QC - 0213 Telephone Quality Control Worksheet (List Samples)

Project Code 115 122, 123, 126,127, 129, 150, 152, 155, 157,
161, 162, 163, 164
QC - 0213

OMB No. 0535-0213

TELEPHONE QUALITY CONTROL
WORKSHEET
For Agricultural Surveys (List and NOL
Samples)
Month:

____________________

Year:

Approval Expires 12/31/2010
6/30/2017

NATIONAL
AGRICULTURAL
STATISTICS
SERVICE

__________________

State: __________________________________________

Farm, Ranch, or
Operation Name: _______________________________________________

Segment: ______________________________________

Operator’s name: _______________________________________________

Tract: __________________________________________

Address: ________________________________________________________

Enumerator: ___________________________________

________________________________________________________

Interview Date: ________________________________

Telephone: _____________________________________________________

Survey Respondent: _______________________________________

Operator

Spouse

Acct/Bkpr

Other

Current respondent: _______________________________________

Operator

Spouse

Acct/Bkpr

Other

Good (Morning/Afternoon/Evening):
I am __________________________ with the _______________ Agricultural Statistics Service. Recently you should have
been contacted by one of our enumerators, Mr./Ms. __________________, to obtain agricultural information about your
farm or ranch. This telephone call is part of our survey quality assurance measures to verify that personal contact was
actually made with you for that purpose. Your response is voluntary and not required by law, but your cooperation will be
appreciated. Facts about your farm or ranch will be kept confidential. Will you help me by answering a few questions about
the interview?
1. During the past few days, do you recall an interview with Mr./Ms. ___________________, for the purpose of obtaining
information about your farming or ranching operation:
Yes - [Go to item 3]
DK or Don't Remember - [Go to item 2]
No - [Go to item 2]
2. During the past few days, did any other person from the _________________ Agricultural Statistics Service, NASS, or
USDA, interview you to obtain information about your farm or ranch?
Yes - [Go to item 3]
DK or Don't Remember - [Conclude interview]
No - [Conclude interview]

3. Did the person conducting the interview ask you to verify the spelling of your name, address, and operation name?
Yes - [Continue]
DK or Don't Remember - [Continue]
No - [Continue]

(Continue on Back)

-2-

Now I would like to verify your type of operating arrangement.
4. Are the day-to-day decisions for this operation made by one individual, a hired manager, or partners?
Reported

Verified
One individual
A hired manager
Partners

5. Now I would like to verify crop and livestock items that are critical to our survey quality.
(Circle correct answer)
Survey Item:

Reported:

Grain Storage Capacity

Verified:

None, Positive

Field Crops:
Planted Acreage

None, Positive

None, Positive

Harvested Acreage

None, Positive

None, Positive

Seeded Acreage

None, Positive

None, Positive

Harvested Acreage

None, Positive

None, Positive

Cattle

None, Positive, Intentions

None, Positive, Intentions

Hogs

None, Positive, Intentions

None, Positive, Intentions

Sheep

None, Positive, Intentions

None, Positive, Intentions

Small Grains:

6. Did Mr./Ms. ______________________________ Conduct the interview in a knowledgeable and professional manner?
Yes
No – [Explain]_____________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________

7. Do you have any additional comments you would like to make concerning our survey contact?
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________

This concludes the interview. Thank you for your help.

Signature:_________________________________________________ Date:___________________________________________________