QID 050801 Prices Paid for Fuels - HQ

PRICES PAID FOR FUELS MARCH 2016
	OMB No. 0535-0003 Approval Expires: 5/31/2016 Project Code: 171 QID: 050801 SMetaKey: 1991
		United States Department of Agriculture
			NATIONAL AGRICULTURAL STATISTICS SERVICE

USDA/NASS National Operations Division 9700 Page Avenue, Suite 400 St. Louis, MO 63132-1547 Phone: 1-888-424-7828 Fax: 1-855-415-3687 E-mail: [email protected]

Please make corrections to name, address and ZIP Code, if necessary.

The information you provide will be used for statistical purposes only. In accordance with the Confidential Information Protection provisions of Title V, Subtitle A, Public Law 107–347 and other applicable Federal laws, your responses will be kept confidential and will not be disclosed in identifiable form to anyone other than employees or agents. By law, every employee and agent has taken an oath and is subject to a jail term, a fine, or both if he or she willfully discloses ANY identifiable information about you or your operation. 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 control number is 0535-0003 . The time required to complete this information collection is estimated to average 5 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.

INSTRUCTIONS:
	Report average prices, before discount, for items listed.
	Include Federal, State and local taxes for GASOLINE.
	Exclude ALL TAXES for DIESEL FUEL and L.P. GAS:.

1. Did this operation sell fuel to farmers/ranchers in the U.S. during the 12-month period March 2015

through February 2016?

Yes - [go to Question 3.] No - [go to Question 2.]

2. Will this operation sell fuel to farmers/ranchers in the U.S. in the future?

Yes – [go to question 4 on back page] No – [go to question 4on back page]

(Over)

3. Report price per unit of fuel for sale to farmers/ranchers in the U.S. on March 15, 2016.

FUELS			NONE	Dollars and Cents Per GALLON
GASOLINE, unleaded, pumped at service station (Include Federal, State and local per gallon taxes) Report price for largest volume sold				508 $	▪ __ __ __
GASOLINE, unleaded, bulk delivery (Include Federal, State and local per gallon taxes)				526 $	▪ __ __ __
DIESEL FUEL, bulk delivery (Exclude all taxes)				504 $	▪ __ __ __
L.P. GAS, propane, butane, etc, bulk delivery (Exclude all taxes)				511 $	▪ __ __ __

COMMENTS:
     

4. SURVEY RESULTS: To receive the complete results of this survey on its release date, go to http://www.nass.usda.gov/Surveys/Guide_to_NASS_Surveys/
Would you rather have a brief summary mailed to you at a later date? 1Yes 3No	9990

Respondent Name:	9911 Phone: ( )		9910 MM DD YY Date: __ __ __ __ __ __

Office Use Only

Response

Respondent

Mode

Enum.

Eval.

R. Unit

Change

Office Use for POID

1-Comp 2-R 3-Inac 4-Office Hold 5-R – Est 6-Inac – Est 7-Off Hold – Est

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

9998

9900

9921

9985

9989 __ __ __ - __ __ __ - __ __ __

Optional Use

9907

9908

9906

9916

S/E Name