SE96-PODES
QUESTIONAIRES
VILLAGE / KELURAHAN POTENSIAL
(PODES)
SE 96
Economic census
Confidential Double copy **) SE96 - PODES
REPUBLIC OF INDONESIA CENTRAL BUREAU OF STATISTIC
1996 ECONOMIC CENSUS POTENSIAL OF VILLAGE/KELURAHAN
I. IDENTIFICATION 01. Province
02 Regency/Municipality *) 03 District
04 Village/Kelurahan/UPT/SPT/PMST*
05 Area Urban -1 Rural -2
II. WORKERS CHARACTERISTIC
Details Enumerator Supervisor
01 Name
02 NIP (Enumerator Identity Number) 03 Date of supervision
04 Signature
*) Cross out inapplicable
**) One copy sends to Province Statistic’s Office, knowing by and another one keep in the Village as a file.
………..,1996
Head of Village/Kelurahan,
III. VILLAGE/KELURAHAN CHARACTERISTIC 1. Legal status of the village
Definitive -1 UPT/SPT -3 go to Q.4 Preparation -2 PMST -4
2. If Q.1 coded “1” or “2”, the status is
Village -1 Kelurahan -2 ® go to Q.4
3. If Q.2 coded “1” , is there any Village Communication Institution (LMD)
Yes -1 No -2
4. If Q.1 “not coded 1” , name of identity village/location ____________________________
5. LKMD/K category
Persiapan -0 Category2 -2 Category1 -1 Category3 -3
6. If Q.1 coded “1”, Village/Kelurahan classification Self-supporting -1 Self-sufficient -3 Self-developing -2
7. This village consist of:
Village administrative unit (RK/RW) …………..RK/RW Neighborhood Association ………RT
8.a.Any changes name of the village after July 1995 (Podes Inti 1995) or not registered on Podes-SE96 village listing’s at the District area Yes -1 No -2 ® go to Q. 9.a
b. If “Yes” , what is the name of old village Name of village_________________________
9.a.Was the village changed land area after July 1995 (Podes Inti 1995) Yes -1 *) No -2 go to Q.10
b. If “Yes”,
(1). “Increased” from area:
a. Enumerator’s area number __________________ b. Province __________________ c. Regency/municipality __________________ d. District __________________
e. Village __________________
(2). “Decreased” , to area:
a. Enumerator’s area number __________________ b. Province __________________ c. Regency/municipality __________________ d. District __________________
e. Village __________________ 10. Village /Kelurahan geography
III. VILLAGE/KELURAHAN CHARACTERISTIC (CONTINUING) 11. Village/ Kelurahan topography
High land -1 Low land -2
12a. Is there any Indonesian Army Force (ABRI) member (Army, Navy, Air Force and Police) lived in this village (not include who are living in the barracks)
Yes -1 No -2 ® go to Q. 13
b. If “Yes” , how many they are __________peoples
13. Environment safety (kamling)
a. Post of kamling Yes -1 No -2 b. Police station Yes -3 No -4 c. Post Police Yes -5 No -6
14a.Source income of majority population
Agriculture -1 Transportation, -7 Mining & -2 storage and
Industry -3 communication Electricity, -4 Finances Institution, -8 gas, and water real-estate, renting, Construction -5 and service company Wholesaler/, -6 Community services, -9
retails, restaurant social, and individual and accommodation
b. If q.14a. coded “1” main potential of sub-sector:
Food planting -1 Plantation -3 Livestock -2 Fishery -4
Forestry -5
IV. POPULATION, ENVIRONMENT, HOUSING, AND SETTLEMENT A. Population
1. The population registration has been carried out regularly Yes -1 No -2
2. Calculating base on last condition
a. Number of population …………people b. Number of woman population …………people c. Number of household ………hh d. Number of household head by woman ………hh
3. Number of household has send they’re children/relatives to university ………hh B. Environment, housing and settlement
1. Kind of fuel used for cooking of majority household Gas/LPG -1 Firewood -3
IV. POPULATION, ENVIRONMENT, HOUSING, AND SETTLEMENT (CONTINUED) 2. Trash disposal of majority household
The trash then -1 River -3 carried away Other (write) -4 In the whole -2 ………..
