National Statistics Office
of Georgia
Geostat
Shinda 04
Approved by the Board of National
Statistics Office of Georgia
Order #7, 17 February, 2010
Survey of incomes and expenditures
Quarterly Questionnaire of Expenditures
The date of the interview
Day
Enumeration Area
Rotation
The time of starting the interview
Month
Household
Year
Sequence number of
interview
The time of ending the interview
Respondent
Interviewer
Regional supervisor
Logical and arithmetical control
According to the “Law of Georgia on Official Statistics” 25th Article, point first, with the view of
fulfilling its functions the Geostat shall be authorized to request and receive from administrative
bodies, physical and legal persons all kinds of statistical data and other information, including
confidential information and/or information containing personal data, in line with the “Law on
Personal Data Protection".
The information provided by you is confidential and protected by the “Law of Georgia on Official
Statistics” 28th Article, point first. It is only used for calculating the general statistical indexes.
Thank you for your cooperation!
Part 1. Expenditures
1. Housing
1.1. Please specify, did you renovate or made major repair of your dwelling or other
own building or did you buy any building materials for this purpose during the past
three months?
To the interviewer: concretize the question to respondent – if the respondent built a new dwelling or other
building/construction for own usage, or made major repair, expanding or reconstructing of the dwelling
or other own building/ construction; or installed or reconstructed electricity, plumbing or heating systems;
or purchased the building materials and equipment for this purpose.
1. Yes  continue
2. No go to 1.3
1.2. Please specify, how much GEL did your household spend on purchasing of building
materials (including expenses on transportation) and on wages of craftsmen and
workers for construction or major repairs of your dwelling or other own buildings
during the past three months?
To the interviewer: If the respondent paid whole cost of these work at once (including the cost of materials and wages of
craftsmen), enter total amount of paid money in the first row.
Type of Expenses
Three Received free of
Two
Past
months charge during
months
month
past 3 months
ago
ago
1. The amount of money paid at once for building or major
repair of dwelling or other building/construction
2. Wall materials (brick, stone, block, etc.)
3. Steel materials (reinforcement, supporting steel pipes, etc.)
4. Cement, sand and crushed stone
5. Roofing materials
6. Doors and windows
7. Wood/timber
8. House plumbing items (pipes, bathrooms, sinks, taps, etc.)
9. Electric system (electrical wirings and etc.)
10.
11.
12.
13.
Heating system
Paint, drying oil, varnish and other materials
Surfacing materials (tiles, floor tiles, mosaic tiles, etc.)
Wallpaper, coarse calico and other materials
14. Other materials for major repair/renovation or building
(please, specify ) ––––––––––––––––––––––––––––––––
15. Services of craftsmen and workers (services of builder,
plasterer, plumber, rigger, loader, etc.)
1.3. Please specify, how much GEL did your household spend on minor maintenance
and repairing of your dwelling or other own buildings during the past three months
To the interviewer: If the respondent paid for these work to craftsmen at once including the cost of materials, write total
amount of paid money in the first row.
Past
month
Type of Expenses
1. The amount of money paid at once for minor repair of
dwelling or other building/construction
2. Services of craftsmen for minor repair
3. Purchasing of materials for minor repair
4. Other expenses (please specify) –––––––––––––––––––––
2
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1.4.
Please specify, how much GEL did your household spend during the past three
months according to the following list
Past
month
Type of Expenses
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Payment for electricity supply
2. Payment for natural gas supply
3. Payment for water gas supply
4. Payment for refuse collection and disposal
5. Charges for maintenance of lifts
6. Dwelling rental payment
7. Payment for providing security of dwelling
8. Other payments for public utilities (please specify)
––––––––––––––––––––––––––––––––––––––––––––––
1.5.
Please specify, how much GEL did your household spend on purchasing of fuel for
heating, lighting and cooking during the past three months according to the
following list
Past
month
Type of Expenses
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Liquefied gas (including storage containers - cylinders)
2. Kerosene
3. Diesel
4. Firewood
5. Coal
6. Manure briquettes used for heating
7. Other type of fuel purchased for heating and lighting
(please, specify) –––––––––––––––––––––––––––––––
1.6.
Please specify, how much GEL did your household spend on purchasing of goods
and services related to your dwelling during the past three months according to the
following list
Past
month
Type of Expenses
1. Payment on telephone calls by fixed and wireless
telephone (user charge, cost of local and international calls
and etc.)
2. Expenses on mobile telephone calls
3. Cost of pay TV channels
4. Payment on internet connection services
5. Payment on telephone (fixed and wireless) installation
and purchasing of SIM card for mobile phone
6. Expenses on purchasing and installation of a meter (for
water, gas, electricity)
7.
Payment on postal services
8. Expenses on natural gas installation
9. Expenses on other goods and services (please, specify)
––––––––––––––––––––––––––––––––––––––––––––
3
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
2. Expenditures on furniture and furnishings
2.1.
Please specify, how much GEL did your household spend on purchasing of
household furniture and furnishings during the past three months according to the
following list (Please, include expenses on shipping and installing, if they where
included in total cost)
Past
month
Item
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Table
2. Chair, armchair
3. Couch, sofa
4. Bed
5. Wardrobe
6. Cupboard
7. Bookcase, bookshelves
8. Furniture for a bedroom
9. Furniture for a sitting room
10. Furniture for a kitchen
11. Furniture for a study room
12. Carpet
13. Chandelier, sconce, wall and table clock
14. Wall and table clock
15. Other expenses (please, specify) __________
16. Expenses on repairing of furniture and furnishings
2.2.
