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हिंदी
Active SHG - Baseline Survey Form
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Basic Information
Zone
*
Ward
Name of SHG
SHG Code
Name of Founder/President
Address
Mobile No
Date of Survey
Consent
Yes
No
Upload Consent Document
Reason for Not Giving Consent
Full Name of the Person
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Section A: Active-Inactive Status
Status of SHG
Active
Inactive
Reasons for Closing the Group
Did Any Organization/NGO Help You Revive the Group?
Yes
No
Are You and Your Group Members Interested?
Yes
No
Why Members Are Not Interested? (Reason 1)
Why Members Are Not Interested? (Reason 2)
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Section B: SHG Registration Information
Is the SHG registered?
Select
Yes
No
With whom is the SHG registered ?
When was the SHG first formation year?
When was the SHG first registration year?
What is the current registration number of the SHG?
Number of Members
Election Ward Number
Name of SHG President
Current Address of SHG President
Phone Number of SHG President
Mobile Number of SHG President
Does the SHG have a bank account?
Select
Yes
No
Does the SHG have an account in (Government) Bank?
Select
Yes
No
Select the bank type
Select
Savings
Current
Name of bank in which the SHG has an account
Account number of SHG in the Bank
Date of opening the Bank account in the bank
What is the current saving amount of the group?
When was the SHG's last savings deposit made in the bank (Latest)?
When was the SHG's last savings deposit made in the bank (Before that)?
Has your SHG taken any loan from the bank?
Select
Yes
No
If yes, how much loan was taken from the bank?
Reason for taking the loan
Member Information
Member 1
Details of Member 1
Disability
Is an Android phone available?
Select
Yes
No
Category
Education
Marital Status
Designation
Age
Aadhar Number
Member's Phone Number
Name
Occupation
If any Vocational Course - Please Specify
Member's Email ID
Add Member
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SHG Questions
How often does the group conduct meetings?
Weekly
Monthly
Others
How often does the group save money?
Weekly
Monthly
Others
What is the amount that has been mutually agreed upon for saving money per person, per month?
Has the group started an internal lending process?
Yes
No
How does the group determine loan priorities? Please select the appropriate code from the given options
Need-Based
Rotation-Based
Others
What is the maximum amount of money a member can receive as a loan during the internal lending process?
What is the maximum time allowed for loan repayment?
How many members have received the loan till date?
No. of times members have received the loan till date?
What is the interest rate per 100 rupees?
How much is the fine for delayed repayment?
what action is taken in the event of not a single rupee being repaid ?
Has your SHG/Bachat Gat undergone an assessment and received a rating?
Yes
No
From whom do you receive guidance in various aspects related to SHGs?
What is the vision of your group?
How many trainings has your SHG/Bachat Gat received so far?
NGO Name
Bank Name
What was the rating provided to your SHG?
Has your SHG/Bachat Gat received any grants?
Yes
No
What government schemes related to SHGs are you aware of?
What government schemes related to women and children are you aware of?
From whom do you receive guidance in various aspects related to SHGs, such as formation, strengthening, bank linkages, starting a business, accessing government schemes, and participating in exhibitions, etc.?
What do you want to do with your group in the next 2 years?
Is the first training your Bachat Gat has received so far?
Yes
No
Is the second training your Bachat Gat has received so far?
Yes
No
Is the third training your Bachat Gat has received so far?
Yes
No
Is the fourth training your Bachat Gat has received so far?
Yes
No
How often are the SHG records updated by the SHG itself?
Name of Register
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Section 2A: Panchasutri and Rating
Can you tell me What the Panchasutri's for SHGs are?
Have you been trained on the Panchasutri?
Yes
No
When was the last time your SHG members received training regarding the Panchasutri?
Who conducted the training on Panchasutri for your SHG last time?
Please specify other details regarding training.
In your opinion, what are the benefits of a rating system?
How many years has the current president held the position?
How often does the group conduct elections/selection of office bearers?
Do other members (non-office bearers/other than president, secretary and treasurer) go for banking related tasks to any other offices?
Who do you turn to for support or to resolve any issues and challenges related to the group?
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Section 2B: Individual and Group Dynamics
How often do all the group members come together?
