1999 SSN99 m41 ques ssn99 m
1
SUSENAS
VSEN99.M
REPUBLIC OF INDONESIA
CENTRAL BUREAU OF STATISTICS
1999 NATIONAL SOCIO-ECONOMIC SURVEY
LISTING OF CONSUMPTION / HOUSEHOLD EXPENDITURES
CONFINDENTIAL
I. IDENTIFICATION
07
08
III. ENUMERATING CHARACTERISTICS
Name and employment identity
number of enumerator
Enumerator ‘s occupation
Provincial staff
1
Regency/municipality 2
staff
Subregency staff
3
Hired worker
4
Date of enumeration
Enumerator’s signature
Name and employment identity
number of supervisor
Supervisor’s Position
Province KS staff
1
Regency/municipality
2
KS staff
Mantis
3
Date of supervision
Serial number
Supervisor’s signature
03
Name & serial number of respondent
04
Address (name of street/lane/RT/RW)
01
Province
01
02
03
04
05
Regency/municipality*)
Subegency
Village / kelurahan *)
Area
02
06
07
08
09
10
11
Enumeration area number
Segments group number
Segment number
Sample code number
Sample serial number of household
Village classification
01
02
1. Urban
2. Rural
03
04
05
06
1. Least
develope
d village
2. Developed
village
II. HOUSEHOLD CHARACTERISTICS
Name of household head
Number of household members
Filled in by
editor
2
3
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001
002
003
004
005
006
007
008
009
010
011
012
013
014
015
016
017
IV. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
A. Cereals
Rice (local, high quality, imported)
Sticky rice
Wet corn with a skin
Dry-shelled corn/corn-rice
Rice flour
Corn flour (maizena)
Wheat flour
Others ……………….
B. Tuber
Cassava
Sweet potato
Sago (not made of cassava,
Example: ‘Ambon” sago)
Taro
Potato
Dried cassava chip
Dried cassava chip flour
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
4
5
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018
019
020
021
022
023
024
025
026
027
028
029
030
031
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Cassava flour (Tapioca)
Kg
Others ……………………
Kg
C. Fish
1] Fresh fish
Yellow tail fish
Tuna
“Tenggiri” fish
“Selar” fish
“Kembung” fish
“Teri” (small fish)
“Bandeng” fish
“Gabus” fish
Tilapia fish
Gold fish
Cat fish
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
6
7
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032
033
034
III. 1. FOOD, DRINK, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Snapper fish
Kg
“Baronang”
Kg
Others ……………….
Kg
035
036
037
038
039
2] Shrimp and other fresh seafoods
Shrimp
Squid
Crab
Shell/snail
Other ……………….
040
041
042
043
044
045
3] Preserved fish
“Kembung” fish
“Tenggiri” fish
Tuna fish
“Teri” (small fish)
“Selar” fish
“Sepat” fish
Kg
Kg
Kg
Kg
Kg
Ounce
Ounce
Ounce
Ounce
Ounce
Ounce
8
9
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046
047
048
049
IV. 1. FOOD, DRINK, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Bandeng” fish
Ounce
“Gabus” fish
Ounce
Canned fish
Ounce
Others ……………….
Ounce
050
051
052
4] Shrimp and other preserved
seafoods
Shrimp (Dried shrimp)
Squid
Other ……………….
053
054
055
056
057
058
059
D. Meat
1] Fresh meat
Beef
Buffalo
Mutton/lamb
Ham
Purebred chicken
Free range chicken
Ounce
Ounce
Ounce
Kg
Kg
Kg
Kg
Kg
Kg
10
11
061
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Other poultry meats …………..
Kg
(state……………………………)
Other meats ………………..
Kg
062
063
064
065
2] Preserved meats
Dried meat
Dried shredded meat
Canned meat
Others ……………….
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060
069
070
3] Other
Liver
Entrails (other than liver)
“Tetelan” (bones with a bit of
adhering meat)
Bones
Others ……………….
