QID Crop or Livestock Loss Survey

Agricultural Surveys Program

0213 - Crop or Livestock Loss Survey

OMB: 0535-0213

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Crop or Livestock Loss Survey


OMB No. 0535-0213

Approval Expires: 6/30/2020

Project Code: xxx QID: xxxxxx

SMetaKey: xxxx




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]









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 to this survey 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 0535-0213. The time required to complete this information collection is estimated to average 10 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 REPORT FOR THE TOTAL ACRES YOU OPERATE


Crops


Acres

xxx


1. Due to recent weather conditions (flooding, drought, freezes, hurricanes, etc.), natural

disasters (earthquakes, landslides, etc.), environmental accidents (pipeline rupture, oil tanker

leakage, chemical spill, etc.) or political unrest (act of war or terrorism, etc.), how many of your

____________ (corn, soybean, wheat, small grains, etc.) acres were damaged or destroyed? . . . . .


Acres

xxx


[If Item 1 is zero, go to Item 4; otherwise continue]


2. How many of these (item 1) acres were or will be replanted for harvest this year? . . . . . . . . . . . . . . .

Crop

xxx



3. What crop was or will be used to replant these (item 2) acres? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



Livestock


4. Were any livestock or poultry lost due to recent disease outbreaks (brucellosis, Avian flu, etc.),

natural disasters, environmental accidents or political unrest?


Shape1 Shape2

Animal Species

Number of Head Lost

xxx


xxx

xxx

xxx

xxx 1 Yes – Continue 3 No Go to Item 6


5. Please report the type and number of livestock or poultry lost.



Stocks


6. Were any of your on-farm storage facilities damaged due to natural disasters, environmental

accidents, or political unrest?


Shape3 Shape4

Bushels

xxx


xxx 1 Yes – Continue 3 No Go to Item 9


7. How many bushels of your on-farm storage capacity were lost? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Commodity

Bushels Lost

xxx


xxx

xxx

xxx


8. Please report the type and amount of grain and oil seed stocks

that were destroyed.




9. Survey Results: To receive the complete results of this survey on the release date, go to www.nass.usda.gov/results/.

Would you rather have a brief summary mailed to you at a later date? Yes = 1 No = 3


099


Please comment on the back of this page, the effects this disaster had on your operation over the last few months.



Respondent Name:

9911


Phone:

9910 MM DD YY

Date:






OFFICE USE ONLY



Response

Respondent

Mode

Enum.

Eval.

Change


785








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-Mail

2-Tel

3-Face-to-Face

4-CATI

5-Web

6-E-mail

7-Fax

8-CAPI

19-Other

9903

098

100

785

789


__ __ __ - __ __ __ - __ __ __




R. Unit

Optional Use


921

407

408

9906

9916


S/E Name







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