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OMB No. 0535-0213 |
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2012 JUNE AGRICULTURAL SURVEY AREA SCREENING |
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VERSION B |
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NATIONAL AGRICULTURAL STATISTICS SERVICE |
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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] |
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State |
Stratum |
Segment |
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Part________ |
of |
___________ |
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___ ___ |
___ ___ ___ ___ |
000___ ___ ___ ___ ___ ___ |
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County __________________________ |
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INTRODUCTION |
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[Introduce yourself and ask for the operator. Rephrase in your own words.] |
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I am working on the June
Agricultural Survey. This is a national survey where agricultural
producers |
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Authority for collection of information on the June Agricultural Survey is 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. Response is voluntary. The information will be used to compile and publish agricultural estimates for individual states and for the United States. |
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The area of land shown on this photo (map) has been selected for this survey. |
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[Show respondent photo or
map. Point out segment boundaries, houses and other
identifying |
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1. On June 1, did you operate land inside these red lines? |
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Yes - [Continue with item 2.]
No - [Determine who are the tract operators inside the
segment. |
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2. What were the boundaries of land operated inside these red lines? |
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[Verify or draw tract boundaries in blue, then continue with item 3.] |
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3. Was any of this land (inside these blue lines) operated by someone else? |
Yes - [Correct boundaries, then continue with page 2.] No - [Continue with page 2.] |
B |
5 |
6 |
8 |
9 |
10 |
11 |
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TRACT |
L E T T E R |
Line 1 – Full Name (First, Middle, Last) Line 2 – Mailing Address Line 3 – City, State, Zip Code Line 4 – Telephone Number |
On the total acres operated on June 1, have there been or will there be any crops grown, hay cut, livestock, poultry or aquaculture raised this year? |
On the total acres operated on June 1, have you sold or will you sell agricultural products or receive government payments this year? |
On the total acres operated on June 1, are any crops now in storage or will there be any crops stored before June 1, 2013? |
Has this operation owned or raised any hogs or pigs in the past 12 months, or does it expect to own or raise any this year? |
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Name: _________________________________________________________
Address: ______________________________________________________
_______________________________________________________________
Phone: (_______) ________-_______________________________________ |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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Name: _________________________________________________________
Address: ______________________________________________________
_______________________________________________________________
Phone: (_______) ________-_______________________________________ |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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Name: _________________________________________________________
Address: ______________________________________________________
_______________________________________________________________
Phone: (_______) ________-_______________________________________ |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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Name: _________________________________________________________
Address: ______________________________________________________
________________________________________________________________
Phone: (_______) ________-_______________________________________ |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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Name: _________________________________________________________
Address: ______________________________________________________
_______________________________________________________________
Phone: (_______) ________-_______________________________________ |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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Name: _______________________________________________________
Address: _____________________________________________________
______________________________________________________________
Phone: (_______) ________-______________________________________ |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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B |
13 |
14 |
15 |
16 |
17 |
18 |
20 |
20a |
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On June 1 were there any horses, ponies, or other equine, regardless of ownership, on the total acres operated?
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Excluding home use, have there been or will there be any vegetables, melons, fruit, nuts or berries, grown on this operation this year? |
Excluding home use, have there been or will there be any nursery, greenhouse, floriculture, sod, cut Christmas trees or other woody crops grown on this operation this year? |
On June 1, did this operation have any idle cropland or more than 99 acres of pasture?
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O F F I C E |
U S E |
NON AGRICULTURAL TRACTS |
A - 01 B - 02 C - 03 D - 04 E - 05 F - 06 G - 07 H - 08 I - 09 J - 10 K - 11 L - 12 M - 13 N - 14 O - 15 P - 16 Q - 17 R - 18 S - 19 T - 20 U - 21 V - 22 W - 23 X - 24 Y - 25 Z - 26
AA - 27 BB - 28 CC - 29 DD - 30 EE - 31 FF - 32 GG - 33 HH - 34 II - 35 JJ - 36 KK - 37 LL - 38 MM - 39 NN - 40 OO - 41 PP - 42 QQ - 43 RR - 44 SS - 45 TT - 46 UU - 47 VV - 48 WW - 49 XX - 50 YY - 51 ZZ - 52
AAA - 53
Etc .
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How many acres are inside these blue lines?
[Enter acres and land use, then continue] |
Does this tract have potential for agriculture before June 1, 2013?
[Enter code] |
What best describes this non-agricultural tract?
[Enter code] |
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Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
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00 |
846 • |
818 |
783 |
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LAND USE |
YES = 1 DK = 2 NO = 3 |
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Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
__ __
00 |
846 • |
818 |
783 |
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LAND USE |
YES = 1 DK = 2 NO = 3 |
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Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
__ __
00 |
846 • |
818 |
783 |
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LAND USE |
YES = 1 DK = 2 NO = 3 |
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Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
__ __
00 |
846 • |
818 |
783 |
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LAND USE |
YES = 1 DK = 2 NO = 3 |
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Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
__ __
00 |
846 • |
818 |
783 |
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LAND USE |
YES = 1 DK = 2 NO = 3 |
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Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
Yes – Go to Questionnaire
DK – Go to Questionnaire
No |
__ __
00 |
846 • |
818 |
783 |
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LAND USE |
YES = 1 DK = 2 NO = 3 |
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B |
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[Complete this check list when enumeration of segment is completed.] |
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1. Total tract letters listed in Column 5, page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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2. Number of tract letters listed on photo or map. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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[Item 1 must equal item 2.] |
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3. Number of Area Version questionnaires completed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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4. Number of tracts with acreage listed in Column 18, page 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
+ |
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5. Total of items 3 + 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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[Item 5 must equal items 1 and 2.] |
[comment on any
enumerating problems caused by segment |
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OFFICE USE |
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__________________________________________________________ |
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Activity |
Date |
Initials |
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__________________________________________________________ |
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Received |
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__________________________________________________________ |
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Clerical Edit |
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__________________________________________________________ |
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OL/NOL Check |
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__________________________________________________________ |
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1st Manual Edit |
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__________________________________________________________ |
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2nd Manual Edit |
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__________________________________________________________ |
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Keyed |
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__________________________________________________________ |
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Verified |
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__________________________________________________________ |
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Interactive Edit |
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__________________________________________________________ |
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Submitted for |
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__________________________________________________________ |
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Mail Maintenance |
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__________________________________________________________ |
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ENUMERATOR:_________________________________________ |
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Reported Acres (RA) |
OFFICE USE Digitized Acres (DA) |
RA / DA |
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DATE:___________________________________________________ |
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | nassuser |
File Modified | 0000-00-00 |
File Created | 2021-01-30 |