BANCIAN ISI RUMAH BERPENDAPATAN RENDAH
|KEMENTERIAN KERAJAAN TEMPATAN & PERUMAHAN |
|BANCIAN ISI RUMAH BERPENDAPATAN RENDAH |
|DI BANDAR, SABAH |
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|[pic] | | TAHUN : | | |
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| |NAMA PBT : | | | | |
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|BUTIRAN PENEMUDUGA |
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|Nama |: | Jawatan : | |
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|Tarikh |: | | |Masa Mula |: | | |Masa Akhir |: | | |
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|A | |BUTIR-BUTIR PENGENALAN |
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|1. | |Daerah Pentadbiran : | | | | | |6. | |No. Unit Bangunan : | | | | |
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|2. | |Parlimen : | | | | | |7. | |No Tempat Kediaman : | | | | |
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|3. | |DUN : | | | | | |8. | |Jenis Penempatan : | | | | |
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|4. | |PBT : | | | | | | | | | | | | |
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|5. | |Bandar : | | | | | | | | | | | | |
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|9. |Nama Ketua Isi Rumah (KIR) : |
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|10 a. |No. Kad Pengenalan Lama (KIR) : | | | | | | | | | |
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| b. |No. Kad Pengenalan Baru (KIR) : | | | | | | |- | | |- | | | | | |
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|11. Alamat Lengkap : | | | | | | | | | | |
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| |No. Rumah/Nama Jalan/Tingkat/Blok |
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| |Taman/Kampung | | | | | | | | |
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|12. |No. Telefon : | | | | | | | | | | | |
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| | |Untuk Kegunaan Pejabat | | | | | | | | |
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| |Jumlah Pendapatan Kasar Isi Rumah (setahun) | |RM | | | | | | | | |
| |(sila dapatkan daripada Bhg.D, soalan 3b) | | | | | | | |
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| |Jumlah Ahli Isi Rumah (termasuk KIR) | | | | | | | | | | |
| |(sila dapatkan daripada Bhg. D, soalan 1) | | | | | | | | |
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|B |BUTIR-BUTIR TEMPAT KEDIAMAN |
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|1 | |Pemilik rumah : | | | | | | | | | | | |
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| | |1. |Sendiri |4. |Setinggan sendiri |7. |Lain-lain (nyatakan): | | | | | | | | |
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| | |2. |Sewa |5. |Setinggan sewa | | | | | | | | |
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| | |3. |Kuarters |6. |Rumah sementara | | | | | | | | |
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|2 | |Jika menyewa, nyatakan bayarannya sebulan : |RM : | | | | | | | | |
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|3 | |Jenis rumah : | | | | | | | | | | | |
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| | |1. |Rumah Pangsa | | | | | | | | | | | |
| | |2. |Teres Setingkat | | | | | | | | | | | |
| | |3. |Teres Dua Tingkat | | | | | | | | | | | |
| | |4. |Rumah Sesebuah | | | | | | | | | | | |
| | |5. |Rumah Kedai | | | | | | | | | | | |
| | |6. |Rumah Panjang | | | | | | | | | | | |
| | |7. |Lain-lain (Nyatakan) : | | | | | | | | | | | |
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|4 | |Keadaan rumah (secara pemerhatian) | | | | | | | | | | |
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| | |1. |Kukuh | | | | | | | | | | | |
