PM-Kisan

1. Name of the Beneficiary^*

2. When did you enroll for _ Scheme? (Check eitherfrom
card or from acknowledgement slip on which respondent’s
name is present)^*

3. Which schemes has your family received benefits from in
the last 1 year?^*

4. How many members are being covered in PM Kisan
Samman Nidhi Scheme? ^*

5. Reference Year^*

1. District Name^*

2. Block Name^*

3. Village / Ward Name^*

4. Gender^*

5. Name of the Farmer^*

6. Aadhar No^*

7. Whether linked with Bank Account^*

8. Name of Village^*

9. Name of Block^*

10. Name of District^*

11. Region^*

12. Age in completed years (Estimate if unknown)^*

13. Who is the head of the family? (Enumerator to explain
that the head of the household is a member who takes
all the major decisions withinthat HH)^*

14. Age of headof the family (―Mukhia‖) as per Scheme^*

15. What is your relation with the head of the family?^*

16. Education^*

17. Social Category^*

18. Occupation^*

19. Total Male Family Members^*

20. Total female Family Members^*

21. Children <16^*

1. Does the family possess at least one mobile phone?^*

2. If Yes, is a mobile mapped to the Scheme?^*

3. Can anyone in the family read and write SMS on a mobile phone?^*

1. How many bank accounts does the family have?^*

2. How many post office accounts does the family have? (0 if none)^*

3. Did head of the family have bank account before Registration under Scheme?^*

4. Did the head of family receive any benefits from government schemes in this account before Scheme registration?^*

5. If Yes, what benefit did she/he receive before Scheme registration?^*

6. Has anyone in your family ever withdrawn money from the account registered in the Scheme in the last one month?^*

1. Land (Hect.) No. of Assets^*

2. Land (Hect.) Year of purchase^*

3. Land (Hect.) Present value (Rs.)^*

4. Land (Hect.) Own fund Purchased during the reference year (Rs.)^*

5. Land (Hect.) Bank Loan Purchased during the reference year (Rs.)^*

6. Land (Hect.) PM Kiasn Scheme Purchased during the reference year (Rs.)^*

7. Land (Hect.) Other Agencies Purchased during the reference year (Rs.)^*

8. Residential House No. of Assets^*

9. Residential House Year of Purchase^*

10. Residential House Present Value (RS)^*

11. Residential House Own Fund Purchased during the reference year (Rs.)^*

12. Residential House Bank Loan Purchased during the reference year (Rs.)^*

13. Residential House PM Kisan Scheme Purchased during the reference year (Rs.)^*

14. Residential House Other Agencies Scheme Purchased during the reference year (Rs.)^*

15. Farm House No.of Assets^*

16. Farm House Year of Purchase^*

17. Farm House Present Value (RS)^*

18. Farm House Own Fund Purchased during the reference year (Rs.)^*

19. Farm House Bank Loan Purchased during the reference year (Rs.)^*

20. Farm House PM Kisan Scheme Purchased during the reference year (Rs.)^*

21. Farm House Other Agencies Purchased during the reference year (Rs.)^*

22. Live Stock No.of Assets^*

23. Live Stock Year of Purchase^*

24. Live Stock Present Value(RS)^*

25. Live Stock Own Fund Purchased during the reference year (Rs.)^*

26. Live Stock Bank Loan Purchased during the reference year (Rs.)^*

27. Live Stock PM Kisan Scheme Purchased during the reference year (Rs.)^*

28. Live Stock Other Agencies Purchased during the reference year (Rs.)^*

29. Tractor with trolley No.of Assets^*

30. Tractor with trolley Year of Purchase^*

31. Tractor with trolley Present Value (RS)^*

32. Tractor with trolley Own Fund Purchased during the reference year (Rs.)^*

33. Tractor with trolley Bank Loan Purchased during the reference year (Rs.)^*

34. Tractor with trolley PM Kisan Scheme Purchased during the reference year (Rs.)^*

35. Tractor with trolley Other Agencies Purchased during the reference year (Rs.)^*

36. Tube-well/Diesel or Electric No.of Assets^*

37. Tube-well/Diesel or Electric Year of Purchase^*

38. Tube-well/Diesel or Electric Present Value (RS)^*

39. Tube-well/Diesel or Electric Own Fund Purchased during the reference year (Rs.)^*

40. Tube-well/Diesel or Electric Bank Loan Purchased during the reference year (Rs.)^*

41. Tube-well/Diesel or Electric PM Kisan Scheme Purchased during the reference year (Rs.)^*

42. Tube-well/Diesel or Electric Other Agencies Purchased during the reference year (Rs.)^*

43. Thresher No.of Assets^*

44. Thresher Year of Purchase^*

45. Thresher Present Value (Rs)^*

46. Thresher Own Fund Purchased during the reference year (Rs.)^*

47. Thresher Bank Loan Purchased during the reference year (Rs.)^*

48. Thresher PM Kisan Scheme Purchased during the reference year (Rs.)^*

49. Thresher Other Agencies Purchased during the reference year (Rs.)^*