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pdfCOMMUNITY ASSESSMENT FOR WILD FOOD HARVEST
COMPREHENSIVE SURVEY FOR ALASKAN PARKS AND MONUMENTS
From [Date] to [Date]
OMB# 1024-0262
Expiration date: ##/##/####
This survey is being conducted by the Alaska Department of
Fish and Game in collaboration with the National Park Service
and with the help of local assistants. The results will be used
to estimate wild food harvests and describe rural
community economies.
We will NOT identify your household. We will NOT use this
information for enforcement. Participation in this survey
is voluntary, and your responses confidential. Even if you
agree to be surveyed, you may skip questions or stop at any
time.
HOUSEHOLD ID:
COMMUNITY ID:
INTERVIEWER 1:
INTERVIEWER 2:
INTERVIEW DATE:
START TIME:
STOP TIME:
DATA CODED BY:
DATA ENTERED BY:
SUPERVISOR:
PAPERWORK REDUCTION ACT STATEMENT:
A federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information, unless a currently valid
OMB control number is displayed. 16 U.S.C.1a‐7 authorizes collection of this information. This information will be used by the National Park
Service, the Federal Subsistence Management Program, and the Alaska Department of Fish and Game, Division of Subsistence to understand
more about the communities eligible to engage in subsistence in [NAME: ALASKA COMMUNITY or PARK]. Response to this request is
voluntary. Your name will not appear anywhere on the completed survey and your responses will be completely anonymous. The public
public reporting burden for completing individual interviews is estimated to take 60 minutes. Please direct comments regarding any aspect of this
collection to: Barbara Cellarius, Wrangell St. Elias National Park and Preserve, Resources Division, Mile 106.8 Richardson Highway, P.O. Box 439,
Copper Center, AK 99573, Barbara [email protected] (email).
COOPERATING ORGANIZATIONS
GATES OF THE ARCTIC
NATIONAL PARK AND PRESERVE
4175 GEIST RD.
FAIRBANKS, AK 99709
907-822-5234
ALASKA DEPARTMENT OF FISH AND GAME
DIVISION OF SUBSISTNCE
1300 COLLEGE RD.
FAIRBANKS, AK 99701
907-328-6116
Page 1
HUGHES VILLAGE
P.O. BOX 45029
HUGHES, AK 99745
907-778-2311
Comprehensive Wild Food Harvest Survey, 2020
REFUSAL BIAS QUESTIONS
HOUSEHOLD ID
… If the household refuses, ask...
We respect your decision not to participate. Could you please quickly answer these two short questions?
1. How many people live in this household?.....................................
2. In 2019, did anyone in this household go hunting or fishing?
Y N ?
(circle one)
Refused to answer these questions…......................................... Y
N
Notes / Commments
REFUSAL QUESTIONS: 00
KIANA: 187
Page 2
Comprehensive Wild Food Harvest Survey, 2020
HOUSEHOLD MEMBERS
HOUSEHOLD ID
First, I would like to ask about the people in your household, permanent members of your household who sleep at your house. This
includes students who return home every summer. I am NOT interested in people who lived with you temporarily, even if they stayed
several months.
Last year, that is, between January 1, 2019 and December 31, 2019 WHO were the head or heads of your household?
Is this person answering
questions on this
survey?
ID #
(circle)
HEAD 1
Y
How is this
person
related to
HEAD 1?
(relation)
N
Is this
person
MALE or
FEMALE?
(circle)
M
F
Is this
person an
ALASKA
NATIVE?
(circle)
Y
In what
YEAR was
this person
born?
(year)
Where were
parents living
when this person
was born?
(AK city or state)
How many years
has this person
Last grade of
lived in Kiana? school completed?
(number)
(number in years)
N
1
NEXT enter spouse or partner. If a household has a SINGLE HEAD, leave HEAD 2 row BLANK and move to PERSON 3.
HEAD 2
Y
N
M
F
Y
N
2
BELOW, enter children (oldest to youngest), grandchildren, grandparents, or anyone else living full-time in this household.
PERSON
03
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
Y
N
M
F
Y
N
3
PERSON
04
4
PERSON
05
5
PERSON
06
6
PERSON
07
7
PERSON
08
8
PERSON
09
9
PERSON
10
10
PERSON
11
11
PERSON
12
12
PERSON
13
13
PERMANENT HH MEMBERS: 01
KIANA: 187
Page 3
Comprehensive Wild Food Harvest Survey, 2020
HOUSEHOLD PARTICIPATION
To continue our questions about people in your household, I would like to ask a few questions about participation in harvesting wild
foods…
Between January 1, 2019 and December 31, 2019
Did this person ….
PERSON
LARGE LAND
MAMMALS
FISH
ID#
FROM
MARINE MAMMALS
BIRDS AND EGGS
PLANTS / BERRIES /
WOOD
PAGE 3
FISH FOR
PROCESS
HUNT /
TRAP
PROCESS
HUNT
PROCESS
HUNT /
GATHER
PROCESS
GATHER
PROCESS
ID #
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
HEAD 1
1
HEAD 2
2
PERSON
03
3
PERSON
04
4
PERSON
05
5
PERSON
06
6
PERSON
07
7
PERSON
08
8
PERSON
09
9
PERSON
10
10
PERSON
11
11
PERSON
12
12
PERSON
13
13
PERMANENT HH MEMBERS: 01
KIANA: 187
Page 4
Comprehensive Wild Food Harvest Survey, 2020
HOUSEHOLD PARTICIPATION
HOUSEHOLD ID
… Continued from previous page
Between January 1, 2019 and December 31, 2019
Did this person ….
PERSON
ID#
PAGE 3
BUILD FISH
WHEELS
BUILD FISH
TRAPS
BUILD SLEDS
SEW SKINS
COOK WILD
FOODS
MAKE HANDICRAFTS
W/NATURAL
MATERIALS
ID #
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
(circle)
HEAD 1
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
Y N
FROM
BUILD A
SHELTER,
CABIN, LEANTO, etc.
1
HEAD 2
2
PERSON
03
3
PERSON
04
4
PERSON
05
5
PERSON
06
6
PERSON
07
7
PERSON
08
8
PERSON
09
9
PERSON
10
10
PERSON
11
11
PERSON
12
12
PERSON
13
13
PERMANENT HH MEMBERS: 01
KIANA: 187
Page 5
Comprehensive Wild Food Harvest Survey, 2020
RETAINED COMMERCIAL HARVESTS
HOUSEHOLD ID
1. Do you or members of your household USUALLY participate in any commercial fishery?...........................................
Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household PARTICIPATE in any commercial fishery?..................................................
Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
Please estimate how many fish ALL MEMBERS OF YOUR HOUSEHOLD
removed from commercial harvests for personal use during the last year.
Include COMMERCIALLY HARVESTED fish that members of this
household gave away, ate fresh, fed to dogs, lost to spoilage, or got by
helping others. If helping others, report ONLY THIS HOUSEHOLD'S
share.
did you or members of your household…
A … FISH commercially for ______?
B … KEEP any ____ from your
commercial catch for your own use 2 or
to share?
C Was the ____ that you kept
INCIDENTAL4 catch?
Read names below
in blanks above
CHINOOK (KING) SALMON
if keep
is "yes"
A
B
COMM
FISH?
How many How many How many
were
were
were
removed for removed for removed to
your OWN
your
give to
USE?5
CREW?5
OTHERS?
C
KEEP?
INCI?
number
number
number
Units3
specify
Y
N
Y
N
Y
N
IND.
Y
N
Y
N
Y
N
IND.
Y
N
Y
N
Y
N
IND.
Y
N
Y
N
Y
N
IND.
Y
N
Y
N
Y
N
IND.
Y
N
Y
N
Y
N
LB.
Y
N
Y
N
Y
N
GAL.
Y
N
Y
N
Y
N
GAL.
Y
N
Y
N
Y
N
IND.
Y
N
Y
N
Y
N
comments
113000001
SOCKEYE (RED) SALMON
115000001
COHO (SILVER) SALMON
112000001
CHUM (DOG) SALMON
111000001
PINK (HUMPIES) SALMON
114000001
HALIBUT
121800001
HERRING
120200001
HERRING ROE
120300001
CRAB
501099001
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes eating, feeding to dogs, sharing or trading with others, etc.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
4 "INCIDENTAL CATCH" means the fish kept was not being commercially fished. For example, a king salmon kept from a chum commerical fishery.
5 Double counting (captains' removals for crew members and crew members' removal for own uses) is fixed in analysis. Collect both.
COMMERCIAL FISHING: 03
KIANA: 187
Page 6
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: SALMON
HOUSEHOLD ID
1. Do you or members of your household USUALLY fish for for subsistence, personal use, or sport?.................................. Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST salmon?...........................................................
N
Y
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
C …give _____ to another HH or community?
if harvest
is "yes"
2
D …try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
SUMMER CHUM
A
Please estimate how many salmon ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were
harvested with ….
INCLUDE salmon that members of this household gave away,
ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
fishing with or helping others, report ONLY THIS HOUSEHOLD'S
share of the harvest.DO NOT INCLUDE catch and release fish or
retained commercial harvests.
GILL
NET OR
SEINE
OTHER
GEAR
(specify
type)
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
B
DIP
NET
FISH
WHEEL
ROD &
REEL3
(number harvested by each gear type)
Units4
amount / type specify
111010000
FALL CHUM
111020000
CHINOOK (KING) SALMON
113000000
COHO
112000000
PINK SALMON
114000000
SOCKEYE SALMON
115000000
UNKNOWN SALMON
119000000
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 "ROD AND REEL" includes fish caught in open water with a hook and and a line attached to a rod or a pole. Jigging through the ice is "ice fishing."
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
SALMON: 04
KIANA: 187
Page 7
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: SALMON
HOUSEHOLD ID
If this household did NOT USE or HARVEST salmon last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map salmon…
ASSESSMENTS: SALMON
110000000
To conclude our salmon section, I am going to ask a few general questions about salmon.
During the last year,1
… did your household use LESS, SAME, or MORE salmon than in recent years? ………………………………………………………. X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH salmon?...............................................................................................................................
Y
N
If NO…
What KIND of salmon did you need?
How would you describe the impact to your household of not
getting enough salmon last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF SALMON: 66, 67
KIANA: 187
Page 8
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: OTHER FISH
HOUSEHOLD ID
1. Do you or members of your household USUALLY fish for other fish for subsistence, personal use, or sport?................... Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST other fish?...........................................................
N
Y
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
C …give _____ to another HH or community?
if
harvest
is "yes"
2
D …try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
HUMPBACK WHITEFISH
A
B
Please estimate how many other fish ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were
harvested with ….
INCLUDE other fish that members of this household gave away,
ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
fishing with or helping others, report ONLY THIS
HOUSEHOLD'S share of the harvest. DO NOT INCLUDE catch
and release fish or retained commercial harvests.
GILL
FISH NET OR
ICE
WHEEL SEINE FISHING
OTHER
GEAR
(specify
type)
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
ROD &
REEL3
(number harvested by each gear type)
Units4
amount / type specify
126408000
LEAST CISCO
126406060
BROAD WHITEFISH
126404000
BERING CISCO
126406040
ROUND WHITEFISH
126412000
SHEEFISH
125600000
UNKNOWN WHITEFISH
126499000
PIKE
125500000
BURBOT
(LINGCOD)
124800000
ARCTIC GRAYLING
125200000
…Continue on next page
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 "ROD AND REEL" includes fish caught in open water with a hook and and a line attached to a rod or a pole. Jigging through the ice is " ice fishing.
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
OTHER FISH: 06
KIANA: 187
Page 9
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: OTHER FISH
HOUSEHOLD ID
…continued from previous page
IF the answer is YES, continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
if
harvest
is "yes"
C …give _____ to another HH or community?
2
D …try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
DOLLY VARDEN
A
B
Please estimate how many other fish ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were
harvested with ….
INCLUDE other fish that members of this household gave away,
ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
fishing with or helping others, report ONLY THIS
HOUSEHOLD'S share of the harvest.DO NOT INCLUDE catch
and release fish or retained commercial harvests.
GILL
FISH NET OR
ICE
WHEEL SEINE FISHING
OTHER
GEAR
(specify
type)
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
IND.
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
Y N Y N
Y N
Y N
Y N
/
ROD &
REEL3
(number harvested by each gear type)
Units4
amount / type specify
125006000
LAKE TROUT
125010000
UNKNOWN TROUT
126299000
LONGNOSE SUCKER
126000000
Did anyone in the household harvest or receive any other nonsalmon fish, such as halibut, hooligan, or char?...... Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 "ROD AND REEL" includes fish caught in open water with a hook and and a line attached to a rod or a pole. Jigging through the ice is " ice fishing.