Please specify, how much GEL did your household spend on purchasing of
household textiles during the past three months according to the following list
Past
month
Item
1. Blanket
2. Mattress
3. Pillow
4. Linen
5. Bedspread
6. Towel, kitchen towels
7. Curtain
8. Tablecloth
9. Other weaver products (please, specify) ––––––––––––––
–––––––––––––––––––––––––––––––––––––––––––––––
4
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
2.3.
Please specify, how much GEL did your household spend on purchasing, installing
and repairing of household equipment and appliances during the past three months
according to the following list Please, include expenses on shipping and installing, if
they where included in total cost)
Past
month
Type of Expenses
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Electric stove
2. Gas stove
3. Kerosene stoves
4. Water heating equipment (tank, “Atmor”, etc.)
5. Heater (gas, electric or wooden oven)
6. Refrigerator and freezer
7. Washing machine and drier
8. Vacuum cleaner and electric floor polisher
9. Sewing machine
10. Knitting machine
11. Dish washing machine
12. Air conditioner
13. Installing and repairing of household appliances
(including cost of labour and cost of materials)
14. Other household appliances (please, specify)
_____________________________________
2.4.
Please specify, how much GEL did your household spend on tableware purchased
for household usage during the past three months according to the following list
Past
month
Type of Expenses
1. Vessel (glass, crystal, plural plastics, etc.)
2. Dinner set, tea -set, coffee set
3. Kitchenware (caldron, pen, kettle, etc.)
4. Knives, forks, spoons
5. Small electric household appliances for kitchen (mixer,
juice extractors, coffee maker, toaster, etc.)
6. Other tableware (please, specify) ___________________
_______________________________________________
5
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
3. Expenditures on clothes, footwear and textiles
3.1.
Please specify, how much GEL did your household spend on clothes and footwear
purchased for household members aged 13 years and above during the past three
months according to the following list
Female = f,
Male = m
Encircle only one.
Use free spaces at
the end of the table
if necessary
Item
1. Leather and fur clothes (full-coat)
f
m
2. Coat, jacket, raincoat, overcoat
f
m
3. Suit (trousers and jacket)
f
m
4. Jacket
f
m
5. Trousers
f
m
6. Dress, shirt, T-shirt
f
m
7. Sweater, pullover, jacket
f
m
8. Sportswear
f
m
9. Underwear, swimsuit
f
m
10. Socks, tights
f
m
11. Hat, beret, scarf, gloves
f
m
12. Other clothes (please, specify) _________
f
m
13. Summer footwear
f
m
14. Winter footwear
f
m
15. Spring - fall footwear
f
m
16. Sport footwear
f
m
17. Slippers
f
m
f
m
f
m
f
m
f
m
f
m
18. Personal effects (bags, handbags, suit-cases, etc.)
and accessories (belts, straps, buttons, zipper, ties,
handkerchief, aprons, etc.)
19. Sewing, knitting, altering and mending of clothes
20. Dry cleaning, laundering, dyeing of clothes
21. Sewing and mending of footwear
22. Hiring of clothes
6
Received
free of
Two Three
Past
charge
months months
month
ago during past 3
ago
months
3.2.
Please specify, how much GEL did your household spend on clothes and footwear
purchased for household members aged 12 years and bellow during the past three
months according to the following list
From 0 to 3 = I
From 3 to 13 = C
Received
Two Three
free of
Encircle only one.
Past
charge
Use free spaces at the month month month
s ago s ago during past 3
end of the table if
necessary
months
Item
1. Summer clothes
I
C
2. Winter clothes
I
C
3. Spring - fall clothes
I
C
4. Socks, tights
I
C
5. Underwear
I
C
6. Other clothes (please, specify) ________
I
C
7. Summer footwear
I
C
8. Winter footwear
I
C
9. Spring - fall footwear
I
C
10. Slippers
I
C
11. Dry cleaning, laundering, dyeing of clothes
I
C
I
C
I
C
I
C
I
C
I
C
I
C
I
C
I
C
I
C
I
C
12. Sewing and mending of footwear
13. Bags, belts, other accessories
14. Sewing, knitting, altering and mending of clothes
15. Hiring of clothes
7
3.3.
Please specify, how much GEL did your household spend on purchasing articles and
appliances for babies during the past three months according to the following list
Past
month
Type of Expenses
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Stroller, playard, baby walker, scales, etc.
2. Articles for personal hygiene of babies (includes baby’s
nappy, cream, cosmetic oil, baby powder, etc.)
3.4.
3.
Pacifiers, nursing bottles, etc.
4.
Other (please, specify)___________________________
Please specify, how much GEL did your household spend on purchasing textiles
during the past three months according to the following list
Past
month
Type of textiles
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Cotton textile
2. Wool textile
3. Silk textile
4. Hemp textile
5. Synthetics textile
6. Other textiles (please, specify)_____________________
3.5.
Please specify, how much GEL did your household spend on purchasing of goods
and services of your household members’ personal care and grooming during the
past three months according to the following list
Past
month
Type of Expenses
1. Buying or repair of electric appliances (electric razors,
hairdryer, hair curlers, etc.)
