HOUSEHOLD INCOME AND EXPENDITURE … 2005/Household income New...Indian Tamil .....3 Sri Lanka Moors...
Transcript of HOUSEHOLD INCOME AND EXPENDITURE … 2005/Household income New...Indian Tamil .....3 Sri Lanka Moors...
CONFIDENTIAL
The information collected in this sur-vey will be strictly confidential ac-cording to the survey ordinance andindividual level information will notbe divulged to any person or agency.
SURVEY SCHEDULE
Department of Census & StatisticsMinistry of Finance and Planning
Sri Lanka
NATIONAL HOUSEHOLD SAMPLE SURVEY PROGRAMME
DistrictSectorMonth
P.S.U.No.
S.S.U. &Household.No.
D.S.Division
(for office use only)
HOUSEHOLD INCOME AND EXPENDITURE SURVEY - 2005
IDENTIFICATION INFORMATIONS
D.S.DivisionDistrictERU
Sector
(01-12) (001 - 999) (1 - 10) (1 - 9)
Result CodeCompleted...............................................1Deferred..................................................2No competent respondant at home.........3Refused...................................................4Household is temporarily closed...... ......5Household is demolished/Vacant:.. ........6Other (Specify)....... ................................9
1. Housing units in D.S. Divisions unaffected by the Tsunami2. (i) Housing units in unaffected census blocks in affected D.S.Divisions (ii) Housing units in affected census blocks in affected D.S.Divisions (iii) Families live in transist camps and transist houses.
Month ofSurvey
P.S.U. No. HouseholdNo.
S.S.UNo.
(Select and circle the perticular number)
1
1. Address (Location) :......................................................................
.........................................................................
2. Province:........................................................................................
3. District : ........................................................................................
4. D.S.Division:.................................................................................
5. Name of MC/UC:-.........................................................................(If Urban Sector)
6. G.N.Division : No......................... Name: ....................................
7. Name of Village :...........................................................................
(If Rural Sector)
8. Name of Estate: .............................................................................
(If Estate Sector)
9. C.B. No.:-............................... S.S.U. No......................................
10. Survey Month:-..............................................................................
11. Sample Stratum:-...............................................................
Number of Households
Result
Name of the Head of the household - ..........
..................................
Interviewer's
Name
Signature:- Date
Supervising Officer's
Name
Signature:- Date
Code for Section - 1
Col 3 Relationship to head of the household
Head of the Household...............................1Wife / Husband ..........................................2Son/Daughter .............................................3Parents .......................................................4Other Relative ............................................5Domestic Servants......................................6Boarder.......................................................7Other...........................................................9
Col. 6 - Ethnicity
Sinhala . ..............................1Sri Lanka Tamil .. ...............2Indian Tamil ......... ..............3Sri Lanka Moors ......... .......4Malay ..... ...........................5Burgher.. .............................6Other ....... ...........................9
Col. 8 Level of Education
Studing Grade 1 ............................... 00Passed Grade 1 .................................01Passed Grade 2 .................................02Passed Grade 3 ..................................03Passed Grade 4...................................04Passed Grade 5 ................................. 05Passed Grade 6 ................................. 06Passed Grade 7...................................07Passed Grade 8.................................. 08Passed Grade 9................................. 09Pssed Grade 10..................................10Passed G.C.E.(O/L) or equivalent..........11Pssed Grade 12 ............................... .12Passed G.C.E. (A/L)/ or equivalent.... . 13Passed G.A.Q./ G.S.Q.......................... .14Passed Degree...................................... 15Passed Post Graduate Degree/Diploma 16No Schooling .......................................19
Col. 7 - Religion
Buddhist . ....................................1Hindu.. ........................................2Islam ......... ..................................3Roman Catholic/ Other Christian. ....................4Other ...........................................9
Col. 9 Marital Status
Never Married ................... 1Married .............................. 2Widowed ............................ 3Divorced ............................. 4Separated ............................ 5
Col. 10 - Usual Activity
Employed .......................... ......... 1Unemployed ........................... .. 2Student ....................................... 3Household Work ......................... 4Unable/ To old to work .............. 5Other ............................................ 9
2
Col. 4 Sex
Male ........................... 1 Female........................ 2
Name of all persons who usuallylive in this household
For persons 10 years and over
For Employedpersons only
Did this person engage in any of the followingactivities during last month or last cultivation
year as employer, employee orown account worker?
