QID Monthly Potato Price Inquiry - Maine

	Project Code 195	OMB NO. 0535-0007: Approval expires 11/30/2012
	MONTHLY POTATO PRICE INQUIRY – Master Copy
	DRAFT			NATIONAL AGRICULTURAL STATISTICS SERVICE
			New England Field Office 53 Pleasant St., Room 2100 Concord, NH 03301 1-800-642-9571 Fax: 1-800-754-7607 [email protected]
Please make corrections to name, address and Zip Code, if necessary. Information requested in this survey is used to prepare estimates of selected agricultural commodities. Under Title 7 of the U.S. Code and CIPSEA (Public Law 107-347), facts about your operation are kept confidential and used only for statistical purposes in combination with similar reports from other producers. Response is voluntary. 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 0535-0007. 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. Please complete this questionnaire within the next few days and return it to us in the enclosed envelope to insure correct and prompt delivery. No stamp is required. You may fax your completed report to 1-877-743-6181.

INSTRUCTIONS: Only report sales of potatoes purchased directly from growers. Purchases should be reported in the month potatoes are delivered. Exclude purchases of potatoes grown outside of Maine. Exclude any potatoes purchased from other shippers or warehouses. If no potatoes were purchased potatoes last month, enter “none”.

POTATOES PURCHASED DIRECTLY FROM MAINE GROWERS (include contract and open market sales)	Reference Month, Year
	Quantity Purchased	Unit	Average Price Paid (Dollars per Unit)
1. For table stock or fresh market		1 Cwt 2 Bbls	$ . __ __
2. For processing (excluding chipping)		1 Cwt 2 Bbls	$ . __ __
3. For chipping…………………………………….		1 Cwt 2 Bbls	$ . __ __

POTATOES PURCHASED DIRECTLY FROM MAINE GROWERS (include contract and open market sales)	First Half of Reference Month + 1, Year
	Quantity Purchased	Unit	Average Price Paid (Dollars per Unit)
1. For table stock or fresh market		1 Cwt 2 Bbls	$ . __ __
2. For processing (excluding chipping)		1 Cwt 2 Bbls	$ . __ __
3. For chipping…………………………………….		1 Cwt 2 Bbls	$ . __ __

COMMENTS:

Survey Results: To receive the complete results of this survey on the release date, go to http://www.nass.usda.gov/results. Would you rather have a brief summary mailed to you at a later date?. . . . . . . . . . . .

Yes = 1 No = 3

099

Respondent Name: ____________________

9911 Phone: (_____) _____

9910 MM DD YY Date: __ __ __ __ __ __

OFFICE USE ONLY

Response

Respondent

Mode

Enum.

Eval.

Change

Optional Use

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

785

921

407

408

9906

9916

S/E Name