| | |2. |Mulai Usang | | | | | | | | | | | |
| | |3. |Usang | | | | | | | | | | | |
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|5 | |Jenis bahan binaan rumah untuk dinding luar (secara pemerhatian) | | | | | | | |
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| | |1. |Batu-bata/konkrit | | | | | | | | | | | |
| | |2. |Batu-bata dan Papan | | | | | | | | | | | |
| | |3. |Papan | | | | | | | | | | | |
| | |4. |Lain-lain (Nyatakan) : | | | | | | | | | | | |
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|6 | |Bilangan bilik tidur : | | | | | | | | | | | |
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|7. | |Jenis tandas yang digunakan : | | | | | | | | | | |
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| | |1. |Tandas tarik | | | | | | | | | | | |
| | |2. |Tandas curah/siram | | | | | | | | | | | |
| | |3. |Lubang | | | | | | | | | | | |
| | |4. |Lain-lain (Nyatakan) : | | | | | | | | | | | |
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|8 | |Adakah kemudahan berikut terdapat di kediaman anda ? | | | | | | | | |
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| | | | |1. |Bekalan air yang dirawat | | | | | | | | |
| | | | |2. |Bekalan elektrik | | | | | | | | |
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|9 | |Jika tiada bekalan elektrik, nyatakan sumber utama kuasa : | | | | | | | | |
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| | |1. |Pelita minyak | | | | | | | | | | | |
| | |2. |Lampu gasoline | | | | | | | | | | | |
| | |3. |Generator/penjana kuasa individu | | | | | | | | | | | |
| | |4. |Lain-lain (Nyatakan) : | | | | | | | | | | | |
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|10 | |Nyatakan sumber utama air untuk keperluan berikut : | | | | | | | | | |
| | |(Sila masukkan kod 1-6 dalam kotak yang disediakan) | | | | | | | | | |
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| | |a. |Minum | | | | | | | | | | |
| | |b. |Membasuh | | | | | | | | | | |
| | |c. |Mandi | | | | | | | | | | |
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| | | |1. |Air paip dalam rumah (dirawat) | | | | | | | | | | |
| | | |2. |Air paip awam / pili awam | | | | | | | | | | |
| | | |3. |Air paip yang belum diolah / dibersihkan (Air Graviti) | | | | | | | | | |
| | | |4 |Air perigi diambil dengan tangan / pam | | | | | | | | | | |
| | | |5. |Air hujan / sungai | | | | | | | | | | |
| | | |6. |Lain-lain (Nyatakan) : | | | | | | | | | | |
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|C |BUTIR-BUTIR KETUA ISI RUMAH |
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|1 | |Umur Sekarang : | | | | | | | | | | | |
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|2 | |Jantina : |1. |Lelaki |2. |Perempuan | | | | | | | | |
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|3 | |Etnik (Suku kaum) : | | | | | | | | | | | |
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|4 | |Agama : |1. |Islam |5. |Confucious/Tao, Agama tradisi orang Cina | | | | | | |
| | | | |2. |Kristian |6. |Agama suku kaum / folk | | | | | | | |
| | | | |3. |Buddha |7. |Tiada Agama | | | | | | | | | |
| | | | |4. |Hindu |8. |Lain-lain (Nyatakan) : | | | | | | | |
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|5 | |Status Perkahwinan : | | | | | | | |
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| | |1. |Bujang |3. |Duda |5. |Berpisah / Ditinggalkan | | | | | | | |
| | |2. |Berkahwin |4. |Janda/Balu | | | | | | | | | |
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|6 | |Tahap pendidikan tertinggi : | | | | | | | | | |
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| | |1. |Sekolah Rendah (Darjah / Tahun 1 hingga 6) | | | | | | | | | |