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
OTHER FISH: 06
KIANA: 187
Page 10
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: OTHER FISH
HOUSEHOLD ID
If this household did NOT USE or HARVEST other fish last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map other fish…
ASSESSMENTS: OTHER FISH
120000000
To conclude our other fish section, I am going to ask a few general questions about other fish.
During the last year,1
… did your household use LESS, SAME, or MORE other fish than in recent years? ………………………………………………………X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH other fish?...............................................................................................................................
Y
N
If NO…
What KIND of other fish did you need?
How would you describe the impact to your household of not
getting enough other fish last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF OTHER FISH: 66, 67
KIANA: 187
Page 11
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: MARINE INVERTEBRATES
HOUSEHOLD ID
1. Do you or members of your household USUALLY participate in non-commercial activities for marine invertebrates?....... Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST marine invertebrates?.............................................. Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
C …give _____ to another HH or community?
if
harvest
is "yes"
2
D
…try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
DUNGENESS CRAB
A
B
Please estimate how many marine invertebrates ALL MEMBERS OF
YOUR HOUSEHOLD got during the last year. How many were harvested
with ….
INCLUDE marine invertebrates that members of this household gave
away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
harvesting with or helping others, report ONLY THIS HOUSEHOLD'S
share of the harvest. DO NOT INCLUDE marine invertebrates caught
commercially, or were not retained.
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
AMOUNT Units4
(amt)
specify
COMMENTS
(text)
501004000
KING CRAB
501008000
TANNER CRAB
501012000
RAZOR CLAMS
500612000
FRESHWATER CLAMS
500604000
BUTTER CLAMS
500602000
CLAMS
500699000
During the last year, did your household use any other kind of marine invertebrates?.................................................................................... Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 "ROD AND REEL" includes fish caught in open water with a hook and and a line attached to a rod or a pole. Jigging through the ice is " ice fishing."
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
MARINE INVERTEBRATES: 08
KIANA: 187
Page 12
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: MARINE INVERTEBRATES
HOUSEHOLD ID
If this household did NOT USE or HARVEST marine invertebrates last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map marine invertebrates…
ASSESSMENTS: MARINE INVERTEBRATES
500000000
To conclude our marine invertebrates section, I am going to ask a few general questions about marine invertebrates.
During the last year,1
… did your household use LESS, SAME, or MORE marine invertebrates than in recent years? …………………………………………X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH marine invertebrates?.................................................................................................................... Y
N
If NO…
What KIND of marine invertebrates did you need?
How would you describe the impact to your household of not
getting enough marine invertebrates last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF MARINE INVERTEBRATES: 66, 67
Page 13
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: LARGE LAND MAMMALS
HOUSEHOLD ID
1. Do you or members of your household USUALLY hunt for large land mammals?
Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST large land mammals?............................................... Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
MOOSE
Y N Y N
Y N
Y N
Y N
211800000
M/F
(specify)
IND
F
IND
IND
UNK
1
211800002
2
211800009
-9
Y N Y N
Y N
Y N
Y N
M
IND
F
IND
IND
211000000
UNK
211000001
1
211000002
2
211000009
-9
BLACK BEAR
(specify amount harvested per month)
UNITS3
M
211800001
CARIBOU
UNKNOWN
HAR
DECEMBER
TRY
NOVEMBER
GIVE
OCTOBER
E
SEPTEMBER
D
AUGUST
USE REC
C
JULY
B
JUNE
A
MAY
Read names below
in blanks above
APRIL
2
D …try to harvest _____?
E …actually harvest any _____?
MARCH
if
harvest
is "yes"
C …give _____ to another HH or community?
FEBRUARY
B …receive _____ from another HH or community
Please estimate how many large land mammals ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were harvested in ….
INCLUDE large land mammals that members of this household gave away,
ate fresh, fed to dogs, lost to spoilage, or got by helping others. If hunting
with or helping others, report ONLY THIS HOUSEHOLD'S share of the
harvest.
JANUARY
2
A … use _______?
SEX
did you or members of your household…
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
210600000
BROWN BEAR
210800000
DALL SHEEP
212200000
MUSKOX
212000000
During the last year, did your household use any other kind of large land mammals?.................................................................................... Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
LARGE LAND MAMMALS: 10
KIANA: 187
Page 14
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: LARGE LAND MAMMALS
HOUSEHOLD ID
If this household did NOT USE or HARVEST large land mammals last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map large land mammals…
ASSESSMENTS: LARGE LAND MAMMALS
210000000
To conclude our large land mammals section, I am going to ask a few general questions about large land mammals.
During the last year,1
… did your household use LESS, SAME, or MORE large land mammals than in recent years? …………………………………………X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH large land mammals?..................................................................................................................... Y
N
If NO…
What KIND of large land mammals did you need?
How would you describe the impact to your household of not
getting enough large land mammals last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF LARGE LAND MAMMALS: 66, 67
Page 15
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: SMALL LAND MAMMALS OR FURBEARERS
HOUSEHOLD ID
1. Do you or members of your household USUALLY hunt or trap for small land mammals or furbearers?............................. Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST small land mammals or furbearers?......................... Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
BEAVER
UNKNOWN
DECEMBER
NOVEMBER
USED
FOR
FOOD OR
FOR
FOOD &
UNITS3
FUR
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
JULY
D
B
JUNE
C
A
MAY
Read names below
in blanks above
OCTOBER
2
D …try to harvest _____?
E …actually harvest any _____?
SEPTEMBER
if
harvest
is "yes"
C …give _____ to another HH or community?
AUGUST
B …receive _____ from another HH or community
APRIL
A … use _______?
Please estimate how many small land mammals or furbearers ALL MEMBERS
OF YOUR HOUSEHOLD got during the last year. How many were harvested in
….
INCLUDE small land mammals or furbearers that members of this household
gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
hunting or trapping with or helping others, report ONLY THIS HOUSEHOLD'S
share of the harvest.
