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    CAF 2012 Form 6

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    jeremydejesus
    This document is a census questionnaire from the National Statistics Office of the Philippines regarding agriculture and fisheries. It contains questions about facilities, input dealers, and service providers related to agriculture and fisheries that are present in different barangays. It also contains a question about natural calamities experienced by barangays in the past five years. All information provided is kept strictly confidential according to Commonwealth Act No. 591.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    CAF 2012 Form 6

    Uploaded by

    jeremydejesus
    57 views2 pages
    This document is a census questionnaire from the National Statistics Office of the Philippines regarding agriculture and fisheries. It contains questions about facilities, input dealers, and service providers related to agriculture and fisheries that are present in different barangays. It also contains a question about natural calamities experienced by barangays in the past five years. All information provided is kept strictly confidential according to Commonwealth Act No. 591.

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    This document is a census questionnaire from the National Statistics Office of the Philippines regarding agriculture and fisheries. It contains questions about facilities, input dealers, and service providers related to agriculture and fisheries that are present in different barangays. It also contains a question about natural calamities experienced by barangays in the past five years. All information provided is kept strictly confidential according to Commonwealth Act No. 591.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    57 views2 pages

    CAF 2012 Form 6

    Uploaded by

    jeremydejesus
    This document is a census questionnaire from the National Statistics Office of the Philippines regarding agriculture and fisheries. It contains questions about facilities, input dealers, and service providers related to agriculture and fisheries that are present in different barangays. It also contains a question about natural calamities experienced by barangays in the past five years. All information provided is kept strictly confidential according to Commonwealth Act No. 591.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    CAF FORM 6 Republic of the Philippines

    NATIONAL STATISTICS OFFICE 6A


    AUTHORITY: Manila
    Section 2(c) of Commonwealth Act (CA) No. 591
    authorizes the National Statistics Office to prepare for
    and undertake all censuses of population, agriculture,
    industry and commerce.
    2012 CENSUS OF AGRICULTURE 6
    AND FISHERIES
    CONFIDENTIALITY:
    Section 4 of CA No. 591 provides that all information
    furnished on this form is held STRICTLY
    CONFIDENTIAL. BARANGAY QUESTIONNAIRE NSCB Approval No. NSO-1218-06
    Expires on October 9, 2013
    (TO BE ACCOMPLISHED BY THE TEAM SUPERVISOR)
    CERTIFICATION GEOGRAPHIC IDENTIFICATION
    I hereby certify that the data set forth herein were
    personally obtained/ reviewed by me and in PROVINCE _____________________________________________
    accordance with the instructions given by the
    National Statistics Office.
    CITY/MUNICIPALITY _____________________________________________

    _________________________________
    TEAM SUPERVISOR TS CODE
    (SIGNATURE OVER PRINTED NAME)
    BARANGAY _____________________________________________

    ______________________________________________
    DATE ACCOMPLISHED INTERVIEW RECORD

    ______________________________________________ NAME OF RESPONDENT ______________________ _______________________


    DSO/SCO LAST NAME FIRST NAME
    (SIGNATURE OVER PRNTED NAME)
    DESIGNATION/POSITION
    ______________________________________________ IN THE BARANGAY __________________________________________________
    DATE REVIEWED
    ADDRESS OF THE
    ______________________________________________ BARANGAY HALL __________________________________________________
    CO/RO/PO SUPERVISOR – DESIGNATION STREET AND/OR SITIO/PUROK NAME

    ______________________________________________
    DATE REVIEWED
    DATE OF VISIT TIME BEGAN TIME ENDED
    MONTH : DAY HOUR : MINUTE HOUR : MINUTE

    INSTRUCTION: ASK ALL QUESTIONS. WRITE X IN THE BOX FOR CODE “1” (YES) OR CODE “2” (NO), ASK FOR THE NUMBER
    OF FACILITIES, INPUT DEALERS, AND SERVICE PROVIDERS THAT ARE PRESENT/AVAILABLE IN THE BARANGAY.
    PART I – PRESENCE/AVAILABILITY OF AGRICULTURAL, AQUACULTURAL, AND FISHERY FACILITIES, INPUT DEALERS,
    AND SERVICE PROVIDERS IN THE BARANGAY
    A. FACILITY
    In your barangay, is there a/an . . . ?
    1 Q1 rice or corn mill? 1 Yes, how many? ___________ 2 No

    Q2 mobile rice or corn mill? 1 Yes, how many? ___________ 2 No


    2 Q1 feed mill? 1 Yes, how many? ___________ 2 No
    3 Q1 slaughterhouse/dressing plant? 1 Yes, how many? ___________ 2 No
    4 Q1 agricultural processing facility/machinery/equipment? 1 Yes, how many? ___________ 2 No

