Household Report Form


A household report form is a document which records the relevant details of the respective household. The form/ report can be used to gather the information which the various authorities such as the government or the other data collection agencies may find important. The report is useful in making estimations such as the population estimates, the estimate of assets/ liabilities. The data may also be used to make predictions such as the future demand of a certain commodity, on the basis of the past record of the households. The household report form given here is a sample of a document which records the financial state of the house.

You can Download the Free Household Report Form, customize it according to your needs and Print. Household Report Form is either in MS Word, Excel or in PDF.

Sample Household Report Form

Household Report Form

Download Household Report Form

 

Household Report Form

Name of the individual filling the form: ________________________

(provide full name in block letters)

Address/ location of the house: _____________________________

City/ State/ Country: __________________________

Zip Code: _____________________

Contact No.: ___________________

Email Address: _______________________ (if any)

No. of members in the household: _________________

Details of the members of the house:

Serial No. Name

(full name)

Age

(in yrs)

Gender Occupation Income

(Rs./ month)

           
           
           

(The details of the individual filling the form must also be included in the box above.)

 

Details of the assets of the household:

Item Value (in Rs.) Owners Name
  1. Cash
   
  1. Savings Account
   
  1. Current Account
   
  1. Stocks/ shares/ other securities
   
  1. Real Estate
   
  1. Vehicles
   
  1. Loans extended
   
  1. _________________
   
  1. _________________
   

Details of the Liabilities of the household:

Item Value (in Rs.) In name of
  1. Mortgage
   
  1. Loans taken
   
  1. _______________
   

Income tax paid by the household last time tax was due: _____________________

Date: ________________________

Signature: ____________________


Category: Report Forms

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