QID June Area Pre-Screening Survey - Sample Version

2021 JUNE AREA SURVEY SCREENING FORM
OMB No. 0535-0213
Approval Expires: xx/xx/xxxx
Project Code: 197
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]

INTRODUCTION

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.
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 control number is 0535-0213. The time required to
complete this information collection is estimated to average 20 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.

The area of land shown on this photo (map) has been selected for this survey.

1. On June 1, will you operate land inside these red lines?
Acres
Yes - Enter acres and continue ..............................................................................................................................
No - Continue

.

2. Was any land inside these red lines administered or controlled by a public agency, industrial
corporation, or grazing association for use on a fee per head or animal unit month (AUM) basis? (AZ.
CA, CO, ID, KS, MT, NE, NV, NM, ND, OK, OR, SD, TX, UT, WA, and WY Only)
Acres
849

Yes - Enter acres and conclude interview.................................................................................................
No - Continue

.

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The next questions refer to total acres operated for this land arrangement.
Yes - Go to conclusion.
3. On the total acres operated on June 1, will there be any crops grown, hay cut, livestock,
No - Continue.
poultry, honey bees or aquaculture raised this year?................................................................
DK - Continue.
Yes - Go to conclusion.
4. On the total acres operated on June 1, will you sell agricultural products or receive
No - Continue.
government payments this year?.............................................................................................
DK - Continue.
Yes - Go to conclusion.
5. On the total acres operated on June 1, will there be any crops stored before June 1,
No - Continue.
2022?.......................................................................................................................................
DK - Continue.
Yes - Go to conclusion.
6. Has this operation owned or raised any hogs or pigs in the past 12 months, or does it
No - Continue.
expect to own or raise any this year?.......................................................................................
DK - Continue.
Yes - Go to conclusion.
7. Has this operation owned or custom fed any sheep or goats since January 1, or does it
expect to own or custom feed any this year?(AZ, CA, CO, ID, MN, MT, ND, NV, OR, SD,
No - Continue.
UT, WA, and WY Only).............................................................................................................. DK - Continue.
Yes - Go to conclusion.
8. On June 1, 2020 will there be any horses, ponies, or other equine, regardless of
No - Continue.
ownership, on the total acres operated?...................................................................................
DK - Continue.
Yes - Go to conclusion.
9. Excluding home use, will there be any vegetables, melons, fruit, nuts or berries, grown
No - Continue.
on this operation this year?........................................................................................................
DK - Continue.
Yes - Go to conclusion.
10. Excluding home use, will there be any nursery, greenhouse, floriculture, sod, cut
No - Continue.
Christmas trees or other woody crops grown on this operation this year?................................
DK - Continue.
Yes - Go to conclusion.
11. On June 1, 2020 will this operation have any idle cropland or more than 99 acres of
No - Continue.
pasture?....................................................................................................................................
DK - Continue.
Acres
846
12. If answered "no" to all questions, how many acres of non-agricultural land do you operate inside
the segment boundaries? Enter acres and land use, then continue........................................................

.

Specify Land Use.....................................................................................................................................
818 1

13. Does this tract have potential for agriculture before June 2022?......................................................

3
2

Yes - Continue.
No
DK

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Conclusion
Thank you. An interviewer will call to set up a telephone appointment to complete the questionnaire with you and collect
your operation information.