    Q2 mobile agricultural processing facility/machinery/equipment? 1 Yes, how many? ___________ 2 No


    5 Q1 fish landing center? 1 Yes, how many? ___________ 2 No
    6 Q1 periodic or permanent agricultural produce market (“bagsakan/bulungan”)? 1 Yes, how many? ___________ 2 No
    7 Q1 hatchery (for poultry and aquafarm species)? 1 Yes, how many? ___________ 2 No
    8 Q1 breeding/multiplier farm (for livestock and poultry)? 1 Yes, how many? ___________ 2 No
    9 Q1 nursery/greenhouse/screenhouse/nethouse? 1 Yes, how many? ___________ 2 No
    B. INPUT DEALER
    In your barangay, is there a . . . ?
    1 Q1 fertilizer dealer? 1 Yes, how many? ___________ 2 No

    Q2 mobile fertilizer dealer? 1 Yes, how many? ___________ 2 No


    2 Q1 pesticide dealer? 1 Yes, how many? ___________ 2 No

    Q2 mobile pesticide dealer? 1 Yes, how many? ___________ 2 No


    3 Q1 seeds dealer? 1 Yes, how many? ___________ 2 No

    Q2 mobile seeds dealer? 1 Yes, how many? ___________ 2 No


    4 Q1 feeds dealer? 1 Yes, how many? ___________ 2 No

    Q2 mobile feeds dealer? 1 Yes, how many? ___________ 2 No


    5 Q1 veterinary medicine dealer? 1 Yes, how many? ___________ 2 No

    Q2 mobile veterinary medicine dealer? 1 Yes, how many? ___________ 2 No


    PART I – PRESENCE/AVAILABILITY OF AGRICULTURAL, AQUACULTUAL, AND FISHERY FACILITIES, INPUT DEALERS,
    6B AND SERVICE PROVIDERS IN THE BARANGAY
    C. SERVICE PROVIDER
    In your barangay, is there a/an . . . ?
    1 Q1 veterinary/paraveterinary clinic/service? 1 Yes, how many? ___________ 2 No

    Q2 mobile veterinary/paraveterinary clinic/service ? 1 Yes, how many? ___________ 2 No


    2 Q1 rental service of farm machinery/equipment? 1 Yes, how many? ___________ 2 No
    3 Q1 financial credit institution:

    i. commercial bank (including rural bank)? 1 Yes, how many? ___________ 2 No

    ii. government bank? 1 Yes, how many? ___________ 2 No


    iii. cooperative bank? 1 Yes, how many? ___________ 2 No
    iv. microfinance institution? 1 Yes, how many? ___________ 2 No
    v. individual money lender? 1 Yes, how many? ___________ 2 No
    vi. self-help group? 1 Yes, how many? ___________ 2 No
    vii. other sources? SPECIFY __________________________________ 1 Yes, how many? ___________ 2 No
    4 Q1 training and/or extension services to farmers and fisherfolks offered by:
    i. cooperative? 1 Yes, how many? ___________ 2 No
    ii. farmers’/fishermen’s organization? 1 Yes, how many? ___________ 2 No
    iii. local government unit? 1 Yes 2 No
    iv. nongovernment organization? 1 Yes, how many? ___________ 2 No
    v. others? SPECIFY _______________________________________ 1 Yes, how many? ___________ 2 No

    PART II – DESTRUCTIVE NATURAL CALAMITY IN THE PAST FIVE YEARS


    Q1 During the past five years, that is, from January 2008 to December 2012, did your barangay experience destructive natural calamities such as a/an . . .

    1 typhoon? 1 Yes, how many times? ______ 2 No

    2 flood? 1 Yes, how many times? ______ 2 No

    3 earthquake? 1 Yes, how many times? ______ 2 No

    4 volcanic eruption? 1 Yes, how many times? ______ 2 No

    5 tsunami? 1 Yes, how many times? ______ 2 No

    6 landslide/mudslide? 1 Yes, how many times? ______ 2 No

    7 infestation/animal disease? 1 Yes, how many times? ______ 2 No

    8 drought? 1 Yes, how many times? ______ 2 No

    9 others, SPECIFY __________________________________________ 1 Yes, how many times? ______ 2 No

    PART III – DOMINANT TERRAIN OF THE BARANGAY


    Q1 What is the dominant terrain of your barangay ?

    1 coastal 3 plain

    2 mountainous/hilly 4 others, SPECIFY ________________

    REMARKS:

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