2. Non-electric appliances (razors, hair curlers, combs,
scissors, toothbrushes, hairpins, scales, nail care tools)
3. Soaps, shaving tools, shampoos, toothpastes, facecleaning products and etc.
4. washing materials (dishwashing detergent, clothes
washing materials, windows, bathroom cleaning products
and other materials of the same purpose)
5. Lotions, deodorants, hair dies, hairsprays
6. Perfumes, toilet waters, cologne
7. Lipstick, mascara, nail polish, face polish, etc.
8. Expenses on Barber’s, stylist’s, masseur’s services, bath
houses, sauna, solarium, etc.
9. Other (please, specify)__________________
8
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
4. Consumption expenditures on transport
4.1.
Please specify, how much GEL did your household spend on purchasing of vehicles
during the past three months according to the following list
Past
month
Items
1.
2.
3.
4.
5.
4.2.
Motor cars
Mini-bus, bus or lorry
Motor-cycle, moped, motor-scooter or quadrocycle
Bicycle
Other vehicles (trailer, cart, towing vehicle, etc.)
(please, specify) –––––––––––––––––––––––––––––––––––
Two
months
ago
Three
months
ago
Received free
of charge
during past 3
Please specify, did your household or any of your household members use any
vehicle during past 3 months
1.
2.
Yes  continue
No go to 4.3
Please specify, how much GEL did your household spend on exploitation of vehicle for own
use during past three months according to the following list
To the interviewer: e.g. if a household member uses a private car as a taxi, do not enter the expenses on fuel having been
incurred due to usage of the car as a taxi. Enter only the expenses on fuel that have been incurred in the
result of usage for personal purposes (of a household or household members)
Received free
Two
Three
Past
of charge
months months
Type of Expenses
month
during past 3
ago
ago
1. Purchasing the tire
2. Purchasing the accumulator
3. Purchasing other spare parts, lubricant and accessories of the vehicle
4. Purchasing the fuel (petrol, diesel, gas, etc.)
5. Expenses on diagnostics and repairs of the vehicle
6. Expenses on technical inspection of the vehicle
7. Other necessary expenses
8. Washing of the vehicle
9. Traffic fines (including non-official payments)
10. Payment on hiring of garages or parking spaces
11. Expenses on an oil and filter changes
12. Other expenses on maintenance and repair of personal vehicles
(please, specify) ––––––––––
4.3. Please specify, how much GEL did your household spend on transportation of any
luggage during the past three months according to the following list (the expenses on
transportation of luggage related to holidays or entrepreneurial business are not
included here)
Past
month
Type of Expenses
1.
2.
3.
4.
4.4.
Two
months
ago
Three
months
ago
Received free
of charge
during past 3
Hire of vehicle
Purchasing the fuel
Payment on services of loaders
Other expenses (please, specify) –––––––––––––
Please specify, how much GEL did your household spend on transportation during
the past three months according to the following list. The expenses on transportation
related to holidays, entrepreneurial or business missions (including study visits,
advanced training, etc.) are not included here.
Past
month
Type of Expenses
1.
2.
3.
4.
5.
6.
Expenses on intra-urban transportation
Expenses on local transportation
Expenses on interurban transportation inside the country
Expenses on transportation outside the country
Catering while traveling
Expenses on Accommodation services of hotels, motels, inns
or on renting the house
7. Other (please, specify) –––––––––––––––––––––––––––––
9
Two
months
ago
Three
months
ago
Received free
of charge
during past 3
5. Expenditures on health care
5.1.
Please specify, is any member of your household chronic patient or disabled person
(please encircle)
1.
2.
Yes  continue
No go to 5.2
Please specify, how much GEL did your household spend on outpatient treatment of
chronic patient or disabled member of your household during the past three months
according to the following list
Past
month
Type of Expenses
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Purchasing of pharmaceutical products for outpatient
treatment
2. Expenses on visit to a doctor, treatment procedures and
examinations
3. Expenses on medical laboratory services and tests
4. Other expenses (purchasing of gifts for doctor, nurse and
other hospital personnel and other non-official payments)
(please, specify) –––––––––––––––––––––––
5.2.
Please specify, has any member of your household suffered any disease during past
three months (please encircle)
1.
2.
Yes  continue
No go to 5.3
Please specify, how much GEL did your household spend on outpatient treatment of your
household member during the past three months according to the following list
To the interviewer: Do not enter expenses on outpatient treatment of chronic diseases
Past
month
Type of Expenses
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Payment on emergency medical services
2. Expenses on visit to a doctor, treatment procedures and
examinations
3. Purchasing of pharmaceutical products
4. Expenses on medical laboratory services and tests
5. Other expenses (purchasing of gifts for doctor, nurse and
other hospital personnel and other non-official payments)
(please, specify) –––––––––––––––––––––––
5.3. Please specify, did any member of your household undergo an inpatient treatment
(being in hospital) during the past three months? (please encircle)
1.
2.
Yes  continue
No go to 5.4
Please specify, how much GEL did your household spend on inpatient treatment of your
household member during the past three months according to the following list
Past
month
Type of Expenses
1. Payment on hospital services (includes services of
accommodation, different procedures, etc.)
