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SUSENAS VSEN99.M REPUBLIC OF INDONESIA

CENTRAL BUREAU OF STATISTICS 1999 NATIONAL SOCIO-ECONOMIC SURVEY LISTING OF CONSUMPTION / HOUSEHOLD EXPENDITURES CONFINDENTIAL

I. IDENTIFICATION III. ENUMERATING CHARACTERISTICS 01 Province 01 Name and employment identity

number of enumerator 02 Regency/municipality*)

03 Subegency 04 Village / kelurahan *)

05 Area 1. Urban 2. Rural

02 Enumerator ‘s occupation Provincial staff 1 Regency/municipality 2 staff

Subregency staff 3 Hired worker 4 06 Enumeration area number 03 Date of enumeration

07 Segments group number 04 Enumerator’s signature 08 Segment number

09 Sample code number

05 Name and employment identity number of supervisor

10 Sample serial number of household 06 Supervisor’s Position Province KS staff 1 Regency/municipality 2 KS staff

Mantis 3 07 Date of supervision Serial number

11 Village classification 1. Least develope d village 2. Developed

village

Filled in by editor

08 Supervisor’s signature II. HOUSEHOLD CHARACTERISTICS

01 Name of household head

03 Name & serial number of respondent 02 Number of household members 04 Address (name of street/lane/RT/RW)

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IV. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

Details Standard unit Total (0,00)

002 Rice (local, high quality, imported) Kg

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(6)

IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

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(8)

III. 1. FOOD, DRINK, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

Details Standard unit Total (0,00)

2] Shrimp and other fresh seafoods

035 Shrimp Kg

036 Squid Kg

037 Crab Kg

038 Shell/snail Kg

039 Other ………. Kg 3] Preserved fish

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IV. 1. FOOD, DRINK, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

Details Standard unit Total (0,00)

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(12)

IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

Details Standard unit Total (0,00)

2] Preserved meats

062 Dried meat Kg

067 Entrails (other than liver) Kg 068 “Tetelan” (bones with a bit of

adhering meat)

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

Details Standard unit Total (0,00) 073 Egg of free range chicken Pieces

074 Duck egg Pieces

080 Sweetened condensed milk 397gr **)

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

Details Standard unit Total (0,00) 089 Chinese cabbage/ white mustard

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total consumption Seri

al nu mb er

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

Details Standard unit Total (0,00) 124 Fermented soy bean sauce Ounce 125 Fermented peanut expeller cake Ounce

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

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(24)

IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

Details Standard unit Total (0,00)

162 Coffee (ground, beans, instant) Ounce

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

Details Standard unit Total (0,00)

178 “Sambal” (chili sauce) /tomato sauce

140 ml*)

179 Prepared spices/package Ounce 180 Other cooking spices

………. *) Small plastic bottle

**) One regular packages

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

Details Standard unit Total (0,00) (taken from VSEN99.LPK)

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

Details Standard unit Total (0,00) 202 “Lontong” (food consisting of rice

steamed in a banana leaf)/ Ketupat sayur (kind of Lontong with vegetables)

Bo l w

203 “Soto”/goulash/ Bo l soup/”rawon”/mince

w 204 “Sate” (small pieces of meat roasted

on skewer)/”Tongseng” (kind of goulash used lamb meat)

Plate/ 5 stick

205 Meat ball noodle/boiled noodle/fried noodle

Bo l w

206 Instant noodle Bowl

207 Snack for kids/crisp/crispy chip Ounce 208 Fish (fried, baked, fermented,

steam, preserved, etc)

Piece

209 Chicken/meat (fried, baked, etc) Piece

210 Ice cream Small bowl

211 Other ice ……… Glass 200ml 212 Other prepared foods ………..

213 Soft drink with CO2 (soda) 200 ml *) ***) “Tea bottle” packaging

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IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK Purchase

(cash/owed)

Own production, given, etc.

Total of consumption Seri

al nu mb er

Details Standard unit Total (0,00)

217 Health drink/energetic drinks 100 ml**) 218 Other drinks (coffee, coffee milk,

tea, chocolate milk)

Glass

219 N. Alcohol beverages

220 Bier 620 ml***)

221 Wine 620 ml***)

222 Other alcohol beverages ………. 620 ml***)

………..

