Form QID 040121 QID 040121 North Dakota - List Sampling Farm Criteria

Project Code 633 QID 040121		OMB No. 0535-0140 Approval Expires 07/31/2009
	North Dakota List Sampling Farm Criteria					NATIONAL AGRICULTURAL STATISTICS SERVICE
				North Dakota Field Office P.O. Box 3166 Fargo, ND 58108-3166 701-239-5306 Fax: 701-239-5613 [email protected]
			We are in the process of updating our list of farm operators. Your answers to questions on acreage and livestock numbers will help us identify duplication and verify current farm operations in North Dakota. Response to this survey is voluntary and not required by law. The information you provide us concerning your farm or ranch will be kept confidential.

SECTION 1 - IDENTIFICATION
Please verify name and address of this operation. Make corrections on label.
1. On land operated by the farm, ranch or individual(s) listed on label:
a. Have or will crops be grown or hay cut at any time during this year, or is any of the land in this operation in government programs?................................................................................				 YES  NO
b. Have or will grains or oilseeds be stored at any time this year, or do you have storage facilities used for storing grain?..............................................................................................				 YES  NO
c. Have or will there be any livestock or poultry on this operation at any time during this year?......................................................................................................................................				 YES  NO
(If “NO” to all questions, go to Section 9)
2. Does this operation do business under any other name, other than as shown on label?
 YES- Enter Name: ___________________________________________ (Do you want this name to appear on the label?)				 YES  NO
 NO
3. Are the day-to-day decisions for this farming (or ranching) operation made by:
 An individual operator?
 Partners? Enter number of partners, including self…………………………………………… (Partners jointly operate and share in decision making. DO NOT include landlord as partner).			_______________
 A hired manager?

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SECTION 2 - ACRES OPERATED
1. How many acres are now in this operation? (Please include land owned and land rented, but exclude land rented to others)	ACRES
Total Acres…………………………………………………………………………………………………………………	100
Total Cropland Acres (including CRP)………………………………………………………………………………...	300
Land in CRP……………………………………………………………………………………………………………….	200
Pasture (exclude public and private land use on an AUM basis)……………………………………………………	220

SECTION 3 - STORAGE CAPACITY
1. What is the total Grain Storage Capacity on this operation?	BUSHELS
(Include all structures normally used for storing grain)………………………………………………………………	305

SECTION 4 – LAND USE
1. Which of the following crops did, or will this operation grow this year?					ACRES
a. All Wheat……………………………………………………………………………………………………………..					390
(1) Winter…………………………………………………………………………………			392
(2) Durum…………………………………………………………………………………			394
(3) Other Spring………………………………………………………………………….			396
b. Barley…………………………………………………………………………………………………………………					315
c. Oats…………………………………………………………………………………………………………………...					352
d. Rye…………………………………………………………………………………………………………………….					370
e. Flax……………………………………………………………………………………………………………………					340
f. Corn for all Purposes………………………………………………………………………………………………..					320
g. Soybeans for all Purposes………………………………………………………………………………………….					372
h. All Sunflower…………………………………………………………………………………………………………					378
(1) Oil Sunflower…………………………………………………………………………			377
(2) Non-Oil Sunflower…………………………………………………………………...			379
i. Dry Edible Beans (Pinto, Navy & Other Varieties – exclude garbonzo beans)…………………….…………					330
j. Garbonzo Beans (Chickpeas – large and small)…………………………………………………………………					331
k. All Hay (Harvested or to be Harvested)…………………………………………………………………………...					345
(1) Alfalfa………………………………………………………………………………….			346
(2) Other Hay…………………………………………………………………………….			347
l. Sugarbeets…………………………………………………………………………………………………………...					374
m. Potatoes (Include potato land rented from others; exclude rented to others)……………………………………………					360
(If potatoes are grown) What is your Potato Storage Capacity?.......................................................................................................					362
					cwt
n. Millet…………………………………………………………………………………………………………………..					397
o. Mustard………………………………………………………………………………………………………………					339
p. Rapeseed…………………………………………………………………………………………………………….					341
q. Canola………………………………………………………………………………………………………………...					373
r. Safflower……………………………………………………………………………………………………………...					371
s. Other (Specify) _______________..............................................................................................................					964
2. Acres in Summer Fallow or idled through Government Programs, exclude CRP acreage……………………					289

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SECTION 5 - HOGS
1. What was the peak number of hogs or pigs OWNED by this operation during the past twelve months?...........							NUMBER
							630
2. Were any hogs or pigs owned by this operation being raised under contract by another person or firm?
 Yes a. What was the peak number? [Verify that these hogs are included in box 630, then continue]…..
 No [continue]
3. Were any hogs or pigs owned by someone else on this operation?
a. What was the peak number?.......................................................................................................................
b. Who owns the hogs and pigs?
Name	Address			City, State, Zip
_________________________	_____________________________			_____________________________
c. Is this hog owner a contractor?  Yes  No

SECTION 6 – OTHER LIVESTOCK
1. What was the peak number of the following livestock items on this operation, regardless of ownership, During the past twelve months?		NUMBER
a. All cattle & calves including milk cows…………………………………………………………………………….		610
(1) Milk cows/heifers that have calved………………………………………………...	615
(2) Beef cows/heifers that have calved……………………………………………….	611
(3) Cattle on feed………………………………………………………………………..	620
b. All sheep……………………………………………………………………………………………………………...		640
(1) Sheep on feed……………………………………………………………………….	641
(2) Stock Sheep………………………………………………………………………….	142
c. Turkeys……………………………………………………………………………………………………………….		770
d. Chickens……………………………………………………………………………………………………………...		760
e. Bee Colonies (owned or controlled by you)………………………………………………………………………		660
f. Mink…………………………………………………………………………………………………………………...		670
g. Horses………………………………………………………………………………………………………………..		675
h. Bison………………………………………………………………………………………………………………….		691
i. Goats………………………………………………………………………………………………………………….		645
j. Other (Specify) _________________..........................................................................................................		964

SECTION 7 – HIRED LABOR
1. What was the peak number of hired workers at any one time during this year?.................................................	885

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SECTION 8 – PARTNER NAMES
1. Did you check “Partners”, in Section 1, Item 3, on face page?
 NO – Go to Section 10.  YES – Continue
2. Please identify the other person(s) in this partnership in the following boxes, then go to Section 10. (Make necessary corrections to the label if present.)
Name ______________________________________________________ Phone_____________________________ (First) (Middle) (Last)
Address _________________________________________________________________________ (Route or Street) (City) (State) (Zip)
Is this partner also involved in another operation?  YES  NO

SECTION 9 – CHANGE IN OPERATOR
1. If not farming or ranching, did you:
 Sell out?  Retire?  Lease/Rent out your land (Landlord only)?  Other (Specify): ___________________
Has this operation (name on label) been sold, or turned over to someone else?
 NO – Go to Section 10.  YES – Please identify the new operator(s):
Name
Address						Phone
City				State		Zip

SECTION 10 – RACE
1. What is the operator’s race?
 American Indian or Alaska Native – specify tribe _____________  Asian  Black or African American
 Native Hawaiian or Other Pacific Islander  White

SECTION 11 - CONCLUSION
1. Do you make any day-to-day decisions for another farm or ranch?
 NO  YES – List other operation(s):
_______________________________________________________________________________________
This completes the questionnaire. Thank you for your help.
Reported by:			Date:
Telephone:

Thank you for cooperating on this Farm Criteria Survey.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB number is 0535-0140. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.