Download:
pdf |
pdf2023 JUNE AREA SURVEY SCREENING FORM - VERSION C
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
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
Name:
_____________________________________________________
Address:
_____________________________________________________
7
Address:
_____________________________________________________
□ 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
Enter acres in
col.21
and conclude
interview.
□ Yes –
Enter acres in
col.21
and conclude
interview.
Phone: (_______) ________-___________________________ □ No
_____________________________________________________
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:
_____________________________________________________
11
□ Yes –
_____________________________________________________
Name:
10
On the total
On the total
On the total
Has this
acres
acres operated
acres
operation
operated on
on June 1, have
operated on
owned or
June 1, have
you sold or will June 1, are any raised any hogs
there been or
you sell
crops now
or pigs
will there be
agricultural
in storage
in the past
any crops
products or
or will there
12 months, or
grown, hay cut,
receive
be any crops
does it expect
livestock,
government
stored
to own or raise
poultry, honey
payments
before
any this
bees or
this
June 1, 2024?
year?
aquaculture
year?
raised
this year?
Phone: (_______) ________-___________________________ □ No
_____________________________________________________
9
Is this tract
Public,
Industrial, or
Grazing
Association
land used on
an AUM
basis?
_____________________________________________________
Name:
8
□ Yes –
Enter acres in
col.21
and conclude
interview.
_____________________________________________________
Phone: (_______) ________-___________________________ □ No
3
13
14
15
Excluding
On June 1,
Excluding
home use,
were there any
home use,
horses, ponies, have there been have there been
or
or other equine, or will there be
will there be
regardless of any vegetables,
any nursery,
ownership, on
melons, fruit,
greenhouse,
the total acres nuts or berries
operated?
grown on this floriculture, sod,
cut Christmas
operation
trees or other
this year?
woody crops
grown on this
operation this
year?
16
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
□ 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
21
PIGA
Does this tract
have potential
for agriculture
before
June 1, 2024?
What best
describes this
nonagricultural
tract?
Acres of
Public,
Industrial,
or
Grazing
Association
land used on
AUM basis.
Enter code
Enter code
Enter acres
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
•
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 | 2023-09-10 |
File Created | 2023-02-13 |