071
072
E. Eggs and milk
Egg of purebred chicken
066
067
068
Kg
Ounce
Kg
Kg
Kg
Kg
Kg
Kg
Kg
12
13
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073
074
075
076
077
078
079
080
081
082
083
084
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Egg of free range chicken
Pieces
Duck egg
Pieces
Quail egg
Pieces
Other eggs
Pieces
Salted egg
Pieces
Pure milk
Liter
Dairy milk
250ml *)
Sweetened condensed milk
397gr **)
Powdered milk
Kg
Baby powder milk
400gr ***)
Cheese
Ounce
Other milk products: …………….
Ounce
085 F. Vegetables
086 Spinach
087 Swamp cabbage
088 Cabbage
*) Boxes
**) Small can
***) Small can
Kg
Kg
Kg
14
15
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089
090
091
092
093
094
095
096
097
098
099
100
101
102
103
104
105
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Chinese cabbage/ white mustard
Kg
(“petsai”)
Green mustard
Kg
String bean
Kg
Legume/green beans
Kg
Tomato
Ounce
Carrot
Kg
Cucumber
Kg
Leaves of cassava
Kg
Eggplant
Kg
Bean sprouts
Kg
Gourd
Kg
Baby corn
Ounce
Vegetables soup/stir-fried
Package
vegetables
“Sayur asam” (sour soup)
Package
Raw jack fruit
Kg
Raw papaya
Kg
Mushroom
Ounce
16
17
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106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Petai” (beans with pungent odor)
Ounce
“Jengkol” (Phithecolobium)
Kg
Shallot
Ounce
Garlic
Ounce
Red chili
Ounce
Green chili
Ounce
Small chili
Ounce
Canned vegetables
Kg
Others ……………..
Kg
G. Pulses
Peanut without skin
Peanut with skin
Soy bean
Mungbean
Cashew nut
Other peanuts
(………………..)
Kg
Kg
Kg
Kg
Ounce
Kg
18
19
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122
123
124
125
126
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Tofu
Kg
Fermented soy bean cake
Kg
Fermented soy bean sauce
Ounce
Fermented peanut expeller cake
Ounce
Others ………………….
Ounce
127
128
129
130
131
132
133
134
135
136
137
H. Fruits
Orange
Mango
Apple
Avocado
“Rambutan”
Lanzon
Durian
Snake fruit
Pineapple
‘Ambon’ Banana
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
20
21
140
141
142
143
144
145
146
147
148
149
150
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
King “Raja” banana
Kg
Other bananas
Kg
……………………
Papaya
Kg
Rose-apple/guava
Kg
“Sawo” (Sapodilla)
Kg
Star fruits
Kg
“Kedondong”
Kg
Watermelon
Kg
Melon
Kg
Jack fruit
Kg
Tomato
Kg
Canned fruits
Kg
Others ………………..
Kg
151
152
153
I. Oil and fat
Coconut oil
Corn oil
Seri
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138
139
Liter
Liter
22
23
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154
155
156
157
158
159
160
161
162
163
164
165
166
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Other cooking oil:
Liter
Coconut
pieces
Margarine/Butter
Ounce
Others
……………………..
J. Beverages
Granulated sugar
Ounce
Palm sugar
Ounce
Tea
Ounce
Coffee (ground, beans, instant)
Ounce
Instant cocoa
150 gram
Powdered cocoa
Ounce
Syrup
620ml*)
Others ……………….
167 K. Spices
168 Salt
169 Candle nuts
*) Large bottle
Ounce
Ounce
24
25
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Coriander/caraway seed
Ounce
Pepper
Ounce
Tamarind
Ounce
Nutmeg
Ounce
Clove
Ounce
Fish paste
Ounce
Soy sauce
140 ml *)
Monosodium glutamate
Gram
“Sambal” (chili sauce) /tomato
140 ml*)
sauce
179 Prepared spices/package
Ounce
180 Other cooking spices
…………………….
181 L. Other consumptions
182 Crisp
Ounce
183 Crisp chip
Ounce
184 Wet noodle
Kg
185 Instant noodle
80 gr**)
*) Small plastic bottle
**) One regular packages
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170
171
172
173
174
175
176
177
178
26
27
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Wheat and rice noodle
Ounce
Macaroni/ dried noodle
Ounce
Jelly
Pack (7 gr)
Baby food (packaging)
150 gr*)
Others
………………………..
