Surveyquestionnaireformatforproject SIDDANNA M BALAPGOL
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Transcript of Surveyquestionnaireformatforproject SIDDANNA M BALAPGOL
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Questionnaire-1Dear Sir/Madam
Name :Gender : M FDate of birth :No of dependants :Address :
I am the student of [COLLEGE NAME], Department of Management studies, [PLACE] and presently doing a project on “Analysis of Marketing Strategies on [RESPECTIVE NAME]”. I request you to kindly fill the questionnaire below and assure you that the data generated shall be kept confidential.
1. Educational Qualification 10th or below 10+2 or below Graduate Post Graduate and above Others(please specify)
2. Your residence is
Owned Rented Company Provided Ancestral/Family PG AccomodationPlease do mention the period at current residence Years Months
3. Do you have a vehicle?
Yes No
If Yes, Four wheeler Two wheeler Other None
Is your vehicle Financed Owned Company ProvidedPlease do mention the Vehicle make (model name)
4. Your Occupation
Salaried Self Employed Retired Housewife Student NRI(Please specify the country you belong)
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5. If Salaried, employed with
Private Limited Partnership Proprietorship Public Limited Public Sector Government MultinationalMention the type of industry your employed,
Advertising/market research Textile Banking Transport Construction/real estate Travel/Tourism Entertainment/Media Telecom Consumer goods Insurance Export/Import Internet services NBFC Call centers/BPO/ITES Hotel/Restaurant Finance Information Technology Pharmaceuticals Others
6. If self-employed your firm is
Private Limited Partnership Proprietorship
Your nature of work in the firm, Broker Journal Landlord Software Professional Chartered Accounted Films/Entertainment professional Consultant Lawyer Manufacturer Doctor Engineer Trade/Distributor Financier Retailers/Grocers Real Estate AgentPlease specify company nameDesignation
7. Are you an account holder in HDFC bank?
Yes No
If yes, Current savings FD DematMention the account number
If No,Are you an account holder in any other bank? Yes NoIf yes, specify name of the bank and type of account
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8. Have you availed loan facilities from any bank?
Yes No
If yes, type of loan Car loan personal loan consumer durable loan loan against shares Housing loan others (please specify)Mention the loan amountName of the bank
9. Are you assessed to tax?
Yes No
Your gross yearly incomeMonthly expense
Do you have any other source of income?
Yes No
If yes, please specifyAverage income per annum
10. Marital status
Married Single
If married,Child 1 ageChild 2 ageChild 3 age
11.If you have an existing policy with any insurance company as life assured, assignee, proposer please mention the details below
Name of the insurerSum assuredYearly premium amount Policy start date
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12. Do you have any existing insurance cover premium paying and/or paid up policies?
Yes NoIf yes, mention the company you investedSum assuredType of policy
Date: Signature of the customer:
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Questionnaire-2
1. What is your preference on insurance plans?
Conventional plan Unit linked plan Not interested
Please mention your interest on the following Unit linked pension plus Unit linked young star plus Unit linked endowment winner Unit linked endowment plus
If conventional plan Savings assurance plan home loan protection plan Children’s plan Term assurance plan Pension plan
Mention the name of the bank if already invested
2. Does your income tax is exempted under section 80C or 80D?
Yes No
3. Has any proposal for assurance on your life ever been declined, postponed, accepted at extra premium, accepted on special terms, accepted with reduced cover or withdrawn by yourself?
Yes No
4. Does your occupation or business is hazardous which may render you susceptible to injury or illness?
Yes No
5.In 100% working hours, what amount of % do you travel?Mode of Transport
6.Have you resided overseas for more than 6 months continuously?
Yes No
If yes,Specify the country and also the duration
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7.Do you take part in any hobbies that could be considered dangerous in any way?(Eg. Mountaineering,aviation etc)
Yes No
8.Are you a “Politically Exposed Person”?
Yes No
9.Have you ever suffered from or received treatment for any symptoms or medical conditions in last 6 months?
Yes No
If yes, please specify
10. Have any of your Parents,brothers or sisters died or suffered prior to the age of 65?
Yes No If yes please specify the cause
For office use only:
Customer ID :PB :TOC* : H/W/C
Prepared By : Date of Preparation :
*H-Hot; W-warm; C-cold