Form Version A Version A June Agricultural Survey Area Screening - Version A

4

Project 124

OMB No. 0535-0213 Approval Expires 12/31/2010

2010 JUNE AGRICULTURAL SURVEY AREA SCREENING

NATIONAL AGRICULTURAL STATISTICS SERVICE

VERSION A

U.S.Department of Agriculture Rm 5030, South Building 1400 Independence Ave., S.W. Washington, DC 20250-2000 Phone: 1-800-727-9540 Fax: 202-690-2090 Email: nass@nass.usda.gov

State

Stratum

Segment

Part_______

of

__________

___ ___

___ ___ ___ ___

000___ ___ ___ ___ ___ ___

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.

Authority to collect information on the June Agricultural Survey is Title 7, Section 2204 of the
U.S. Code. The information will be used to prepare agricultural estimates for individual States
and for the United States. Individual reports are confidential. Response is voluntary.

The area of land shown on this photo (map) has been selected for this survey.

[Show respondent photo or map. Point out segment boundaries, houses and other identifying
landmarks to help the respondent become familiar with the segment.]

1. On June 1, did you operate land inside these red lines?

Yes - [Continue with item 2.]

No - [Determine who are the tract operators 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 of this land (inside these blue lines) operated by someone else?

Yes - [Correct boundaries, then continue with item 4.]

No - [Continue with item 4.]

4. Was any land inside these blue 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.]

A

5				6		7	8	9	10	11
TRACT	L E T T E R			Line 1 – Full Name (First, Middle, Last) Line 2 – Mailing Address Line 3 – City, State, Zip Code Line 4 – Telephone Number		[Is this tract Public, Industrial, or Grazing Association land used on an AUM basis?	On the total acres operated on June 1, have there been or will there be any crops grown, hay cut, livestock, poultry or aquaculture raised this year?	On the total acres operated on June 1, have you sold or will you sell agricultural products or receive government payments this year?	On the total acres operated on June 1, are any crops now in storage or will there be any crops stored before June 1, 2011?	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?
				Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________		Yes – Enter acres in col.21 and conclude interview. No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No
				Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________		Yes – Enter acres in col.21 and conclude interview. No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No
				Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________		Yes – Enter acres in col.21 and conclude interview. No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No
				Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________		Yes – Enter acres in col.21 and conclude interview. No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No
				Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone: (_______) ________-____________________________		Yes – Enter acres in col.21 and conclude interview. No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No
					Name: ____________________________________________________ Address: ____________________________________________________ ____________________________________________________ Phone: (_______) ________-___________________________	Yes – Enter acres in col.21 and conclude interview. No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No
				A

12	13	14	15	16	17		18	20	21
Has this operation owned or custom fed any sheep or lambs since January 1, or does it expect to own or custom feed any this year?	On June 1, were there any horses, ponies, or other equine, regardless of ownership, on the total acres operated?	Excluding home use, have there been or will there be any vegetables, melons, fruit, nuts or berries, grown on this operation this year?	Excluding home use, have there been or will there be any nursery, greenhouse, floriculture, sod, cut Christmas trees or other 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?	O F F I C E	U S E	NON AGRICULTURAL TRACTS		PIGA	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 O - 15 P - 16 Q - 17 R - 18 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 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….
							How many acres are inside these blue lines? [Enter acres and land use, then continue.]	Does this tract have potential for agriculture before June 1, 2011? [Enter code.]	Acres of Public, Industrial, or Grazing Association land used on AUM basis. [Enter acres]
Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	__ __ 00		846 •	818	849 •
							LAND USE	YES = 1 DK = 2 NO = 3
Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	__ __ 00		846 •	818	849 •
							LAND USE	YES = 1 DK = 2 NO = 3
Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	__ __ 00		846 •	818	849 •
							LAND USE	YES = 1 DK = 2 NO = 3
Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	__ __ 00		846 •	818	849 •
							LAND USE	YES = 1 DK = 2 NO = 3
Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	__ __ 00		846 •	818	849 •
							LAND USE	YES = 1 DK = 2 NO = 3
Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	Yes – Go to Questionnaire DK – Go to Questionnaire No	__ __ 00		846 •	818	849 •
							LAND USE	YES = 1 DK = 2 NO = 3
A

[Complete this check list when enumeration of segment is completed.]
1. Total tract letters listed in Column 5, page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		=
[Item 6 must equal items 1 and 2.]

[comment on any enumerating problems caused by segment boundaries, split fields, aerial photo coverage, etc.]
		OFFICE USE
__________________________________________________________		Activity	Date	Initials
__________________________________________________________		Received
__________________________________________________________		Clerical Edit
__________________________________________________________		OL/NOL Check
__________________________________________________________		1st Manual Edit
__________________________________________________________		2nd Manual Edit
__________________________________________________________		Keyed
__________________________________________________________		Verified
__________________________________________________________		Interactive Edit
__________________________________________________________		Submitted for processing
__________________________________________________________		Mail Maintenance updates completed
__________________________________________________________
ENUMERATOR:_________________________________________		Reported Acres (RA)	OFFICE USE Digitized Acres (DA)	RA / DA
DATE:___________________________________________________
A