FARMERS’s PROFILE
Special Area for Agricultural Development
Department of Agriculture
Reference No. (Generated by ODK/Excel Template):
FARMERS PROFILE
YEAR COVERED: PROJECT TITLE: PROJECT COST:
Y Y Y Y
SURNAME FIRST NAME
SEX: Male Female
MIDDLE NAME EXTENSION NAME
ADDRESS
REGION PROVINCE MUNICIPALITY/CITY
BARANGAY SITIO / PUROK
COORDINATES
LATITUDE LONGITUDE ALTITUDE ACCURACY
CONTACT NO.: PERSON WITH DISABILITY (PWD): Yes No LANGUAGE SPOKEN:
DATE OF BIRTH: RELIGION:
M M D D Y Y Y Y
CIVIL STATUS: Single Married
AGE: PLACE OF BIRTH: Widowed Separated
IP or Non IP: IP Non IP With Voter's ID? Yes No
If Yes, Ethnic Group: If yes, Specify Number:
HIGHEST EDUCATIONAL ATTAINMENT:
None Elementary Graduate Highschool Graduate College Graduate
Vocational Elementary Undergraduate Highschool Undergraduate College Undergraduate
HOUSEHOLD DATA
HOUSEHOLD SIZE: A. (3-4 Persons) D. (9 or more Persons) MOHTLY HOUSEHOLD INCOME:
B. (5-6 Persons) E. (2 or less) Php 2,000.00 below Php 6,000.00-7,999.00
C. (7-8 Persons) Php 2,000.00-3,999.00 Php 8,000.00-9,999.00
Php 4,000.00-5,999.00 Php 10,000.00 and above
NUMBER OF HOUSEHOLD MALE: FEMALE: No. of Years in Farming:
NUMBER OF HOUSEHOLD MEMBERS: Monthly Household Income Derived from farm-
related activity only:
Land Tenureship: Owned Co-Owned Rent Lease Other, pls specify:
MEMBERSHIP IN ORGANIZATIONS OF FARMERS
ORGANIZATION NAME: DATE OF MEMBERSHIP: (MM/DD/YYY)
POSITION: President Vice-President Member Other, pls specify:
LIVELIHOOD
MAIN SOURCE OF INCOME:
FARMING FARMWORKER/LABORER Employment FISHERFOLKS Others, Specify:
A. ON-FARM INCOME
INCOME GENERATED IN PESO (PHP) HOUSEHOLD MEMBERS INVOLVED
INCOME GENERATING ACTIVITY FREQUENCY
PER ACTIVITY PER ACTIVITY
Required Fields
B. OFF FARM INCOME
Amount (Php) Amount (Php)
4Ps SUPPORT Employment
Sari Sari Store PUV Driving
Carpentry/Masonry Other (specify):
No. of Contributing Household Member (Non-Farm Related): Female Male Children (If Applicable)
C. MAIN CROP
TOTAL VOLUME FOR
VOLUME OF PRODUCTION TOTAL VOLUME FOR
CULTIVATED PERSONAL CONSUMPTION TOTAL VOLUME
CROP VARIERY PER PLANTING SEASON RE-PLANTING
AREA (Ha) PER PLANTING SEASON SOLD (Kg)
(Kg/Season) PURPOSES
(Kg/Month)
D. LIVESTOCK
LOT LOCATION TOTAL VOLUME FOR
LIVESTOCK/ TOTAL VOLUME
BREED SITIO/PUROK,BARANGAY, NUMBER OF HEADS PERSONAL CONSUMPTION
POULTRY SOLD (Kg)
CITY/MUNICIPALITY/ PROVINCE PER HEAD (Head/Month)
INTERVENTIONS
TYPES OF INTERVENTION INTERVENTION QUANTITY UNIT OF MEASUREMENT
(USE EXTRA SHEET OF PAPER FOR ADDITIONAL INTERVENTIONS)
I hereby declare that all information indicated above are true and correct, and that they may be used by Department of Agriculture for the purposes
of registration to the Special Area for Agricultural Development (SAAD) Database and other legitimate interests of the Department pursuant to its
mandates
DATE SIGNATURE ABOVE PRINTED NAME OF FARMER THUMBMARK
