COMMUNITY PROFILE

NAME OF BARANGGAY:
MUNICIPALITY:
PROVINCE:
1. Area:

_________________________________________________
_________________________________________________
_________________________________________________
__________________________________________

2. Topography:

__________________________________________

3. Type of Soil:

__________________________________________

4. Population:

__________________________________________

5. No. of Household:

__________________________________________

6. No. of Puroks:

__________________________________________

7. No. of School:
A. Elementary:

_____________________________________________

B. High School:

_____________________________________________

C. No. of Teachers: _____________________________________________

8. Religions:____________ ____________ & ____________ ____________ %
____________ ____________ & ____________ ____________ %
9. Distance from Town to Proper:
10.Professionals:

__________________________________________________________

11.Skilled Laborers:
12.Literacy:

_____________________________________________

__________________________________________________________

a.) Illiterates:

_______ %

b.) Literates: _______ %

13.Chief Products: __________________________________________________________

14.Accessibility:

__________________________________________________________

15.Potable Water Supply: ___________________________________________________

16.Potable Tourist Attractions:

___________________________________________________

17.Possibility of Irrigation:___________________________________________________
18.Lighting: ________________________________________________________________
19.Peace and Order:

__________________________________________________________
ORGANIZATIONAL PROFILE

1. Name of Organization:
_______________________________________________________
2. Official Address:
_______________________________________________________
3. Objectives:
_______________________________________________________

3.1General:
_____________________________________________________________
3.2Specific:
_____________________________________________________________
4. Date Organized: _______________ Date Registered: _______________
Registration No.: ________________
5. Name of Institution/Agency/Organization that assist in the formation of the
organization (if any):
_________________________________________________________________________________
6. Registration of the Organization (other than DOLE, if any):
Registering Agency
Registration No.
Date Registered
__________________________
_______________________
_________________________
__________________________
_______________________
_________________________
7. Name of President: _______________________________________________
8. Total Membership: __________________ Male: _____________ Female: _____________
9. Category (Occupation) of members:
_______ Farmers
________ Self-employed
_______ Fisherfolks
________ Mixed (pls. specify)
_______ Forestry Workers
_______________________________
_______ Handicraft workers
_______ Craftsmen
________ Other (pls. specify)
_______ Farm Laborer
10.Activities undertaken by the organization:
10.1 Education/Training (if any):
Title
Date Conducted
____________________________ ______________________
________________________
____________________________ ______________________
________________________
____________________________ ______________________
________________________

Conducted By

10.2

Socio/Non Socio-Economic Projects (if any):

Title
Date Started
Assisted By
_____________________ __________________ _________________
________________
_____________________ __________________ _________________
________________
_____________________ __________________ _________________
________________

Status

11.Funds: (i.e. membership, monthly dues, earning from projects and other donations)
Sources
Amount to Date
________________________________
P ______________________________
________________________________
P ______________________________
________________________________
P ______________________________
12.Affiliation/Linkages (if any):
__________________________________________________________
13.Identified problems of the organization:
Problems
Proposed Solution/s
__________________________________
___________________________________________
__________________________________
___________________________________________
__________________________________
___________________________________________

Attachmen
t3
CASE NO.

____________________________________________________________________________________

HOUSEHOLD QUESTIONARE

___________________________________________________________________________________
Region: __________________
___________________________
City/Municipality __________________
___________________

Province
Baranggay

Name of Respondent _______________________________________

Interviewer _______________________________________________
Date of Interview __________________________________________
Editor/coder ______________________________________________

Page 2

CASE NO.
1. ECONOMIC INDICATORS
1. Source of Income of Household Head

Main

-------------------------------------------------------------------------------Secondary
: Code :
--------------------------------------------------------------------------------A. Farming
:
:
Irrigated Lowland
:
01
Rainfed Lowland
:
02
Rainfed Lowland
:
03
Kaingin
:
04 :
B. Fishing
:
:
Subsistence fisherfolk
: 05
:
C. Service Worker
:
:
Regular wage earner
: 06
:
Casual worker/labourer
: 07
Part time/contractual
: 08
:
D. Self-employed (vendor, animal raising,
:
:
manufacturing, small-scale industry)
: 09

:
:
:

:
:

--------------------------------------------------------------------------------If answer is 01-04, go to item no. 2-15;

