Professional Documents
Culture Documents
Form C MSME
Form C MSME
Name of Respondent Designation in the Firm Sex Age Contact Details Email Address
⃝ Male ⃝
Female
Stakeholder Category Industry Cluster Registered Business Name Business Address Type of Enterprise/Business Size
RESPONDENT PROFILE
Availability of Official/Legal/Administrative Document
Form of Enterprise Administration Administration Administration
⃝ Single/Sole ⃝ Partnership ⃝ Issued by: ____________________ Issued by: __________________ Issued by: __________________
Corporation
Expiration Date: _______________ Expiration Date: ____________ Expiration Date: ____________
⃝ Other: _____________________
Product Quality
Certification Name: Certification Name: Certification Name:
Certification Name: ____________
________________ ________________ ________________
Issued by: __________________________ Issued by: __________________________ Issued by: __________________________ Issued by: ________________________
Expiration Date: _____________________ Expiration Date: _____________________ Expiration Date: _____________________ Expiration Date: ___________________
INPUT SUPPLIER
Fertilizer: Organic
Store Capacity (Current Volume, ave./month) Potential Other Info Other Info
Fertilizer: Synthetic
Store Capacity (Current Volume, ave./month) Potential Other Info Other Info
Chemical: Pesticides
Store Capacity (Current Volume, ave./month) Potential Other Info Other Info
Chemicals: Herbicides
Store Capacity (Current Volume, ave./month) Potential Other Info Other Info
Vermicast Compost
Store Capacity (Current Volume, ave./month) Potential Other Info Other Info
Others: ______________________________
Store Capacity (Current Volume, ave./month) Potential Other Info Other Info
POST-HARVEST
Drying
Area/Capacity Utilization (%) Potential for Expansion-demand Other Information
Storage
Area/Capacity Utilization (%) Potential for Expansion-demand Other Information
Hauling
Area/Capacity Utilization (%) Potential for Expansion-demand Other Information
PROCESSING
Semi Processing
Current Capacity/Production Potential for Expansion Other Information
⃝ YES ⃝ NO
⃝ YES ⃝ NO
TRADING
Consolidation/ Buy & Sell
Volume / Capacity Potential for Expansion Other Information
⃝ YES ⃝ NO
MARKETING
Packaging and Labelling
Production Capacity/ month Potential for Expansion Other Information
⃝ YES ⃝ NO
FINANCIAL SERVICES
Micro-Financing
Loan Portfolio (specific to RAPID priority crops) Potential for Expansion Other Information
⃝ YES ⃝ NO
⃝ YES ⃝ NO
NUMBER OF WORKERS/LABORERS
No. of in house
Number of Workers (Qty.) Number of IP Group Ave. # of workday/month Ave. Salary/Wage/month
_____ Male _____ Female _____ Male _____ Female
No. of sub-contractor
Number of Workers (Qty.) Number of IP Group Ave. # of workday/month Ave. Salary/Wage/month
_____ Male _____ Female _____ Male _____ Female
Pricing ⃝ Yes ⃝ No
What problem do you see that limits your growth and development? Support Network/Group
Capability ⃝
Technology/Equipment ⃝
Access to Market ⃝
Chamber of Commerce ⃝
Trade Association ⃝
Cooperative ⃝
⃝
Does your membership in the organization helps you in your Yes
livelihood? ⃝
No
Why?
Remarks:
Date: Date: