BASIC INFORMATION OF HANDICRAFT ARTISANS / CRAFT PERSONS

OF
BAREILLY CLUSTER
QUESTIONNAIRE OF SURVEY

1.

Name of the head of the household

2.

Father/Husbands name

3.

House Serial No

4.

Mohalla

5.

Village/Ward

6.

Block/Municipality

7.

District

8.

Whether belongs to (please tick)

SC

ST

OBC

Minority

If so, give certificate no..and date..

9.

Ration card:

Antoday

BPL

Please give card noand date of issue

10.1. EPIC Card No10.2. Adhar No.

10.3. Weavers I Card No10.4. Mobile No..

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11. Bank Account:-

Name of the Bank

Location

IFSC Code

Bank account no

Balance (as
on date)
5

12. Details of family members:Sl

no

Name

Relation
Sex
with
Head of
family
3
4
Head

Age
(in
yrs)

Education level

Engaged in Engaged in
weaving
preparatory
work

2
3

13. Product details (for the year 2013-14):Sl.

no

1
1

Product

2
ZARI & ZARDOZI

CANE &
BAMBOO

WOODEN
FURNITURE

KITE MAKING /
MANJHA

Production
No.
of Value in Rs.
pcs
or
yardage
3
4

Sale value (in Rs.)

Co-op.
Master
society
Craft
person
5
6

Exhibition

Exporter

Others

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TERRACOTTA

6.

GOLDSMITH
CRAFTS
IRON
HANDICRAFTS
OTHERS

7.
8.

14.Benefits availed during XII Plan (2012-13 to till date)

IMPROVED TOOL KITS
Credit, waiver of loan
Skill up-gradtion (training),
Designs,
Participation in fairs/exhibitions/ haats,

15. Requirement of the Artisan for undertaking high value production:

Modernization of production facilities
/accessories
Workshed

Raw material

Design support

Training

Credit

Marketing

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16. Common Infrastructure required at village/community level for value addition in the
production process including finishing
(Please indicate existing facilities and additional requirements for making it functional)

Existing facilities available

Additional requirements

17. Co-operative Society

Services extended by the existing NGO / SHGs / Co-operative Society / DC(H) / EPCH / NCDPD or
others :
18. Is any educated persons of the artisan family is interested for setting up handloom business. If
so, support required:

19. Others

(Signature of Officer)

(Signature of Artisan )

Note:
Take photo of the family as available
Ph 1-1 Handicraft made by Artisan
Ph 1-2 Antoday or BPL Card
Ph 1-3 Certificate of belonging to SC/ST/OBC/Minority
Ph 1-4 Election Photo Identity Card and Aadhar Card
Ph 1-5 Bank Account photo of passbook
Ph 1-5-1 Front page
Ph 1-5-2 Last page
Ph 1-5-3 Cheque

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