2. Surgical operation
3. Purchasing of pharmaceutical products
4. Expenses on medical laboratory services and tests
5. Total cost of hospital treatment
6. Other expenses (purchasing of gifts for doctor, nurse and
other hospital personnel and other non-official payments)
(please, specify) –––––––––––––––––––––––
10
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
5.4. Please specify, did any member of your household give birth or was she expecting
childbirth during the past three months? (please encircle)
1.
2.
Yes  continue
No go to 5.5
Please specify, how much GEL did your household spend on lying-in of your household
member and on consultations during the past three months according to the following list
Past
month
Type of Expenses
1.
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Payment on emergency medical services
Purchasing of pharmaceutical products
Lying-in hospital fee (including a payment on services of
physicians)
4.
Payment on maternity welfare services (including treatment,
medical laboratory services and tests)
5.
Other expenses (purchasing of gifts for doctor, nurse and other
hospital personnel and other non-official payments) (please,
specify) –––––––––––––––––––––––
5.5. Did any member of your household visit a dentist
2.
3.
during past three months? (please
encircle)
1.
2.
Yes  continue
No go to 5.6
Please specify, how much GEL did your household spend on dental treatment of your
household member during the past three months according to the following list
Past
month
Type of Expenses
1.
Expenses on dental services (including cost of the materials)
2.
3.
4.
Purchasing of pharmaceutical products
Expenses on medical laboratory services and tests
Other expenses (please, specify) ––––––––––––––––––
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
5.6. Please specify, did any member of your household made a preventive inspection or
purchase pharmaceutical products just in case during the past three months?
(please encircle)
1.
2.
Yes  continue
No go to 5.7
Please specify, how much GEL did your household spend for this purpose during past
three months according to the following list?
Past
month
Type of Expenses
1.
2.
3.
3.
Received free of
charge during
past 3 months
Please specify, how much GEL did your household or any of household members
spend on purchasing of therapeutic appliances and equipment for own usage during
the past three months according to the following list
Past
month
Type of Expenses
2.
Three
months
ago
Expenses on preventive inspection
Purchasing of pharmaceutical products
Other expenses (please specify) –––––––––––––––––––
5.7.
1.
Two
months
ago
Purchasing of device for monitoring blood pressure,
phonendoscope, corrective eyeglasses and contact lenses
Purchasing of wheelchairs, crutches, artificial limbs for
disabled persons
Purchasing of other medical appliances (clinical
thermometers, bandages, cotton-wool, syringes, pampers for
elder people, etc.) –––––––––––––––––
11
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
6. Expenditures on education and child care
6.1.
Does any member of your household attend a pre-school institution or do you have
hired a babysitter? (please encircle)
1.
2.
Yes  continue
No go to 6.2
Please specify, how much GEL did your household spend on pre-school education of child
(children) during the past three months according to the following list
Past
month
Type of expenditures
1.
Tuition payment
2.
Purchasing of educational materials (pencil, soft-tip pen,
drawing notebook, bag, etc.)
3.
Hiring of babysitter
4.
The amount of money paid at once for excursion,
celebration or other event
Non-official expenses (collecting of money for
different purposes, purchasing of gifts for the institution
personnel, etc.)
5.
6.
6.2.
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Other expenses (please, specify) –––––––––––––––––––
–––––––––––––––––––––––––––––––––––––––––––––
Does any member of your household attend a school? (please encircle)
1. Yes  continue
2. No go to 6.3
Please specify, how much GEL did your household spend on school education of child
(children) during the past three months according to the following list
Past
month
Type of expenditures
1.
Tuition payment
2.
Purchasing of educational materials (pencil, pen, ruler,
notebook, schoolbag, etc.)
3.
Purchasing of books and educational materials (making
copies, etc.)
4.
The amount of money paid at once for excursion,
banquet or other event
Non-official expenses (collecting of money for
different purposes, purchasing of gifts for the institution
personnel, etc.)
5.
6.
6.3.
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Other expenses (please, specify) –––––––––––––––––––
–––––––––––––––––––––––––––––––––––––––––––––
Has any member of your household hired a private tutor, or attended any hobby
group (e.g. music, dancing, swimming, etc.)? (please encircle)
1.
2.
Yes  continue
No go to 6.4
Please specify, how much GEL did your household spend on purchasing training materials
and as tuition payment during the past three months according to the following list
Past
month
Type of expenditures
1.
Payment for private tutor and tuition materials
2.
Payments for training in a hobby group (groups) and
tuition materials
12
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
6.4. Does any member of your household attend a professional educational institution college (former technical school, secondary professional school and etc.)? (please
encircle)
1.
2.
Yes  continue
No go to 6.5
Please specify, how much GEL did your household spend on professional education during
the past three months according to the following list
Past
month
Type of expenditures
1.
Tuition payment
2.
Purchasing of educational materials (pencil, pen, ruler,
etc.)
Purchasing of books and educational materials (making
copies, etc.)
The amount of money paid at once for excursion,
banquet or other event
Non-official expenses (collecting of money for
different purposes, purchasing of gifts for the institution
personnel, etc.)
Other expenses (please, specify) ––––––––––––––––––
3.
4.
5.
6.
6.5.
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Does any member of your household attend a tertiary education institution (BA,
MA, PHD)? (please encircle)
1.
2.