Relationshipto head of the
household
42434445
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
1 3 9 164 6 11 12 13 14 15108
* **
SerialNo.
* *2 43
Ser
ial N
o.
Rel
atio
nshi
p to
hea
d of
the
hous
ehol
d
Sex
Age
as
at la
st b
irth
day
SECTION 01 - DEMOGRAPHIC CHARACTERISTICS
Eth
nici
ty
Lev
el o
f E
duca
tion
(5 y
ears
and
ove
r)
Rel
igio
n
Mar
ital
sta
tus
Usu
al A
ctiv
ity
Indu
stry
Pai
dE
mpl
oym
ent
Agr
icul
tura
lA
ctiv
itie
s(S
easo
nal C
rops
)
Agr
icul
tura
lac
tivi
ties
(Non
sea
sona
lcr
ops,
live
stoc
kfi
shin
g) Non
agri
cult
ural
acti
viti
es
Mai
nO
ccup
atio
n
Industry(discribe)
2
3
* Main Occupation(discribe)
Names of the persons who are members of this household & usually live elsewhere in thecountry or abroad
Usually live in1. In the country2. Abroad
CodeQty,
UnitItem
2 3 4
0102
010301040105
0106
0107
01080109
0110
01110112
0113
0114
0115
0201
0203
0204
0205
0206
0207
0208
02
01
Consumed
5
0101
1 2 3 4 5
0211
0212
02130214
0215
0219
0210
0209
3. Pulses
1. Dhal
2. Green Gram
3. Gram
4. Cowpea
5. Soya
6. Soya meat
7. Other ........
03
9. Those/Itly
10. Rice (Meat & Vegetables)
11. Rice (Fish & Vegetables)
12. Rice (Vegetable only)
13. Curry (Meat)
14. Curry (Fish)
15. Curry (Vegetables)
16. Other .........
03010302
0303
03040305
0306
0309
4. Vegetables
1. Ash plantain
2. Brinjal
3. Ladies Fingers (Bandakka)
4. Bitter gourd
5. Long beans
Snake gourd
Ridge gourd
8 Sweet pumpkin
04
2.1 Weekly consumption on Food and Drink
0402
0401
0403
0404
0405
0406
0407
0408
0119
(Rs.)
Section 2 - Expenditure
Value Item Code UnitConsumed
Qty.Value(Rs.)
grams
grams
grams
grams
gramsgramsgrams
grams
grams
grams
0202
numbernumber
number
number
numbernumber
number
number
1. Cereals
1. Rice - (Kekulu)
2. Rice - (Samba)
3. Rice - (Nadu)
4. Rice - (Basmathi)
5. Rice flour
6. Wheet flour
7. Kurakkan flour
8. Maize
9. Samaposha
10. Noodles
11. Papadam
12. Infants cereal foods (Nestum)
13. Barley
14. Sago
15. Corn flakes
16. Other .........
2. Prepared foods
1. Bread (Normal)
2. Bread (Special)
3. Rospaan
4. Buns/Spanchi
5. Hoppers
6. String Hoppers
7. Pittu
8. Rotti
4
number
number
grams
grmas
gramsgrams
grams
grams
grams
gramsgrams
grams
gramsgrams
grams
gramsgrams
grams
grams
gramsgramsgrams
grams
grams
CodeQty.