191 M. Prepared foods & drinks
(taken from VSEN99.LPK)
192 White Bread
Small pack
193 Sweet bread/other bread
Piece
194 Dry cake/Biscuit/’semprong’
Ounce
195 Wet cake
Piece
196 Fried food
Piece
197 Mungbean porridge
Bowl
198 Salad/’ketoprak/’pecel’
Plate
199 A Plate of rice and side dish
Plate
200 Fried rice
Plate
201 Rice
Plate
*) Small pack
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186
187
188
189
190
28
29
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202
203
204
205
206
207
208
209
210
211
212
213
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Bowl
“Lontong” (food consisting of rice
steamed in a banana leaf)/ Ketupat
sayur (kind of Lontong with
vegetables)
“Soto”/goulash/
Bowl
soup/”rawon”/mince
Plate/ 5 stick
“Sate” (small pieces of meat roasted
on skewer)/”Tongseng” (kind of
goulash used lamb meat)
Meat ball noodle/boiled
Bowl
noodle/fried noodle
Instant noodle
Bowl
Snack for kids/crisp/crispy chip
Ounce
Fish (fried, baked, fermented,
Piece
steam, preserved, etc)
Chicken/meat (fried, baked, etc)
Piece
Ice cream
Small bowl
Other ice ……………
Glass 200ml
Other prepared foods ……………..
Soft drink with CO2 (soda)
200 ml *)
Beverages without CO2:
214 Packaging water
215 Packaging tea
*) Small Glass Bottle
**) Small Plastic Bottle
***) “Tea bottle” packaging
500 ml **)
200 ml ***)
30
31
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216
217
218
219
220
221
222
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Package of fruit essence
200 ml*)
Health drink/energetic drinks
100 ml**)
Other drinks (coffee, coffee milk,
Glass
tea, chocolate milk)
N. Alcohol beverages
Bier
Wine
Other alcohol beverages ……….
………………..
223 O. Tobacco and betel
224 Filtered clove cigarette
225 Unfiltered clove cigarette
226 Menthol Cigarette
227 Tobacco
228 Betel leaves/areca nut
229 Other …………………..
*) Package in a box
**) Small bottle
***) Large bottle
620 ml***)
620 ml***)
620 ml***)
pieces
pieces
pieces
Ounce
32
33
Seri
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(1)
230
231
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
The house of living is:
Owned property/free of rental 1
Lease
2
Rent
3
Rent purchased
Official house
Other
4
5
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:
235
If the status of dwelling is purchase-rent, official and others, average value of monthly renting:
Rp. ……………
Maintenance costs of the house (painting, plastering, painting the wall, roof, window glass, hinge, etc,
including wages for the workers)
236
237
(4)
A. Housing and Household facility
Rp. ………….
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
238
Value:
34
35
Seri
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(1)
239
240
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
Telephone
Water (“PAM” = Municipal Water Corporation / carrying pole water / purchased)
Quantity: a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
241
242
Value:
LPG (Liquid Propane Gas)
Quantity: a. A month ago: ……………………kg
b. 12 months ago: ………………….kg
243
244
Value
City Gas
Quantity:
245
246
247
248
Value:
Kerosene
Quantity:
(3)
(4)
a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
a. A month ago: ……………………liter
b. 12 months ago: ………………….liter
Value
Generator
a. Type and number of fuel used:
Gasoline
Solar
249
1
2
Kerosene
3
A month ago: ……………..liter
12 months ago: ……………liter
Value
36
37
Seri
al
NO.
(1)
250
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
Quantity:
251
252
253
(4)
a. A month ago: ……………………liter
b. 12 months ago: ………………….liter
Value:
c. Maintenance and repair
Charcoal
Quantity:
a. A month ago: ……………………kg
b. 12 months ago: ………………….kg
254
255
Value
Firewood and other fuel
256
Others (flashlight, storage battery, matches, mosquito repellent, lamp, air freshener, Liquid floor cleaner, etc)
257
B. Goods and Services
258
(3)
b. Lubricant oil:
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)
38
39
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
Seri
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NO.
