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pdf2023 JUNE AREA SURVEY SCREENING FORM - VERSION C
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
KS, NE, NM, OK, TX
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 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
13
14
15
Excluding home Excluding home
On June 1,
were there any use, have there use, have there
been or
horses, ponies, been or will there
will there be
be any
or other equine,
any nursery,
vegetables,
regardless of
greenhouse,
melons, fruit,
ownership, on
floriculture, sod,
nuts or berries
the total acres
cut Christmas
grown on this
operated?
trees or other
operation
this year?
16
On June 1, did
this operation
have any idle
cropland or more
than 99 acres of
pasture?
woody crops
grown on this
operation 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
□ 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
O
F
U
F
S
I
E
C
E
□ 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
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
Questionnaire
Questionnaire
Questionnaire
Questionnaire
□ No
□ No
□ No
□ No
Enter acres and
land use, then
continue
Does this tract
have potential
for agriculture
before
June 1, 2024?
What best
describes this
nonagricultural
tract?
Enter code
Enter code
818
783
21
PIGA
Acres of
Public,
Industrial,
or
Grazing
Association
land used on
AUM basis.
Enter acres
849
LAND USE
□ YES = 1
□ DK = 2
□ NO = 3
00
•
846
818
783
849
•
__ __
LAND USE
□ YES = 1
□ DK = 2
□ NO = 3
00
•
846
818
783
•
849
LAND USE
□ YES = 1
□ DK = 2
□ NO = 3
00
•
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
__ __
□ DK – Go to
20a
•
__ __
□ DK – Go to
How many acres
are inside
these
red lines?
846
__ __
□ DK – Go to
20
NON-AGRICULTURAL TRACTS
__ __
□ DK – Go to
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
File Type | application/pdf |
File Modified | 2022-11-18 |
File Created | 2022-11-18 |