Appendix 4 Project Location Map – Appendix 5 Map of Construction Area that uses WB financing – Appendix 6 Socioeconomic Household Questionnaire – (This survey has two Parts. Part 1 is socioeconomic survey and Part 2 collects information on loss of assets and the affected households’ perception of impact and their plan) PART 1 SOCIOECONOMIC SURVEY – Household code .....................Date of survey: __ / __ / 2016 Address of Respondent: …………………......................................…………..…….……................................. 1. RESPONDENT’S INFORMATION 1 Full name 2 Gender 1-Male 2- Female Age: 3 Ethnicity 2. GENERAL INFORMATION ON HOUSEHOLDS Full name of head of 4 household Total of household 5 Male: Female: members Total number of family members (persons) having 6 stable jobs
Appendix 4 – Project Location Map Appendix 5 – Map of Construction Area that uses WB financing Appendix 6 – Socioeconomic Household Questionnaire (This survey has two Parts. Part 1 is socioeconomic survey and Part 2 collects information on loss of assets and the affected households’ perception of impact and their plan) PART 1 – SOCIOECONOMIC SURVEY Household code .....................Date of survey: __ / __ / 2016 Address of Respondent: …………………......................................…………..…….……................................. 1. RESPONDENT’S INFORMATION 1 Full name 2 Gender 1-Male 2- Female Age: 3 Ethnicity 2. GENERAL INFORMATION ON HOUSEHOLDS 4 Full name of head of household 5 Total of household members Male: Female: 6 Total number of family members (persons) having stable jobs
SFG2785-REVISED-RP-P156849-Box402885B-PUBLIC-Disclosed-2-8-2017.docx