QID Alfalfa Seed Cleaners Inquiry

alfalfa seed CLEANERS inquiry – 2018 crop
							OMB No. 0535-0002 Approval Expires: 10/31/2018 Project Code: 788
								NATIONAL AGRICULTURAL STATISTICS SERVICE
							USDA/NASS - Montana Mountain Region P.O. Box 150969 Lakewood, CO 80215-0969 Phone: 1-303-236-2300 Fax: 1-866-314-4029 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. Your responses 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 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 number is 0535-0002. The time required to complete this information collection is estimated to average 15 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.

Please return your report by mail or fax your report to 1-866-314-4029 by January 31, 2018.

1. Do you have facilities to clean Alfalfa Seed? Yes – [Continue] No – [Please sign and return]
Please only include Alfalfa Seed Grown in Montana during the 2018 Crop Year that has been or will be cleaned in your plant, both purchased and custom cleaned. Exclude cleaned or partly cleaned seed received from other cleaning plants.

	2018 Alfalfa Seed Custom Cleaned	2018 Alfalfa Seed Purchased from Growers
	Quantity of Seed Cleaned	Quantity of Clean Seed Purchased	Average Price per Clean Pound
Public Varieties:
Certified	lbs	lbs	$ ___ . __ __ lbs
Non-Certified	lbs	lbs	$ ___ . __ __ lbs
Proprietary Varieties:
Certified	lbs	lbs	$ ___ . __ __ lbs
Non-Certified	lbs	lbs	$ ___ . __ __ lbs

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

Response

Respondent

Mode

Enum.

Eval.

Change

Office Use for POID

1-Comp 2-R 3-Inac 4-Office Hold 5-R – Est 6-Inac – Est 7-Off Hold – Est 8-Known Zero

9901

1-Op/Mgr 2-Sp 3-Acct/Bkpr 4-Partner 9-Oth

9902

1-PASI (Mail) 2-PATI (Tel) 3-PAPI (Face-to- Face) 6-Email 7-Fax 19-Other

9903

9998

9900

9985

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

Optional Use

9907

9908

9906

9916

S/E Name