UnitItemConsumed
Value
9. Beans
10. Carrot
11. Beet root
12. Cabbage
13. Tomatoes
14. Leeks
15. Knol khol
16. Capsicum
17. Dambala
18. Raddish
19. Drumstick
20. Cucumber
21. Kekiri
22. Ash pumpkin
23. Elabatu (Thalana batu)
24. Kohila yams
25. Lotus stemo
26. Plantain flower
27. Ambarella
28. Cadjunuts (raw)
29. Mashrooms
30. Jack immatured (Polos)
31. Other .........
4. Katurumurunga
0414
0415
0416
0417
0418
0419
0420
0421
0422
0423
0424
0425
0426
0427
0428
0429
04300439
0409 grams
0410
0411
04120413
0445
0446
0447
0448
0449
0450
0459
0441
0442
04430444
0601
0602
0604
0501
0502
0503
0504
0505
0506
0507
0509
05
06 6. Meat
1. Chicken
2. Beef
3. Mutton
4. Pork
5. Sausages / Meetballs
6. Other ........
0603
0609
0605
(Rs.)
1. Mukunuwenna
2. Gotukola
3. Kankun
Leafy Vegetables
grams
grams
grams
grams
grams
gramsgrams
grams
grams
grams
gramsgramsgrams
grams
grams
grams
grams
Item Code UnitConsumed
Qty. Value(Rs.)
grams
grams
grams
grams
grams
grams
5. Nivithi
6. Thampala
7. Sarana
8. Kohila leaves
9. Onion leaves
10. Cabbage leaves
11. Other.......
number
gramsgrams
grams
grams
grams
grams
5. Yams and other
1. Jak/jak seeds
2. Bread fruit
3. Potatoes
4. Sweet potatoes
5. Mannioc
6. Kiriala
7. Innala
8. Other yams.........gramsgrams
grams
5
bundles
bundlesbundles
bundles
bundlesbundles
bundles
bundles
bundlesbundles
7. Fish
1. Balaya
2. Seer
3. Mora
4. Paraw
5. Thalapath
6. Kelawalla
7. Other large fish
8. Sprats
9. Hurulla
0701
0702
0703
0704
0705
0706
07070708
0709
07
9. Balaya
10. Mora/Keelan
11. Paraw
12. Anguluwa
13. Prawns
14. Cuttle fish
15. Fresh water fish - dried
16. Jadi
17. Other......
0711
07120713
0714
0715
0716
071707180719
0801
0802
0803
08040805
0806
0807
0808
0710
0809
0810
0811
0812
0813
0814
0815
1101
1102
0901 number
0909
1001 number
1002
11031104
1105
1106
number
1107
09
10
11
10. Karalla/Katuwalla
11. Kumbalawa/Angila
12. Salaya/Sudaya
13. Other small fish
14. Lula
15. Teppili/Telapiya/Korali
16. Other fresh water fish
17. Prawns
18. Crabs
19. Cuttle fish
20. Canned fish (Salmon) 0720
088. Dried Fish
1. Sprats
2. Keeramin
3. Salaya
4. Hurulla
5. Seer
6. Katta
8. Anjila7. Koduwa
0816
0819
Code Qty.UnitItem
Consumed
Code Qty.UnitItem
Consumed
gramsgrams
grams
grams
grams
grams
gramsgrams
grams
grams
grams
gramsgramsgrams
grams
grams
grams
grams
gramsgrams
grams
grams
grams
grams
gramsgrams
grams
grams
grams
gramsgrams
grams
grams
grams
grams
grams
grams
grams
gramsgrams
grams
grams
grams
grams
grams
6
Value(Rs.)
Value(Rs.)