223 O. Tobacco and betel

224 Filtered clove cigarette pieces 225 Unfiltered clove cigarette pieces 226 Menthol Cigarette pieces

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

A. Housing and Household facility The house of living is:

Owned property/free of rental 1 Rent purchased 4

Lease 2 Official house 5

Rent 3 Other 6

232 If the house is own property/last free renting, estimation monthly renting: Rp. ………. 233 If the house is leased:

a. Last of lease agreement: ……….year b. Lease value: Rp. ………..

c. Average lease value in a month: Rp. …………

234 If the house rented, monthly value of renting: Rp. ………….

235 If the status of dwelling is purchase-rent, official and others, average value of monthly renting: Rp. ………

236 Maintenance costs of the house (painting, plastering, painting the wall, roof, window glass, hinge, etc, including wages for the workers)

237

238

Electricity:

Used of electricity (quantity): a. A month ago: …….………..kwh/watt *)

b. 12 months ago: ……….kwh/watt *) Note: If household doesn’t know KwH unit (for example: Non-PLN user), How to account:

Number of watt used times number of hour of monthly using electricity divided 1000 Value:

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

239 Telephone 240

241

Water (“PAM” = Municipal Water Corporation / carrying pole water / purchased) Quantity: a. A month ago: ………m3

b. 12 months ago: ……….m3 Value:

242

243

LPG (Liquid Propane Gas)

Quantity: a. A month ago: ………kg

a. Type and number of fuel used:

Gasoline 1 Kerosene 3 A month ago: ………..liter Solar 2 12 months ago: ………liter Value

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

b. Lubricant oil:

Quantity: a. A month ago: ………liter b. 12 months ago: ……….liter Value:

c. Maintenance and repair 253

256 Others (flashlight, storage battery, matches, mosquito repellent, lamp, air freshener, Liquid floor cleaner, etc) 257

258

B. Goods and Services

Bathing soap, toothpaste, toothbrush, and shampoo

259 Beauty stuffs (perfume, pomade, deodorant, powder, nail clippers, lipstick, comb, etc), and sanitary napkin 260 Treatment of skin, face, nails, hair (expenses of cutting, curl, cream bath, ‘lulur’ (herbal cosmetics used to

lighten of skin, etc)

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

Government hospital Private hospital

Medical Doctor practice

Puskesmas (Integrated Health Center) Supporting Puskesmas

Clinic/”Mother and Child’s Clinic”/Health Clinic “BP” Posyandu (Integrated Health Services Post)/Cadre Midwife/paramedic/practice nurses

Traditional healer/Shinshe (Chinese traditional healer) Purchased medicine with medical doctor prescription

Own treatment/purchased medicine without medical doctor prescription/purchased herbs as a medicine

272 273 274 275

Other health:

Pregnancy treatment cost Delivery cost

Immunization cost for children under 5 years Check-up and using contraceptive costs

276 Health treatment (vitamin, herbs, massage, fitness, etc)

277

Expenses of school & courses

Donation for school development (down payment of school enrollment) School fee (SPP) and BP3/POMG contribution (tuition)

Other school contribution (skill education, additional lesson, test, etc.) Textbooks/photo copy of textbooks

Stationers (calculator, ‘jangka’ = compass for describing circle, etc) Course’s fee

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(42)

IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

283 Newspapers, magazines, books, and stationery (outside of school and courses needs) including rents of magazines/literatures

284 Postal, Telegram, public phone, and post materials, including pager contribution

285

Fuel of motor vehicle used for household needs (not for business/working) a. Gasoline

Quantity: (1) A month ago: ……….liter (2) 12 months ago: ………..liter Value:

b. Solar fuel

Quantity: (1) A month ago: ……….liter (2) 12 months ago: ………..liter Value:

c. Lubricant oil

Quantity: (1) A month ago: ……….liter (2) 12 months ago: ………..liter Value:

291 Maintenance and repairs of motor vehicle (brake oil, water for car battery, car battery, etc) 292 Costs of transportation (bus, train, airline, ship, ‘becak’ (pedicab), parking fee, toll fee, etc)

293 Hotel, motel, cinema, play, sport, decoder, and other recreation, (excluded transportation cost and purchase of goods for recreation)

294 House maid and driver (wages or salary)

295 Other goods (tissue, camphor, banana leaves, coconut leaves, stick for ‘sate’, etc) 296 Other services (Identity card, Driver license, birth certificate, photo copy, photo, etc)

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

C. Clothing, Footwear, and Head gear

Ready made man’s wear (Blazer, long-sleeved shirt, Jacket, sarong, pants, T-shirt, underwear, etc) 299 Ready made woman’s wear (Gown, long fabric, blouse, nightgown, sweater, skirt, sarong, shawl, “angkin”

(cloth waisband), underwear, etc)

300 Ready made children’s wear (clothes, pants, sweater, shirts, under wear, baby napkin, etc) 301 Materials/fabrics for man, woman, and children (wool, polyester, cotton, silk, etc) 302 Sewing cost, fixed the clothes, thread, and other stuffs of sewing needs

303 Footwear for man (shoes, sandal, sock, etc) 304 Footwear for woman (slippers, shoes, sandal, etc) 305 Footwear for children

306 Head gear for man, woman and children (hat, ‘kopiah” =rimless cap, veil, etc) 307 Laundry-soap (in bar form, powder, cream, and liquid)

308 Material of clothing maintenance (Softener, whitener, starch and other clothing maintenance) 309 Others (towel, belt, shoe polish, tie, tailor-fee, small hanger, etc)