MARCH
2
FEBRUARY
did you or members of your household…
JANUARY
During the last year,1
(specify amount harvested per month)
(amount)
specify
220200000
MUSKRAT
222400000
PORCUPINE
222600000
WOLF
223200000
WOLVERINE
223400000
COYOTE
220400000
FOX
(SPECIFY)
220800000
SNOWSHOE HARE
221004000
LYNX
221600000
MARTEN
222000000
…Continue on next page
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
SMALL LAND MAMMALS OR FURBEARERS: 14
KIANA: 187
Page 16
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: SMALL LAND MAMMALS OR FURBEARERS
HOUSEHOLD ID
…continued from previous page
LAND OTTER
UNKNOWN
DECEMBER
NOVEMBER
OCTOBER
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
JULY
B
JUNE
A
MAY
Read names below
in blanks above
SEPTEMBER
2
D …try to harvest _____?
E …actually harvest any _____?
AUGUST
if
harvest
is "yes"
APRIL
B …receive _____ from another HH or community
…give _____ to another HH or community?
C
MARCH
2
A … use _______?
Please estimate how many small land mammals or furbearers ALL MEMBERS
OF YOUR HOUSEHOLD got during the last year. How many were harvested in
….
INCLUDE small land mammals or furbearers that members of this household
gave away, ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
hunting or trapping with or helping others, report ONLY THIS HOUSEHOLD'S
share of the harvest.
NUMBER
USED
FOR
FOOD OR
FOR
FOOD &
FUR
UNITS3
FEBRUARY
did you or members of your household…
JANUARY
During the last year,1
(specify amount harvested per month)
(amount)
specify
221200000
ERMINE
(WEASEL)
223000000
MINK
222200000
During the last year, did your household use any other kind of small land mammals or furbearers?.............................................................. Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
SMALL LAND MAMMALS OR FURBEARERS: 14
KIANA: 187
Page 17
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: SMALL LAND ANIMALS
HOUSEHOLD ID
If this household did NOT USE or HARVEST small land animals last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map small land mammals…
ASSESSMENTS: SMALL LAND MAMMALS/FURBEARERS
220000000
To conclude our small land mammals/furbearers section, I am going to ask a few general questions about small land
mammals/furbearers.
During the last year,1
… did your household use LESS, SAME, or MORE small land mammals/furbearers than in recent years? ……………………………X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH small land mammals/furbearers?................................................................................................... Y
N
If NO…
What KIND of small land mammals/furbearers did you need?
How would you describe the impact to your household of not
getting enough small land mammals/furbearers last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF SMALL LAND ANIMALS: 66, 67
Page 18
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: MARINE MAMMALS
HOUSEHOLD ID
1. Do you or members of your household USUALLY hunt for marine mammals?
Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST marine mammals?....................................................Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
BEARDED SEAL
Y N Y N
Y N
Y N
Y N
M/F
IND
IND
IND
300802001
1
300802002
2
300802009
-9
Y N
Y N
Y N
M
IND
F
IND
IND
300812000
UNK
300812001
1
300812002
2
300812009
-9
STELLER SEA LION
Y N Y N
Y N
Y N
Y N
M
IND
F
IND
IND
301200000
UNK
301200001
1
301200002
2
301200009
-9
FUR SEAL
Y N Y N
Y N
Y N
Y N
300804000
M
IND
F
IND
IND
UNK
300804001
1
300804002
2
300804009
-9
WHALE (SPECIFY)
(specify)
F
UNK
Y N Y N
(specify amount harvested per month)
UNITS3
M
300802000
SPOTTED SEAL
UNKNOWN
HAR
DECEMBER
TRY
NOVEMBER
GIVE
OCTOBER
E
SEPTEMBER
D
AUGUST
USE REC
C
JULY
B
JUNE
A
MAY
Read names below
in blanks above
APRIL
2
D …try to harvest _____?
E …actually harvest any _____?
MARCH
if
harvest
is "yes"
FEBRUARY
B …receive _____ from another HH or community
C …give _____ to another HH or community?
Please estimate how many marine mammals ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were harvested in ….
INCLUDE marine mammals that members of this household gave away, ate
fresh, fed to dogs, lost to spoilage, or got by helping others. If hunting with
or helping others, report ONLY THIS HOUSEHOLD'S share of the harvest.
JANUARY
2
A … use _______?
SEX
did you or members of your household…
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
301699000
UNKNOWN SEAL
(OR SEAL OIL)
300899000
During the last year, did your household use any other kind of marine mammals?......................................................................................... Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
MARINE MAMMALS: 10
KIANA: 187
Page 19
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: MARINE MAMMALS
HOUSEHOLD ID
If this household did NOT USE or HARVEST marine mammals last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map marine mammals…
ASSESSMENTS: MARINE MAMMALS
300000000
To conclude our marine mammals section, I am going to ask a few general questions about marine mammals.
During the last year,1
… did your household use LESS, SAME, or MORE marine mammals than in recent years? …………………………………………… X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH marine mammals?......................................................................................................................... Y
N
If NO…
What KIND of marine mammals did you need?
How would you describe the impact to your household of not
getting enough marine mammals last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF MARINE MAMMALS: 66, 67
Page 20
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: MIGRATORY WATERFOWL
HOUSEHOLD ID
1. Do you or members of your household USUALLY hunt for migratory waterfowl?...............................................
Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST migratory waterfowl?...................................................Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
…give _____ to another HH or community?
C
if
harvest
is "yes"
2
D …try to harvest _____?
E …actually harvest any _____?
Please estimate how many migratory waterfowl ALL MEMBERS OF
YOUR HOUSEHOLD got during the last year. How many were
harvested in ….
INCLUDE migratory waterfowl that members of this household gave
away, ate fresh, fed to dogs, lost to spoilage, or got by helping
others. If hunting with or helping others, report ONLY THIS
HOUSEHOLD'S share of the harvest.
January
February
Read names below
in blanks above
CANADA GEESE
A
B
July
October
March
April
May
June
August
September
November
December
WINTER
SPRING
SUMMER
FALL
Season
of
harvest
unknown
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
(number killed in each season)
UNITS3
(number) (specify)
410404990
WHITE-FRONTED GEESE
410410000
SNOW GEESE
410408000
SWAN
(SPECIFY)
410699000
LOON
(SPECIFY)
411216990
AMERICAN WIGEON
410236020
TEAL
410232990
MALLARD
410214000
NORTHERN PINTAIL
410220000
NORTHERN SHOVELER
410230000
…Continue on the next page
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
MIGRATORY WATERFOWL: 15
Page 21
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: MIGRATORY WATERFOWL
HOUSEHOLD ID
…continued from previous page
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
C …give _____ to another HH or community?
if
harvest
is "yes"
2
D
…try to harvest _____?
