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Occupation

Details
Farmer Artisan Labourer Industry Others Income
Head of the family
Other members
 
 
 
What types of credit cards do you have (Select all that apply)?
 
Visa
 
Mastercard
 
American Express
 
Discover
 
Diners Club

 
 
 
Household & Farm Assets
 
 
Details
Value (approx.) Remarks
House value (Kutcha own/ Kutcha rented/Pucca own/Pucca rent)
 
 
b. If farmer,  Farm land details



Marginal Farmers  ( below 1 Ha),

Small Farmers  (1-2 ha)

Semi-medium Farmers  (2-4 ha)

Médium Farmers  (4-10 Ha)

Large Farmers   (over 10 ha)
Value Remarks
i Own land
ii Leased in land
iii Leased out land
 
 
 
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Satisfied
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