QID 153838 June Area Survey Screening Form Version C

2017 JUNE AREA SURVEY SCREENING - Version C
	OMB No. 0535-0213 Approval Expires: 6/30/2018 Project Code: 124 QID: 153838 SMetaKey: 3838
		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: 1-855-515-1328 E-mail: [email protected] KS, NE, NM, OK, TX

State

Stratum

Segment

Part ____

of

______

___ ___

___ ___ ___ ___

000___ ___ ___ ___ ___ ___

County ________________

	INTRODUCTION
[Introduce yourself and ask for the operator. Rephrase in your own words.]
I am working on the June Agricultural Survey. This is a national survey where agricultural producers are asked to provide information on crops and livestock.
The information you provide will be used for statistical purposes only. Your response will be kept confidential and any person who willfully discloses ANY identifiable information about you or your operation is subject to a jail term, a fine, or both. This survey is conducted in accordance with the Confidential Information Protection provisions of Title V, Subtitle A, Public Law 107-347 and other applicable Federal laws. For more information on how we protect your information please visit: https://www.nass.usda.gov/confidentiality. Response to this survey is voluntary.
The area of land shown on this photo (map) has been selected for this survey.
[Show respondent photo or map. Point out segment boundaries, houses and other identifying landmarks to help the respondent become familiar with the segment.]
1. On June 1, did you operate land inside these red lines?
Yes - [Continue with item 2.] No - [Determine who are the tract operators inside the segment. Thank respondent and conclude interview.]
2. What were the boundaries of land operated inside these red lines?
[Verify or draw tract boundaries in blue, then continue with item 3.]

3. Was any of this land (inside these blue lines) operated by someone else?

Yes - [Correct boundaries, then continue with item 4.]

No - [Continue with item 4.]

4. Was any land inside these blue lines administered or controlled by a public agency, industrial corporation,
or grazing association for use on a fee per head or animal unit month (AUM) basis?

Yes - [Correct boundaries and assign a separate tract code to the PIGA land, then go to page 2.]

No - [Go to page 2.]

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5			6	7	8	9	10	11
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	Is this tract Public, Industrial, or Grazing Association land used on an AUM basis?	On the total acres operated on June 1, have there been or will there be any crops grown, hay cut, livestock, poultry, honey bees 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, 2018?	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?
			Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________	Yes – Enter acres in col.21 and conclude interview. 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	Yes – Go to Questionnaire DK – Go to Questionnaire No
			Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________	Yes – Enter acres in col.21 and conclude interview. 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	Yes – Go to Questionnaire DK – Go to Questionnaire No
			Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________	Yes – Enter acres in col.21 and conclude interview. 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	Yes – Go to Questionnaire DK – Go to Questionnaire No
			Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________	Yes – Enter acres in col.21 and conclude interview. 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	Yes – Go to Questionnaire DK – Go to Questionnaire No
			Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________	Yes – Enter acres in col.21 and conclude interview. 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	Yes – Go to Questionnaire DK – Go to Questionnaire No
			Name: ____________________________________________________ Address: ____________________________________________________ ____________________________________________________ Phone: (_______) ________-___________________________	Yes – Enter acres in col.21 and conclude interview. 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	Yes – Go to Questionnaire DK – Go to Questionnaire No
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13	14	15	16	17		18	20		20a	21
On June 1 were there any horses, ponies, or other equine, regardless of ownership, on the total acres operated?	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?	O F F I C E	U S E	NON-AGRICULTURAL TRACTS				PIGA	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.
						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, 2018? [Enter code]		What best describes this non-agricultural tract? [Enter code]	Acres of Public, Industrial, or Grazing Association land used on AUM basis. [Enter acres]
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		849 •
						LAND USE	YES = 1 DK = 2 NO = 3
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		849 •
						LAND USE	YES = 1 DK = 2 NO = 3
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		849 •
						LAND USE	YES = 1 DK = 2 NO = 3
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		849 •
						LAND USE	YES = 1 DK = 2 NO = 3
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		849 •
						LAND USE	YES = 1 DK = 2 NO = 3
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		849 •
						LAND USE	YES = 1 DK = 2 NO = 3
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[Complete this check list when enumeration of segment is completed.]
1. Total tract letters listed in Column 5, page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Number of tract letters listed on photo or map. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
[Item 1 must equal item 2.]
3. Number of Area Version questionnaires completed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Number of tracts with acreage listed in Column 18, page 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .					+
5. Number of tracts with acreage listed in Column 21, page 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .					+
6. Total of items 3 + 4 + 5. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .					=	5326
Worksheet	[Item 6 must equal items 1 and 2.]
Ag Tract Acres		Non-Ag Tract Acres	PIGA Tract Acres

[comment on any enumerating problems caused by segment boundaries, split fields, aerial photo coverage, etc.]		OFFICE USE
____________________________________________		Activity	Date	Initials
____________________________________________		Received
____________________________________________		Clerical Edit
____________________________________________		OL/NOL Check
____________________________________________		1st Manual Edit
____________________________________________		2nd Manual Edit
____________________________________________		Keyed
____________________________________________		Verified
____________________________________________		Interactive Edit
____________________________________________		Submitted for processing
____________________________________________		ELMA updates completed
____________________________________________
ENUMERATOR:________________________________		Reported Acres (RA)	OFFICE USE Digitized Acres (DA)	RA / DA
DATE:________________________________________
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