(1)
(2)
(3)
(4)
Health
261
262
263
264
265
266
267
268
269
270
271
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
Other health:
272
273
274
275
276
Pregnancy treatment cost
Delivery cost
Immunization cost for children under 5 years
Check-up and using contraceptive costs
Health treatment (vitamin, herbs, massage, fitness, etc)
Expenses of school & courses
277
278
279
280
281
282
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
40
41
Seri
al
NO.
(1)
283
284
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
Newspapers, magazines, books, and stationery (outside of school and courses needs) including rents of
magazines/literatures
(3)
(4)
Postal, Telegram, public phone, and post materials, including pager contribution
Fuel of motor vehicle used for household needs (not for business/working)
285
286
287
288
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:
290
291
c. Lubricant oil
Quantity: (1) A month ago: ………………………….liter
(2) 12 months ago: ………………………..liter
Value:
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
294
Hotel, motel, cinema, play, sport, decoder, and other recreation, (excluded transportation cost and purchase of
goods for recreation)
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)
289
42
43
Seri
al
NO.
(1)
297
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
300
Ready made man’s wear (Blazer, long-sleeved shirt, Jacket, sarong, pants, T-shirt, underwear, etc)
Ready made woman’s wear (Gown, long fabric, blouse, nightgown, sweater, skirt, sarong, shawl, “angkin”
(cloth waisband), underwear, etc)
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)
298
299
(3)
(4)
C. Clothing, Footwear, and Head gear
44
45
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
Seri
al
NO.
(1)
310
D. Durable goods
311
312
Furniture’s ( table, chair, bed, wardrobe, showcase, long-shelf, mirror, kitchen cabinet, baby bed, etc)
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)
Household utensils (Iron, broom, scissors, knife, machete, saw, vacuum cleaner, hanger, soldering tools, etc)
314
315
(2)
317
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)
Decoration goods (wall decoration, aquarium, decoration goods made of ceramic, porcelain, onyx, marble,
wood, etc)
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
324
Sport utensils (chess, racket, ball, net, bet, stick, including swim trunk, shoes for playing soccer/roller shoes,
glasses for swimming, etc) and its repaired
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)
316
(3)
(4)
46
47
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
Seri
al
NO.
(1)
327
E. Taxes and insurance:
328
329
Building and Land tax (PBB)
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
F. Festivities and ceremonies
334
336
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)
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).
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)
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)
335
339
(2)
(3)
(4)
48
49
Seri
al
no.
(1)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
IV. 3. AVERAGE EXPENSES OF HOUSEHOLD IN A MONTH ( IN RUPIAH)
Type of expenses
During a week
(2)
(3)
Cereals (IV.1 A)
Tuber (IV. 1 B)
Fish (IV. 1 C)
Meat (IV. 1 D)
Egg and Milk (IV. 1 E)
Vegetables (IV. 1 F)
Pulses (IV. 1 G)
Fruits (IV. 1 H)
Oil and Fat (IV. 1 I)
Beverages materials (IV. 1 J)
Spices (IV. 1 K)
Other consumption’s (IV. 1 L)
Prepared foods and beverages (IV. 1 M)
Alcohol’s drink (IV. 1 N)
Tobacco and betel (IV. 1 O)
Sub Total (1 to 15)
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
Average in a
month*)
During 12
months
(4)
(5)
50
51
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:
(sent the money, give donation, gift, grant, and aid)
6. Other expenses and revenue
Expenses:
a. Purchased of bond/gold/jewelry, immovable goods
including repairs of building
Revenue:
(received money wired, legacy, donation, gift and aid)
Revenue:
a. Sold of bond/gold/jewelry/immovable goods, secondhand 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)
52
53
VI. NOTE
54
SUSENAS
VSEN99.M
REPUBLIC OF INDONESIA
CENTRAL BUREAU OF STATISTICS
1999 NATIONAL SOCIO-ECONOMIC SURVEY
LISTING OF CONSUMPTION / HOUSEHOLD EXPENDITURES
CONFINDENTIAL
I. IDENTIFICATION
07
08
III. ENUMERATING CHARACTERISTICS
Name and employment identity
number of enumerator
Enumerator ‘s occupation
Provincial staff
1
Regency/municipality 2
staff
Subregency staff
3
Hired worker
4
Date of enumeration
Enumerator’s signature
Name and employment identity
number of supervisor
Supervisor’s Position
Province KS staff
1
Regency/municipality
2
KS staff
Mantis
3
Date of supervision
Serial number
Supervisor’s signature
03
Name & serial number of respondent
04
Address (name of street/lane/RT/RW)
01
Province
01
02
03
04
05
Regency/municipality*)
Subegency
Village / kelurahan *)
Area
02
06
07
08
09
10
11
Enumeration area number
Segments group number
Segment number
Sample code number
Sample serial number of household
Village classification
01
02
1. Urban
2. Rural
03
04
05
06
1. Least
develope
d village
2. Developed
village
II. HOUSEHOLD CHARACTERISTICS
Name of household head
Number of household members
Filled in by
editor
2
3
Seri
al
nu
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er
(1)
001
002
003
004
005
006
007
008
009
010
011
012
013
014
015
016
017
IV. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
A. Cereals
Rice (local, high quality, imported)
Sticky rice
Wet corn with a skin
Dry-shelled corn/corn-rice
Rice flour
Corn flour (maizena)
Wheat flour
Others ……………….