E …actually harvest any _____?
Please estimate how many migratory waterfowl ALL MEMBERS OF
YOUR HOUSEHOLD got during the last year. How many were
harvested in ….
INCLUDE migratory waterfowl that members of this household gave
away, ate fresh, fed to dogs, lost to spoilage, or got by helping
others. If hunting with or helping others, report ONLY THIS
HOUSEHOLD'S share of the harvest.
November
December
Read names below
in blanks above
BLACK SCOTER
(BLACK DUCKS)
A
B
C
D
E
January
April
February
May
July
September
March
June
August
October
WINTER
SPRING
SUMMER
FALL
Season
of
harvest
unknown
UNITS3
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
(number killed in each season)
(number) (specify)
410228020
WHITE-WINGED SCOTER
410228060
OTHER SCOTER
410228990
BUFFLEHEAD
410202000
UNKNOWN GOLDENEYE
(SPECIFY)
410210990
UNKNOWN EIDER
(SPECIFY)
410206990
LONG-TAILED DUCK
(OLDSQUAW)
410218000
During the last year, did your household use any other kind of migratory waterfowl?......................................................................................... Y
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
MIGRATORY WATERFOWL: 15
Page 22
N
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: OTHER BIRDS
HOUSEHOLD ID
1. Do you or members of your household USUALLY hunt for other birds?...............................................
Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST other birds?...........................................................
Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
if
harvest
is "yes"
C …give _____ to another HH or community?
2
D …try to harvest _____?
E …actually harvest any _____?
Please estimate how many other birds ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were harvested
in ….
INCLUDE other birds that members of this household gave away,
ate fresh, fed to dogs, lost to spoilage, or got by helping others. If
hunting with or helping others, report ONLY THIS HOUSEHOLD'S
share of the harvest.
November
December
Read names below
in blanks above
PTARMIGAN
A
B
January
February
March
April
May
June
July
August
September
October
Season
of
harvest
unknown
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
WINTER
SPRING SUMMER
FALL
(number killed in each season)
UNITS3
(number) (specify)
421804000
SPRUCE GROUSE
421802020
RUFFED GROUSE
421802060
SHARP-TAILED GROUSE
421802040
During the last year, did your household use any other kind of other birds?.................................................................................................... Y
IF YES, enter the name in a blank row above, and answer the questions in that row.
N
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
3 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
OTHER BIRDS: 15
Page 23
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: BIRD EGGS
HOUSEHOLD ID
1. Do you or members of your household USUALLY harvest bird eggs?...............................................
Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST bird eggs?...........................................................
Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
if
harvest
is "yes"
C …give _____ to another HH or community?
2
D …try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
GULL EGGS
(SPECIFY)
A
B
Please estimate how many bird eggs ALL MEMBERS OF YOUR
HOUSEHOLD got during the last year. How many were harvested with ….
INCLUDE bird eggs that members of this household gave away, ate fresh,
fed to dogs, lost to spoilage, or got by helping others. If harvesting with or
helping others, report ONLY THIS HOUSEHOLD'S share of the harvest.
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
IND.
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
AMOUNT Units4
(amt)
specify
COMMENTS
(text)
431212000
GEESE EGGS
(SPECIFY)
430400000
DUCK EGGS
(SPECIFY)
430200000
During the last year, did your household use any other kind of bird eggs?...................................................................................................... Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
BIRD EGGS: 15
KIANA: 187
Page 24
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: BIRDS AND EGGS
HOUSEHOLD ID
If this household did NOT USE or HARVEST birds and eggs last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map birds and eggs…
ASSESSMENTS: BIRDS AND EGGS
400000000
To conclude our birds and eggs section, I am going to ask a few general questions about birds and eggs.
During the last year,1
… did your household use LESS, SAME, or MORE birds and eggs than in recent years? ……………………………………………… X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH birds and eggs?............................................................................................................................. Y
N
If NO…
What KIND of birds and eggs did you need?
How would you describe the impact to your household of not
getting enough birds and eggs last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF BIRDS AND EGGS: 66, 67
KIANA: 187
Page 25
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: PLANTS AND BERRIES (INCLUDING WOOD)
HOUSEHOLD ID
1. Do you or members of your household USUALLY harvest plants and berries (including wood)?........................................Y
N
2. During the last year (between January 1, 2019 and December 31, 2019),
did you, or members of your household USE or TRY TO HARVEST plants and berries (including wood)?....................... Y
N
IF the answer to QUESTION 2 is NO, to to the NEXT PAGE .
IF the answer is YES , continue on this page …
During the last year,1
Please estimate how many plants and berries (including wood) ALL
MEMBERS OF YOUR HOUSEHOLD got during the last year.
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
if
harvest
is "yes"
C …give _____ to another HH or community?
2
D …try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
BLUEBERRY
A
B
INCLUDE plants and berries (including wood) that members of this
household gave away, ate fresh, fed to dogs, lost to spoilage, or got by
helping others. If harvesting with or helping others, report ONLY THIS
HOUSEHOLD'S share of the harvest.
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
AMOUNT Units4
(amt)
specify
COMMENTS
(text)
601002000
LOW BUSH CRANBERRY
601004000
RASPBERRY
601020000
HIGH BUSH CRANBERRY
601006000
CROWBERRY (BLACKBERRY)
601007000
CLOUD BERRY
(SALMONBERRY)
601016000
LABRADOR TEA
602018000
ROOTS (FOR FOOD)
602009000
ROSE HIPS
NCHOO
602036000
MUSHROOMS
(SPECIFY)
602040000
…Continue on the next page
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
PLANTS AND BERRIES (INCLUDING WOOD): 17
KIANA: 187
Page 26
Comprehensive Wild Food Harvest Survey, 2020
HARVESTS: PLANTS AND BERRIES (INCLUDING WOOD)
HOUSEHOLD ID
…continued from previous page
During the last year,1
did you or members of your household…
2
A … use _______?
B …receive _____ from another HH or community
C …give _____ to another HH or community?
if harve
is "yes"
2
D …try to harvest _____?
E …actually harvest any _____?