| | |2. |Menengah Rendah (Peralihan / Tingkatan 1 hingga 3) | | | | | | | | | |
| | |3. |Menengah Atas ( Tingkatan 4 hingga 5, GCE O Level) | | | | | | | | | |
| | |4. |Vokasional / Teknik ( Tingkatan 4 hingga 5) | | | | | | | | | |
| | |5. |Institusi Kemahiran teknikal & Perdagangan | | | | | | | | | |
| | |6. |Lepasan Menengah ( Tingkatan 6, GCE A Level, Matrikulasi) | | | | | | | | | |
| | |7. |Lepasan Politeknik / Maktab / Kolej / Universiti | | | | | | | | | |
| | |8. |Tiada Pendidikan | | | | | | | | | |
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|7 | |Kemahiran yang dimiliki : | | | | | | | | |
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| | | | |1. |Pertukangan rumah | |6. |Kraftangan | | |1. | | |6. | | |
| | | | |2. |Pertukangan perabut | |7. |Menjahit | | |2. | | |7. | | |
| | | | |3. |Membancuh simen | |8. |Andaman | | |3. | | |8. | | |
| | | | |4. |Membuat batu bata | |9. |Memasak | | |4. | | |9. | | |
| | | | |5. |Membaiki kenderaan | |10. |Lain-lain (Nyatakan) | | |5. | | |10. | | |
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|8 |a) |Status pekerjaan : | | | | | | | | |
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| | |1. |Bekerja sendiri |4. |Pesara | | | | | | | | | |
| | |2. |Pekerja bergaji |5. |Tiada pekerjaan | | | | | | | | | |
| | |3. |Suri rumah |6. |Lain-lain | | | | | | | | | |
| | | |Jumlah pendapatan sebulan : | | | | | | | | | | | |
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| |b) |Jika menjawab kod 1 atau 2, apakah tugas-tugas/jenis kerja utama yang anda buat ? | | | | | | | |
| | |(Nyatakan) | | | | | | | | |
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| |c) |Berapakah jarak dari Tempat Kediaman ke Tempat Kerja berkenaan ? (jarak sehala) | | | | | | | |
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| |d) |Apakah pengangkutan utama yang digunakan untuk ke Tempat Kerja ? | | | | | | | | |
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| | |i. |Sendiri | | |ii. |Awam | | | | | | | | | |
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| | | |1. |Basikal | | |1. |Teksi | | |i. | | |ii. | | |
| | | |2. |Motosikal | | |2. |Bas | | | | | | | | |
| | | |3. |Kereta | | |3. |Lain-lain (Nyatakan) | | | | | | | | |
| | | |4. |Lain-lain (Nyatakan) | | | | | | | | | | | | |
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|9 | |Simpanan/Pelaburan yang dimiliki : | | | | | | | | |
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| | | |1. |Tabung Haji | |5. |Koperasi | | |1 | | |5 | | |
| | | |2. |ASB | |6. |Amanah Saham Negeri | | |2 | | |6 | | |
| | | |3. |ASN | |7. |Dana Negeri | | |3 | | |7 | | |
| | | |4. |Bank | |8. |Lain-lain (Nyatakan) | | |4 | | |8 | | |
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| | | | | | | |Untuk kegunaan pejabat |
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|10 | |Bantuan yang diterima. (Dalam masa 12 bulan yang lalu) | | | | | | | |
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| | |i. | | |ii. | Anggaran Setahun (RM) |i. |ii. | |
| | | |1. |Baitulmal |1a | | | | | | | | | | | | | |
| | | |2. |Jabatan Kebajikan Masyrakat |2a | | | | | | | | | | | | | |
| | | |3. |Skim Pembangunan Kesejahteraan Rakyat (SPKR) |3a | | | | | | | | | | | | | |
| | | |4. |Jabatan/Majlis Agama Negeri |4a | | | | | | | | | | | | | |
| | | |5. |Agensi Lain (Nyatakan) | | | |5a | | | | | | | | | | |
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|11 | |Pinjaman yang diterima. (Dalam masa 12 bulan yang lalu) | | | | | | | |
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| | |i. | | |ii. | Anggaran Setahun (RM) |i. |ii. | | | | |
| | | |1. |Amanah Ikhtiar Malaysia (AIM) |1a | | | | | | | | | | | | | |
