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Form # 3
Approved by the DS decree #45
of 5 July 2004
Ministry of Economic Development
of Georgia
Department for Statistics
Questionnaire of Census of Agriculture of Georgia 2004
5. Household composition
Code
Rayon
(Not to be filled by enumerator
(To be filled only in case where the answer to the question 2 is 1)
Supervisor area #
1
Holding #
1. Holding location
Region
Rayon
Rural Sakrebulo
Village
City/town
Street
House Number
Below 15
1
From 15 to 64
2
65 and above
3
Total (1+2+3)
4
Female
3
2
7. Total area of the holding and its structure
(indicate the areas in ha within 0.01 ha)
(Not to be filled by the enumerator
Total area of the holding including rented in;
does not include land owned but rented out (27+33) 1
Individual entrepreneur
3.
Joint Responsibility Society
4.
2
Rented from a private person
3
Land under temporary crops
Limited Responsibility Society
6.
Joint Stock Company
7.
Cooperative
8.
Other (Specify)
9.
(Not to be filled by the enumerator)
3. Which is the ownership form of the holding?
Private
1.
2.
4. Information about the holder
First Name
Last Name
Name of company
Address
Phone number (home or office)
Mobile phone number
Sex
Male
1.
Female 2.
Achieved
education
level
Higher
1.
Vocational
2.
Is agcriculture
main occupation
of the holder?
Yes 1.
Secondary 3.
Primary 4.
Without
education 5.
No 2.
Non-agricultural land
Age
Land under permanent crops
5.
Agricultural land
Comandite Society
Arable land
(Specify the quantity)
Of which:
2.
Rented from the state
4
Wheat
Maize for grains
6
Potato
7
5
Sunflower
8
Vegetables
9
Melons
10
Fodder crops
11
Fallow
12
Temporarily uncultivated land
Total arable land (4+12+13)
14
Orchards
15
Berries
16
Vineyards (18+19)
17
White species
18
Red species
19
в том
числе:
Several households
Of which
2. Who is the holder?
Household
1.
Public
Total(1+2)
6. How many parcels does the total area of the holding consist of?
Code
Code
Male
Age group
Enumeration area #
13
Citrus plantations
20
Tea plantations
21
Other permanent crops
22
Total permanent crops (15+16+17+20+21+22) 23
Land under protective cover
Permanent pastures
24
Permanent meadows
26
Total agricultural land (14+23+24+25+26)
27
Area under yards, buildings
28
Woodland
29
Area under water for aquaculture
30
Other area under water
31
Other land
32
Total non-agricultural land (28+29+30+31+32)
33
25
8. Numbers of fruit and citrus trees
Number of trees in
compact plantations
Type
Total
#
1
Apple
1
Pear
2
10. Livestock
(Of all age and sex)
Number of
scattered trees
Of
which of
producing
age
Total
2
3
Of
which of
producing
age
Type
#
Bovines
1
Of which dairy
2
Buffaloes
4
3
Of which dairy
4
5
Pigs
Of which mothers
6
Quince
3
Plum
4
Cherry
5
Goats
9
Apricot
6
Horses
10
Peach
7
Asses and mules
11
Sour plum
8
Rabbits
12
Cornel
9
Nutrias
13
Walnut
10
Beehives
14
Hazelnut
11
Poultry of all types
15
Persimmon
12
Fig
13
Pomegranate
14
Kiwi
15
Feijoa
16
Mulberry
17
Lemon
18
Tangerine
19
Апельсины
20
Grapefruit
21
Sheep
7
Of which mothers
Type
Code
Total
1
2
2
Saperavi
2
3
Chinuri
3
4
Tsitska
4
5
Tsolikauri
5
6
Izabela (Adesa)
6
7
8
17
11. Agricultural machinery used in the holding
Vine species
1
16
Of which laying
Количество лозы
в виноградниках
Rkatsiteli
8
Of which chicken
Tractors of all types
(wheel, caterpillar, mini)
1
Hand mini tractors
2
Combine harvesters
3
Automobiles of all types
4
9. Numbers of vines by species
1
Number
Количество отдельностоящих лоз
Of which
of
producing Total
age
3
4
Of which
of
producing
age
5
Of which lorries of all types
Number used
during the last
12 months
Of which
owned
1
2
5
12. How last 12 months' agricultural production
of the holding was used?
Mainly for home consumption
Mainly for sale
1.
2.
13. Food security of the household
(To be filled only in case where the answer to the question 2 is 1)
1. During the last 12 months, was there any
time that your household was not provided
with the food they normally eat?
Yes
1.
No
2.
Yes
1.
No
2.
9
10
11
12
2. During the last 12 months, was there any
time that your household feared that they
will not have enough food?
Confidentiality of the information presented is ensured by the article
#12 of the Law of Georgia “On Statistics”
Thank you very much for cooperation!