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2. What benefit do you receive under the scheme? (Field executive to please mark a tick mark
against the appropriate benefit and fill in the blanks)
3. From which year have you received the benefit of the scheme? (Field executive to please mark a
tick mark against the appropriate choice)
i. 2014-15
ii. 2015-16
iii. 2016-17
iv. 2017-18
4. Are you aware who is providing the funds for the scheme for your benefit? ? (Field executive to
please mark a tick mark against the respondent’s choice)
i. Central Government
ii. State Government
iii. Both Central and State Government
iv. I do not know
v. I will not say
5. In what form do you receive the benefit under the scheme? ? (Field executive to please mark a
tick mark against the respondents’ choice)
i. Cash
ii. Cheque
iii. Direct Benefit Transfer (DBT) to my account
iv. Sometimes Cash and Sometimes Cheque
v. Sometimes DBT and sometimes Cash/Cheque
6. How is the benefit delivered to you? (Field executive to please mark a tick mark against the
respondent’s choice)
7. How regularly do you receive the benefit? (Field executive to please mark a tick mark against the
respondent’s choice)
i. Every time I receive the benefit on time
ii. Almost all the time I receive the benefit on time
iii. Most of the times I receive the benefit on time
iv. Many times I do not receive the benefit on time
v. Most of the time I receive the benefit on time
vi. Almost all the time I do not receive the benefit on time
vii. Never do I receive the benefit on time
8. With respect to the response above, what in your case are the reasons known to you for not
receiving benefits on time: (Field executive to please mark a tick mark against the respondent’s
choices)
9. Please tell me about the delay you face when you go to collect your benefit. (Field executive to
please mark a tick mark against the respondent’s choice)
i. Every time I go there is a lot of delay/wait
ii. Most of the times I go there is a lot of delay/wait
iii. Most of the time I receive the benefit without much delay/wait
iv. There never is a delay in receiving the benefit when I go to collect it
10. With respect to the response above, what in your case are the reasons known to you for
delay/wait when you go to receive the benefits: (Field executive to please mark a tick mark
against the respondent’s choices)
11. Has Adhaar seeding been done in your case? (Field executive to please mark a tick mark against
the respondent’s choice)
i. Yes
ii. No
iii. Do not Know whether seeding done
iv. Do not have an Adhaar Card
v. Any other_______
12. In case you are receiving benefits under DBT, how is your experience with DBT so far? (Field
executive to please mark a tick mark against the respondent’s choices- multiple choces are
permitted)
iii. I do not find it any more convenient than the earlier method of cash and check
collection/delivery
iv. I find that due to DBT, I receive the correct and due amount in my account without
anyone deducting any amount from the benefit
13. Please give your suggestions to improve the working of DBT so as to deliver better benefits to
beneficiaries?
14. If your Adhaar has been seeded, how was your experience with the Adhaar Seeding process?
iii. I found that due to Aadhar Seeding , I receive the correct and due amount in my account
without anyone deducting any amount from the benefit
15. If your Adhaar has been updated, how was your experience with the Adhaar Updation process?
iii. I found that due to Aadhar Updation , I receive the correct and due amount in
my account without anyone deducting any amount from the benefit
16. To what uses do you put the benefit (assistance/pension) amount to? (Field Executive – put rank
mark against the responses indicated by the respondent- rank 1 for most common use, rank 2
for less than that, rank 3 for next and so on..)
17. Is the benefit that you receive sufficient for meeting your requirements?
i. Yes
ii. No
iii. Cannot say
In case answer to previous question is ‘No’, then answer next question , else skip the next
question and go to question mentioned after that
18. What according to you should be the level of benefit that you will find sufficient ? (Field
Executive-Record Verbatim)
19. Have you ever had a grievance with the process of this scheme that we are discussing? (Field
Executive-Put a tick mark against the best choice)
i. Yes
ii. No
iii. Cannot say
In case answer to previous question is ‘Yes’, then answer next question , else skip the next
question and go to question mentioned after that
20. What did you do to resolve your grievance? (Field Executive-Put a tick mark against the best
choice)
In case answer to previous question is from choices i. to v, then answer next question , else
skip the next question and go to question mentioned after that
21. Were you satisfied with the way your grievance was handled (appropriateness of resolution,
time taken for resolution etc.)?
i. Yes
ii. No
iii. Cannot say
22. Does Gram Sabha have any role to play in the implementation of this scheme in your area?
i. Yes
ii. No
iii. Cannot say
In case answer to previous question is ‘ Yes’, then answer next question , else skip the next
question and go to question mentioned after that
23. What role does Gram Sabha play in implementation of this scheme in your area? (Field
Executive- Record Verbatim)
24. Has Social Audit of this scheme been carried out in your area?
i. Yes
ii. No
iii. Cannot say
In case answer to previous question is ‘ Yes’, then answer next question , else skip the next
question and go to question mentioned after that
25. What do you think is the importance of Social Audit in improving the implementation of this
scheme in your area? (Field Executive- Record Verbatim)
26. In case you are a woman, have you felt any discrimination based on your gender at any time
while availing the benefit of the scheme?
i. Yes, I have faced difficulty and discrimination due to my gender many times while availing
the benefit of the scheme
ii. Yes, I have faced difficulty and discrimination due to my gender a few times while availing
the benefit of the scheme
iii. No, I have never faced any difficulty and discrimination due to my gender while availing the
benefit of the scheme
iv. I do not want to respond to this question
In case answer to previous question is either i. or ii., then answer next question , else skip
the next question and go to question mentioned after that.