Yes  continue
No go to 6.6
Please specify, how much GEL did your household spend on tertiary education of any
household member during the past three months according to the following list
Past
month
Type of expenditures
1.
Tuition payment
2.
Purchasing of educational materials (pencil, pen, etc.)
3.
Purchasing of books and educational materials (making
copies, etc.)
The amount of money paid at once for excursion,
banquet or other event
Non-official expenses (collecting of money for
different purposes, purchasing of gifts for the institution
personnel, etc.)
4.
5.
6.
6.6.
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Other expenses (please, specify) ––––––––––––––––––
Did any member of your household attend any professional or advanced training
courses (computer, foreign languages, driving license, or some handicraft courses
etc.) during the past three months? (Please encircle)
1.
2.
Yes  continue
No go to 7
Please specify, how much GEL did your household spend on professional or advance
training of any household member during the past three months according to the following
list
Past
month
Type of expenditures
1.
2.
3.
Tuition payment
Purchasing of educational materials (pencil, pen, etc.)
Purchasing of books and educational materials (making
copies, etc.)
13
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
4.
Other expenses (please, specify) ––––––––––––––––––
7. Expenditures on recreation and culture
7.1.
Please specify, how much GEL did your household spend on purchasing of goods
and services during the past three months according to the following list
Past
month
Type of expenditures
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Two
Three Received free of
months months charge during
ago
ago
past 3 months
TV set
Purchasing of audio/video/radio hardware and its accessories (VCR,
video cameras, etc.)
Purchasing of musical instruments and its accessories
Purchasing of photographic equipment and its accessories
Purchasing of personal computers and its accessories
Purchasing of toys (toy cars, toy construction sets, dolls, etc.)
Purchasing of equipment for sport (balls, rackets, skies, etc.)
Expenses related to cultural events (cinema, theatre, opera, concerts,
circus, museum, library, exhibition, sports events, etc.)
Purchasing of books, pictures, sculptures, etc.
Purchasing of newspapers and magazines
Payments on recreational and cultural services (services provided by
sports stadiums, swimming pools, tennis courts, park amusements,
etc.)
Expenses on photographic printing; Purchasing of spare parts for
photographic and cinematographic equipment (films, cassettes, battery
etc.)
Purchasing of pets (a dog, a cat), fishes and decorative plants and the
expenses related to their care
14. Expenses on gambling (service charges for lotteries, totalizators,
casinos, poker clubs and other gambling establishments)
15. Purchasing of landline and mobile phones, pagers and its accessories
16. Other expenses on goods and services related to recreation and culture
(please, specify) ––––––––––––––––––––––––––––––––––––––––––
17. Expenses on repairing of durable goods related to recreation and
culture
7.2.
Have you or your household member had holidays inside or outside the country
during the past three months (in a country house, in a resort, in a sanatorium etc.)?
(Please encircle)
1.
Yes  continue
2. No go to 8
Please specify, how much GEL did your household spend on recreation during the past
three months according to the following list
Past
month
Type of expenses on recreation inside the country
1. Rentals paid for hotels, sanatoriums, private homes, etc.
2. Expenses on catering
3. Expenses on transportation related to recreation
4. Other expenses related to recreation (please, specify) –––––––––––––
––––––––––––––––––––––––––––––––––––––––––––––––––––––––
5. Total expenses related to recreation
Type of expenses on recreation outside the country
6. Rentals paid for hotels, sanatoriums, private homes, etc.
7. Expenses on catering
8. Expenses on transportation related to recreation
14
Three Received free of
Two
months months charge during
past 3 months
ago
ago
9.
Other expenses related to recreation (please, specify) –––––––––––––
––––––––––––––––––––––––––––––––––––––––––––––––––––––––
10. Total expenses related to recreation
8. Expenditures related to ceremonies
8.1.
Was any celebration (wedding, christening, birthday, funeral, etc.) held in your
household during the past three months? (Please, encircle)
1. Yes  continue
2. No go to 8.2
Please specify, how much GEL did your household spend on this celebration(s) during the
past three months according to the following list
To the interviewer: If the respondent household paid all the expenditures on food and non-food products related
to the ceremony at once, please write it down in the 16th item
Past
month
Type of expenditures
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Expenses on food products
1.
Purchasing of bread and cereals
2.
Purchasing of meat
3.
Purchasing of fish
4.
Purchasing of milk and dairy products
5.
Purchasing of eggs
6.
Purchasing of fruits
7.
Purchasing of vegetables
8.
Purchasing of sugar, tea, coffee
9.
Purchasing of confectionery
10. Purchasing of soft drinks
11. Purchasing of alcoholic beverages
12. Purchasing of other food (please
specify)__________________
Expenses on non-food products
13.
Purchasing of ceremony attributes, renting of a hall,
tables, dishes, etc.
14.
Payment on services of musicians, photographers,
cameraman and other personnel (e.g. cook, waters)
15.
Expenses on other non-food products (please, specify)
–––––––––––––––––––––––––––––––––––––––––––––
Expenses paid in total for ceremonies
16.
8.2.
Please specify, how much GEL did your household spend on ceremonies of wedding,
christening, birthday, funeral and etc. occurred in other households according to the
following list
To the interviewer: Do not enter into 3rd item the expenses on transportation and rentals paid for accommodation
in hotels, private houses and etc. if those expenses are already entered in Question 4.4
Past
month
Type of expenditures
1.
