Form QID 153841 QID 153841 May 2016 Field Sample Permission Form

ARS RESIDUE AND BIOMASS SURVEY PERMISSION FORM - May 2016
							OMB No. 0535-0251 Approval Expires: 4/30/2017 Project Code: 516 QID: 153841 SMetaKey: 3841
								United States Department of Agriculture
								NATIONAL AGRICULTURAL STATISTICS SERVICE
							USDA/NASS - Iowa Upper Midwest Region 210 Walnut St., #833 Des Moines, IA 50309 Phone: 1-800-772-0825 Fax: 1-855-271-9802 Email: [email protected]
Please make corrections to name, address and ZIP Code, if necessary
We are collecting information on residue and biomass and need your help to make the information as accurate as possible. 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. Multiple contacts may occur. You may skip any item(s) you prefer not to answer.
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 0535-0251. The time required to complete this information collection is estimated to average 20 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.

USDA’s National Agricultural Statistics Services’ Iowa field office is working on a joint project with the Agricultural

Research Service (ARS) Hydrology and Remote Sensing Lab to conduct research on biomass and crop production in the

South Fork watershed area. This study requires estimating the level of plant residue at specific points in particular fields.

One or more points of interest lie in a field that you operate.

The project involves taking pictures of the soil surface to measure corn and soybean residue. The pictures and

measurements will then be used by ARS personnel along with satellite images to estimate soil carbon sequestration, or

how much carbon is retained in the soil.

Granting permission means 2 - 4 people will walk into your field the week of May 22, 2016, and take pictures of the residue with a digital camera, as well as use transect lines to measure residue. For a few selected sites, we will also collect small soil and crop residue samples. NASS/ARS intends to visit again in December to obtain corn samples. As always, your name and any identifying information will be kept confidential.

If you would like the results that pertain to your field, you will be mailed information once it is available.

Yes, I give permission	______________________________________________			(signed name)
No. I do not give permission		__________________________________________		(enumerator initial)
Yes, I would like results mailed to me			__________________________________	(printed name)
			__________________________________	(address)
			__________________________________
Please feel free to call the office at 1-800-772-0825 if you have any questions.