What is the purpose for all the group members to come together?
Let's imagine a scenario where the SHG office bearers are not there. In such a case, how confident are the women in the SHG when it comes to visiting offices and effectively expressing their thoughts, negotiating, and presenting their viewpoints to external members?
What is the 1st challenge your SHG faces from within the group?
What is the 2nd challenge your SHG faces from within the group?
What is the 3rd challenge your SHG faces from within the group?
What is the 4th challenge your SHG faces from within the group?
What is the 5th challenge your SHG faces from within the group?
What topics are discussed when you all meet?
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Section 3: Financial, Digital Literacy, and Inclusion
Part 1: Financial and Digital Literacy
How many members possess the following knowledge?
Fill up a form to open a bank account with minimum help from others?
Write a Cheque?
Withdraw money using cheques?
Deposit cash in account?
Do you know about what interest is and how it is charged?
Understand the difference between Savings and Current account?
Know how to apply for a loan in a bank?
Know about fixed deposits?
Know that a loan can be availed against a fixed deposit?
Know that a joint account can be opened with someone else known to them?
Know that either they or the other joint account holder can withdraw money from the account?
Know that they can withdraw money from the account?
Know that they can withdraw money from the ATM of their bank?
Know that an ATM card PIN should not be shared with anyone?
Know that personal presence is required when making ATM withdrawals?
Know that the Credit/Debit card PIN should not be shared with anyone?
Know that in case of loss of bank cards, they need to inform the bank immediately?
Are aware about phone payment apps like G Pay, Phone Pe, Paytm, etc.?
Can independently transfer and receive money through the phone payment apps?
Know how to make payments for household or business expenses like mobile recharge, electric bills, and gas bills through phone banking?
Know about net banking?
Have a personal account in a bank?
Manage their banking transactions independently?
Know about different types of insurance and their associated benefits?
Know about any other financial products and services?
Does a Bank Sakhi or CRP guide the SHG members for banking-related aspects?
Yes
No
Who do SHG members go to for any banking-related support?
Has your SHG received training on banking aspects from banks, NGOs, or other organizations?
Yes
No
Have you appointed any office bearer or account officer to manage the banking affairs of your group?
Yes
No
Has the SHG ever taken any loan from a bank?
Yes
No
Part 2: Loan Details
(To be added based on your input)
Bank Name:
Purpose:
Which Year You Take Loan:
Amount Taken (Rs):
Amount Repaid (Rs):
Status:
Select status
Active
Repaid
Defaulted
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Section 4: Livelihood
Does your SHG engage in any business activities?
Yes
No
How many women in your group do individual business?
Please specify Business products (Individual Business)
How many women in your group participate in family business?
Please specify Business products (Family Business)
How many women from your group work for livelihood?
Please specify Business products/job
In terms of engaging in business activities, what category does your SHG fall into?
What was the nature of the business?
Please specify others (Nature of Business)
What challenges were faced?
What are the main reasons for its closure?
Why, in your opinion, is the group or group members not involved in any Income Generating Activities?
Please specify other reasons
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Please tell me the answers to the following
No. of women involved from group
Product
Expected/current source of finance
Source of finance
Total Loan amount (in Rs)
SHG contribution (in Rs)
Self investment (in Rs)
Grant received (in Rs)
Production per year (if food then in Kg/ if non-food then pieces)
Volume sold per year (if food then in Kg/ if non-food then pieces)
Revenue per year (in Rs)
Geographical location of business
Type of Buyers
Number of Buyers
Total workforce Occupied in Business
Licenses
Brand name
Promotion channels
Selling mode for product (e.g., Facebook, Instagram, Offline, Stall, Exhibitions, etc.)
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Business Details
How did you decide to select this business?
Have you or other members conducted any market survey?
Yes
No
Have you or other members done a risk assessment related to this business?
Yes
No
If yes, what risks have been identified?
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What is your key expectations from the following stakeholders?
Your Group
NGOs helping SHGs
Banks
Government
What are 2 or 3 factors that make your group homogeneous or bring your group together?
Is there any Skill Requirement from SHG members and how many members are interested in each training?
What is the SHG livelihood activity? Please specify other
How many members are involved in the below activities?
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