If answer is 05, go to item no. 16-24;
If answer is 06-08, go to item no. 25;
If answer is 09, go to item no. 26.
FARMING
2. Tenurial Status
------------------------------------------------: Code :
------------------------------------------------Owner/operator
:
1
:
Tenant/worker
:
2
Others, specify
:
3
_______________________
:
:
_______________________
:
:
_______________________
:
:
_______________________
:
:
-----------------------------------------------3. Size of Land (hectare)
------------------------------------------------: Code :
------------------------------------------------Less than 1 ha.
:
1.0-2.0
:
2.1-3.0
:
3.1-4.0
:
4.1-5.0
:
More than 5 ha.
:
------------------------------------------------

1
2
3
4
5
6

:
:

:
:
:
:
:
:

Page 3
__ __ __ __
CASE NO. /__/__/__/__/

______________________________________
Crops Produced
-------------------------------------------------------------4. Palay
/__/
5. Corn
/__/
6. Legumes
/__/
7. Vegetables
/__/
8. Rootcrops
/__/
9. Coconut
/__/
10. Sugar cane
/__/
11. Others, spec.
/__/
___________
___________
-----------------------------------------------------------12. Size of cultivated area _____ (hectares)
--------------------------------------------------------------: Code :
---------------------------------------------------------------Less than 0.5
:
1 :
0.5 - 0.9
:
2 :
1.0 -1.9
:
3 :
2.0 -2.9
:
4 :
3.0 -4.9
:
5 :
5.0 and above
:
6 :
-----------------------------------------------------------------

Code: 1= Yes
2 = No

__
/__/

13. No. Of cropping/ year _______________

14. Utilization of share of harvest per cropping season
------------------------------------------------------------------------------------------------------------------------------------:
:
(a)
:
(b)
:
(c)
:
(d)
:
(e)
:
(f)
:
:
:
Total : Usually : Unit : Usual Home : Retained :
Loan
:
: Code
:
Share :
Sold
: Price : Consumption:: For seeds:
Repayment :
:
: ---------------: ------------:
as :--------------------:-------------- :----------------:
:
: Unit : Qty
:
(%)
:
sold :
(%)
:
(%)
:
(%)
:
------------------------------------------------------------------------------------------------------------------------------------:
Rice
:
1
: :
:
:
:
:
:
:
Corn
:
2
: :
:
:
:
:
:
:
Vegetables :
3
: :
:
:
:
:
:
:
Others,
:
4
: :
:
:
:
:
:
:
Specify
:
:
:
:
:
:
:
:
:
________
:
:
:
:
:
:
:
:
:
________
:
:
:
:
:
:
:
:
:
-------------------------------------------------------------------------------------------------------------------------------------TOTAL
:
:
:
:
:
:
:
:
:
-------------------------------------------------------------------------------------------------------------------------------------15. Estimated annual income from farming ______________ (derive from Q# 13 & 14)

Proceed to Q #27
Page 4
__ __ __ __
CASE NO. /__/__/__/__/
FISHING
__
16. Type of boat/ banca operated
---------------------------------------------:Code :
----------------------------------------------Motorized
: 1
Non-motorized
: 2
----------------------------------------------__
18. Type of fishing activity
---------------------------------------------:Code :
---------------------------------------------Hook and line (kawil): 1
:
Hoop/ fish net
: 2
:
Others, specify
: 3
:
:
:
:
:
_____________
:
:
_____________
:
:
----------------------------------------------

/__/

:
:
/__/

__
17. Boat Ownership
-----------------------------------:Code:
-----------------------------------Owned
: 1
Rented
: 2
-----------------------------------__
19. Types of fish caught
------------------------------------:Code :
------------------------------------Fish
:
1
Crustaceans
:
2
(crabs, shrimp)
Others, specify :
3 :
_____________ :
:
_____________ :
:
_____________ :
:
-------------------------------------

20. Number of fishing expeditions (per unit time) during fishing season
__
a. Daily (no. Of fishing days/ week ___)
/__/
b. Weekly (no. Of fishing weeks/ month ___)
/__/ __
c. Monthly (no. Of fishing months/ year ___)
/__/__/
d. Total number of fishing expeditions during fishing season
/__/__/
21. Number of fishing expeditions (per unit time) during off-fishing season
__
a. Daily (no. Of fishing days/ week ___)
/__/
b. Weekly (no. Of fishing weeks/ month ___)
/__/ __
c. Monthly (no. Of fishing months/ year ___)
/__/__/
d. Total number of fishing expeditions during off-fishing season /__/__/
22. Total number of fishing expeditions (Q#20d & Q#21d)