9. Eggs1. Hen
2. Other...
10. Coconuts
1. Nuts
2. Cocnut milk powder
11. Condiments
1. Dried chillies
2. Chilly powder
3. Red onions
4. Bombey onions
5. Garlic
6. Maldive fish
7. Pepper
Code UnitItemConsumed
1108
1109
11101111
1112
11131114
1115
1116
1117
1118
111911201121112211231129
12. Other foods
1 Sauce
2 Marmite / Vegemite
3 Soup cubes
4 Lime pickle
5 Chutney
6 Canned fruits
7 Other....
1201
120212031204
1205
1206
1209
1302
1303
1304
13051306
1307
13081309
13101319
1301
1 Coconut oil
2 Vegetable oil
3 Gingerley oil
4 Ghee
5 Other....
1401
140214031404
1409
14. Fats & Oils14
1501
150215031504
1509
13. Milk & Milk Foods13
7
8 Turmeric / Turmeric powder
9 Curry powder (sarakku)
10 Green chillies
11 Limes
12 Cumin seeds
13 Fennel seeds
14 Coriander
15 Mathe seeds
16 Mustard
17 Goraka
18 Tamarind19 Cinnamon
20 Salt
21 Karapincha/ Rampe
22 Ginger
23 Vinegar
24 Other....
number
gramsgrams
grams
12
Code Unit Value(Rs.)
Qty.
Consumed
ml1 Cow milk
2 Goat milk
3 Curd
4 Yoghurt / Moru
5 Condensed milk
6 Milk powder
7 Infant milk powder
8 Butter
9 Margarine
10 Cheese
11 Other...
grams
gramsgrams
gramsgramsgrams
ml
ml
ml
mlml
ml
ml
15. Sugar / Juggery / Treacle
1 Sugar
2 Juggery
15
3 Treacle
4 Honey
5 Other....
grams
grams
ItemQty. Value
(Rs.)
Code UnitItemConsumed
1601
1602
1603
1604
1605
16061607
1608
1609
1610
1619
16. Fruits
1 Banana
2 Pineapple
3 Papaw
4 Mangoes
5 Apple
6 Avacado
7 Wood apple
8 Oranges
9 King coconuts / Kurumba
10 Grapes
11 Other....
1651
1652
1653
16541659
grams
gramsgrams
gramsgrams
17. Confectionery & Short eats
1 Jam
2 Ice cream
3 Chocolates
4 Toffees
5 Biscuits
6 Jelly packets
17
grams
Item Code UnitQty.
1707
1708
1709
1710
1711
1712
1719
1701
17021703
17041705
1706
grams
grams
Consumed
Value(Rs.)
7 Snacks
8 Cake
9 Kewum/ Kokis etc.
10 Musket/ Kaludodol etc.
11 Thalabola/ Rulan etc.
12 Cutlets/ Patis / Wade /Pestry etc.
13 Other.....
1801
1802
1803
1804
18051806
180718081809
18101811
18121819
number
16
Dried fruits
1 Dates
2 Cajunuts
3 Ground nuts
4 Plums
5 Other....
number
numbernumbernumber
number
number
number
grams
number
18
gramsgrams
grams
grams
grams
number
numbernumber
number
number
8
number
number
number
numbernumber
Qty. Value(Rs.)
18.Beverages (Non Alcoholic)
1 Tea Dust/ Leaves
2 Coffee powder/ Seeds
3 Soft drink
4 Fruit drink/ Cordial
5 Saruwath
6 Milk tea
7 Plain tea
8 Milk coffee
9 Coffee
10 Ice packets
11 Gruel
13 Bottled water
12 Other.....
1905
1906
1907
1908
19091910
1911
1912
1919
1920
1921
1922
1923
1924
19044. Beer/Stout
5. Whiskey/Brandy
6. Gin
7. Wine
8. Other liquor
9. Drugs (Ganja,Haroin etc.)
10. Cigarettes
11. Cigars
12. Beedi
13. Other pipe tobacco
14. Betel leaves
15. Arecanuts
16. Tobacco chewing
17. Chunam
18. Bulathwita/Saravita
1. Toddy
2. Arrack
3. Kassippu
1901
1902
1903
19
19. Liquor, Drugs andTobacco
Code Qty.Unit
Consumed
(Rs.)
Item
numbernumber
number
number
9
number
number
Value
2101
2103
2104
2105
2106
2107
number
number
number
22052204
2203
∗
2102 ml.
2208
2209
2219
2403
Main household - include all members of the household exclude servants and boarders.
2001
2002
2003
kg.
kg.