| | | |2. |Tabung Ekonomi Usahawan Nasional (TEKUN) |2a | | | | | | | | | | | | | |
| | | |3. |MARA |3a | | | | | | | | | | | | | |
| | | |4. |Yayasan P’bangunan Ekonomi Islam M’sia(YAPEN) |4a | | | | | | | | | | | | | |
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|12 | |Apakah anda menghidap mana-mana penyakit dan mendapat rawatan seperti berikut ? | |
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| | | |ii. | |Rawatan | | | | | | | |
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| | | | Klinik / Hospital |Secara |Tiada | | | | | | |
| |i. |Penyakit |kerajaan |swasta |tradisional |rawatan | | | | | | |
| | | |(1) |(2) |(3) |(4) | | |i. |ii. | | |
| | |1. |Darah tinggi | | | | | | | | | | |
| | |2. |Kencing manis (Diabetis) | | | | | | | | | | |
| | |3. |Leleh (Asma) | | | | | | | | | | |
| | |4. |Buah pinggang | | | | | | | | | | |
| | |5. |Barah (Kanser) | | | | | | | | | | |
| | |6. |Jantung / Strok | | | | | | | | | | |
| | |7. |Sakit sendi (Gout) | | | | | | | | | | |
| | |8. |Gastric/Dugal | | | | | | | | | | |
| | |9. |Batuk / TB | | | | | | | | | | |
| | |10. |Lain-lain (Nyatakan) | | | | | | | | | | |
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|13 |Jenis Kecacatan / Ketidak upayaan (secara pemerhatian) | | |
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| | |1. |Pendegaran | | | | | | | |
| | |2. |Penglihatan | | | | | | | |
| | |3. |Fizikal | | | | | | | |
| | |4. |Cerebral Palsy | | | | | | | |
| | |5. |Lain-lain (Nyatakan) | | | | | | | | |
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|14 |Jika ada kecacatan, adakah sudah didaftarkan di Jabatan Kebajikan Masyarakat | | | | | | |
| |sebagai Orang Kurang Upaya ? | | | | | | | |
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| | |1. |Ya | |2. |Tidak | | | | | |
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|D |BUTIR-BUTIR AHLI DAN TANGGUNGAN | |Untuk kegunaan pejabat |
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|1 |Bilangan ahli isi rumah yang tinggal serumah (termasuk KIR) : | | | | | | | | | |
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|2 |Bilangan ahli isi rumah di bawah tanggungan KIR : | | | | | | | | | | |
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|3a |Bilangan ahli isi rumah yang bekerja : | | | | | | | | |
|3b |Jumlah Pendapatan Bulanan : RM | | | | | | | | | | | |
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|4 |Bilangan ahli isi rumah yang berumur 60 tahun ke atas : | | | | | | | | |
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|5. |Adakah terdapat ahli isi rumah berumur di bawah 7 tahun yang disahkan oleh doctor atau | | | | | | | |
| |jururawat di klinik kerajaan mengalami kekurangan zat makanan atau kurang berat badan ? | | | | | | | |
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| | |1. Ya | |2. Tidak | | | | | |
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|6 |Jika Ya di soalan 5, adakah kanak-kanak ini menerima bantuan bakul makanan | | | | | | |
| | melalui Program Pemulihan Kanak-kanak Kekurangan Zat Makanan, Kementerian | | | | | | |
| |Kesihatan Malaysia atau bantuan susu tepung penuh krim ? | | | | | | |
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| | | |1. Ya | |2. Tidak | | | | | |
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|7 |Pemilikan harta isi rumah : | |
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| | |1. |Kereta bermotor | | | | | | | |
| | |2. |Motosikal/skuter | | | | | | | |
| | |3. |Basikal | | | | | | | |
| | |4. |Bot | | | | | | | |
| | |5. |Alat hawa dingin | | | | | | | |
| | |6. |Mesin basuh | | | | | | | |
| | |7. |Peti sejuk | | | | | | | |