__ __
/__/__/

/__/

:
:
/__/

:
:
:

Page 5
__ __ __ __
CASE NO. /__/__/__/__/
23. Utilization of catch (approximate per fishing expedition)
-------------------------------------------------------------------------------------------------------------------:
:
(a)
:
(b)
:
(c)
:
(d)
:
(e)
:
:
:
Total : Usually : Unit : Usual Home : Retained :
: Code
:
Share :
Sold
: Price : Consumption:: For seeds:
:
: ---------------: ------------:
as :--------------------:-------------- :
:
: Unit : Qty
:
(%)
:
sold :
(%)
:
(%)
:
--------------------------------------------------------------------------------------------------------------------Fish
:
1
: :
:
:
:
:
:
Crustaceans :
2
: :
:
:
:
:
:
Others,
:
3
: :
:
:
:
:
:
Specify
:
: :
:
:
:
:
:
________
:
:
:
:
:
:
:
:
________
:
:
:
:
:
:
:
:
________
:
:
:
:
:
:
:
:
--------------------------------------------------------------------------------------------------------------------TOTAL
:
:
:
:
:
:
:
:
--------------------------------------------------------------------------------------------------------------------24. Estimated annual income per fishing expedition (derive from Q# 22 & 23)
__ __ __ __
/__/__/__/__/
SERVICE WORKER
25. Income
Annual Income
Monthly Rate
Daily Rate
Casual
Days work per week
Weeks per month
Months per year
Regular
Months per year
Part Time (Contractual)
Days work per week
Weeks per month
Months per year

P_________
P_________
P_________

__ __ __ __
/__/__/__/__/

__________
__________
__________
__________
__________
__________
__________

Proceed to Q#27
SELF-EMPLOYED
26. Income
:
Average per year P_______
/__/__/__/__/
Amount per day P__________
Amount per week P________
P_________
Workdays per week
__________
Weeks per month
__________
Months per year
__________

__ __ __ __
Amount per month

Proceed to Q#27
Page 6
__ __ __ __
CASE NO. /__/__/__/__/
ALL RESPONDENTS
27. Other sources of income of Household Head aside from main occupation.
Amount (per month)
No. of mos./yr.
Annual
Amount
Income from secondary source
P _____________
_________
P ______________
Assistance from relatives/friends
P _____________
_________
P ______________
Pension
P _____________
_________
P
______________
Backyard produce
P _____________
_________
P
______________
Others, pls. specify
P _____________
_________
P
______________
__ __ __ __ __
Subtotal
/__/__/__/__/__/
28. Contributions of other members to household income
(Specify household member)
Amount (per month)
No. of mos./yr.
Annual
Amount
________________________
P ______________
__________
P_____________
________________________
P ______________
__________
P_____________
________________________
P ______________
__________
P_____________
__ __ __ __ __
Subtotal
/__/__/__/__/__/

__ __ __ __ __
29. TOTAL INCOME OF THE HOUSEHOLD P___________per year
SUMMARY:

/__/__/__/__/__/

From main source of income of household headP____________

From other sources of income of household head
P____________
Contribution of other household members
P____________

II. OTHER SOCIO-ECONOMIC INDICATORS

__
30. House Ownership
/__/
--------------------------------------------------: Code:
---------------------------------------------------Owned
: 1 :
Rented
: 2 :
House being shared for free
: 3
Others, specify
: 4 :
__
31. Type of Dwelling Unit
/__/
--------------------------------------------------: Code:
----------------------------------------------------

Concrete
Semi-Concrete
Wood
Light materials

:
:
:
:

1
2
3
4

:
:
:
:

Page 7
__ __ __ __
CASE NO. /__/__/__/__/
__
31. Number of rooms
/__/
--------------------------------------------------: Code:
---------------------------------------------------1 room
: 1 :
2 rooms
: 2 :
3 rooms
: 3 :
4 rooms
: 4 :
5 and above
: 5 :