B. Tuber
Cassava
Sweet potato
Sago (not made of cassava,
Example: ‘Ambon” sago)
Taro
Potato
Dried cassava chip
Dried cassava chip flour
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
4
5
Seri
al
nu
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er
(1)
018
019
020
021
022
023
024
025
026
027
028
029
030
031
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Cassava flour (Tapioca)
Kg
Others ……………………
Kg
C. Fish
1] Fresh fish
Yellow tail fish
Tuna
“Tenggiri” fish
“Selar” fish
“Kembung” fish
“Teri” (small fish)
“Bandeng” fish
“Gabus” fish
Tilapia fish
Gold fish
Cat fish
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
6
7
Seri
al
nu
mb
er
(1)
032
033
034
III. 1. FOOD, DRINK, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Snapper fish
Kg
“Baronang”
Kg
Others ……………….
Kg
035
036
037
038
039
2] Shrimp and other fresh seafoods
Shrimp
Squid
Crab
Shell/snail
Other ……………….
040
041
042
043
044
045
3] Preserved fish
“Kembung” fish
“Tenggiri” fish
Tuna fish
“Teri” (small fish)
“Selar” fish
“Sepat” fish
Kg
Kg
Kg
Kg
Kg
Ounce
Ounce
Ounce
Ounce
Ounce
Ounce
8
9
Seri
al
nu
mb
er
(1)
046
047
048
049
IV. 1. FOOD, DRINK, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Bandeng” fish
Ounce
“Gabus” fish
Ounce
Canned fish
Ounce
Others ……………….
Ounce
050
051
052
4] Shrimp and other preserved
seafoods
Shrimp (Dried shrimp)
Squid
Other ……………….
053
054
055
056
057
058
059
D. Meat
1] Fresh meat
Beef
Buffalo
Mutton/lamb
Ham
Purebred chicken
Free range chicken
Ounce
Ounce
Ounce
Kg
Kg
Kg
Kg
Kg
Kg
10
11
061
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Other poultry meats …………..
Kg
(state……………………………)
Other meats ………………..
Kg
062
063
064
065
2] Preserved meats
Dried meat
Dried shredded meat
Canned meat
Others ……………….
Seri
al
nu
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er
(1)
060
069
070
3] Other
Liver
Entrails (other than liver)
“Tetelan” (bones with a bit of
adhering meat)
Bones
Others ……………….
071
072
E. Eggs and milk
Egg of purebred chicken
066
067
068
Kg
Ounce
Kg
Kg
Kg
Kg
Kg
Kg
Kg
12
13
Seri
al
nu
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er
(1)
073
074
075
076
077
078
079
080
081
082
083
084
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Egg of free range chicken
Pieces
Duck egg
Pieces
Quail egg
Pieces
Other eggs
Pieces
Salted egg
Pieces
Pure milk
Liter
Dairy milk
250ml *)
Sweetened condensed milk
397gr **)
Powdered milk
Kg
Baby powder milk
400gr ***)
Cheese
Ounce
Other milk products: …………….