Read names below
in blanks above
MOUSEFOODS
A
B
Please estimate how many plants and berries (including wood) ALL
MEMBERS OF YOUR HOUSEHOLD got for subsistence uses during the
last year. How many were harvested with ….
INCLUDE plants and berries (including wood) that members of this
household gave away, are fresh, fed to dogs, lost to spoilage, or got by
helping others. If harvesting with or helping others, report ONLY THIS
HOUSEHOLD'S share of the harvest.
C
D
E
USE REC
GIVE
TRY
HAR
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
GAL.
Y N Y N
Y N
Y N
Y N
CORD.
Y N Y N
Y N
Y N
Y N
CORD.
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
Y N Y N
Y N
Y N
Y N
AMOUNT Units4
(amt)
specify
COMMENTS
(text)
602060000
SPRUCE TIPS
602030000
OTHER WILD GREENS
602038000
WILD RHUBARB
602006000
CHAGA
(SALMONBERRY)
602046040
PUNK
602046010
WOOD (OTHER )
(SPECIFY USE)
604000000
FIREWOOD
604000002
During the last year, did your household use any other kind of PLANTS AND BERRIES (INCLUDING WOOD)?.......................................... Y
N
IF YES, enter the name in a blank row above, and answer the questions in that row.
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
2 "USE" includes harvesting, processing, eating, trading, feeding to dogs, etc. "TRY" includes looking, hunting, fishing, or any attempt to get.
4 UNITS will differ by species and situation. Units may be pounds (lbs), individuals (ind), portions of individuals (1/4), buckets, sacks, tubs, etc.
PLANTS AND BERRIES (INCLUDING WOOD): 17
KIANA: 187
Page 27
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: PLANTS AND BERRIES
HOUSEHOLD ID
If this household did NOT USE or HARVEST plants and berries last year, go to the ASSESSMENT section below.
Otherwise, continue with mapping, and assessment sections…
MAPPING
Refer to data collection maps and mapping instructions to map plants, berries, and wood…
ASSESSMENTS: PLANTS AND BERRIES (INCLUDING WOOD)
600000000
To conclude our plants and berries (including wood) section, I am going to ask a few general questions about plants and berries
(including wood).
During the last year,1
… did your household use LESS, SAME, or MORE plants and berries (including wood) than in recent years? ……………………… X L S M
IF LESS or MORE …
X = do not use
WHY was your use different?
1
2
During the last year,1
…did your household GET ENOUGH plants and berries (including wood)?............................................................................................. Y
N
If NO…
What KIND of plants and berries (including wood) did you need?
How would you describe the impact to your household of not
getting enough plants and berries (including wood) last year?
… no impact
… minor
… moderate
… major
… severe
(0)
(1)
(2)
(3)
(4)
HEATING FROM FIREWOOD
What proportion of your household's home heating comes from firewood?
(Circle one)
None
A little (some, but
less than half)
About half
A lot (more than
half, but not all)
All
?
In the past 5 years has your harvest area for firewood changed?................................................................................................... Y
N
?
If YES, please explain why?
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
NETWORKS & ASSESSMENTS OF PLANTS AND BERRIES: 66, 67
Page 28
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
HARVEST SUMMARY: ALL RESOURCES
HOUSEHOLD ID
ASSESSMENTS: ALL RESOURCES
0
To conclude our harvests section, I am going to ask a few general questions about wild resources.
During the last year,1
… did your household use LESS, SAME, or MORE wild resources than in recent years? …………………………………………………
X L S M
IF LESS or MORE …
X = do not use
1
WHY was your use different?
2
During the last year,1
…did your household GET ENOUGH wild resources?.............................................................................................................................. Y
N
Has your ability to get to your hunting, fishing, and gathering areas changed in the last 5 years due to difficult environmental conditions Y
… If YES, could you describe those conditions?
N
1
2
ASSESSMENTS: RESOURCE HEALTH
Between January 1, 2019 and December 31, 2019... Were there any resources that your household avoided harvesting or were concerned about
consuming due to disease, contamination, or other resource health issues?
(Note to interviewer: this is not about resource numbers (i.e. low population), but about physical characteristics of the resource.)
If YES, which resources did you avoid and why?
ASSESSMENTS: GEAR PURCHASES
SNAP funds (also known as 'food stamps') can be used to purchase materials related to catching or processing subsistence foods.
We'd like to learn about how people use SNAP funds to purchase these items to get the food they need.
Prior to this survey, were you aware that you could purchase subsistence FISHING or HUNTING GEAR with SNAP funds?............... Y
N
If YES…
Did your household use SNAP funds to purchase subsistence FISHING or HUNTING GEAR?............................................................ Y
N
If NO,
Why not?
If YES,
What types of gear did your household purchase?
(circle all that apply)
Nets
Lines
Hooks
Fishing rods
Harpoons
Knives
Ice augers
Other
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
How important to your households subsistence fishing and hunting is the availability of SNAP funds for purchasing gear?
Not important
Important
Very Important
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
ASSESSMENTS OF ALL RESOURCES: 66
KIANA: 187
Page 29
Comprehensive Wild Food Harvest Survey, 2020
ADDITIONAL ASSESSMENTS
HOUSEHOLD ID
TRANSPORTATION AND MOTORIZED EQUIPMENT
During the last year (between January 1, 2019 and December 31, 2019),
...did members of your household use the following when harvesting or attempting to harvest wild foods?
BOAT
980110000
SNOWMACHINE
980210200
4-WHEELER/ORV
980210200
AIRPLANE
980230000
HIGHWAY VEHICLE
980220000
DOGSELD
Y
circle
N ?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
980210300
HORSES
980250100
… Does your household own, borrow, rent, or charter this equipment? Or do you ride along with someone else?”
BOAT
980110000
SNOWMACHINE
980210200
4-WHEELER/ORV
980210200
AIRPLANE
980230000
HIGHWAY VEHICLE
980220000
DOG SLED
980210300
HORSES
980250100
Ride along with
someone else
Y N ?
Own
Y N ?
Borrow
Y N ?
Rent
Y N ?
Charter
Y N ?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Y
N
?
Comments:
During the last year (between January 1, 2019 and December 31, 2019),
Did members of your household use the following or other motorized equipment when harvesting or attempt to harvest wild foods?
circle
CHAINSAW
Y N ?
980600300
ICE AUGER
Y N ?