Purchasing of presents (evaluate in GEL)
2.
Total amount of money given as gift
15
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
3.
4.
Expenses on transportation and rentals paid for
accommodation in hotels, private houses, etc.
Other expenses (please, specify) –––––––––––––––––––
–––––––––––––––––––––––––––––––––––––––––––––
9. Other expenditures
Please specify, how much GEL did your household spend on items listed below during
the past three months
9.1.
Past
month
Type of expenditures
1.
Three
months
ago
Received free of
charge during
past 3 months
Money or parcel sent to relatives, friends and etc. (except
household members) living abroad (please, estimate the
approximate cost of parcels)
The amount of money or cost of things, products given away
(except gifts related to any ritual/ceremony)
Payments on financial services or commission fee (e.g. for money
transfer etc.)
Payments on legal services (services of notary, lawyer, legal
consultation, etc.)
Loss of money
Expenses on hiring housemaid, housekeeper or cook.
Expenses on birth, ID, marriage, death certificates and passport
Expenses on dating agencies
Expenses on license (for hunting, fishing, cutting trees, etc.)
Expenses on learning to drive and driving license
Other expenses and payments (please, specify) –––––––––––
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Please specify, how much GEL did your household spend as a payment on insurance
during the past three months according to the following list
9.2.
Past
month
Type of expenditures
1.
2.
3.
4.
5.
6.
7.
Two
months
ago
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
Payments of life insurance
Payments of pension insurance
Payments of accident insurance
Payments of health insurance
Payments of transport insurance
Payments of property insurance
Payments of other insurance (please, specify)______________
10. Expenditures on products purchased for processing
10.1.
Did your household purchase or receive free of charge any products, domestic animals
or poultry for the purpose of processing (including slaughtering for producing of
meat) during the past three months (producing of wine, jam, compote, sauces, canned
food and etc.) (Please encircle)
1.
2.
Yes  continue
No go to part 2
Please specify, how much GEL did your household spend on purchasing of products listed below
during the past three months
Type of expenditures
1. Purchasing crops (maize, wheat, soy, etc.).
2. Purchasing grapes or “chacha” (for producing wine,
vodka, juice, etc.)
3. Purchasing fats for producing canned foods
4. Purchasing tomato for producing sauces etc.
5. Purchasing fruits for producing compotes and jams
Two
Quantity of Past
months
Measurement
purchased month
ago
unit
products (GEL)
(GEL)
(Kg)
(Kg)
(L)
(Kg)
(Kg)
16
Quantity of Received
Three products
free of
month received
charge
free of
s ago
during past
(GEL) charge
3 months
(GEL)
6. Purchasing vegetables for producing marinades
7. Purchasing vegetables (tomatoes, aubergines, peppers,
carrots, etc.) for producing canned food
8. Purchasing meat for canning
9. Purchasing poultry or livestock for slaughtering
10. Purchasing milk
11. Purchasing sugar
12. Purchasing salt
13. Purchasing fish
14. Purchasing Other products for processing (please,
specify) ––––––––––––––––––––
(Kg)
(Kg)
(Kg)
(Unit)
(L)
(Kg)
(Kg)
(Kg)
Part 2. Agriculture
1. Farming
1.1.
Please specify, how much GEL did your household spend as a payments related to
land use during the past three months according to the following list
Past
month
Type of expenditures
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Land tax
2. Payment for leased land
3. Other payments (please, specify) ––––––––––––––––––––
1.2. Please specify, how much GEL did your household spend on purchasing/repairing
machinery and tools needful for dwelling and agricultural land during the past
three months according to the following list
Past
month
Type of expenditures
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
1. Purchasing of tractor
2. Purchasing of mini-tractor or motor-block
3. Purchasing of small gardening tools (e.g. hoe, spade, scythe,
sickle, rake, etc.)
4. Purchasing of small joiner's tools (hand plane, saw, etc.)
5. Purchasing of small metal working tools (file, hand drill, etc.)
6. Purchasing of machines, machining workstations, electric drill,
electric saw, water pump, other relatively big instruments and
devices
7. Purchasing of other tools and equipment (hammer, pliers, tool
for chemical treatment of vineyard, distillation of vodka, ladder,
wheelbarrow, hose, etc.)
8. Expenses on repairing of the above mentioned tools and devices
9. Other expenses (please, specify) –––––––––––––––––––––––
1.3.
Please specify, how much GEL did your household spend on utilization of
agricultural land during the past three months according to the following list
Past
month
Type of expenditures
1. Purchasing of fertilizers
2. Purchasing of chemicals
3. Expenses on land irrigation
4. Expenses on hiring of agricultural machinery for land tillage,
cultivation and other agricultural activities
5. Purchasing of fuel for the agricultural machinery (tractor,
combine, motor block, etc.)
6. Purchasing of seeds
17
Two
months
ago
Three
months
ago
Received free of
charge during
past 3 months
7. Purchasing of saplings and seedlings
8. Expenses on hiring of workforce
9. Other expenses (please, specify) –––––––––––––––––––––––
18
1.4.
Please specify, how much harvest did your household gather and how much utilized from it during the past three months, and how
much did you lay in stock by the end of the past month?