Ounce
085 F. Vegetables
086 Spinach
087 Swamp cabbage
088 Cabbage
*) Boxes
**) Small can
***) Small can
Kg
Kg
Kg
14
15
Seri
al
nu
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(1)
089
090
091
092
093
094
095
096
097
098
099
100
101
102
103
104
105
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Chinese cabbage/ white mustard
Kg
(“petsai”)
Green mustard
Kg
String bean
Kg
Legume/green beans
Kg
Tomato
Ounce
Carrot
Kg
Cucumber
Kg
Leaves of cassava
Kg
Eggplant
Kg
Bean sprouts
Kg
Gourd
Kg
Baby corn
Ounce
Vegetables soup/stir-fried
Package
vegetables
“Sayur asam” (sour soup)
Package
Raw jack fruit
Kg
Raw papaya
Kg
Mushroom
Ounce
16
17
Seri
al
nu
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er
(1)
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
“Petai” (beans with pungent odor)
Ounce
“Jengkol” (Phithecolobium)
Kg
Shallot
Ounce
Garlic
Ounce
Red chili
Ounce
Green chili
Ounce
Small chili
Ounce
Canned vegetables
Kg
Others ……………..
Kg
G. Pulses
Peanut without skin
Peanut with skin
Soy bean
Mungbean
Cashew nut
Other peanuts
(………………..)
Kg
Kg
Kg
Kg
Ounce
Kg
18
19
Seri
al
nu
mb
er
(1)
122
123
124
125
126
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Tofu
Kg
Fermented soy bean cake
Kg
Fermented soy bean sauce
Ounce
Fermented peanut expeller cake
Ounce
Others ………………….
Ounce
127
128
129
130
131
132
133
134
135
136
137
H. Fruits
Orange
Mango
Apple
Avocado
“Rambutan”
Lanzon
Durian
Snake fruit
Pineapple
‘Ambon’ Banana
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
Kg
20
21
140
141
142
143
144
145
146
147
148
149
150
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
King “Raja” banana
Kg
Other bananas
Kg
……………………
Papaya
Kg
Rose-apple/guava
Kg
“Sawo” (Sapodilla)
Kg
Star fruits
Kg
“Kedondong”
Kg
Watermelon
Kg
Melon
Kg
Jack fruit
Kg
Tomato
Kg
Canned fruits
Kg
Others ………………..
Kg
151
152
153
I. Oil and fat
Coconut oil
Corn oil
Seri
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(1)
138
139
Liter
Liter
22
23
Seri
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(1)
154
155
156
157
158
159
160
161
162
163
164
165
166
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Other cooking oil:
Liter
Coconut
pieces
Margarine/Butter
Ounce
Others
……………………..
J. Beverages
Granulated sugar
Ounce
Palm sugar
Ounce
Tea
Ounce
Coffee (ground, beans, instant)
Ounce
Instant cocoa
150 gram
Powdered cocoa
Ounce
Syrup
620ml*)
Others ……………….
167 K. Spices
168 Salt
169 Candle nuts
*) Large bottle
Ounce
Ounce
24
25
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Coriander/caraway seed
Ounce
Pepper
Ounce
Tamarind
Ounce
Nutmeg
Ounce
Clove
Ounce
Fish paste
Ounce
Soy sauce
140 ml *)
Monosodium glutamate
Gram
“Sambal” (chili sauce) /tomato
140 ml*)
sauce
179 Prepared spices/package
Ounce
180 Other cooking spices
…………………….
181 L. Other consumptions
182 Crisp
Ounce
183 Crisp chip
Ounce
184 Wet noodle
Kg
185 Instant noodle
80 gr**)
*) Small plastic bottle
**) One regular packages
Seri
al
nu
mb
er
(1)
170
171
172
173
174
175
176
177
178
26
27
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Wheat and rice noodle
Ounce
Macaroni/ dried noodle
Ounce
Jelly
Pack (7 gr)
Baby food (packaging)
150 gr*)
Others
………………………..