2201
2301Fees to private medical practitioners
(including cost of medicine)
Fees to Ayurvedic medical practitioners
Consultation fees to specialists
Payments to medical laboratories for
test analysis etc.
Payments to private hospitals and
nursing homes.
Purchase of medical and pharmaceutical
products.
2302
2303
2304
2305
2306
2309
23
Taxi/three wheelers (other than schooling)
2401
2402
2.2 Household expenditure on Housing, Fuel and Light, Non-durable goods, Services and Consumer durables for main Household
2109
2108 number
2207
Toilet soap
Tooth paste
Tooth brushes
Powder(Cosmetic powder)
Perfumes
Face cream / Lotions
Hair oils , cream & Hair dye
22
3. Personal care expenses(Last month)
2202
2206
2210
CodeQty.
Unit
Main household
Item
∗Code
Qty.Unit
Main householdItem
4. Health expenses(Last month)
∗
10
Electricity (Monthly average)
Kerosene oil (Monthly average)
Fire wood (Monthly average)
Gas (Monthly average)
Bulbes (Last month)
Match box (Last month)
Candles (Last month)
Battery (Last month)
Other ...... (Last month)
5. Transport (Last month)Transport fees
Train/bus (other than schooling)
Van (other than schooling)
Value(Rs.)
Value(Rs.)
1. Housing (Average per month)
Rent (Estimated rent of owner occupiedhouse should be included in Col.5)
Taxes
Water bills
212. Fuel & Light (Average Per Month)
Lipstick / Cutex
Shaving equipment
Hair cut/ Hair dressing & shaving charges
Other......
Main householdItem Code Unit
Qty.
2404
Main householdItem Code Unit
Qty.
∗ ∗
2606
∗
2405
2409
2411
2412
2413
2414
2415
2501
2502
2601
2602
2603
2607
2604
2605
2608
2619
2609
2701
2702
2703
2704
2705
2706
2707
2708
2709
2710
2719
2419
Repair charges of spare partsaccessaries
2509
Value(Rs.)
Value(Rs.)
Cinamas / Drama / Video films
Books/ News papers / Magazines
Diploma etc.)
Lotteries/ Bettings
Arts/ Music/ Dancing
Pets/ Aquarium
Sports
Beauty care/ Cookery/ Dress making
Toys
Maintanence of radio receivers,television & Video decks
Main household - include all members of the household exclude servants & boarders.
25
267. Education ( Last month)
27
Other.....
Transport charges for schooling
Ships & air lines
Other....
Maintance of Private Vehicals Petrol & other fuel
Oil Tyre, tube & spare parts
Licence & insurance
Other.....
6. Communication ( Last month)
Excursions/ Piligrimages
Postal & Tlegraph Charges
2503
2504
Telephone charges (Taken from outside)
Other.....
School text books
School facility fees (Government)
School fees (Private)
Tution fees
Boarding fees
Fees for higher education
(External Degree / Post graduate Degree
Fees for professional & Technical education
Other.....
8. Recreation, entertainment & Cultural activities (Last month)
Telephone charges (Domestic/ Mobile) (Avrege permonth)
Exercise book/ Stationeries
News papers/ Magazines (Related to education)
Telephone charges ( E-mail, internet)
∗
3002
3003
3004
3005
3042
3043
3049
3016
3029
c. m.
c.m.
c.m.
c.m.
9. Non-durable household goods (Last month)
Washing soapWashing powderMosquito coilsDetergentsInsecticides (for home use)PoslishesPaintsOther....
28
280128022803
2804280528062807
2809
2901
2902
3001
2903
2909
3006
Housecoats/Komonas/Night dresses
Brassieres
Socks/Stockings
Ties
Handkerchiefs
Children's dresses
School uniforms
Towels
Bed sheets
Pillow cases
Mosquito nets
Other.....
Materials purchase in meters
For clothing
For school uniforms
For curtains/Furnishing materials
Other.....
