This document appears to be a stakeholder format used to collect information from farmers benefiting from groundwater management schemes in India. It collects details about the farmer, their income sources and debts, land ownership and irrigation sources before and after the scheme. It also asks about water sharing with other farmers, crop choices, agricultural production and inputs, yields, sales and income. The format is used to understand the impact of groundwater management projects on participating farmers and communities.

1. CB GMS S t udy St ake Holder Fo rm at
AF PR O, H yd era ba d 1 of 6
STAKE HOLDER FORMAT
Village/ Habitation ---------------------District ----------------------- BUA ------------------
Name of the Investigator ------------------------- Date: ------------------
1. Details of the Farmer
Head of the family Male Female Total Category
2. Income and Debt Details
Source of Income Income Debt ( Cumulated since-------- Year)
Agriculture
Livestock
Agricultural Labour
Business
Enterprise
Employment
Others
Name of the Scheme -------------------
Year of Commission --------------------
Land irrigated under one bore well --- (No.) Farmers
Names (Area under bore well)
1. ------------------------ 4. -----------------------
2. ------------------------ 5. -----------------------
3. ------------------------ 6. -----------------------
Name of the WUG :
3-A. Land ownership
Project Intervention(APWELL/APFAMGS/CWS)
Before scheme After scheme
Inherited Purchased Leased Inherited Purchased Leased
Acres Cost Acres Cost Acres Cost Acres Cost Acres Cost Acres Cost
Irrigated
Rain fed
Fallow land
Waste land

2. CB GMS S t udy St ake Holder Fo rm at
AF PR O, H yd era ba d 2 of 6
3-B. What are the irrigation sources ?
Capital cost
invested(Rs)
Source Scheme
/Own
Area
under
irrigation
(Ac)
Width/
Diameter
(in
inches)
Depth
(in ft)
Power
Electricity
/
Diesel
engine
Pump
Capacity
(HP) Self Project
Maintenanc
e cost (Rs.)
per annum
Open
Well
Bore
Well -I
Bore
Well -II
Bore
Well -III
Tank
3-C. Assets:
Asset Before Bore well After (----- year)
No./Details No./Details Appx.Cost (Rs.)
1 House (No./Type)
2 Land (Acres)
3 Cows (No.)
4 Buffaloes(No.)
5 Bullocks(No.)
6 Sheep(No.)
7 Goats(No.)
8 T.V. (Yes/ No)
9 Motor Cycle (Yes/ No)
10 Tractor (Yes/ No)
11 Agriculture equipment / implements
Total

3. CB GMS S t udy St ake Holder Fo rm at
AF PR O, H yd era ba d 3 of 6
4. Water Sharing (Do you share water/sell water to your fellow farmers?) Yes/No If YES
Sl
No
Water sharing Responde
nt Farmer
Farmer 1 Farmer2 Farmer3 Farmer 4
1
Area irrigated(in acres)
2 No of irrigations (Weekly
once/Fortnightly/Twice in a
week)
3 No of pumping hours for each
irrigation
4 Charges per irrigation per annum
5. Details of irrigation (2005-2006)
Item Kharif Rabi Summer Total/average Remarks
Bore well yield (in inches)
Extent of land Irrigated
(acres)
Average pumping hours
per day
6. Influence of tank/s on the bore well
YES NO DO NOT KNOW
1. Tank distance from Bore well ------- km
2. If borewell yield has improved due
to the tank, will you contribute for
maintenance of the tank?
YES Details NO

4. CB GMS S t udy St ake Holder Fo rm at
AF PR O, H yd era ba d 4 of 6
7. Choice of crop based on Irrigation sources
Crop Choice of
crop
Cultivated
crop
What are the reasons
Paddy
Cotton
Chilli
Pulses
Ground nut
Vegetables
Fodder Crops
Others
1. Insufficiency of Water 2. Low Rainfall 3. Power availability 4. No. of hours of availability 5. Availability
of water 6. Consistent bore well yield 7. Any other

5. CB GMS S t udy St ake Holder Fo rm at
AF PR O, H yd era ba d 5 of 6
8. Agricultural production (current year 2005-2006)
KHARIF RABI SUMMER PERENNIAL
Item Crop1 Crop2 Crop3 Crop4 Crop1 Crop2 Crop3 Crop4 Crop1 Crop2 Crop1 Crop2
1 Name of crop
2 Area (Acres)
3 Variety
4 Duration (Days)
5 Seed
Quantity(Kg)
6 Month of
sowing
INPUT COSTS
a Total Seed
cost(Rs)
b Fertilizer
Quantity (Kg)
1.
2.
3.
c Total Fertilizer
Cost (Rs).
d Manure
quantity(Kg)
e Manure cost
(Rs)
f Pesticides
spray /Quantity
(Lts/Kgs)
1.
2.
3.
4.
5.

6. CB GMS S t udy St ake Holder Fo rm at
AF PR O, H yd era ba d 6 of 6
i Total Pesticides
cost (Rs)
8 No of
irrigations(days)
9 Pumping hours
per day
10 Hired Labour
cost (Rs.)
11 Cost of hired
implements
(Rs)
12 Total costs (Rs)
13 Yield(Quintal)
14 Yield
sold(Quintal)
15 Sale
amount(Rs)
16 Net income
(Rs)
9. Any Other
Case Study/Observations/Experience