QID Annual Potato Processing Inquiry

Project 195			OMB No. 0535-0007 Approval Expires 11/30/2012
	ANNUAL 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 on the reverse page.)

INSTRUCTIONS: In the table below, please provide a breakdown of the volume of raw potatoes used at the plant to produce the various processed potato products during the past season. If actual figures are not available, convert the finished product to raw potato equivalents, using your normal factors.
1.	How many hundredweight of U.S. grown raw whole potatoes from the <CROP YEAR> crop were and will be processed at your plant(s)? (Include <CROP YEAR> crop winter, spring, summer and fall potatoes, but exclude new crop, <CROP YEAR + 1> potatoes.). . . . . . . . . . . .		Cwt.
2.	Of the quantity reported in Item 1, how many hundredweight were or will be used for making:			POTATOES FROM THE <CROP YEAR> CROP
	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		Cwt.
	OTHER POTATOES (fresh pack, potato salad, vodka, etc.)		Cwt

	3. In the table below, please report the quantity of <crop yr> potatoes purchased/received over the previous twelve months from the following States and Sources. Exclude potatoes purchased for seed.
				<Crop yr>
State		Source		Quantity (cwt)	Dollar/cwt
		Growers
		Shippers
		Processing Plants
		Grower
		Shipper
		Processing Plant
		Grower
		Shipper
		Processing Plant

– PLEASE CONTINUE ON REVERSE SIDE –

4.	Of the quantity reported in Item 3 which were NOT processed, how many hundredweight were:			<crop yr>
	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.

LOCATION OF ADDITIONAL PLANTS OPERATED IN THIS STATE (Complete only if this report covers more than one plant.)
Firm Name:	________________________________________		Firm Name:	_________________________________________
Plant Manager:	________________________________________		Plant Manager:	_________________________________________
Address:	________________________________________		Address:	_________________________________________
City:	________________________________________		City:	_________________________________________
Phone:	________________________________________		Phone:	_________________________________________

Firm Name:	________________________________________		Firm Name:	_________________________________________
Plant Manager:	________________________________________		Plant Manager:	_________________________________________
Address:	________________________________________		Address:	_________________________________________
City:	________________________________________		City:	_________________________________________
Phone:	________________________________________		Phone:	_________________________________________

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