3. Place of latrine of majority household
Private -1 Public -3 Shared -2 not a -4
4. Gutter condition
Fast -1 Water is stuck -3 Slowly -2 No gutter -4
5. Pollution environment (during a year ago) Type of pollution Have -1
a. Critical land area ____________ ha b. Could not be planting ____________ ha c. Not yet planting ____________ ha d. If Q.6.c. filled in, why not be planting yet?
Not critical yet -1
No cost/power -2
Doesn’t have instruction yet -3 Community doesn’t care -4
Other -5
Critical land succeeded planting ____________ ha during last 3 years Number of houses according to construction
a. Regular ____________ units b. Irregular ____________ units Number of houses according to the quality
a. Permanent ____________ units b. Semi – permanent ____________ units c. Simple ____________ units Number of buildings/constructions are ____________ units having 4 floors or more
a. Is there any river passed this village
IV. POPULATION, ENVIRONMENT, HOUSING AND SETTLEMENT (CONTINUED) 12. a. Is there community living along the river?
Yes -1 No -2 ® Skip to Q. 13.a
b. If ‘Yes”
(1) Number of household ……….. h.h (2) Number of house’s building ……….. Units 13. a. Is there community living under high voltage of electric’s network Yes -1 No -2 ® Skip to Q. 14.a
b. If “yes”
(1) Number of household ……….. h.h (2) Number of house’s building ……….. units 14. a. Is there any poor settlement’s in this village/kelurahan?
Yes -1 No -2 ® Skip to Q. 15.a
b. If “Yes” ,
(1) Land area ………. Ha (2) Number of household member ………. Peoples (3) Number of household ………. H.h
15. a. Within the last 2 years, is there any new house built by community? Yes -1 No -2 ® Skip to Q. 16.a
b. If “Yes”, number of new house built ……….units
16. a. Within the last 2 years, is there any new house built by Developer? Yes -1 No -2 ® Skip to Q. 17.a
b. If “Yes”,
(1) Total number ………….. units (2) Number of simplest type house’s (RSS) ………….. units (3) Number of simple type house’s (RS) ………….. units (4) Number of ‘middle’ type house’s ………….. units (5) Number of luxurious type house’s ………….. units 17. a. Is there any processing/macnufacture ‘s industry in this village? Yes -1 No -2 ® Skip to Q. 20.a
b. Number of industry? ………….. units 18. a. If Q.17.a. coded “1”, type of wasted produce:
(1) Solid Yes -1 No -2If Q.18.a.(1) and Q 18.a.(2) filled in (2) Liquid Yes -3 No -4 “No”, skip to Q. 19
(3) Gas Yes -5 No -6 (4) Voices Yes -7 No -8
b. If Q.18.a. (1) or R 18.a. (2) filled in “Yes”, how was industrial’s waste processed?
(1) Recycling Yes -1 No -2 (2) Processed by Waste Process Unit (UPL) Yes -3 No -4 than discarded
IV. POPULATION, ENVIRONMENT, HOUSING AND SETTLEMENT (CONTINUED) 19.a. Is there any materials (material of construction) industry?
Yes -1 No -2 ® skip to Q. 20.a.
b. If “yes”, number of industry ………. Units
20.a. Is there any household’s trash transporter service in this village? Yes -1 No -2 ® skip to block V
b. If “yes”, how many times taken away from the house every month? ……… times
V. EDUCATION
1. Number of school according to level of education and building ownership
School If there is no school available
Government Private Level of education Having a
VI. SOCIO-CULTURE A. Number of Places of worship
1. Mosque : units
2. Prayer-house (=small mosque) : units 3. Church/Chapel : units
4. Pura (place of worship of Hinduism) : units 5. Vihara (place of worship of Buddhist) : units B. Social activity
1. Boy Scouts Have -1 Have not -2 2. Orphanage Have -3 Have not -4 3. Elderly House Have -5 Have not -6 4. Handicap rehabilitation Have -7 Have not -8 5. Youth Club Have -1 Have not -2 6. Family Welfare Management Have -3 Have not -4 (Program at village level to educate Woman on various aspects of family welfare)
VII. RECREATION AND ENTERTAINMENT 1. a. Movie Theater /Cinema
Have -1 ® Skip to Q.2 Not have -2
b. If “not have”,
(1) Closest distance from the village office’s …………. km (2) Time to spent ………… hour
2. Recreation place
VIII. HEALTH
e. Puskesmas (Integrated Health Center) f. Supported Puskesmas (small Puskesmas) g. Medicinal treatment center
h. Doctor practice place’s
i. Polindes (Village Maternity Post) j. Pharmacy
k. Drug Store
Number of Health Workers who live in this village:
a. Doctor 1. Male ……… person 2. Female ……… person b. Paramedics (exclude Midwife)
1. Male ……… person 2. Female ……… person c. Midwife ……… person d. Midwife at the village ……… person
(as localization of Government Order)
e. Traditional Birth Attendance 1. Skilled ………… person 2. Unskilled ……….. person Illness Epidemic during a year ago
a. Diarrhea and vomiting ……….. times b. Denging fever ……….. times c. Other (please write down) ……….. ……….. times
a. Source of water for drinking/cooking:
PAM/PDAM/SAM -1 Spring -5
b. Source of water for bathing/washing:
IX. TRANSPORTATION A. TRANSPORT
1. Road facility inter village
a. Traffic inter village majority through:
Land -1 Sea/river -2 ® to Q.2 Air -3 ® to Q.2
b. If the traffic majority through land (Q.1.a. coded “1”) (1). Type of widest road
Asphalt/Concrete/cone block -1 Soil -3 Hardened (stone, pebble, etc) -2 Other -4
……….
