QID June Area Frame Screening Form - Version B

Agricultural Surveys Program

0213 - June Area Frame Screening Form - Version B

OMB: 0535-0213

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2020 JUNE AREA SURVEY SCREENING FORM - VERSION B
OMB No. 0535-0213
Approval Expires: 10/31/2022
Project Code: 124
Survey ID: 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: 1-855-415-3687
Email: [email protected]
AL, AR, DE, FL, GA, IL, IN, IA, KY, LA,
MD, MI, MN, MS, MO, NH, NJ, NY, NC,
OH, PA, SC, TN, VA, WV, WI

State

Stratum

Segment

___ ___

___ ___ ___ ___

000___ ___ ___ ___ ___ ___

Part _____

of ______

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 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.
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 the tract operators are 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 page 2.]
□ No - [Continue with page 2.]
B

2
5

6

T
R
A L
C E Line 1 – Full Name (First, Middle, Last)
T T Line 2 – Mailing Address
T
Line 3 – City, State, ZIP Code
E
Line 4 – Telephone Number
R

8

9

On the total
On the total
acres
acres operated on
operated on June June 1, have you
1, have there been
sold or will you
or will there be
sell agricultural
any crops grown,
products or
hay cut, livestock,
receive
poultry, honey
government
bees or
payments
aquaculture raised
this
this year?

year?

10

11

On the total
acres
operated on
June 1, are any
crops now
in storage
or will there
be any crops
stored
before
June 1, 2021?

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?

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Phone: (_______) ________-____________________________

□ No

□ No

□ No

□ No

Name:

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Phone: (_______) ________-____________________________

□ No

□ No

□ No

□ No

Name:

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Phone: (_______) ________-____________________________

□ No

□ No

□ No

□ No

Name:

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Phone: (_______) ________-____________________________

□ No

□ No

□ No

□ No

Name:

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Phone: (_______) ________-____________________________

□ No

□ No

□ No

□ No

Name:

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

Name:
_____________________________________________________

Address:
_____________________________________________________
_____________________________________________________

_____________________________________________________

Address:
_____________________________________________________
_____________________________________________________

_____________________________________________________

Address:
_____________________________________________________
_____________________________________________________

_____________________________________________________

Address:
_____________________________________________________
_____________________________________________________

_____________________________________________________

Address:
_____________________________________________________
_____________________________________________________

_____________________________________________________

Address:
_____________________________________________________
_____________________________________________________

Phone: (_______) ________-____________________________
B

3
13

14

15

16

Excluding home Excluding home
use, have there
use, have there
been or
been or will there
will there be
be any
any nursery,
vegetables,
greenhouse,
melons, fruit, nuts
or berries, grown floriculture, sod,
cut Christmas
on this operation
trees or other
this year?
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?

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

On June 1,
were there any
horses, ponies,
or other equine,
regardless of
ownership, on
the total acres
operated?

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

17

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

O
F
U
F
S
I
E
C
E

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

□ Yes – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

Does this tract
have potential for
agriculture before
June 1, 2021?

What best
describes this
nonagricultural
tract?

Enter acres and
land use, then
continue

Enter code

Enter code

818

783

•
__ __

LAND USE

□ YES = 1
□ DK = 2
□ NO = 3

00
846

818

783

•
__ __

A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

-

01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

LAND USE

□ YES = 1
□ DK = 2
□ NO = 3

00
846

818

783

•
LAND USE

□ YES = 1
□ DK = 2
□ NO = 3

00
846

818

783

•
LAND USE

□ YES = 1
□ DK = 2
□ NO = 3

00
846

818

783

•
__ __

Questionnaire

20a

How many acres
are inside
these
blue lines?

846

__ __

□ DK – Go to

20

NON-AGRICULTURAL TRACTS

__ __

□ DK – Go to

18

LAND USE

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...

□ YES = 1
□ DK = 2
□ NO = 3

00
846

818

783

•
__ __

00

LAND USE

□ YES = 1
□ DK = 2
□ NO = 3
B

4
[Complete this check list when enumeration of segment is completed.]

1. Total tract letters listed in Column 5, page 2 (sum of all Screening Forms for this segment)..............................
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. Total of items 3 + 4 .....................................................................................................................................
=

5326

(Item 5 must equal items 1 and 2.)
Worksheet
Ag Tract Acres

Non-Ag Tract Acres

[Comment on any enumerating problems caused by segment
boundaries, split fields, aerial photo coverage, etc.]

OFFICE USE
Activity

________________________________________________________

Date

Initials

OFFICE USE
Digitized
Acres

RA / DA

________________________________________________________ Received
________________________________________________________ Clerical Edit
________________________________________________________ OL/NOL Check
st
________________________________________________________ 1 Manual Edit
nd
________________________________________________________ 2 Manual Edit

________________________________________________________ Keyed
________________________________________________________ Verified
________________________________________________________ Interactive Edit
________________________________________________________ Submitted for processing
________________________________________________________ ELMA updates completed

ENUMERATOR:_____________________________________
DATE:_____________________________________________
B

Reported Acres
(RA)


File Typeapplication/pdf
AuthorDavis, Ramonia - NASS
File Modified2020-03-19
File Created2020-03-19

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