1. Wheat
2. Maize
3. Cucumber
4. Tomato
5. Beet
6. Carrot
7. Potato
8. Cabbage
9. Eggplant
10. Onion
11. Garlic
12. Green beans, peas
13. Water-melon, melon, pumpkin
14. Greens, radish, pepper
15. Feed for cattle (Soya, barley, oats, etc.)
16. Coarse feed for cattle (hay, straw, stubble,
etc.)
19
9
10
11
12
13
14
The stock by the end of
the past month
8
Rotten amount
during past three
months (Kg)
Received
sum (GEL)
7
Given away during
past three months
(Kg)
Sold
amount
6
Received
sum (GEL)
5
Fed amount during
past three months
(Kg)
sown amount
during past three
months (Kg)
Processed amount
during past three
months (Kg)
4
Three month ago
Sold
amount
3
Two months ago
Received
sum (GEL)
2
During the past
month
Sold
amount
1
Consumed in the
household during
past three months
(Kg)
Product name
Amount of harvest
for past three
months (kg)
To the interviewer: In the 3rd, 4th, 5th, 6th, 7th, 9th, 11th, 13th and 14th columns enter the amount of the utilized harvest gathered during past three months or taken from
stocks. Do not enter utilized amount of products if they were bought.
Utilization (including utilization from stock)
15
17. Beans, peas
18. Stone fruits (cherry, plums, peach, wild plum,
etc.)
19. Apple
20. Pear
21. Other pome fruits (quince, medlar, etc.)
22. Citrus (lemon, tangerine, orange)
23. Sub-tropical fruits (persimmon, pomegranate,
fig, kiwi, fijoa, etc.)
24. Grapes
25. Berries (strawberry, raspberry, currant,
blackberry, etc.)
26. Walnut, hazelnut, almonds
27. Tea leafs
28. Sunflower
29. Leaf tobacco
30. Flowers (unit)
32. Seedlings of grape, citrus, fruit, etc. (unit)
33. Vegetable seedlings (unit)
34. laurel leaf
35. Other (please, specify) ––––––––––––––––
20
9
10
11
12
13
14
The stock by the end of
the past month
8
Rotten amount
during past three
months (Kg)
Received
sum (GEL)
7
Given away during
past three months
(Kg)
Sold
amount
Fed amount during
past three months
(Kg)
6
Received
sum (GEL)
5
Three month ago
Sold
amount
4
sown amount
during past three
months (Kg)
Processed amount
during past three
months (Kg)
Consumed in the
household during
past three months
(Kg)
3
Two months ago
Received
sum (GEL)
2
During the past
month
Sold
amount
1
Amount of harvest
for past three
months (kg)
Product name
Utilization (including utilization from stock)
15
1.5.
Please specify, how much products did your household produced if you proceed any harvest during past three months; How much
produced products did your household utilized during past three months, and how much did lay in stock by the end of the past month
To the interviewer: Please enter information about the products produced (derived) after processing your own harvest as well as the products produced (derived)
1. Flour
(Kg)
2. Wine
(L)
3. Vodka
(L)
4. Vegetable oil
(L)
5. Sauces, ketchup
(L)
6. Churchkhela, tkhlapi and dried fruits
(Kg)
7. Compote, fruit juices
(L)
8. Jam, murabba
(L)
9. Marinades
(L)
10. Canned foods
(L)
11. Other products produced after
processing of cereals (bran, etc.)
(Kg)
12. Tea
(Kg)
Sold
amount
Received
sum (GEL)
Sold
amount
Received
sum (GEL)
Sold
amount
Received
sum (GEL)
Given away
during past three
months
Rotten amount
during past three
months
The stock by the end of the
past month
Fed amount
during past three
months
2
7
8
9
10
11
12
13
14
15
Utilization (including utilization from stock)
Consumed in the
household during
past three months
1
Amount of produced
products
Product name
Measurement unit
after processing of products that are purchased or received free of charge for the purpose of processing)
3
6
During the past month
13. Other (please, specify) –––––––––––
21
Two months ago
Three month ago
2. Cattle breeding, poultry farming, fish-breeding
2.1.
Please answer, does your household own or have in free use productive domestic
animals, poultry or fish industry? (please, encircle)
1.
2.
Yes  continue
No go to part 2.6
Please specify, how much GEL did your household spend on domestic animals during the
past three months according to the following list
Past
month
Type of Expenses
Two
Received free of
Three
months
charge during
months ago
ago
past 3 months
1. Payment on veterinary service
2. Expenses on transport service (transportation of domestic animals,
poultry, beehives, etc.)
3. Expenses on hiring of labour force
4. Expenses on medicines/drugs (on veterinarian’s orders)
5. Other expenses (please, specify) –––––––––––––––––––––––
2.2. Please specify, how much GEL did your household spend on feeding of domestic
animals during the past three months according to the following list
Past
month
Type of Expenses
Two
Received free of
Three
months
charge during
months ago
ago
past 3 months
1. Purchasing of coarse feed (hay, straw, stubble, etc)
2. Purchasing of corn, wheat and etc. for feeding domestic animals,
and poultry
3. Purchasing of combined food and bran for feeding domestic animals
and poultry
4. Purchasing of food for feeding fishes
5. Other expenses (please, specify) –––––––––––––––––––––––
2.3.
