Govt. of Punjab

State Institute of Rural Development,Mohali

Questionnaire for Assessment of Gram Panchayats (2012-13)

Date of Verification:

Name of Verifiers:

Team Leader:

Sr. no. Name Phone Number

1.

2.

1. Basic Information:

1.1 Name of Gram Panchayat: 1.2 Block

1.3 District: 1.4 Pin Code:

1.5 Telephone No.: 1.6 Email-ID:

1.7 Name & Mobile No. of Sarpanch : 1.8 Age of Sarpanch:

1.9 Gender of the Sarpanch: Male/ Female 1.10 Qualification of Sarpanch: Illiterate/under Matric/Matric/Graduate/Post Graduate/if any then give the details:

1.11 Category of Sarpanch: GEN/SC/OBC 1.12 Name & Mobile No. of Panchayat Secretary :

1.13 Population & Literacy :

Index 2001 OR 2011(Census)Men Women Total

(a) Population(b) Schedule Caste Population(c)Literacy Rate

1.14 Number of Families: SC : GEN: OBC: Total:

1.15 Number of Voter (according to latest electoral list): Men: Women: Total:

1.16 Details of New Gram Panchayat Panch:Sr. No. Name of GP Panch General OBC SC Mobile No.

1

2

3

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5

6

7

8

9

10

11

12

13

1.17 Number of GP Members (Old Panchayat including Sarpanch):-

General SC BC Total Total

Male Female Male Female Male Female Male Female

2.Panchayat Performance:

a) Panchayat functioning:Question Total

MarksMarks Obtained

Revised Marks given by state verifying team

Observation on the basis of field verification (mention source of information )

Decision of SPPAC with detailed reasons for non-acceptance of the findings of field verification teams

(i) How many meetings of the Panchayat were held in 2012-13?(a) No. of mandated meetings in a year: One meeting in every

month12

(b) No. of mandated meetings held with proper quorum in 2012-13:On-Watch

(c) No. of Special meeting held in 2012-13:(d) Total No. of mandated and Special meeting held in 2012-13:

3

(ii) Provide the following information about the first meeting of Gram Panchayat in every quarter (April, July, October and January):

Quarter Date Total no. of members attended

No. of SC members attended

No. of women who attended

April-June, 2012

July-September, 2012

October-December, 2012

January-March, 2013

Total

Percentage(To be calculated by the Evaluator)

6

(iii) For how many meetings agenda was circulated in advance during 2012-13 ?

1

(iv) In how many meetings decisions were taken by vote or consensus after discussion in 2012-13?

1

(v) For how many meetings minutes were recorded including the discussion, differences, different opinion, suggestion, etc along with the names of the GP members who raised issues in 2012-13 ?

1

(vi) Please tick mark if resolutions were passed on following issues during the year 2012-13:

Sr. No. Issues Date of resolutiona Approval of Budget/ Planningb Review of Schemesc Waterd Educatione Livelihoodf Nutritiong Healthh Women issuesi SC issuesj Child care issuesk Sanitationl Road/ connectivitym Streetlightsn Environmento Agriculture Diversificationp Abuse Controlq Dowryr Caste issuess Common Landt Female Feticideu Sportsv Deforestationw Other Social issues

3

(vii) If any of the powers of Panchayat has been revoked for irregularity or illegality in 2012-13?(if yes then give the detail) (On-Watch)

0

(b) Functioning of Gram Sabhas (i) How many meetings of the Gram Sabha were held in 2012-13?

(a) No. of mandated meetings in a year: Two(b) No. of mandated meetings held in 2012-13:

(On-Watch)

1

(ii) How many Gram Sabha Meetings were adjourned due to lack of quorum? 1

(iii) Please Provide following information regarding two Gram Sabha meetings held during 2012-13:Date Total No. of members

attendedNo. of women who attended

(First Meeting)

(Second Meeting)

Total

Percentage (Find out Evaluator)

6

(iv) Has the GP maintained the record of agenda notice and propaganda through announcement when meetings of the Gram Sabha were called.(Please give the detail)

1

(v) In 2012-13, for how many Gram Sabha meetings minutes were recorded with discussion, suggestion, etc. with the name of Gram Sabha members, who raised issues in the meetings.

