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pdfNATIONAL
AGRICULTURAL
STATISTICS
SERVICE
U.S. Department of Agriculture
Rm 5829, South Building
1400 Independence Avenue, S.W.
Washington, D.C. 20250-2000
1-800-727-9540
Fax: 202-690-2090
E-mail: [email protected]
Form Approved
OMB Number 0535-0218
Approval Expires 12/31/20##
Project code 904
Phase III
QUALITY CONTROL WORKSHEET
for
2012 AGRICULTURAL RESOURCE MANAGEMENT SURVEY
PHASE III
State: _________________________________________________
Farm, Ranch, or
Operation Name: __________________________________________
Version:
Operator’s name: _________________________________________
ID/POID: ______________________________________________
Address: __________________________________________________
Enumerator: ___________________________________________
__________________________________________________
Interview Date & Time: ________________________________
Telephone: _______________________________________________
Survey Respondent: ___________________________________
Operation Mgr/
Partner
Spouse
Accountant/
Bookkeeper
Other
Current Respondent: __________________________________
Operation Mgr/
Partner
Spouse
Accountant/
Bookkeeper
Other
INTRODUCTION:
[Introduce yourself, and ask for the survey respondent. Rephrase in your own words.]
Recently you should have been contacted by one of our interviewers, Mr./Ms.
,
for the Agricultural Resource Management Survey. This telephone call is part of our survey quality assurance measures
to verify that personal contact was actually made with you for that purpose. Your response is voluntary and not required
by law, but your cooperation will be appreciated. Facts about your farm/ranch will be kept confidential.
1. During the past few days, do you recall an interview with Mr./Ms.
obtaining information about your farming or ranching operation?
, for the purpose of
YES - [Go to item 3.]
NO - [Go to item 2.]
DON'T REMEMBER - [Go to item 2.]
2. During the past few days, did any other person from the
Agricultural Statistics Service,
NASS, or USDA, interview you to obtain information about your farm or ranch?
YES - [Go to item 3.]
NO - [Conclude interview.]
DON'T REMEMBER - [Conclude interview.]
3. Did the person conducting the interview ask you to verify the spelling of your name, address
and the operation name?
YES
NO
DON'T REMEMBER
[Continue on back.]
-2-
4. Now I need to verify farm operation items that are critical to our survey procedures.
a. Total Land Operated (Section A, item 4)
Reported
Verified
_______________________
_______________________
b. During 2012, did this operation have MARKETING CONTRACTS for any commodities it produced?
(A marketing contract is a written or oral agreement reached before harvest of a crop or before completion of a livestock
production stage, setting a price or pricing formula.)
YES
NO
c.
During 2012, did this operation have PRODUCTION CONTRACTS for any commodities it produced?
(A production contract is a written or oral agreement setting terms, conditions, and fees to be paid by the contractor to the operation
for the production of crops, livestock, or poultry. The contractor usually owns the commodity and often provides inputs.)
YES
NO
d. Was debt used in funding the operation of this farm/ranch in 2012, including any loans obtained in earlier
years? (Include seasonal production and other loans taken and repaid during 2012.)
YES
NO
e. Did you use hired labor (either for wages, contract, or custom) in 2012?
YES
NO
5. Did Mr./Ms.
conduct the interview in a knowledgeable and professional manner?
YES
NO – Explain: ____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
6. Do you have any additional comments you would like to make concerning our survey contact?
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
This concludes the interview. Thank you for your help.
Signature:___________________________________________________
Date:____________________________________________________
File Type | application/pdf |
Author | Carol Pinto |
File Modified | 2012-05-25 |
File Created | 2012-05-24 |