Please specify, haw many productive (or for rearing) domestic animals, poultry or
fish bought your household and how much GEL spent on it during the past three
months according to the following list
To the interviewer: Do not enter the quantity of domestic animals bought by household for slaughtering in the near future
Type of domestic animal
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Quantity
(unit)
Cow (for milk producing or to breed)
Buffalo (for milk producing or to breed)
Calf (for rearing)
Sheep, goat (for wool, milk)
Lamb, kid (for rearing)
Pig (to breeding)
Piggy (for rearing)
Rabbit, bunny, nutria (to breed)
Horse or foal
Donkey or foal
Hen
Turkey
Goose
Duck
Guinea fowl
Chicken, ducking, gosling, etc.
Fish
Colony of bees
Other domestic animals (please, specify)
22
Expenses (GEL)
Past month
Two months
ago
Received free of
charge during past
Three
3 months
months ago
2.4.
Please specify the quantity of livestock products, poultry products and fish products produced in your household during past three
months. Please specify how much of it was utilized during past three months and how much did you lay in stock by the end of the past
month
1.
Beef
(Kg)
2.
Pork
(Kg)
3.
Other meet
(Kg)
4.
Poultry
(Kg)
5.
Milk
(L)
6.
Egg*
(Unit)
7.
Wool, feather
(Kg)
8.
Leather
(Unit)
9.
Honey
(Kg)
10. Fish or fry
(Kg)
8
11. Other products (please, specify)
* Eggs could be included in “Processed” (4) column, only if they were used for breeding.
23
10
11
12
13
Rotten amount
during past three
months (Kg)
9
Given away during
past three months
(Kg)
Received
sum (GEL)
Received
sum
(GEL)
7
Three month ago
Sold
amount
4
Sold
amount
Processed
amount during
past three
months
Consumed in the
household
during past three
months
3
Two months ago
Received
sum (GEL)
2
During the past month
Sold
amount
1
Amount of
produced
products
Product name
Measurement
unit
Utilization (including utilization from stock)
14
The stock by the end of
the past month
To the interviewer: Do not enter the quantity of utilized or stocked products if they were bought.
15
1
2
1.
Sausage
(Kg)
2.
Ham, bacon
(Kg)
3.
Other canned food
(Kg)
4.
Yogurt
(L)
5.
Sour-cream
(L)
6.
Curd
(Kg)
7.
Cheese
(Kg)
8.
Cottage cheese
(Kg)
9.
Butter
(Kg)
10. Wool products
(Kg)
11. Salt, smoked or canned fish
(Kg)
3
7
8
12. Other (please, specify) ____________
24
9
10
11
12
13
14
The stock by the end of the
past month
Rotten amount
during past three
months (Kg)
Received
sum (GEL)
Sold amount
Three month ago
Received
sum (GEL)
Two months ago
Sold amount
Received
sum (GEL)
Sold amount
During the past month
Given away during
past three months
(Kg)
Utilization (including utilization from stock)
Consumed in the
household during
past three months
Product name
Amount of products
produced during
past three months
Please specify, how much products did your household produced if you proceed any meat products, poultry products and fish
products during past three months; How much produced products did your household utilized during past three months, and how
much did lay in stock by the end of the past month (Please give us information about the products produced (derived) after processing
your own livestock-poultry-fish products as well as the products produced (derived) after processing of products that are purchased or
received free of charge for the purpose of processing)
Measurement unit
2.5.
15
2.6.
Please specify, haw many domestic animals or poultry sold your household and
how much GEL received as income during the past three months according to the
following list
Type
Quantity
(unit)
1. Cow
2. Ox
3. Buffalo
4. Calf
5. Sheep
6. Goat
7. Lamb, kid
8. Pig
9. Piggy
10. Rabbit, bunny, nutria
11. Horse or foal
12. Donkey or foal
13. Hen
14. Turkey
15. Goose
16. Duck
17. Chicken, ducking, gosling, etc.
18. Guinea fowl
19. Colony of bees
20. Other (dog, cat, etc.)
25
Income (GEL)
Two months Three months
Past month
ago
ago
3. Utilization of different types of fuel
3.1. Please
specify, during the reference period how much fuel did your household
utilize for heating, lighting, cooking, vehicles or other purpose? Please, determine
amount for each measurement unit
Measurement unit
To the interviewer: Please, include both purchased and received for free or amount of fuel produced by
household. Also, include amount of fuel both received during reference period and utilized
from stocks. Do not include amount of fuel used for business.
1.
Liquid gas (for gas cylinder)
Kg
2.
Kerosene
L
3.
Diesel fuel (both for heating and as vehicle fuel)
L
4.
Petrol/gas for vehicles
L
5.
Liquid petroleum gas as vehicle fuel
6.
Fuel oil/black oil
Kg
7.
Coal and coal briquette
Kg
8.
Charcoal
Kg
9.
Firewood and brushwood
During past 3 months,
total
Cubic meter
Cubic meter
10. Bricks of dry dung
Kg
11. Briquettes, granules, sawdust/scobs, nutshells and other types of
solid fuel
Kg
12. Other (please, specify)_________________________
4. Subjective assessment of the interviewers:
How reliable is the information given by the respondent?
1. Information is reliable
2. Information is more or less reliable
3. Information is less reliable
4. Information is not reliable
The interviewer’s comments:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Thank you for your cooperation!
26
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