2

(vi) Has the Gram Sabha conducted social audit during 2012-13?(a)For NREGA(b)Community monitoring of Health Services Under NRHM

2

(vii) Did Gram Sabha discussed and passed resolutions on following issues during 2012-13?a. NREGA Job Card Yes Nob. Budget Yes Noc. Village Development Plan Yes No

d. Rural Latrine Yes Noe Annapurna Scheme Yes Nog. Any other (Give details) Yes No

2

(c) Performance of Standing Committees(i) Has the Gram Panchayat formed the standing committees by passing the resolution under Sec. 25 of Punjab Panchayati Raj Act and allocated work to them?

Sr. No. Standing Committees Date of meeting in which work allocated to them

A. Production Committee

B. Social Justice Committee

C. Amenities Committee

2

(d) Performance of Village Health Sanitation and Nutrition Committees:(i) Did the member of VHSNC Supervised/Investigated the mid-day meal in the school and Angarwari:Sr. No. Name of School/ Angarwari Date of Investigation/Monitoring

1

3. Management of Personnel and Capacity Building

(b) Training programmes organized(i) Have all elected representatives and Panchayat Secretary/Village Development organiser attended at least one training programme? (Tick one only)a) Attended by All Yes No

b) Attended by some Yes No

c) No one Attended Yes No

2

(b) Attendance of officials’ in Panchayat meeting(ii) Do the officials of following department devolved to GP attend the meetings of Gram Panchayat? (Please give the details of officials who attend the meeting of GP)Department Name Yes No if Yes then write the name of

officialEducation Department

Health Department

Veterinary Department

Water Department

Village development

Social Security, Women and Child developmentSocial welfare, SC & BC

2

(c) Review of work of officials (iii) If yes in (ii) above does Gram Panchayat review work of officials? (Please give the details of that meeting )

2

4. Planning and budget formulation

(a)Preparation of annual plan(i) Was the annual plan of the Gram Panchayat prepared for 2012-13? 1

(ii) Was the annual plan of the Gram Panchayat submitted to next level? (a) The date on which annual plan passed by Gram Sabha: (b) Date on which annual plan Submitted to Panchayat Samiti :

1

(b) Process of preparation of annual plan(i) Was the annual plan discussed in the Gram Sabha? 1

(ii) Were suggestions of the Gram Sabha incorporated? 1

(iii) Were following other stakeholder groups consulted?Sr. No. Stakeholders Name Yes OR No1. Farmers2. Women Group3. Youth Group4. CBOs5. NGO

1

(iv) Was convergence with departmental plans/ schemes ensured in preparation of annual plan? if yes then give following information:-Sr. No.

Names of the Schemes in which Convergence was done

Details of works Converged (Scheme wise)

Details of expenditure (Scheme wise)

2

(c) Budget(i) Was a budget prepared as per norms and in time for FY 2013-14?

On-Watch1

(i) Was gender budget prepared for FY 2013-14? 1

5. Income generation

(a) Planning for own income:(i)Whether Income generation for 2012-13 was discussed and any new sources of income for 2012-13 were identified in the Gram Panchayat ?(Mention the date of meeting in which decision were taken)

Date of GP Meeting Detail of New Sources identified

2

(ii)Whether income was generated from these sources?(Please give details of the amount generated )

Name of the New Sources Income Generated from it

2

(iii)What is the total income from own sources? 4

Sr. No. Year Total Amount1 2012-132 2011-12

(iii)Whether any income generating assets like shop etc. created in Gram panchayat during 2012-13? (Please give the detail of Assets)

Name of new asset created Income generated from it 2

(b) Voluntary contributions generated in form of money, kind or labour

(i) Did the Gram Panchayat generate any income from voluntary contributions in the form of labour, cash or kind in 2012-13? If so, describe:Details of Voluntary Contribution Amount of Voluntary Contribution

2

(c) Land under illegal Possession(i) Whether any property (Land or Shops etc.) of Gram Panchayat is under illegal 0

possession, for which no efforts has been made for its eviction ?Property under ownership of Gram Panchayat

Area under illegal possession

Detail of efforts made for eviction of illegal possession

Area under illegal possession (% age of Total area)

6. Performance

(a) Physical achievements in schemes:(a) Please provide the targets achieved in schemes implemented by the Gram Panchayat as follows:

Name of scheme

Central Govt./State Govt./Other

Actual target (Give Counting & measurement) e.g. No. Of houses, No. Of beneficiaries, street area in Sq. Mt. etc.