(2) Is the road can be pass through 4 wheels or more vehicle all the years? Yes -1 No -2
2. Type of public transportation used by community to the district’s capital/closest city Code Type of transportation
01 Bicycle “Ojek” (bicycle used for Have -1 Not have -2 public transport passenger)
02 “Becak” (Pedicab, with tricycle) Have -3 Not have -4 03 Wagon/”Pedati” (horse-drawn cart) Have -5 Not have -6 04 “Delman/Dokar/Bendi” (two-wheeled buggy/ Have -7 Not have -8
horse-drawn buggy/two-wheeled carriage)
05 Motor cycle “Ojek” Have -1 Not have -2 06 3 wheeled motor vehicle Have -3 Not have -4 07 4 wheeled motor vehicle Have -5 Not have -6 08 Rowboat Have -7 Not have -8 09 Motor boat Have -1 Not have -2 10 Motor ship Have -3 Not have -4 11 Other Have -5 Not have -6
3. From these transportation facility above (detail 2), the main transport : ………(put the selected code of detail 2 into the box)
4. a. Public motor transport station/terminal Have -1 Not have -2 b. Rail-way station Have -3 Not have -4 c. Seaport Have -5 Not have -6
d. River pier Have -7 Not have -8 e. Airport Have -1 Not have -2
5. Easeness of majority population to reach some closest facilities: Facility Easy to reach
a. Hospital Very easy -1 Easy -2 Difficult -3 Very difficult -4
b. Puskesmas/other health facility Very easy -1 Easy -2 Difficult -3 Very difficult -4
c. Market with permanently building Very easy -1 Easy -2 Difficult -3 Very difficult -4
IX. TRANSPORTATION (CONTINUED) B. COMMUNICATION
1. Household who has a telephone …………. H.h 2. Communication radio …………. Unit 3. a. Post Office/Post Office assistant/ Post House
Have -1 ® to Q. 4 Not have -2
b. If “Not have”, the closest distance to the Post Office …………. Km 4. Mobile Post Have -1 Not have -2 5. Public Television Have -3 Not have -4 6. Household who has the television …………. H.h 7. Household who has the satellite antenna …………. H.h 8. Household who has Radio ………… h.h 9. Newspaper/magazine customers Have -1 Not have -2 10. Public Message Board Have -3 Not have -4
X. LAND USED
A. Village’s land area (R.B + R.C) ……….. ha
B. Rice field area (R.1 + R.2) ………….…. ha
1. Rice fields area used for farming (R.a + R.b + R.c + R.d) ………. ha
a. Technical Irrigation ……… ha b. Non-technical irrigation ……… ha c. “Tadah hujan” Dependent on rain water for irrigation ……… ha
d. The rise and fall of the tides, polder, lowlands, and swamp
which planted of rice ……….ha 2. Rice fields area are not used for farming temporarily: ……… ha
C. Non rice field land area (R.1 +R.2 + R.3 ) ……… ha
1. Non rice field land area used for farming
(R.a +R.b + R.c + R.d) ……… ha a. Unirrigated agricultural field/”huma” (field for dry rice ………….. ha cultivation)/”tegal” (cultivation without irrigation)/
plantation/pond / “tambak” (earthen dam) ………….. ha
b. Plantation ………….. ha
c. Peoples forest ………….. ha
d. Other ………….. ha
2. Non rice field land area which not used for farming (R.a +R.b + R.c)
a. Land for housing and settlement ………….. ha b. Land for other building (industry, office complex, ………….. ha shopping complex)
c. Other (excluded State Forest) ………….. ha
XI. ECONOMIC A. PRODUCTION FACILITY AND MARKETING
