QID 2006 Integrated Screening Survey

Agricultural Resource Management, Chemical Use, and Post-harvest Chemical Use Surveys

0218-ARMS-I-HQ-2006

Agricultural Resource Management, Chemical Use, and Post-harvest Chemical Use Surveys

OMB: 0535-0218

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6


Project 905


OMB No. 0535-0218 Approval Expires 9/30/2008

2006 INTEGRATED SCREENING SURVEY

NATIONAL

AGRICULTURAL

STATISTICS

SERVICE



National

U.S. Department of Agriculture,

Rm 5030, South Building

1400 Independence Ave., S.W.

Washington, DC 20250-2000

Phone: 1-800-727-9540 Fax: 202-690-2090

Email: [email protected]


Information requested on this report will be used to select a sample of growers to obtain agricultural data on resource management practices. Your voluntary cooperation is needed to ensure that all producers are represented in this state and national survey. As always, your response to this survey is confidential. Please return your report in the enclosed postage paid envelope. Thank you for your help.

1. Please make any needed corrections to the name, including the correct operation name, and
mailing address on the label.



2. During 2006, will this operation grow crops, including field crops, fruits, vegetables,
nursery/greenhouse, or other specialty crops, cut
hay, have any livestock or poultry, sell agricultural
products, receive government payments (CRP, WRP, etc.), have more than 19 acres of
idle cropland, or have more than 99 acres of pastureland?

YES - Go to 2006 Total Acres Operated, below.

NO – Complete items 2a and 2b; then go to Conclusion on back.

2a. Has the operation name on the label been sold, rented, or turned over to someone else?

YES

NO

Will the land be used for any agricultural purpose
by you (the individual listed on the label), or anyone else
in the next year?

YES NO DON’T KNOW

Please explain, then go to Conclusion on back page.


2b. What is the name and address of the new operator?


Operation Name_________________________________________

_________________________________________________________

Operator Name__________________________________________

_________________________________________________________

Address_________________________________________________

_________________________________________________________

City____________________

State____________

Zip__________

_________________________________________________________

Phone(___________________________________) _______________________________


_________________________________________________________





















SECTION 1 - 2006 TOTAL ACRES OPERATED

(Complete section, then go to 2006 Value of Sales, next page.)

3. Considering the farmstead, all cropland, pastureland, wasteland, wetland, woodland and government
program land, how many Total Acres does this operation---


ACRES

a. Own?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +

901

b. Rent or Lease from others, including for Cash, Shares or Rent Free?. . . . . . . . . . . . . . . . . . . . +

902

c. Rent to others, including for Cash, Shares or Rent Free?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

905

4. Total Acres Operated: [item 3a +3b -3c]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . =

900



5. Of the total [item 4] acres operated, how many acres are considered Cropland?

(Include hay land, summer fallow, idle cropland, cropland pasture, and cropland in government programs.). . . . . . . . .

802



SECTION 5 - 2005 VALUE OF SALES


15. Considering



►Sales of all crops, livestock, poultry, and livestock products (milk, eggs, etc.) sold in 2005.

►The value of product removed for all crops, livestock, and poultry produced under
contract in 2005.

►Sales of all miscellaneous agricultural products in 2005.

►All government agricultural payments received in 2005.

►Landlord’s share of government payments and crops sold in 2005.





Was the Gross Value of Sales for

this farm or ranch in 2005:

[Check box and enter code.]


$1,000 or more [Enter code “2” in

box 860, and go to Operation Type.]


Between $1 - $999 [Enter code “1” in

box 860, and complete table.]


NONE [Enter code “99” in box 860,

and complete table.]

GVS CODE

(Complete these items if the 2005 Gross Value of Sales was less than $1000.)

860

Record all crops and other land uses, including cropland and pasture, on this operation in 2006.


Acres

Record all livestock and poultry that are NOW on this operation


Number



________________________


________

_________________


___________

________________________


________

_________________


___________

________________________


________

_________________


___________



































































SECTION 6 - OPERATION TYPE


16. Are the day-to-day decisions for this operation made by one individual,

a hired manager, or partners? [Check one]


One individual - [Go to Conclusion, on back page.]

A hired manager - [Go to Conclusion, on back page.]

Partners – [Complete items 16a and 16b, then go to Conclusion, on back page.]




Number

a. How many individuals, including the operator, are involved in the day-to-day decisions for this operation?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




b. Please record partners’ names and addresses, then go to Conclusion, on back page.

[Enter names and address of partners not already listed.

Include partners who jointly operate land and share in decision making. Do not include landlords and tenants as partners.]


PARTNER 1

PARTNER 2

Partner name:_______________________________________________

Partner name:______________________________________________

Address____________________________________________________

Address:___________________________________________________

City:______________________

State:____________

Zip:__________

City:_____________________

State:____________

Zip:__________

Phone: (______)_____________

Phone: (______)_____________     

PARTNER 3

PARTNER 4

Partner name:_______________________________________________

Partner name:______________________________________________

Address:____________________________________________________

Address:___________________________________________________

City:______________________

State:___________

Zip:____________

City:_____________________

State:___________

Zip:____________

Phone: (______)_____________

Phone: (______)_____________



Continue on Back Page


COMMENTS





























































SECTION 7 - CONCLUSION


17. Do you (the operator named on the label) make any day to day decisions for another farm or ranch?

YES –Please list the other operations(s):____________________________________________________________________________

[Complete a separate questionnaire for each additional operation]

NO – [Continue.]


18. To assist in identifying duplication in our list of farm operators, please report the operator’s Social Security Number. If this operation has a Federal Employer Identification Number, this would also be helpful. Reporting your SSN and EIN is voluntary.
This information is collected under the general authority of Title 7, Section 2204, of the U.S. Code


OPERATOR’S SSN


FEDERAL EIN



470


___ ___ - ___ ___ ___ ___ ___ ___ ___


466


___ ___ - ___ ___ ___ ___ ___ ___ ___


















This completes the survey. Thank you for your help.





Reported by:_____________________________________

Telephone:(_______)

_______________________

Date:___________________

OFFICE USE

R. Unit

Ptr 1 Str

Ptr 2 Str

Ptr 3 Str

Ptr 4 Str


Pasture Points

OPS

SSO 1

ADJ

921

925

926

927

928


869

923

407

922

Response

Respondent

Mode

Enum.

Eval.

MM DD YY

GVS Points

POID

9901

9902

9903

0098

100

9910

861

789

___ ___ ___ ___ ___ ___ ___ ___ ___

__ __ __ __ 06


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 15 minutes per response.




File Typeapplication/msword
File TitleProject 905
AuthorUSDA
Last Modified Byhancda
File Modified2008-06-12
File Created2008-06-12

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