Tailoring charges
For clothing
For schooling uniforms
Skirts/Blouses
Banians
Men's under wears
Women's under wears
3011
3017
3015
3014
3013
3012
3018
3019
3020
3021
3041
3010
3009
3008
30613062
10. Household services
(Last month)
Laundry charges
Grinding charges
Wages to servants and chauffers
Payments for other household services
11. Clothing and Textiles
(Last six months)
TrousersShirts
Sarees
T-shirts
Sarongs/VettiesFrock
29
∗Code
Main household
ItemCode UnitItem
Main household - include all members of the household exclude servants and boarders. ∗
number
number
number
number
numbernumber
number
number
number
number
number
number
number
number
number
number
number
number
number
number
number
Unit
number3007
12
Qty. Qty. Value
(Rs.)Value(Rs.)
Main household
Main household
Value(Rs.)
Item Code UnitQty.
Main household
Value(Rs.)
Item Code UnitQty.
∗ ∗
3101
3102
3103
3105
3210
3211
3212
32133214
3219
3302
3303
3301
3305
3106
3304
3306
3307
3308
3309
3310
3311
3313
3107
3104
3109
3202
3201
3204
3203
3205
3206
3207
3209
∗
3312
320831
32
number
number
number
number
number
number
number
number
numbernumber
number
numbernumber
number
number
number
number
numbernumber
number
numbernumber
number
Main household - include all members of the household exclude servants & boarders
number
number
number
number
number
number
number
33
13
Brooms/ Brushes/ Ekels
Mats/ Pillows
Rugs/ Carpets
Mettress
Torches
Thermos flasks
Twines/ Ropes
Other......
14. Durable household goods (Last 12 months)
Chairs (Plastic / Wood)
Tables
Settees
Almyrahs
Beds
Other furniture
Clocks/ Wrist watches
Cookers (Kerosene/ gas/ Eletric)
Mixing machines, Grinders, Beaters
Irons
Refrigerators
Fans
Sewing machines
number
number
number
number
number
12. Footwear & other personal effects
(Last 6 months)
Shoes
Sandals / Slippers
Umbrellas
Hand bags/ Travelling bags
Hats/ Helmets
Rain coats
Repair charges for shoes, bags, umbrellas
etc.
Other....
13. Durable household goods
(Last 6 months)
Glass ware
Plastic ware
Aluminium ware
Clary ware/ Pots
Cane ware
Cutlery
Lamp/ Lamp shades
3321
3320
3315
3316
3319
33223323
3324
3325
3314
3317
3318
3326
3329
3327
3339
Contribution to trade unions,
Thrift societies etc.
Insurance / Agrahara
Other savings (including seettu)
Payments of debits
Income tax
Other...
34
Main household∗
Qty.Code UnitItem
Value(Rs.)
Main household - include all members of the household exclude servants and boarders.∗
number
number
number
number
number
number
number
number
number
number
number
numbernumber
number
number
Item
14
15. Other expenses
(Last month)
Provident funds, W.& O.P.fund
Radio, Record players and Tape recorders
Television and Vedio decks
Washing machines
Musical instruments
Bicycles
Motor cycles/Scooters
Motor cars/Vans
Prams/Gocarts/Tricycles
Garderning tools and equipments
Cameras and Projectors
Computers
Jewelleries
Telephones / Cellular phones
Other kitchen appliances
(Heaters, Rice cookers etc.)
Other...
Durable goods purchased in instalments .
16. Other adhoe (rarely) expenses(Last 12 months)
3501
3502
3503
3504
3505
3506
3507
3509
Qty.
∗
UnitCode
3401
3402
3403
3404
3405
3406
3409
Expenditure on weddings/ Funerals for family
members
Social activities/ Ceremonies
Litigation
Gift, Donation, Similar tranfers
Maintance/ Repairing
Purchased properties, houses
Loans givien
Other...
Main household
Value(Rs).
15141312111098765432
1
If any boarder or domestic servant given in column 1 of section 1, not spent any of the above. Please note down here.
