Name of BANK
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1. How would senior management of Bank rate the following possible objective for Bank (0= minor objective, 1= imp objective) a) Financial sustainability
0
1
b) Outreach to poor
0
1
c) Positive impact on income of clients
0
1
d) Positive impact on education and social status of clients
0
1
2. Does Bank provide loan to (0= never, 1=less than 30% of loan, 2= more than 30%) a) Urban areas with nationally below-average socio economic development 0 1 2 b) Rural areas with nationally below-average socio-economic development 0 1 2 c) Workers with unsecured status (no assets and uncertainty on daily employment) 0 1 2 d) Women
0
1
2
e) Illiterate individuals
0
1
2
3. Does Bank accept to provide loan only secured by “social” collateral (recommended by trusted third party) (0=never, 1= less than 30%, 2=for more than 30%) 0
1
2
1
4. How many different type of loan products does Bank provides?(0=only one, 1=2 or 3, 2=more than 3) 0 1 2 Name of these Products-------------------------------------------------
5. Does Bank provide consumption / emergency loan? (0=no, 1=yes) 0 1
6. How many different type of saving products does Bank provide?( 0=no saving product, 1= 1 or 2, 2= more than 2) 0 1 2
7. Flexibility of repayment (0= only one program fixed by Bank, 1= program purpose different formula, 2= schedule is decided with clients when receiving loan) 0 1 2
8. In rural environment, what is the maximum distance client travels to receive a loan (0= more than 10 km, 1=less than 10 km) 0
1
9. In urban areas, are credit agents going out of there institutes to meet there clients? (0=no, 1=yes) 0 1
10. Has Bank ever conducted market survey to improve quality of service to the client? (0=no, 1=early stage of MFI, 2=regularly (at least once a year)) 0 1 2
2
11. Percentage of client drop-out over last 12 months (0=more than 30%, 1=1030%, 2=less than 10%) 0 1 2
12. Non financial services related to financial management (business training, management of family budget etc) (0= no, 1=for some clients, 2=for all clients on voluntary basis) 0 1 2 13. Non financial services related to social needs: literacy training, health service, access to social workers etc (0= no, 1=for some clients, 2=for all clients on voluntary basis) 0 1 2 14. Does loan statement make difference between amount of principle and amount of interest to be paid in order to give clear information to borrower (0=no, 1=yes) 0 1 15. Did Bank ever conducted socio-economic studies to assess the situation of clients? (0=never, 1=planned in near future, 2=once, 3=regularly) 0 1 2 3
16. Does Bank provides some type of insurance that librates the family from burden of debt in case of death of borrower (0=no, 1=yes) 0 1
17. Does Bank works with local loan officers who can speaks the local language and know the local culture (0=no, 1=some loan officers, 2=most of loan officers) 0 1 2
3