"#$ reso#s led o h"s 'ho"'e# 7o8 rate of intere!t# ?a! offered/arranged y t"e an*!# t i! ea!y 0vague1# 2ru!t8ort"y lender 

# f ot"er! 0plea!e !pecify1 ___________________________ 

12. I+ %orro0ed +ro sour'es oher h# %#&s 0h"'h o+ he +ollo0"#$ reso#s ledo h"s 'ho"'e# )eing ale to orro8 relatively !mall !um!# did not need to provide !ecurity or guarantee!# t 8a! availale locally# can ma*e repayment! in ca!" in !mall 8ee*ly or fortnig"tly !um!# t i! convenient ecau!e t"ey come to t"e door to collect# t i! ecau!e *no8 t"e lender/collector # f ot"er! 0plea!e !pecify1 ___________________________ 

13. I+ e!er %orro0ed 0h 0s he ye o+ he 'red"?lo##

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C. OT5ER FINANCIAL SERVICES

*8. Are you us"#$ #y oher +or o+ +"##'"l ser!"'e or rodu'# No# f ye! t"en 8"ic" one: # n!urance # +redit card # Deit card

  # f ot"er! 0plea!e !pecify1 ______________________ 9(*1. -h 0ere he reso#s +or #o !"l"#$ #y +or o+ "#sur#'e# 2oo e-pen!ive can=t afford it# @u!t don=t ot"er no real rea!on!# No need for it# don=t "ave muc" not"ing valuale# am in proce!! of doing it# No in!urance men coming to door no8#

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*4. A#d 0ould you sy h"s d!"'e 0s# 5ery "elpful #

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,2. Are you s"s+"ed 0"h he @C?@F odel or you +eel he #eed o+ %#& %r#'h your l'e# $e! !ati!fied# No not !ati!fied 0plea!e give rea!on!1

 _______________________________________________ _ 

 ______________________________________________________________________ 

,3. -h do you h"#& h he Go!er#e# lo'l %od"es %#&s NGOs #d ohers"$h #eed odo o +urher 'h"e!e +"##'"l "#'lus"o#

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