Form QID Organic Survey Quality Control Form

	NATIONAL AGRICULTURAL STATISTICS SERVICE	Organic Survey Quality Control Form	Form Approved OMB Number 0535-0249 Approval Expires 07/31/20XX Project code 968
U.S. Department of Agriculture Rm 5829, South Building 1400 Independence Avenue, S.W. Washington, D.C. 20250-2000 1-800-727-9540 Fax: 202-690-2090 E-mail: nass-dc@nass.usda.gov

ID: __________________________________________

State:

Enumerator:

Interview Date:

Operation Name:

Operator’s Name:

Address:

Telephone:

Survey Respondent:

Current Respondent:

Good (Morning/Afternoon/Evening):

I am with the Agricultural Statistics Service. Recently you should have been contacted by one of our enumerators, Mr./Ms. , to obtain information about your operation. This telephone call is part of our survey quality assurance measures, to verify that personal contact was actually made with you for that purpose. Your response is voluntary and not required by law, but your cooperation will be appreciated. Facts about your farm or ranch will be kept confidential. Will you help me by answering a few questions about the interview?

1. During the past few days, do you recall an interview with Mr./Ms. , for the purpose of obtaining information about your organic production?

Yes - [Go to Item 3.]

DK or Don't Remember - [Go to Item 2.]

No - [Go to Item 2.]

2. During the past few days, did any other person from the Agricultural Statistics Service, NASS, or USDA, interview you to obtain information about your operation?

Yes - [Go to Item 3.]

DK or Don't Remember - [Conclude interview.]

No - [Conclude interview.]

3. Did the person conducting the interview ask you to verify the spelling of your name, address, and operation name?

Yes - [Continue.]

DK or Don't Remember - [Continue.]

No - [Continue.]

4. Now I would like to verify the types of organic plants your operation produced and sold last year.

Reported Verified Crop Types Propagative Floriculture Materials and Unfinished Plants

		Field Crops	(Wheat, Corn, Soybeans, Oats, Barley, Flaxseed, etc.)
		Vegetables	(Lettuce, Tomatoes, Carrots, etc.)
		Fruit, Nuts and Berries	(Grapes, Tree Nuts, Apples, Citrus, etc.)

5. Now I would like to verify the types of organic livestock, poultry, and livestock products produced and sold last year.

Reported Verified Livestock and Poultry Types

		Raised Organic Cattle and/or Calves
		Raised Organic Hogs
		Raised Organic Sheep
		Raised Organic Goats
		Raised Organic Poultry

6. Were you asked any questions about your expenses for the organic portion of your operation?

YES NO

7. Did Mr./Ms. conduct the interview in a knowledgeable and professional manner?

YES NO [Explain] ________________________________________________

8. Do you have any additional comments you would like to make concerning our survey contact?

This concludes the interview. Thank you for your help.