USAHA SURVEI

BADAN PUSAT STATISTIK R A H A S I A PENDAFTARAN PERUSAHAAN/USAHA SURVEI INDUSTRI MIKRO DAN KECIL 2016 (3) (8) ko de 1 atau 2 ; Kol. (11) kode 1 Kegiat...

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BADAN PUSAT STATISTIK

PENDAFTARAN PERUSAHAAN/USAHA

SURVEI INDUSTRI MIKRO DAN KECIL 2016 RAHASIA

VI M K 16-L1 BLOK I. KETERANGAN TEMPAT

101. PROVINSI

104. DESA/KELURAHAN *)

102. KABUPATEN/KOTA *)

105. NOMOR BLOK SENSUS (NBS)

103. KECAMATAN

106. NOMOR KODE SAMPEL (NKS)

*) Coret yang tidak sesuai

BLOK II. RINGKASAN KODE KBLI-2 DIGIT

URAIAN (1)

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(3)

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(17)

(18)

(19)

(20)

(21)

(22)

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201. JUMLAH RUMAH TANGGA ( Blok III Kolom (6) nomor urut terakhir pada halaman terakhir ) 202.a. POPULASI INDUSTRI MIKRO (B.III R.c hal. terakhir Kol. 19 s.d 42) 202.b. SAMPEL INDUSTRI MIKRO (B.IV Kol. 1 s.d 24 R. mhi) 203.

POPULASI INDUSTRI KECIL

Jumlah

10

(26)

Halaman ……... dari ….….. halaman

No. Urut

Penggunaan Bangun -an

Jika Kol. (4) kode 2, Apakah untuk usaha IMK dan aktif berproduksi selama triwulan I 2016 *)

(Kode)

Ya

Bangunan S e g m e n

F i s i k

S e n s u s

(2)

(3)

Keterangan:

(4)

Nama Kepala Rumah Tangga (KRT)

-1 Kol. (12)

Tidak (1)

Jika Kol. (4) kode 1 atau 3

-0 (5)

Ya Tidak

No. (6)

(7)

a.

Jumlah halaman ini

b.

Jumlah kumulatif halaman sebelumnya

c.

Jumlah kumulatif halaman ini

Kode Kol. (4)

Selama triwulan I 2016*), adakah ART berusaha di sektor IMK?

Tempat tinggal Bukan tempat tinggal Campuran

-1 -2 -3

USAHA/RUMAH TANGGA

Jika Kol. (5) kode 1; Kol. (10)

kode 1 atau 2 ; Kol. (11) kode 1

Nama ART

Selama triwulan I 2016*) adakah pihak lain yang berusaha disektor IMK di Tempat bangunan ini? usaha (Kode) Ya -1

-0 Kol. (11) (9)

(10)

Nama Perusahaan/Usaha atau Pengusaha/Pemilik

Tidak - 0

No.

(11)

(12)

*) Khusus usaha musiman yang aktif berproduksi selama periode Triwulan II 2015 s.d Triwulan I 2016

Kode Kol. (10)

(13)

Kegiatan Utama (Tuliskan sejelas-jelasnya)

Alamat Lengkap (Jalan, No., RT/RW)

(15)

(14)

Di bangunan sensus ini Bukan di bangunan sensus/keliling Di bangunan sensus lain

-1 -2 -3

Jika Kolom (17) bertanda cek (√)

Isikan tanda cek (√) sesuai jumlah tenaga kerja termasuk pemilik pada bulan terakhir berproduksi Triwulan I 2016

Jika Kol. (8) kode 1

-1

(8)

BLOK III : PENDAFTARAN

Isikan tanda cek (√) sesuai kode 2-digit KBLI

Kode 2-digit KBLI

1-4

5 - 19

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(17)

(18)

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(20)

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(28)

(29)

(30)

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(36)

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(38)

(39)

(40)

(41)

(42)

BLOK IV: KETERANGAN

PENARIKAN SAMPEL UTAMA

KBLI 2 digit

KBLI 2 digit

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(24)

Mhi = ………

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Mhi : jumlah industri mikro menurut KBLI, diambil dari isian Blok III Rincian C Kolom 19-42 mhi : target sampel industri mikro menurut KBLI dalam satu blok sensus (perhitungan dilakukan BPS kabupaten/kota) Ihi : interval sampel

Mhi : jumlah industri mikro menurut KBLI, diambil dari isian Blok III Rincian C Kolom 19 - 42 mhi : target sampel industri mikro menurut KBLI dalam satu blok sensus (perhitungan dilakukan BPS kabupaten/kota) Ihi : interval sampel

BLOK V . C A T A T A N Apabila ada hal-hal yang memerlukan keterangan lebih lanjut, tuliskan pada blok ini. Selain informasi dari responden, pencacah, dan pemeriksa juga bisa menambahkan catatan untuk memperjelas masalah yang berkaitan dengan daftar isian.

BLOK VI. KETERANGAN PETUGAS

URAIAN Nama petugas Tanggal

Tanda tangan

PENCACAH

PENGAWAS