If any of the items in column 3-15, have been received free of charge, their estimated value should also be included as an expenditure.
1
1.
2.
3.
4.
5
6
7
2.3 Expenditure on Housing, Fuel and Light, Non durable goods, Services and Consumer durables for Boarders and Domestic Servants.
Name of boarders and DomesticServants who has spent moneyon any of the following column 3-15
2 Go to section 3
Ser
ial n
umbe
r as
giv
en in
col
umn
1 of
sec
tion
1
Foo
d pu
rcha
sed
outs
ide t
heho
useh
old
(Las
t wee
k)
Fue
l and
ligh
t(L
ast m
onth
)
Clo
thin
g an
d te
xtil
es(L
ast s
ix m
onth
s)
Non
dur
able
hou
seho
ldgo
ods
(Las
t mon
th)
Hou
seho
ld s
ervi
ces
(Las
t mon
th)
Per
sona
l car
e an
d H
ealt
hex
pens
es(L
ast m
onth
)
Tra
nspo
rt a
ndC
omm
unic
atio
ns(L
ast m
onth
)
Rec
reat
ion,
Ent
erta
inm
ents
Edu
cati
on, C
ultu
ral a
ctiv
i-ti
es e
tc. (
Las
t mon
th)
Mis
cell
aneo
us(L
ast m
onth
)
Boa
rdin
g, f
ee p
aid
(Las
t mon
th)
Am
ount
sen
t to
fam
ily/
pare
nts
(Las
t mon
th)
Am
ount
tra
nsfe
red
as s
avin
gs,
prov
iden
t fu
nds,
W
&O
P t
axes
,do
nati
ons
etc.
(L
ast m
onth
)
(Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.)
Are there Boarders and/or Domestic Servants in this household Yes No
15
Dur
able
hou
seho
ld g
oods
(Las
t 12
mon
ths)
Section 3 - Income
2
2
2
1
2
1
2
1
2
1
1
2
1
1
2
1
List all the household members (usually live inthis household) including boarders and domes-tic servants who were paid employees duringlast four weeks/ Last calendar month.
3.1 Income from paid employment/s during last four weeks/last calendar month
(Rs.)
During last calendar month
If any of the household members (usually live ) engage as an employee during last 4 weeks / Last calender month. Fill in the relevant columns.
Main - 1
Secondary - 2
(discribe the occupation)
Principal/Secondaryoccupation
Ser
ial n
umbe
r as
giv
en in
colu
mn
1 of
sec
tion
1
Tip
s, C
omm
issi
ons,
All
owan
ces,
Ove
r-ti
me
pay
etc.
Sal
arie
s/ W
ages
Bon
us, A
rrea
rspa
ymen
t
(Rs.) (Rs.)
16
Last 12 months
Serialnumberas given
incolumn
1 ofsection 1
Value of amountconsumed by this
householdValue ofout put
Codes for column 3
Paddy................................... 1Chillies................................ 2Onions................................. 3Vegetables ..........................4Cereal items........................ 5Yams...................................6Tobacco...............................7Other................................... 9
Last cultivation year
Last two cultivation season
(Yala/Maha or Maha/Yala)
**
Total
3.2 Income from Agricultural activities - Paddy, Other seasonal crops and Tobacco
** Last cultivation year
List all the household members (usually live)including boarders and domestic servants who haveany cultivated paddy and/ or other seasonal crops asemployers or own accounts workers.
*
**
Paddy Other seasonalcrops and Tobacco
R P
(Rs.) (Rs.) (Rs.)
Cultivatedland area
* CostCod
e(f
or o
ffic
e us
e on
ly
A
Hired Labour
Seeds
Fertilizer
Chemicals
Transpor charges
Other...
17
(If any of the household members cultivate paddy, other seasonal crops and tobacco as an employer or own account worker for sale and/or household consumptionduring last cultivation year. Fill in the relevant columns)
3.3 Income from other agricultural activities
Value of out put
(Rs.)
*Value of amountconsumed by this
household(Rs.)