1. a. Shopping complex category Have -1 ® to Q.2 Not have -2
b. If “Not have”,
(1). The distance ………. Km (2). Time to spend ………. Hours 2. a. Market with permanent building/semi-permanent ………. Units b. If not have
(1). The distance ………. Km (2). Time to spend ………. Hours 3. Market without permanent building ………. Units 4. Supermarket/department store ………. Units 5. Veterinary market ………. Units 6. Slaughterhouse ………. Units
7. Fish dropping point ………. Units 8. Fish Auction place ………. Units 9. Electric/electronic tools shop ………. Units 10. Agriculture production facility kiosk
Own by KUD (Village Cooperative Unit) ………. Units Own by non-KUD ………. Units 11. Industrial Area ………. Units 12. Industrial Central (please write down) ………. Units ………
13. Small industrial area ………. Units 14. Small industrial village (please write down) ………. Units ………
15. Place of excavated material marketing ………. Units 16. Fuel Station ………. Units 17. Agent/seller of LPG ………. Units 18. a. Restaurant ………. Units b. How many of them has a permission certificate from ………. Units “Diparda” (
19. Food/drinks stall ………. Units
B. BUSINESS AND RENTAL SERVICES
1. Party facility equipment rental ………. Units 2. Vide cassette/laser Disc rental ………. Units 3. Car/motor vehicle rental ………. Units 4. Photo copy business ………. Units 5. Repairs of non-motor vehicle ………. Units 6. Repairs of motor vehicle (car, motorcycle) ………. Units 7. Repairs of electronic and electric tools ………. Units 8. Beauty salon ………. Units 9. Studio photo ………. Units
XI. ECONOMIC (CONTINUED)
Man power distributor ………. Units
Hotel/Motel/hostel/inn ………. Units
Travel Bureau / Agent ………. Units Computer service rental ………. Units a. Joint Business Group ………. Units Have -1 Not have -2 ® to C ………. Units
b. If “have”,
(1) Number of group ……… Group (2) Number of member of each group ……… Group FINANCE INSTITUTION
Number of Banks (public bank) a. Bank’s Offices
(Central Office, branch office) …..………. Units b. Cash Office …..………. Units c. “BRI” (Indonesia Peoples Banks) unit office and …..………. Units BRI Village Service Post
Number of “Bank Perkreditan Rakyat”/BPR (Peoples Credit Bank) a. BPR non “Badan Kredit Desa” (Village Credit Institution)
(New BPR, P.T. Bank Pasar/P.T. Bank Desa, Bank Karya Produksi Desa, BPR ex LDKP)
(1). Central Office and branch …..………. Units (2). Cash Office …..………. Units b. BPR “Badan Kredit Desa”
(1). “Bank Desa” …..………. Units (2). “Lumbung Desa” …..………. Units c. Lembaga Dana Kredit Pedesaan/LDKP (Village Credit Fund Institution)
Number of Pawn office …..………. Units Number of Insurance company …..………. Units Number of Cooperative …..………. Units a. Village Cooperative Unit (KUD) …..………. Units b. Craft industry & Small Industry Cooperative (Kopinkra) …..………. Units c. Lending and saving cooperative …..………. Units d. Other non-KUD cooperative …..………. Units Other Financial Institution
a. Other Credit office …..………. Units b. Other Financial Institution Offices …..………. Units Credit facility received by community during a year ago
a. KUK (Small Business Credits) Have -1 Not have -2
If Q.5. has content and one of Q.7 content is “Have”, is they’re of the credit distributed through this village cooperative?