191 M. Prepared foods & drinks
(taken from VSEN99.LPK)
192 White Bread
Small pack
193 Sweet bread/other bread
Piece
194 Dry cake/Biscuit/’semprong’
Ounce
195 Wet cake
Piece
196 Fried food
Piece
197 Mungbean porridge
Bowl
198 Salad/’ketoprak/’pecel’
Plate
199 A Plate of rice and side dish
Plate
200 Fried rice
Plate
201 Rice
Plate
*) Small pack
Seri
al
nu
mb
er
(1)
186
187
188
189
190
28
29
Seri
al
nu
mb
er
(1)
202
203
204
205
206
207
208
209
210
211
212
213
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Bowl
“Lontong” (food consisting of rice
steamed in a banana leaf)/ Ketupat
sayur (kind of Lontong with
vegetables)
“Soto”/goulash/
Bowl
soup/”rawon”/mince
Plate/ 5 stick
“Sate” (small pieces of meat roasted
on skewer)/”Tongseng” (kind of
goulash used lamb meat)
Meat ball noodle/boiled
Bowl
noodle/fried noodle
Instant noodle
Bowl
Snack for kids/crisp/crispy chip
Ounce
Fish (fried, baked, fermented,
Piece
steam, preserved, etc)
Chicken/meat (fried, baked, etc)
Piece
Ice cream
Small bowl
Other ice ……………
Glass 200ml
Other prepared foods ……………..
Soft drink with CO2 (soda)
200 ml *)
Beverages without CO2:
214 Packaging water
215 Packaging tea
*) Small Glass Bottle
**) Small Plastic Bottle
***) “Tea bottle” packaging
500 ml **)
200 ml ***)
30
31
Seri
al
nu
mb
er
(1)
216
217
218
219
220
221
222
IV. 1. FOOD, BEVERAGES, AND TOBACCO CONSUPMTIONS DURING PREVIOUS WEEK
Purchase
Own production,
Total of consumption
(cash/owed)
given, etc.
Standard unit Total
Details
Value
Total
Value
Total
Value
(4) + (6)
(5) + (7)
(0,00)
(Rp)
(0,00)
(Rp)
(0,00)
(Rp)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Package of fruit essence
200 ml*)
Health drink/energetic drinks
100 ml**)
Other drinks (coffee, coffee milk,
Glass
tea, chocolate milk)
N. Alcohol beverages
Bier
Wine
Other alcohol beverages ……….
………………..
223 O. Tobacco and betel
224 Filtered clove cigarette
225 Unfiltered clove cigarette
226 Menthol Cigarette
227 Tobacco
228 Betel leaves/areca nut
229 Other …………………..
*) Package in a box
**) Small bottle
***) Large bottle
620 ml***)
620 ml***)
620 ml***)
pieces
pieces
pieces
Ounce
32
33
Seri
al
NO.
(1)
230
231
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
(3)
The house of living is:
Owned property/free of rental 1
Lease
2
Rent
3
Rent purchased
Official house
Other
4
5
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:
235
If the status of dwelling is purchase-rent, official and others, average value of monthly renting:
Rp. ……………
Maintenance costs of the house (painting, plastering, painting the wall, roof, window glass, hinge, etc,
including wages for the workers)
236
237
(4)
A. Housing and Household facility
Rp. ………….
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
238
Value:
34
35
Seri
al
NO.
(1)
239
240
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
Telephone
Water (“PAM” = Municipal Water Corporation / carrying pole water / purchased)
Quantity: a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
241
242
Value:
LPG (Liquid Propane Gas)
Quantity: a. A month ago: ……………………kg
b. 12 months ago: ………………….kg
243
244
Value
City Gas
Quantity:
245
246
247
248
Value:
Kerosene
Quantity:
(3)
(4)
a. A month ago: ……………………m3
b. 12 months ago: ………………….m3
a. A month ago: ……………………liter
b. 12 months ago: ………………….liter
Value
Generator
a. Type and number of fuel used:
Gasoline
Solar
249
1
2
Kerosene
3
A month ago: ……………..liter
12 months ago: ……………liter
Value
36
37
Seri
al
NO.
(1)
250
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
Quantity:
251
252
253
(4)
a. A month ago: ……………………liter
b. 12 months ago: ………………….liter
Value:
c. Maintenance and repair
Charcoal
Quantity:
a. A month ago: ……………………kg
b. 12 months ago: ………………….kg
254
255
Value
Firewood and other fuel
256
Others (flashlight, storage battery, matches, mosquito repellent, lamp, air freshener, Liquid floor cleaner, etc)
257
B. Goods and Services
258
(3)
b. Lubricant oil:
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)
38
39
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
Seri
al
NO.