980210200
WINCH
Y N ?
980600500
GENERATOR
Y N ?
980600200
OTHER (Specify)
Y N ?
ADDITIONAL ASSESMENTS
Page 30
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
ADDITIONAL ASSESSMENTS
HOUSEHOLD ID
HANDICRAFTS
It is legal to collect shed or discarded animal parts (horn, antlers, bones, etc…) on NPS lands for the making and selling of handicrafts for
personal use, barter or sale.
Y
During the last year (between January 1, 2019 and December 31, 2019), did members of your household collect shed or
discarded animal parts such as horn/antlers on NPS lands?
N
?
...If YES, which of the following did you collect? If applicable, what NPS unit did you collect if from?
amount
circle
HORNS
Y
N
?
Y
N
?
Y
N
?
Y
N
?
unit (ind, lbs, etc.)
location (name of NPS parklands or description of where you
collected them)
940100322
ANTLERS
940100323
BONES
940100328
OTHER (specify)
It is legal to collect plant materials on NPS lands for making handicrafts for personal use, barter or sale.
During the last year (between January 1, 2019 and December 31, 2019), did members of your household collect plant
materials on NPS lands for the production and sale of and handicrafts?
Y
N
?
...If YES, which of the following did you collect? If applicable, what NPS unit did you collect if from?
amount
circle
BIRCH BARK
Y
N
?
Y
N
?
Y
N
?
Y
N
?
unit (ind, lbs, etc.)
location (name of NPS parklands or description of where you
collected them)
604002000
WILLOW
604013000
GRASS
940100328
OTHER (specify)
2
1 ''LAST YEAR'' means between January 1, 2019 and December 31, 2019.
ADDITIONAL ASSESMENTS
Page 31
KIANA: 187
Comprehensive Wild Food Harvest Survey, 2020
FOOD SECURITY
HOUSEHOLD ID
The questions on this page have been asked all over the United States to find out if Americans have enough to eat. We would like to know if people
in your community have enough to eat. I'd like you to think about all your household's food, both wild food and store-bought...
Which of these three statements best describes the food eaten in your household in the last 12 months…
(Circle one)
STATEMENT 1. We had enough of the kinds of food we wanted to eat…………………………
STATEMENT 2. We had enough food, but not always the KIND of food we wanted to eat……
STATEMENT 3. Sometimes, or often, we did NOT HAVE ENOUGH food to eat………………
HH1O
1
2
3
If 2 or 3
Now I am going to read you several statements about different food situations.
Please tell me whether EACH statement was true for your household (HH) in the last 12 months.
STATEMENT 4. We WORRIED that our household would run out of food before we could get more.
In the last 12 months, was this ever true for your household?................................................................................ N
If YES…
HH2
Y
?
…in which months did this happen?......................................................................................................... J F M A M J J A S O N D
…did this happen because your household couldn't get WILD FOOD,
your HH couldn't get STORE-BOUGHT food, or your HH couldn't get BOTH KINDS of food?..................
WILD STOR BOTH
STATEMENT 5. We could not get the kinds of foods we wanted to eat because of a LACK OF RESOURCES.
HH4
By "lack of resources," we mean your household did NOT have what you needed to hunt, fish, gather, OR did not
have enough money to buy food.
In the last 12 months, was this ever true for your household?................................................................................ N
If YES…
Y
?
…in which months did this happen?......................................................................................................... J F M A M J J A S O N D
…did this happen because your household couldn't get WILD FOOD,
your HH couldn't get STORE-BOUGHT food, or your HH couldn't get BOTH KINDS of food?..............
WILD STOR BOTH
STATEMENT 6. The food we had JUST DID NOT LAST, and we could not get more.
In the last 12 months, was this ever true for your household?................................................................................ N
HH3
Y
?
If YES…
…in which months did this happen?......................................................................................................... J F M A M J J A S O N D
Now, think just about your household's WILD FOOD…
STATEMENT 7. The WILD food we had JUST DID NOT LAST, and we could not get more.
In the last 12 months, was this ever true for your household?................................................................................ N
Y
?
If YES…
…in which months did this happen?................................................................................................. J F M A M J J A S O N D
Now, think just about your household's STORE-BOUGHT food…
STATEMENT 8. The STORE-BOUGHT food we had JUST DID NOT LAST, and we could not get more.
In the last 12 months, was this ever true for your household?................................................................................ N
Y
?
If YES…
…in which months did this happen?......................................................................................................... J F M A M J J A S O N D
If any ONE of the STATEMENTS 4, 5, OR 6 was "YES," continue with food security questions on next page. Otherwise, go to next section…
FOOD SECURITY: 201
KIANA: 187
Page 32
Comprehensive Wild Food Harvest Survey, 2020
FOOD SECURITY
HOUSEHOLD ID
If any ONE of the STATEMENTS 4, 5, or 6 on previous page was "YES," continue with food security questions below. Otherwise, go to next section…
In the past 12 months, did you or other adults in your household ever CUT THE SIZE OF YOUR MEALS OR
SKIP MEALS because the HH could not get the food that was needed? …………………………….…………
AD1
N
Y
?
If YES…
…in which months did this happen?........................................................................................... J F M A M J J A S O N D
In the last 12 months, did you or other adults in your household ever EAT LESS THAN YOU FELT YOU SHOULD
because the HH could not get the food that was needed?..............
AD2
N
Y
?
because there was not enough food?..............................................................
N
Y
?
In the last 12 months, did adults in the HH LOSE WEIGHT because there was not enough food?....................
N
Y
?
In the last 12 months, did adults in the HH ever NOT EAT FOR A WHOLE DAY
because there was not enough food?.............................................................
N
Y
?
In the last 12 months, were adults in the HH ever HUNGRY BUT DID NOT EAT
AD3
AD4
If YES…
…in which months did this happen?...................................................................................
FOOD SECURITY: 201
AD5
J F M A M J J A S O N D
KIANA: 187
Page 33
Comprehensive Wild Food Harvest Survey, 2020
EMPLOYMENT
HOUSEHOLD ID
The next few pages ask about jobs and income. We ask about these things because we are trying to understand all parts of the community economy.
Many people use wages from jobs to support hunting, fishing, and gathering activities.
Between January 1, 2019 and December 31, 2019 ...