XI. ECONOMIC (CONTINUED) D. ESTABLISHMENT/BUSINESS BY ECONOMIC SECTOR
1. Number of agriculture establishment of law ……… Units 2. Number of excavation location of C category according to the excavated
a. Stone, coral ……….. location 3. Industry (large, small, medium/household handicraft) ……….. unit 4. Industry business with < 20 persons man power ……….. unit 5. Electric’s establishment/business non – PLN(State Electricity ……….. unit Enterprise)
6. Construction establishment’s of law ……….. unit 7. Few units of housing and settlements developed by ……….. unit Developer
8. Trade establishment of law ……….. unit 9. Transportation, Warehousing, and Communication
a. Transportation company
(1). Motor transportation company ……….. unit (2). Non motor transportation company ……….. unit b. Warehousing company ……….. unit c. Public Warehousing ……….. unit d. Communication
(1). Public telephone (using coin) ……….. unit (2). Public telephone (using card) ……….. unit (3). “Wartel” (telephone stall) ……….. unit (4). “Warpostel” (telephone and post stall) ……….. unit (5). “Warpaspostel” ( ……….. unit E. OTHERS
1. Household according by economic sector (based on main job of household head) a. Agriculture/farming ………. h.h b. Mining and Exploration ……….. h.h c. Industry/handicraft ……….. h.h d. Electricity, Gas, and Water ……….. h.h
2. Number of household which the member of household worked
in agriculture sector ……….. h.h 3. Number of electric’s customer household ……….. h.h
a. PLN ……….. h.h
XI. ECONOMIC (CONTINUED) a. Main road village lighting
Have -1 Not have -2 ® to Q.5.
b. If “have”, type: PLN electricity (formally by Government) -1
Other electricity -2
Non-electricity -3
Number of household has motor vehicle with 4 wheels or more drive ……..… h.h
(including for business)
Number of household has motor vehicle with 2 wheels or 3 wheels ……….. h.h or motor boat (including for business
Community socio-economic situation in general
Wealthiest -1 Poor -4 Wealthy -2 Poorest -5 Rich -3
a. Do the village conducted family welfare registration
Done -1 Not yet -2 ® skip to Block XII
b. If “done”, how many family according to type of welfare: (1) Pre-prosperous family …………. family (2) Prosperous Family stage I …………. family (3) Prosperous Family stage II …………. family (4) Prosperous Family stage III …………. family (5) Prosperous Family stage III + …………. Family
XII. 1995/1996 VILLAGE FINANCIAL 1. Realization of village expenses and income (000 Rp)
a. Income Rp……….
(1). Left over (plus) of 1994/1995 budgets Rp………. (2). a. Village ‘original’ income Rp……….
b. Community self-supporting (money, goods, Rp………. and in kind)
(3). Funding from Central level Rp………. (4). Funding from province level Rp………. (5). Funding from Regency level Rp………. (6). Other revenues/income Rp………. b. Routine expenses
(1). Left over (mines) 1994/1995 budgets Rp………. (2). Employee expenses Rp……….
(3). Goods expenses Rp………. (4). Maintenance expenses Rp………. (5). Travelling expenses Rp………. (6). Other routine expenses Rp………. (7). Miscellaneous expenses Rp………. c. Development expenses Rp……….
XII. 1995/1996 VILLAGE FINANCIAL (CONTINUED) 2. Have you ever received Integrated Area Development Fund (PKT) or Integrated
Area Development (P2WT)
Yes -1 No -2
3. Percentage of PBB (land and building taxes) income realization during 1994/1995 budgets of targeted ………. %
4. a. Have this village ever received IDT (Hard to reach Village Yes -1 No -2 ® to Block XIII
b. If “Yes” budgets year:
(1). 1994/1995 Yes -1 No -2 (2). 1995/1996 Yes -3 No -4 (3). 1996/1997 Yes -5 No -6 5. a. If Q.4.a coded “1”,
(1). Number of community group (“pokmas”) in this village ……… group (2). Number of community group which has received IDT fund ……… group (3). Number of family which has received IDT fund ……… group b. Number of supporting of community group which has received ……… group IDT fund
XIII. HEAD OF VILLAGE CHARACTERISTIC 1. Age ………… years old
2. Sex
Male -1 Female -2
2. The highest education ever completed:
No schooling -1 High School -5 Not completed -2 Academy -6 Primary School University -7 Primary School -3
Junior High School -4
4. Duration of occupy (since got promotion till to enumeration carry out ……. year
XV. SKETCH OF CHANGED AREA Province : ………
Regency/Municipality : ……… é
District : ……… U
