Questionnaires for BC

1. Bank: 2. Name of CSP: 3. Occupation a. Main: b. Subsidiary: 4. Name of BC: 5. Name of Branch: 6. Name of village in which CSP is residing: 7. Name of village served by CSP: 8. No. of A/C served by CSP: 9. No. of hours CSP is available in each village: 10. Weather Smartcard has been issued & operationalised? YES/NO 11. If yes, product offered? a. Deposit 1. Recurring deposit 2. Fixed deposit b. Overdraft c. Micro-credit 1. GCC 2.KCC/SCC/JLG 3. Any other d. Remittance e. Govt. payments 1. MANREGA 2.Old Age Pension 3. Widow pension 4.Any other f. Private payment 1. From a/c holders 2. From others a/c to a/c 3.Any other: g. Micro pension 1. Swaviman (NPS) Scheme 2.Any other

h. Micro insurance i. Life insurance 1. Collection of premium 2.Payment of claim j. Non-life insurance 1. Asset insurance 2.Health insurance 3.Crop insurance 4.Any other

12. If No, What are impediments? a. Smart card are not issued b. POS device is yet to be made operational c. Any other 13. No of transaction per day (AVG for a month): 14. No of transaction per account (AVG for a month): 15. Limit on cash payment per a/c per day: 16. Limit on cash payment per day: 17. Remuneration received per transaction: 18. What other products can be offered through smart cards? 19. No. of a/c opened and amount involved since opening of the outlet as CSP as on date of survey a. Name of village: b. Savings 1. No. of a/c: 2.Amount: c. Micro credit 1. No. of a/c: 2.Amount: d. Inoperative a/c: 20. Suggestion from CSP for improving the facilities under FI:

Questionnaire for BCs Client

1. Block: 2. Bank: 3. Name of village: 4. Name of Head Of Family: 5. Married: YES/NO 6. No. of adult member in family: a. Male b. Female 7. Details of Account a. No. of A/C: b. Operative/Inoperative: 8. How he has come to know about Facilitates available from Bank/CSP a. Through BC/CSP c. Workshops b. Through NGO d. Any Other 9. Types of facilities availing of from BC/CSP please indicate branch CSP/NONE a. Deposit Accounts d. Loan Accounts b. Remittance e. Micro-insurance c. Pension f. Any Other 10. Weather the CSP/BC resides in the village and accessible any time? YES/NO 11. If CSP/BC resides in other village? YES/NO 12. How many hours in a day he is available? : 13. Are there any fix timings? YES/NO 14. How many days in a week the CSP/BC is available? : 15. Weather account holder is happy with the services offered by the CSP/BC? YES/NO a. If no what are his expectation from CSP/BC

16. Weather satisfied with bank facility? If yes what makes him happy? a. Deposit- door steps services/Prompt payment b. Micro credit-sanction of adequate amount of loan/less documentation c. Remittance-reasonable service charges/prompt service d. Micro insurance-affordable premium/prompt settlement of land e. Pension affordable premium/simple documentation/prompt settlement of claim f. Other-prompt payment/personalized service 17. If not satisfied with bank facility please indicate reason and also indicate what facility he wants? 18. Any other information, account holder wants to give for the betterment under financial inclusion facilities?