QID Monthly Potato Processing Inquiry (one column)

Project 195			OMB No. 0535-0007 Approval Expires 11/30/2012
	MONTHLY POTATO PROCESSING INQUIRY – Master Copy
	DRAFT				NATIONAL AGRICULTURAL STATISTICS SERVICE
				California Field Office P.O. Box 1258 Sacramento, CA 95812 1-800-851-1127 Fax: 1-888-478-5637 [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 .

REPORT FOR THE PLANT(S) OPERATED IN THIS STATE (If this report includes more than one plant, please indicate the location of each plant below.)
	<OLD YEAR>
1. How many hundredweight of U.S. grown raw whole potatoes from the <crop yr> crop were processed at your plant(s) during <previous month yyyy>?.

2.	Of the quantity reported in Item 1, how many hundredweight were or will be used for making:			<OLD YEAR>
	POTATO CHIPS (include shoestring potatoes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		Cwt.
	FROZEN POTATOES
		Frozen French Fries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		Other Frozen specialties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
	CANNED POTATOES
		Canned potatoes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		Other canned products: (soup, hash, stews, etc.) . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
	DEHYDRATED POTATOES (including starch and flour)		Cwt.
	OTHER POTATOES (potato salad, vodka, etc.)		Cwt

3. Are you finished processing potatoes from the <OLD YEAR> crop?

1 Yes 3No

104

4. In the table below, please report the quantity of <OLD YEAR> crop potatoes purchased/received in <month> from the following States and Sources. Exclude potatoes purchased for seed.
			REFERENCE MONTH, YEAR
			<OLD YEAR> CROP
	State	Source	Quantity (cwt)	Dollar/cwt
		Growers
		Shippers
		Processing Plants
		Grower
		Shipper
		Processing Plant
		Grower
		Shipper
		Processing Plant

– PLEASE CONTINUE ON REVERSE SIDE –

5	Of the quantity reported in Item 4 which were NOT processed, how many hundredweight were:			<OLD YEAR>
	SOLD FOR FRESH MARKET (US #1 or US #2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		Cwt.
	TRANSFERRED OR SOLD TO OTHER PROCESSING PLANTS (include Washed Processed Potatoes)
		In <HOME STATE>. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		In Other States (Specify____________________________). . . . . . . . . . . . . . . . .	Cwt.
	OTHER DISPOSITION
		Used or Sold for Seed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		Used or Sold for Livestock Feed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		Shrink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		Dumped . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Cwt.
		Other Use (Specify____________________________). . . . . . . . . . . . . . . . .	Cwt.

	In the table below, please report the quantity of <OLD YEAR> crop potatoes purchased/received in during the first half of <month + 1> from the following States and Sources. Exclude potatoes purchased for seed.
			FIRST HALF OF REFERENCE MONTH + 1, YEAR
			<OLD YEAR> CROP
	State	Source	Quantity (cwt)		Dollar/cwt
		Growers
		Grower
		Grower
	SURVEY RESULTS: To receive the complete results of this survey on the release date, go to www.nass.usda.gov/results/.
	Would you rather have a brief summary mailed to you at a later date?			1 Yes 3No		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