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PAGE 65

A1. CROP FARMING AND GARDENING


(c) During the period JANUARY to JUNE 2012, did you or any member of your family incur expenses , in
cash or in kind, in the production of the crops harvested?

1 - YES 2 - NO, GO TO NEXT PAGE (A2)

Item Code In Cash In Kind Total

1. Seeds 001310 __________ __________ __________

2. Fertilizer 001320 __________ __________ __________

3. Pesticide 001330 __________ __________ __________

4. Fuel and oil 001340 __________ __________ __________

5. Wages of hired labor and paid family 001350 __________ __________ __________
members

6. Interest paid on agricultural loan (if any) 001360 __________ __________ __________

7. Irrigation fees and other water charges 001370 __________ __________ __________

8. Rent of land, equipment, and work animal 001380 __________ __________ __________

9. Other expenses 001390 __________ __________ __________

TOTAL 001300 ========= ========= =========

COMPUTATION OF NET INCOME FROM CROP FARMING AND GARDENING:

Code [ JANUARY - JUNE 2012 ]

TOTAL VALUE 001200 _______________

Less: TOTAL COSTS 001300 _______________

NET INCOME 001000 ===============

COMPUTATIONS/REMARKS:

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