SurveyId 3838 2023 June Area Survey Screening Form - Version A

2023 JUNE AREA SURVEY SCREENING FORM - VERSION A
OMB No. 0535-0213
Approval Expires: 5/31/2023
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]
Website: agcounts.usda.gov
AZ, CA, CO, ID, MT, NV, ND, OR, SD, UT,
WA, WY

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 and Statistical Efficiency Act of 2018, Title III of Pub. L. No. 115-435, codified in
44 U.S.C. Ch. 35 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.
[Refer respondent to photo or map. Provide segment boundaries, houses and other identifying landmarks to help the respondent become
familiar with the segment.]
1. On June 1, did you live or 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 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?

□ Yes - [Correct boundaries and assign a separate tract code to the PIGA land, then go to page 2.]
□ No - [Go to page 2.]

2

5
T
R
A
C
T

L
E
T
T
E
R

6

Line 1 – Full Name (First, Middle, Last)
Line 2 – Mailing Address
Line 3 – City, State, ZIP Code
Line 4 – Telephone Number

7

8

9

10

11

On the total
On the total
Has this
acres
On the total
acres operated
operation
operated on
acres
Is this tract
on June 1, have
owned or
June 1, have
operated on
Public,
there been or will you sold or will June 1, are any raised any hogs
Industrial, or
you sell
or pigs
there be
crops now
any crops grown,
Grazing
agricultural
in the past
in storage
hay cut,
Association
products or
12 months, or
or will there
land used on livestock, poultry,
receive
does it expect
be
any
crops
honey bees or
an AUM
government
to own or raise
stored
aquaculture
basis?
payments
any this
before
raised
this
year?
June 1, 2024?
this year?

year?

Name:
_____________________________________________________

Address:
_____________________________________________________

□ Yes –
Enter acres in
col.21
and conclude
interview.

_____________________________________________________

Phone: (_______) ________-___________________________ □ No
Name:
_____________________________________________________

Address:
_____________________________________________________

□ Yes –
Enter acres in
col.21
and conclude
interview.

_____________________________________________________

Phone: (_______) ________-___________________________ □ No
Name:
_____________________________________________________

Address:
_____________________________________________________

□ Yes –
Enter acres in
col.21
and conclude
interview.

_____________________________________________________

Phone: (_______) ________-___________________________ □ No
Name:
_____________________________________________________

Address:
_____________________________________________________

□ Yes –
Enter acres in
col.21
and conclude
interview.

_____________________________________________________

Phone: (_______) ________-___________________________ □ No
Name:
_____________________________________________________

Address:
_____________________________________________________

□ Yes –
Enter acres in
col.21
and conclude
interview.

_____________________________________________________

Phone: (_______) ________-___________________________ □ No
Name:
_____________________________________________________

Address:
_____________________________________________________

□ Yes –
Enter acres in
col.21
and conclude
interview.

_____________________________________________________

Phone: (_______) ________-___________________________ □ 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

□ 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

□ 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

□ DK – Go to

□ DK – Go to

□ DK – Go to

□ DK – Go to

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

3

12

13

14

15

Excluding
Excluding
Has this
On June 1,
home use,
home use,
operation
were there
have there
have there
owned or
any horses,
been or
been or will
custom fed
ponies, or
will there be
there be any
any sheep or other equine,
any nursery,
vegetables,
goats since
regardless of
greenhouse,
melons, fruit,
January 1, or ownership, on
floriculture,
nuts or berries
does it expect
the total
sod, cut
grown on this
to own or
acres
Christmas trees
operation
custom feed
operated?
or other woody
this year?
any this year?
crops grown on

16
On June 1, did
this operation
have any idle
cropland or
more than 99
acres of
pasture?

this operation
this year?

17

Questionnaire

Questionnaire

Questionnaire

O
F
U
F
S
I
E
C
E

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ No

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ No

__ __

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ No

Questionnaire

Questionnaire

Questionnaire

__ __

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ No

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ No

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

Questionnaire

□ No

□ No

□ No

□ No

□ No

849

783

849

LAND USE

□ YES = 1
□ DK = 2
□ NO = 3
•
846

818

783

849

•
LAND USE

□ YES = 1
□ DK = 2
□ NO = 3

00

•
846

818

783

849

•

□ YES = 1
□ DK = 2
□ NO = 3
•
846

818

783

849

•

00

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

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...

LAND USE

00

__ __
Questionnaire

818

00

Questionnaire

□ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to

783

•

□ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to
Questionnaire

849

□ YES = 1
□ DK = 2
□ NO = 3
846

__ __
Questionnaire

783

LAND USE

Questionnaire

□ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to

Enter acres

•

□ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to
Questionnaire

818

00

__ __
Questionnaire

Enter code

•

Questionnaire

□ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to

Acres of
Public,
Industrial,
or
Grazing
Association
land used
on AUM
basis.

□ YES = 1
□ DK = 2
□ NO = 3
846

□ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to
Questionnaire

PIGA

What best
describes this
nonagricultural
tract?

•

__ __
Questionnaire

21

LAND USE

Questionnaire

□ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to

Enter code

818

00

□ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to
Questionnaire

20a

•

Questionnaire

□ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to

Questionnaire

Enter acres and
land use, then
continue

846

□ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to
Questionnaire

How many
Does this tract
acres are inside have potential
these
for agriculture
red lines?
before
June 1, 2024?

Questionnaire

□ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to □ DK – Go to

20

NON-AGRICULTURAL TRACTS

□ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to □ Yes – Go to
Questionnaire

18

LAND USE

□ YES = 1
□ DK = 2
□ NO = 3
•

4
[Complete these items 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. Number of tracts with acreage listed in Column 21, page 3........................................................+
6. Total of items 3 + 4 + 5..................................................................................................................=

5326

(Item 6 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.]

PIGA Tract Acres

Codes to be used in Column 20a are:
(1) Residential

________________________________________________________ (2) Woods
________________________________________________________ (3) Idle Open Land (Not Idle Cropland.)
________________________________________________________ (4) Pasture(Not Hayed or Grazed.)
________________________________________________________ (5) Water
________________________________________________________ (6) Reported Non-Ag by Respondent
________________________________________________________ (7) Vacant Houses
________________________________________________________ (8) Obvious Non-Ag
________________________________________________________ (9) Grassland (Not Hayed or Grazed.)
________________________________________________________ (10) Hunting Preserve or Private Land Managed for Wildlife
________________________________________________________ (11) Government Land
________________________________________________________ (12) Other

ENUMERATOR:________________________________
DATE:________________________________________

Reported Acres
(RA)

OFFICE USE
Digitized
Acres

RA / DA