Agricultural product(Describe)
*
List all household members (usually live)including boarders & domestic servants who haveengaged any other agricultural activities/Livestock as employers or own accountsworkers.
Last month / Average per month
+
Serialnumberas given
incolumn 1
ofsection 1 +
Cultivated areaCost(Rs.)
PRA
Fish ........................................06Eggs. ......................................07Milk........................................08Other food items.. ..................09Fire wood ...............................10Other.......................................19
Not necessary for cultivated area under the codes from 05-10 in column 4
18
Tea, Rubber..... .......................01Coconuts ................................02Coffe, Pepper, Betel etc..........03Banana/ Fruits.........................04Meat........................................05
Codes for column 3........ Hired Labour
Seeds
Fertilizer
Chemicals
Transports/ Tractor charges
Other
Total
If any of the household members engage in any other agricultural activities / Livestock as an employer or own account workers for sale during last 12 months. Fill in the relevent columns.
Cod
e
3.4 Income from Non-agricultural activities during last calendar month
1.
2.
3.
4
5
6
7
8
9
10
1 2 43 5 6
*
(If any of the household members engage in any non - agricultural activities as an employer or own account worker for sale during last cultivation year. Fill in therelevant columns)
List all the household members(usually live)including boarders domestic servants whohave engaged Non- agricultural activities asemployers or own account workers.
Serialnumberas given
in column1 of
section 1
Economic activity
Cod
e(f
or o
ffic
e us
e on
ly Last calendar month
Mining and Quarrying................................1Manufacturing............................................2Construction...............................................3Trade..........................................................4Transport....................................................5Guest house, restaurants, bars, hotels etc..6Other services............................................7
Code for column 3
(Rs.)(Rs.)
19
* CostValue ofout put
Hired Labour
Inputs
Transport
Other...
Total
(Describe)
3.5.1 Income from Other cash receipt during last calendar month/ Last 12 months
Income in last month
Pensionpayment
Current remittance andtransfers
During last 12 months
Sales of assests(Land , house,
jewellery)
3.5.2 Income by chance or adhoc gains during last 12 months
List all the household members (usually live) in-cluding boarders and servants who have receivedany other cash receipt.
Ser
ial n
umbe
r as
give
n co
lum
n 1
ofse
ctio
n 1
(Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.)
(Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.)
20
Samurdhi/Food
stamps
Rents fromproperties/
Boarding feesetc.
OtherIncome
Dividendsinterests etc.
Income fromabroad
Loans takenfrom banks/
Money lendersetc.
Withdrawal fromsavings & bank
deposits.
Lottery/ Anyadhoc gains
Seettu/Repayments
of loansgivien
List all the household members (usually live) ex-cluding boarders and servants who have receivedany income by chance or rarely.
Ser
ial n
umbe
r as
give
n co
lum
n 1
ofse
ctio
n 1
Compansation Other(Specify)
(Rs.)
Within thecountry
Disability andrelief payments
List all the household members in-cluding boarders domestic servants whohave received income in kind.
Other 2
Employer 1
Employer 1
3.7 Monthly rental value of owner occupied house
Q. Did the household occupy its own house last calendar month.
1Yes
2
→
Please Note:- If items like cloths, warrants etc. have been received relief payments, their estimated value should be filled under the head of the household.
(Last week) (Last month) (Last 6 months) (Last month)(Last month)
From employers/Others.
3.6 Income in kind during last calendar month(If any of the household members receive any of the following items as a payment or fringe benefit/donation/gift from the employer or other during relevant
period. Fill in the relevant columns)
Serialnumberas given
incolumn
1 ofsection 1
(Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.)
Other 2
Employer 1
Employer 1
Other 2
Employer 1
Employer 1
Other 2
Other 2
Other 2
Employer 1
Other 2
No
What is the estimated gross rental value per month Rs.
21
Meals, Fooditems etc.
Housing Clothing OtherMedicalfacilities
Warrants/Passes etc.
(last month)(Including free
transport)