050801 Prices Paid for fuels

2

Project Code 171 QID 050801		OMB No. 0535-0003: Approval Expires 12/31/2007
	PRICES PAID FOR FUELS April 2007				NATIONAL AGRICULTURAL STATISTICS SERVICE
Please make corrections to name, address and Zip Code, if necessary.				U.S. Department of Agriculture, Rm 5030, South Building 1400 Independence Ave., S.W. Washington, DC 20250-2000 1-800-727-9540 Fax: 202-690-2090 E-mail: [email protected]
			Data from this survey are used to compute the index of Prices Paid by Farmers. This index measures price trends and changes that affect farm production input costs. Specifically, data from this survey are used for: Evaluation of Farm policy and legislation. Updating cost of production estimates used in determination of net farm income. Computation of Parity Prices for selected agricultural commodities. Individual reports are kept confidential. Response to this survey is voluntary and not required by law. However, your cooperation is very important in order to estimate these prices accurately. Please mail your report promptly in the enclosed postage paid envelope. Thank you for your cooperation.

INSTRUCTIONS:		TAXES
	Report prices currently in effect.		GASOLINE: Include Federal, State and local taxes
	Report the price for the brand or quality with the largest volume of sales.		DIESEL FUEL and L.P. GAS: Exclude ALL TAXES.
	Report prices only for items sold.
	Deduct any discounts normally given.
	Do not enter a range of prices.

FUELS
GASOLINE, unleaded, pumped at service station (Include Federal, State and local per gallon taxes) Report price for largest volume sold. Check one--	Key Lock Self Service Full Service	per gallon	508 $	▪ ___ ___ ___
GASOLINE, unleaded, bulk delivery (Include Federal, State and local per gallon taxes)		per gallon	526 $	▪ ___ ___ ___
DIESEL FUEL, bulk delivery (Exclude all taxes)		per gallon	504 $	▪ ___ ___ ___
L.P. GAS, propane, butane, etc, bulk delivery (Exclude all taxes)		per gallon	511 $	▪ ___ ___ ___

Would you like to receive a free copy of the results of this survey in the mail?
YES – [Enter code 1.] NO – [Enter code 3.]			099
The survey results will also be available in Agricultural Prices, on the Internet at http://www.nass.usda.gov on April 30, after 3 pm ET.

Reported by: ____________________________________	Phone (______) ______________	9910 Date	MM DD YY _ _ _ _ _ _

Response		Respondent		Mode		Enum.	Eval.	Office Use for POID
1-Comp 2-R 3-Inac 4-Office Hold 5-R – Est 6-Inac – Est 7-Off Hold – Est 8-Known Zero	9901	1-Op/Mgr 2-Sp 3-Acct/Bkpr 4-Partner 9-Oth	9902	1-Mail 2-Tel 3-Face-to-Face 4-CATI 5-Web 6-e-mail 7-Fax 8-CAPI 19-Other	9903	098	100	789 __ __ __ - __ __ __ - __ __ __
								Optional Use
								407		408
S/E Name

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The time required to complete this information collection is estimated to average 5 minutes per response.