| | |8. |Dapur masak gas/elektrik | | | | | | | |
| | |9. |Dapur minyak tanah | | | | | | | |
| | |10. |Dapur kayu/arang | | | | | | | |
| | |11. |Ketuhar gelombang mikro | | | | | | | |
| | |12. |Radio/hi-fi | | | | | | | |
| | |13. |Televisyen | | | | | | | |
| | |14. |Video/VCD/DVD | | | | | | | |
| | |15. |Telefon talian tetap | | | | | | | |
| | |16. |Telefon bimbit | | | | | | | |
| | |17. |Komputer peribadi | | | | | | | |
| | |18. |Langganan internet | | | | | | | |
| | |19. |Astro | | | | | | | |
| | |20. |Tanah | | | | | | | |
| | |21. |Ternakan | | | | | | | |
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| | |soalselidik-bandar | | | | |
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|Tangkapan Data |: | | | |/ | |/ | |
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|Panduan menggunakan kod-kod | | | | | | |
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|1. PENTADBIRAN DAERAH |
|01 – DBKK |07 – Penampang |13 – Kuala Penyu |19 – Kinabatangan |
|02 – MPS |08 – Semporna |14 – Kota Belud |20 – Kunak |
|03 – MPT |09 – Tuaran |15 – Ranau |21 – Tambunan |
|04 – LBK |10 – Papar |16 – Kota Marudu |22 – Tenom |
|05 – Keningau |11 – Beaufort |17 – Pitas |23 – Nabawan |
|06 – Lahad Datu |12 – Sipitang |18 – Beluran | |
| |
|2. PARLIMEN |
|P167 Kudat |P174 Penampang |P180 Keningau |P186 Sandakan |
|P168 Kota Marudu |P175 Papar |P181 Tenom |P187 Kinabatangan |
|P161 Kota Belud |P176 Kimanis |P182 Pensiangan |P188 Silam |
|P170 Tuaran |P177 Beaufort |P183 Beluran |P189 Semporna |
|P171 Sepanggar |P178 Sipitang |P184 Libaran |P190 Tawau |
|P173 Kota Kinabalu |P179 Ranau |P185 Batu Sapi |P191 Kalabakan |
| |
|3. DEWAN UNDANGAN NEGERI |
|N1 Banggi |N16 Luyang |N31 Paginatan |N46 Tanjung Papat |
|N2 Tanjung Kapor |N17 Tanjung Aru |N32 Tambunan |N47 Kuamut |
|N3 Pitas |N18 Petagas |N33 Bingkor |N48 Sukau |
|N4 Matunggong |N19 Kapayan |N34 Liawan |N49 Tungku |
|N5 Tandek |N20 Moyog |N35 Melalap |N50 Lahad Datu |
|N6 Tempasuk |N21 Kawang |N36 Kemabong |N51 Kunak |
|N7 Kadamaian |N22 Pantai Manis |N37 Sook |N52 Sulabayan |
|N8 Usukan |N23 Bongawan |N38 Nabawan |N53 Senallang |
|N9 Tamparuli |N24 Membakut |N39 Sugut |N54 Bugaya |
|N10 Sulaman |N25 Klias |N40 Labuk |N55 Balung |
|N11 Kiulu |N26 Kuala Penyu |N41 Gum-Gum |N56 Apas |
|N12 Karambunai |N27 Lumadan |N42 Sungai Sibuga |N57 Sri Tanjung |
|N13 Inanam |N28 Sindumin |N43 Sekong |N58 Merotai |
|N14 Likas |N29 Kundasang |N44 Karamunting |N59 Tanjung Batu |
|N15 Api-Api |N30 Karanaan |N45 Elopura |N60 Sebatik |
| |
|4. PIHAK BERKUASA TEMPATAN |
|M01 DBKK |M07 MD Penampang |M13 MD Kuala Penyu |M18 MD Kinabatangan |
|M02 MPS |M08 MD Semporna |M14 MD Kota Belud |M19 MD Kunak |
|M03 MPT |M09 MD Tuaran |M15 MD Ranau |M20 MDTambunan |
|M04 LBK |M10 MD Papar |M16 MD Kota Marudu / Pitas |M21 MD Tenom |
|M05 MD Keningau |M11 MD Beaufort |M17 MD Beluran |M22 MD Nabawan |
|M06 MD Lahad Datu |M12 MD Sipitang | | |
| |
|5. BANDAR |
|Tuliskan nama Bandar / pekan berkenaan |
| |
|6. NO. UNIT BANGUNAN |
|Tuliskan nombor unit bangunan |
| |
|7. NO. TEMPAT KEDIAMAN |
|Tuliskan nombor tempat kediaman |
| |
|8. JENIS PENEMPATAN |
|01 Rumah sebuah 1 singkat |07 Rumah teres 1 tingkat |
|02 Rumah sebuah 2 singkat |08 Rumah teres 2 tingkat |
|03 Rumah sebuah 3 tingkat ke atas |09 Rumah teres 3 tingkat ke atas |
|04 Rumah berkembar 1 tingkat |10 Flat / Apartment |
|05 Rumah berkembar 2 tingkat | |
|06 Rumah berkembar 3 tingkat ke atas | |
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soalselidik-bandar
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KKTPS/BPP/2006/01
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Nama Tarikh
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