…Did any members of your household earn money from a JOB or from SELF EMPLOYMENT?................................... Y
N
Starting with the first head of your household, what job or jobs did he or she have last year?
For each member of this household born before 2004, list EACH JOB held last year. For household members who did not have a job, write:
RETIRED, UNEMPLOYED, STUDENT, HOMEMAKER, DISABLED, etc..
1ST JOB
1
6 910100000
6 910100000
SOC:
6 910100000
6 910100000
SOC:
6 910100000
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
6 910100000
7
6 910100000
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
8
6 910100000
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
9
6 910100000
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
10 6 910100000
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
/ YR
/ YR
schedule:
SIC:
If a person FISHES COMMERCIALLY or is
otherwise SELF-EMPLOYED, list that as a separate
job. For job title, enter COMMERCIAL FISHER,
CARVER, SEWER, BAKER, etc. Work schedule
usually will be ON CALL. For gross income from selfemployment, enter revenue MINUS expenses.
/ YR
schedule:
SIC:
10TH JOB
/ YR
schedule:
SIC:
9TH JOB
/ YR
schedule:
SIC:
8TH JOB
/ YR
schedule:
SIC:
7TH JOB
/ YR
schedule:
SIC:
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
/ YR
schedule:
SIC:
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
/ YR
schedule:
SIC:
6TH JOB
6
SHIFT - PART TIME
J F M A M J J A S O N D FT PT SF OC SP $
SOC:
/ YR
schedule:
SIC:
5TH JOB
5
ON-CALL, VARIES
J F M A M J J A S O N D FT PT SF OC SP $
4TH JOB
4
gross income 3
schedule:
SIC:
3RD JOB
3
(circle one)
In the past
year how
much did hee
or she earn in
this job?
J F M A M J J A S O N D FT PT SF OC SP $
2ND JOB
2
PART TIME
Person
code What kind of work For whom did he
from did he or she do in or she work in this In the past year, what months
page 2
this job?
job?
did he or she work in this job?
1
(job title )
(employer)
(circle each month worked)
(ID #)
FULL TIME
INCLUDE EACH PERSON 16 YEARS AND OLDER EVEN IF THEY DID NOT
HAVE A JOB
SHIFT - FULL TIME
WORK SCHEDULE2
If a person does not earn money from any
kind of work, enter RETIRED,
UNEMPLOYED, DISABLED, STUDENT, or
HOMEMAKER or other appropriate
description as the job title.
Leave employer, months worked, schedule,
and gross income blank.
EMPLOYMENT: 23
WORK SCHEDULE
FT - Fulltime (35+
hr/wk)
PT - Parttime (<35
hr/wk)
SF - Shift (2wks
on/2wks off, etc.)
SP - Shift - part time
OC - Irregular, on call
GROSS
INCOME is the
same as
TAXABLE
INCOME on a
W-2 form. Selfemployment,
enter revenue expense
KIANA: 187
Page 34
Comprehensive Wild Food Harvest Survey, 2020
OTHER INCOME
HOUSEHOLD ID
Between January 1, 2019 and December 31, 2019 ...
…Did any members of your household receive a dividend from the Permanent Fund or a native corporation?.............. Y
N
IF NO, go to the next section on this page
IF YES, continue below…
Did anyone in TOTAL amount all
your household members of your
household
receive income
received from
from
____________ ____________ in
2019
in 2019
(circle one)
(dollars)
DIVIDENDS
ALASKA PERMANENT
FUND DIVIDEND
32
NATIVE CORPORATION
DIVIDENDS
13
Y
N
$
/ YR
Y
N
$
/ YR
Alaska PFD IN 2019
1
2
3
4
PFD = $2,072
PFDs = $4,144
PFDs = $6,216
PFDs = $8,288
5
6
7
8
9
10
11
PFDs = $10,360
PFDs = $12,432
PFDs = $14,504
PFDs = $16,576
PFDs = $18,648
PFDs = $20,720
PFDs = $22,792
Regional corporations
Dividend
Village Corporation(s)
Dividend
Between January 1, 2019 and December 31, 2019 ...
…Did any members of your household receive OTHER income such as SENIOR BENEFITS or UNEMPLOYMENT?........................... Y
N
IF NO, go to the next section on this page
IF YES, continue below…
PENSION &
RETIREMENT
5
DISABILITY
Received?
Total amount?
(dollars)
(circle one)
(dollars)
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
FUEL VOUCHERS
49
MEETING HONORARIA
(not per diem*)
50
OTHER (describe)
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
Y
N
$
/ YR
3
SUPPLIMENTAL SECURITY
INCOME (SSI)
10
Y
N
$
/ YR
for _________ weeks =
for _________ weeks =
ENERGY
ASSISTANCE
Y
N
$
/ YR
for _________ weeks =
for _________ weeks =
Y
N
$
/ YR
35
ENTITLEMENTS
TANF
(say "tanif", used to be AFDC)
2
CHILD
SUPPORT
15
FOSTER
CARE
41
Y
31
VETERANS ASSISTANCE
STATE BENEFITS
FAMILY & CHILD
12
WORKERS'
COMP
8
SOCIAL
SECURITY
7
Total amount?
(circle one)
FOOD STAMPS
(QUEST CARD)
11
ADULT
PUBLIC ASSISTANCE
9
ALASKA SENIOR
BENEFITS (LONGEVITY)
6
OTHER
EMPLOYMENT RELATED
UNEMPLOYMENT
Received?
OTHER (describe)
* per diem covers travel expenses, and is not counted as income.
Scratch paper for calculations
Senior Benefits of $125 per month for 12 months = $1,500 per elder
Senior Benefits of $175 per month for 12 months = $2,100 per elder
Senior Benefits of $250 per month for 12 months = $3,000 per elder
OTHER INCOME: 24
KIANA: 187
Page 35
Comprehensive Wild Food Harvest Survey, 2020
COMMENTS
HOUSEHOLD ID
DO YOU HAVE ANY QUESTIONS, COMMENTS OR CONCERNS?
INTERVIEW SUMMARY:
DON'T FORGET TO FILL IN THE STOP TIME _______________________________________
COMMENTS: 300
KIANA: 187
Page 36
| File Type | application/pdf |
| File Title | NPS WORKING DRAFT - DSK (2019.11.26).xlsx |
| Author | dskoster |
| File Modified | 2020-01-14 |
| File Created | 2019-12-03 |