(NFSM) – Stakeholder Farmer

Schedule No^*

Name of the Enumerator^*

Date^*

State^*

District^*

Taluka/Block/Mandal^*

Village^*

Gram Panchayat^*

Name of Family Head/Respondent^*

Gender^*

Farming Experience (in Years)^*

Contact Number^*

Category^*

Are you a member of local body?^*

Family income per annum (Rs.)^*

Land Details^*

Land Details (Total Land Holding: Addition of all above)^*

Are you aware of Soil Health Card Scheme (SHC)^*

Are you aware of Model Village Program (MVP)^*

Do you know the reasons for soil testing?^*

Have you attended the MVP Demonstration in your village^*

If Yes, when^*

How many MVP demonstrations have you attended?^*

How many farmers visited your field for seeing demonstration^*

Have you attended any Farmer Trainings related to soil health card or fertilizer application?^*

If Yes when?^*

How many such training programmes have you attended till date?^*

Did the training program is helped you?^*

Did you receive any information related to Soil fertility/status frequently?^*

If YES, please mention sources^*

How frequently you receive information?^*

Mode of information^*

Have you received SHC ?^*

When did you received SHC?^*

Did you received SHC after sowing of crop ?^*

If Yes, mention number of days delayed^*

Distance of soil testing centre from your home (Kms)^*

Are you a Demonstration (Demo) farmer in the MVP?^*

If Yes, how many acres of your land have you allotted as the Demonstration plot (acres)^*

If Yes, what is the benefits you received as Demo Farmer (Quantity in Kgs)^*

If Yes, what is the benefits you received as Demo Farmer (Amount in Rupees)^*

Did you continue this input combination from the Demo in the next crop season^*

Do you know the procedure for soil sampling?^*

Are you aware of soil testing centres/lab?^*

Are you able to read and understand the information in SHC?^*

If No, did anyone explained the information of SHC?^*

Are you aware of your soil nutrient status?^*

For how many crops recommendation is given in your SHC (Total Number)^*

For how many crops recommendation is given in your SHC (mention Crop Names)^*

Did you grow recommended crop in the SHC?^*

If Yes, have you followed the recommended doses of fertilizers and nutrients?^*

Did you receive any information related to Soil fertility/status frequently?^*

Total Fertilizer Usage due to SHC

If Increased (% or Amount)

If Decreased (% or Amount)

Do you feel due to SHC the cost of cultivation decreased?

Do you feel due to SHC there is an increase in soil fertility?

Do you feel due to SHC there is an increase in crop yield?

Major constraints in receiving SHC (list the reasons)

Major constraints in adoption of SHC recommendations

Suggestion for improving SHC scheme

Rate the Performance of SHC Scheme