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ICR 202609-0535-002 · OMB 0535-0213 · Object 174461200.
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Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | 2 |
| Author | Stock, Curt - REE-NASS |
| File Modified | 2026-11-03 |
| File Created | 2026-10-23 |
| Conversion State | complete |
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2027 JUNE AREA SURVEY SCREENING FORM - VERSION A 0MB No. 0535-0213 Approval Expires: x/xx/20xx Project Code: 124 Survey ID: 3838 USDA iiiii 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 Ill 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 RL A E Cr Line 1 - Full Name (First, Middle, Last) T T Line 2 - Mailing Address Line 3- City, State, ZIP Code E Line 4 - Telephone Number R 8 Is this tract Public, Industrial, or Grazing Association land used on anAUM basis? On the total acres operated on June 1, have there been or will there be any crops grown, hay cut, livestock, poultry, honey bees or aquaculture raised this year? On the total On the total Has this operation acres operated acres owned or on June 1, have operated on you sold or will June 1, are any raised any hogs or pigs crops now you sell agricultural in storage in the past or will there 12 months, or products or receive does it expect be any crops government stored to own or raise any this payments before June 1, 2028? year? this year? YesEnter acres in col.21 and conclude interview. D Yes-Goto Questionnaire D Yes-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No D YesEnter acres in col.21 and conclude interview. Yes-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No YesEnter acres in col.21 and conclude interview. D Yes-Goto Questionnaire D Yes-Goto Questionnaire D Yes-Goto Questionnaire D Yes-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No YesEnter acres in col.21 and conclude interview. D Yes-Goto Questionnaire D Yes-Goto Questionnaire D Yes-Goto Questionnaire D Yes-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No YesEnter acres in col.21 and conclude interview. D Yes-Goto Questionnaire D Yes-Goto Questionnaire D Yes-Goto Questionnaire D Yes-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No D YesEnter acres in col.21 and conclude interview. Yes-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No □ Name: Address: Phone: c ) - Name: Address: Phone: c ) - □ Name: Address: Phone: c ) - □ Name: Address: Phone: c ) - □ Name: Address: Phone: c ) - Name: Address: Phone: c ) - 11 7 6 □ □ □ □ □ □ □ □ 10 9 □ □ Yes-Goto Questionnaire □ □ □ □ □ Yes-Goto Questionnaire □ D Yes-Goto Questionnaire □ □ Yes-Goto Questionnaire □ □ □ □ □ Yes-Goto Questionnaire □ D Yes-Goto Questionnaire □ □ Yes-Goto Questionnaire □ □ □ □ □ Yes-Goto Questionnaire □ 3 13 12 14 15 Excluding On June 1, Has this Excluding home use, operation were there home use, havethere owned or have there any horses, been or ponies, or been or will custom fed wil l there be any sheep or other equine, there be any any nurs ery, goats since regardless of vegetables, greenhous e, January 1, or ownership, on melons, fruit, floriculture, nuts or berries does ii expect the total s od, cut to own or acres grown on this Christmas trees custom feed operated? operation or other woody any this year? this year? crops grown on this operation this year? □ Yes-Goto Questionnaire □ DK-Goto Questionnaire □ No □ Yes-Goto Questionnaire □ DK-Goto Questionnaire □ No □ Yes-Goto Questionnaire □ □ □ Yes-Goto Yes-Goto Questionnaire Questionnaire □ □ DK-Goto DK-Goto Questionnaire Questionnaire □ No □ No □ □ Yes-Goto Yes-Goto Questionnaire Questionnaire □ □ DK-Goto DK-Goto Questionnaire Questionnaire □ No □ No □ □ Yes-Goto Yes-Goto Questionnaire Questionnaire □ Yes-Goto Questionnaire □ DK-Goto Questionnaire □ No □ Yes-Goto Questionnaire □ DK-Goto Questionnaire □ No □ Yes-Goto Questionnaire On June 1, did this operation have any idle cropland or more than 99 acres of pasture? □ DK-Goto Questionnaire □ DK-Goto Questionnaire □ No □ No □ No □ No □ No □ □ □ No □ Yes-Goto Questionnaire Questionnaire □ No □ No □ □ Yes-Goto Yes-Goto Questionnaire Questionnaire Questionnaire □ No □ Yes-Goto Questionnaire Questionnaire □ □ DK-Goto Questionnaire DK-Goto Questionnaire □ No □ No □ No □ No □ No □ □ □ Yes-Goto Questionnaire □ DK-Goto Questionnaire □ No Yes-Goto Yes-Goto Questionnaire Questionnaire □ □ DK-Goto DK-Goto Questionnaire Questionnaire □ No □ No □ □ Yes-Goto Questionnaire □ DK-Goto Questionnaire □ No □ -- □ DK-Goto Questionnaire □ No -- 00 849 . . 818 783 849 . LAND USE DYES= 1 D DK =2 . D NO =3 818 783 849 . LAND USE D NO =3 818 783 849 . S - 19 T - 20 U - 21 V - 22 W - 23 X - 24 Y - 25 Z - 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 00-41 PP-42 QQ-43 RR-44 SS-45 W-48 WW-49 XX-50 YY-51 ZZ-52 AAA-53 Etc ... LAND USE DYES=1 D DK =2 . R - 18 UU-47 D DK =2 . A - 01 B - 02 C - 03 D - 04 E - 05 F - 06 G - 07 H - 08 I - 09 J - 10 K - 11 L - 12 M - 13 N - 14 0 - 15 P - 16 Q - 17 TT-46 DYES= 1 846 □ 783 D NO =3 00 Yes-Goto Questionnaire 849 D DK =2 846 □ DK-Goto DK-Goto Questionnaire Questionnaire . 818 00 Yes-Goto Questionnaire 783 DYES= 1 □ No DK-Goto Questionnaire □ -- Enter acres LAND USE 846 □ Enter code D NO =3 00 Yes-Goto Questionnaire □ DK-Goto □ DK-Goto □ DK-Goto □ DK-Goto □ DK-Goto Questionnaire -- Acres of Public, Industrial, or Grazing Association land used onAUM basis. D DK =2 846 □ 818 PIGA What best describes this nonagricultural tract? DYES= 1 00 Yes-Goto Questionnaire □ . Enter code 21 LAND USE □ No DK-Goto Questionnaire Questionnaire Enter acres and land use, then continue 846 -- 20a NON-AGRICULTURAL TRACTS 00 □ DK-Goto Questionnaire □ -- 20 How many Does this tract acres are inside have potential these for agriculture red lines? before June 1, 2028? 846 Yes-Goto Questionnaire □ Yes-Goto Questionnaire 18 □ No □ Yes-Goto Yes-Goto Questionnaire Questionnaire 0 F u F s I E C E □ DK-Goto DK-Goto Questionnaire Questionnaire □ 17 Yes-Goto Questionnaire DK-Goto Questionnaire Yes-Goto Questionnaire □ 16 . D NO =3 818 783 849 LAND USE DYES= 1 D DK =2 D 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) ................ IL...-_ _ _ ___, 2. Number of tract letters listed on photo or map .......................................................................... lL...-_ _ _ ___, (Item 1 must equal item 2.) 3. Number of Area Version questionnaires completed.................................................................. I~----~ 4. Number of tracts with acreage listed in Column 18, page 3 ..................................................... +IL..-_____. 5. Number of tracts with acreage listed in Column 21, page 3 ..................................................... +IL------~ 6. Total of items 3 + 4 + 5 ............................................................................................................... =1 ..5_32_6_ _ ___. (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