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pdf2023 JUNE AREA SURVEY SCREENING FORM - VERSION B
OMB No. 0535-0213
Approval Expires: ??/??/20??
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
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 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 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
8
9
On the total
On the total
acres
acres operated on
operated on
June 1, have you
June 1, have
sold or will you
there been or will
sell agricultural
there be
products or
any crops grown,
receive
hay cut, livestock,
government
poultry, honey
payments
bees or
this
aquaculture
year?
raised
this 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, 2024?
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: (_______) ________-____________________________
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
floriculture, sod,
or berries grown
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
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
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
•
__ __
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
•
□ YES = 1
□ DK = 2
□ NO = 3
846
818
•
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
Does this tract
have potential for
agriculture before
June 1, 2024?
•
__ __
□ DK – Go to
20a
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
783
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. Total of items 3 + 4 .......................................................................................................................=
5326
(Item 5 must equal items 1 and 2.)
Worksheet
Ag Tract Acres
[Comment on any enumerating problems caused by
segment boundaries, split fields, aerial photo coverage,
etc.]
Non-Ag 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 | 2023-09-10 |
| File Created | 2023-02-13 |