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

Furniture’s ( table, chair, bed, wardrobe, showcase, long-shelf, mirror, kitchen cabinet, baby bed, etc) 312 Household facilities (sewing machine, refrigerator, fan, washing machine, Air condition, etc)

313 Supporting household utensils (mattress, pillow, table cloth, bed sheet, ashtray, pillow sheet, blanket, plaited mat, curtain, carpet, etc)

314 Household utensils (Iron, broom, scissors, knife, machete, saw, vacuum cleaner, hanger, soldering tools, etc) 315 Kitchen/eaten utensils (plate’s rack, stove, cooking pot, pan, pail, wok, spoon, thermos bottle, plate, glass,

mixer, blender, microwave, oven and other utensils made of glass, ceramic, melamine, and plastic) 316 Decoration goods (wall decoration, aquarium, decoration goods made of ceramic, porcelain, onyx, marble,

wood, etc)

317 Repaired of utensils, supporting and instruments household

318 Watch, clock, camera, glasses, video camera, other optic tools and its repaired 319 Umbrella, bag, luggage, and its repaired

320 Expensive jewelers made of metal and gold (gold, diamond, pearl, etc) and its repaired 321 Children’s toy and its repaired

322 Television, video, radio, cassette, radio cassette, guitar, piano/organ, computer, and its repaired

323 Sport utensils (chess, racket, ball, net, bet, stick, including swim trunk, shoes for playing soccer/roller shoes, glasses for swimming, etc) and its repaired

324 Vehicle (bicycle, motor cycle, car, etc) and large repairs 325 Pets and plants including the maintenance expenses

326 Other durable goods (cradle, baby carriage, electric installation, telephone, pipe, pager, and its repairs)

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IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO

Value in Rupiah Seri

E. Taxes and insurance: Building and Land tax (PBB) 329 Radio & TV tax, and its type 330 Vehicle (motor and non motor) tax

331 Other tax/levied (Household, garbage, safety, grave, etc) 332 Accident & loss, and health insurance

333 334

F. Festivities and ceremonies

Wedding (rents of tools such as wedding equipment’s chair, tend, plate, etc and services such as bride, and expenses for bride make up maker, the priest, and hall rents, etc)

335 Circumcision, birthday (expenses for professional circumciser, doctor/paramedics/traditional cicumciser, balloon, food in a box, ribbon/paper for decoration, rent for chairs, hall & entertainment rents).

336 Religious festival (‘Qurban’ festival, offering, etc) 337 Haj expenses

338 Other traditional ceremony (invite “ustadz” (Moslem teacher which expert in religion), Priest, making offering, etc)

339 Burial expenses (cost of bathing the body, material to cover the body, service of digging the soil, coffin, cost of crematorium, cost of ‘ngaben’ (fire ceremony of Hindus), etc)

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IV. 3. AVERAGE EXPENSES OF HOUSEHOLD IN A MONTH ( IN RUPIAH)

13 Prepared foods and beverages (IV. 1 M) 14 Alcohol’s drink (IV. 1 N)

15 Tobacco and betel (IV. 1 O) 16 Sub Total (1 to 15)

17 Sub total (16) x 30 7

18 Housing and Household facility (IV. 2 A) 19 Goods and Services (IV. 2 B)

20 Clothes, Footwear, and Headgear (IV. 2 C) 21 Durable goods (IV. 2 D)

22 Tax and Insurance (IV. 2 E) 23 Festivities and ceremonies (IV. 2 F)

24 Average of monthly household expenses(17 to 23)

*) content of serial number 18 to 23 in Column 4 same as the content of serial number 18 to 23 in Column 5 divided 12

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V. INCOME, REVENUE AND EXPENSES OF NON CONSUMPTION DURING 12 MONTHS AGO (IN RUPIAH)

1. In kind and in cash of wages/salary 2. Income of agriculture business

a. Agriculture of foods and non foods

b. Other agriculture (Husbandry, Poultry, various livestock, fishery, forestry) 3. Income from non agriculture business

4. Income outside of wage/salary and business a. Estimation of housing rents

b. Other (interest, land rental, rents-leased, pension, bounded official / scholarship, claimed life insurance, dividend, lost and accident, income of non-business, )

5. Expenses and revenue of wired (transferred)

Expenses: Revenue:

(sent the money, give donation, gift, grant, and aid) (received money wired, legacy, donation, gift and aid) 6. Other expenses and revenue

Expenses: Revenue:

a. Purchased of bond/gold/jewelry, immovable goods a. Sold of bond/gold/jewelry/immovable goods, second- including repairs of building hand goods

b. Others (saving, paid of insurance, lend/paid of owe, b. Others (took the saving, claimed other insurance, down payment, paid “arisan” = regular social gathering received “arisan” = regular social gathering whose whose member contribute to and take turns sum of money, member contribute to and take turns sum of money, etc) lent, goods pawning, etc)

7. Income/revenue of household

(Number of income/revenue, details 1 to 6 – total expenses, details 5 to 6) 8. Average income/revenue of household in a month (details 7 : 12)

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VI. NOTE

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