Physical Achievement (Give Counting & measurement)

4

(b) Expenditure against allotment in schemes

i) Please provide the expenditure against the allotment available in each scheme of the Gram Panchayat as follows

Name of Scheme

Central/ State / other

Allotment available to Panchayat in 2012-13(in Rs.)

Amount spent in 2012-13 (in Rs.)

4

(c) Expenditure on SC

(c) Utilization of funds allocated for SCs:Total funds earmarked for SCs in all Schemes:

a. Actual Allocationb. Actual Expenditure

2

(d) Expenditure for women development(i) Describe the allotment for the women's development program in Panchayat's annual Planning in 2012-13:

a. Total non personal Expenditure:b. Allotment for women development

programmes:

1

(ii) In 2012-13 give the details of Expenditure on women's development programmes against the allocation in Panchayat's annual Planning?

a. Total Allotment for women development programmes:

b. Actual Expenditure on women development programmes:

1

(e) Untied funds expenditure

(i) Please provide following information about untied funds in the Gram Panchayats: (including the Gram Panchayat own sources like Common land,13th

finance Commission etc. )Sources from which untied fund is availableAmount of untied fund available in 2012-13(in Rs.)Total Amount spent in 2012-13(in Rs.)Purpose of expenditure (Please give Details)Expenditure to address needs of SCs Women(in Rs.)Expenditure on basic needs such as drinking water/drainage/sanitation(in Rs.)

3

(f) Performance of civic duties

(i) Does the Gram Panchayat provide for safe drinking water supply to 100% households during 2012-13?

Yes No 1

(ii) Does the Gram Panchayat provide streetlight to 100% area during 2012-13 ?

Yes No 1

(iii)Does the Gram Panchayat provide drainage facility to 100% area during 2012-13?

Yes No 1

(iv)Has the Gram Panchayat got Nirmal Gram Puruskar during 2012-13?

Yes No 1

(v)Has the Gram Panchayat done 100% registration of birth and death during 2012-13?

Yes No 1

(vi) Has the Gram Panchayat done 100% registration of Marriage during 2012-13?

Yes No 1

(g) Panchayat and local institutionsPlease state what initiatives the Gram Panchayat had taken to strengthen local institutions such as School, Fair Price Shops, Health facilities and Anganwadi, etc (Give Descriptive Details )

2

(h) Panchayat and Community Group

What activities did the Gram Panchayat undertake with community based groups such as SHGs, Women groups, minority groups, Youth groups, with groups of SCs during 2012-13?

2

(i) Special initiatives taken by the PanchayatPlease describe any special initiatives taken by the Gram Panchayat during 2012-13 to improve the life of citizens, especially marginalized groups such as physically challenged, HIV positive, sex workers, lepers, child labour etc.

2

(j) IEC Initiative

Has the Gram Panchayat taken initiative to inform and educate people on social issues, local issues etc. Explain.

2

7. Accountability and transparency

(a) Maintenance of Accounts(i) Are Gram Panchayat accounts maintained in the format prescribed by the Government?

Yes No 1

(ii) Are these records upto- date and authenticated?(On-Watch)

Yes No 1

(iii) Are these accounts computerized? Yes No 1

(iv) Whether accounts of 2012-13 were placed before Gram Sabha (Please mention the date of meeting)?

Yes No 1

(b) Audit

(i) Please provide information of previous audits of the Gram Panchayat:a. Last date of audit

b. Name of audit agency

c. How many audit paras complied with?

d. How many audit paras are pending?

2

(c) Grievance Redressal (i) How many grievances from citizens were received by the Gram Panchayat

during 2012-13?2

(ii) How many of these were addressed? (d) Compliance to RTI Act

(i) Total No. of application under RTI Act received by the Gram Panchayat during 2012-13?

1

(ii) How many of these were replied with requisite information?(ii) How many of these applications went into appeal? 1(iv) Has important information related to BPL list, pensioners, funds received and expenditure, list of officials to whom grievances are to be addressed etc. been displayed in the Gram Panchayat and public places as per provisions of RTI Act?

1

1. Signature of Sarpanch:

2. Signature of Panch:

Signature of Panchayat Secretary:

Format B: Summary of Observations:Name of Gram PanchayatBlockDistrictDate of VerificationSummary of Observations:

Best practices in the Panchayat (if any) with descriptions:

Signature and Name of Field Verification team:Sr. No. Name Signature Date1.2.