(1)
(2)
(3)
(4)
Health
261
262
263
264
265
266
267
268
269
270
271
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
Other health:
272
273
274
275
276
Pregnancy treatment cost
Delivery cost
Immunization cost for children under 5 years
Check-up and using contraceptive costs
Health treatment (vitamin, herbs, massage, fitness, etc)
Expenses of school & courses
277
278
279
280
281
282
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
40
41
Seri
al
NO.
(1)
283
284
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
Newspapers, magazines, books, and stationery (outside of school and courses needs) including rents of
magazines/literatures
(3)
(4)
Postal, Telegram, public phone, and post materials, including pager contribution
Fuel of motor vehicle used for household needs (not for business/working)
285
286
287
288
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:
290
291
c. Lubricant oil
Quantity: (1) A month ago: ………………………….liter
(2) 12 months ago: ………………………..liter
Value:
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
294
Hotel, motel, cinema, play, sport, decoder, and other recreation, (excluded transportation cost and purchase of
goods for recreation)
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)
289
42
43
Seri
al
NO.
(1)
297
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
(2)
300
Ready made man’s wear (Blazer, long-sleeved shirt, Jacket, sarong, pants, T-shirt, underwear, etc)
Ready made woman’s wear (Gown, long fabric, blouse, nightgown, sweater, skirt, sarong, shawl, “angkin”
(cloth waisband), underwear, etc)
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)
298
299
(3)
(4)
C. Clothing, Footwear, and Head gear
44
45
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
Seri
al
NO.
(1)
310
D. Durable goods
311
312
Furniture’s ( table, chair, bed, wardrobe, showcase, long-shelf, mirror, kitchen cabinet, baby bed, etc)
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)
Household utensils (Iron, broom, scissors, knife, machete, saw, vacuum cleaner, hanger, soldering tools, etc)
314
315
(2)
317
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)
Decoration goods (wall decoration, aquarium, decoration goods made of ceramic, porcelain, onyx, marble,
wood, etc)
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
324
Sport utensils (chess, racket, ball, net, bet, stick, including swim trunk, shoes for playing soccer/roller shoes,
glasses for swimming, etc) and its repaired
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)
316
(3)
(4)
46
47
IV. 2. EXPENDITURE OF NON FOOD GOODS DURING A MONTH AND 12 MONTHS AGO
DETAIL
Value in Rupiah
A month ago
12 month ago
Seri
al
NO.
(1)
327
E. Taxes and insurance:
328
329
Building and Land tax (PBB)
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
F. Festivities and ceremonies
334
336
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)
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).
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)
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)
335
339
(2)
(3)
(4)
48
49
Seri
al
no.
(1)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
IV. 3. AVERAGE EXPENSES OF HOUSEHOLD IN A MONTH ( IN RUPIAH)
Type of expenses
During a week
(2)
(3)
Cereals (IV.1 A)
Tuber (IV. 1 B)
Fish (IV. 1 C)
Meat (IV. 1 D)
Egg and Milk (IV. 1 E)
Vegetables (IV. 1 F)
Pulses (IV. 1 G)
Fruits (IV. 1 H)
Oil and Fat (IV. 1 I)
Beverages materials (IV. 1 J)
Spices (IV. 1 K)
Other consumption’s (IV. 1 L)
Prepared foods and beverages (IV. 1 M)
Alcohol’s drink (IV. 1 N)
Tobacco and betel (IV. 1 O)
Sub Total (1 to 15)
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
Average in a
month*)
During 12
months
(4)
(5)
50
51
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:
(sent the money, give donation, gift, grant, and aid)
6. Other expenses and revenue
Expenses:
a. Purchased of bond/gold/jewelry, immovable goods
including repairs of building
Revenue:
(received money wired, legacy, donation, gift and aid)
Revenue:
a. Sold of bond/gold/jewelry/immovable goods, secondhand 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)
52
53
VI. NOTE
54