1 2
3 4
5 6
7
1 2 3 4 5 6 7
1 2 3 4 5 6 1
2 3
4 5
6 7
1 2
3 4
5 6
1 2
3 4 38
1 2
3 4
5 6
7 8
9 10
1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9 1 2 3 4
2.1
2.2
2.3
2.4 2.5
2.6
2.7
2.8 2.9
2.10
2.11
2.12
What type of dwelling best describes your current dwelling?
What is the major construction material of the exterior walls of dwelling, in
the main living area of the family?
What is the major construction material of the roof of this dwelling, in the
main living area of the family?
What is the major construction material of the floor of this dwelling, in the
main living area of the family? When was this dwelling
How many years has your household been living in this
dwellingtent? IF LESS THAN 1 YEAR, WRITE0
YEARS If greater than 3 years 2.9
In the last 3 years how many times have you moved house
with your dependants?
TIMES
How many of these moves in the last 3 years have been because
of forced eviction? Not able to pay increased rent, disputed
tenure, occupation by others
TIMES How did you acquire this current
dwelling or what is your occupancy status?
Do you have any document that shows ownership of this dwelling?
Do you pay rent to live in this dwelling?
How much money per month does your household pay to live in this
dwelling? If pay in goods or services , estimate the value per
month
AFS PER MONTH 2.14
SECTION 2: HOUSING AND UTILITIES
1 2 1
2 3
4 5
1 2
1 2
3 5 38
1 2
3 4
5 6
7 8
9 10
11 12
1 2 3 4 5 6 7 8 9
1 2
1 2
1 2
1 2
1 2
1 2
1 2
1 2
1 2
2.13 2.14
2.15
2.16 2.17
2.18
2.19 2.20
2.21
How many rooms both exclusively yours and shared does your household occupy? Exclude
corridors, balconies IF KUCHI, RECORD NUMBER
If you were to purchase this dwelling today,
how much would it cost? IF DO NOT KNOW PUT 888
AFS Do you have an outstanding debt as
a result of purchasing this dwellling, constructionrepairs on
this dwelling, advance rental payments, or mortgage?
What kind of kitchencooking facilities does this dwelling have?
SECTION 2: HOUSING AND UTILITES
Are any of these rooms shared with another
household? H
How many of these rooms are used exclusively by your household?
Exclude corridors, balconies IF KUCHI, RECORD NUMBER OF TENTS
ROOMSTENTS ROOMSTENTS
SURVEYOR EVALUATION:
Access to this dwelling is through:
Has your household had electrictiy at any time in the
past 30 days from any of these sources mark ALL that apply?
YES NO
During the past 30 days, how many days and how many hours per day on average has electricity
been supplied to your household from this source?
Number of Days Hours Per Day
Electric grid Government Generator
Personal generator engine
Personal generator hydro
Community generator engine
Community generator hydro
Solar Wind
Battery IF ALL NO IN 2.20 2.22
1 2 3 4 5 6 7
1 2
1 2
1 2
1 2
3 4
5 6
7 8
9 10
1 2
3 4
5 6
7 8
9
2.22
2.23
2.24
1 2
3 4
5 6
7 8
9 10
11
2.25 2.26
