QID 050801 Prices Paid for Fuels - HQ

PRICES PAID FOR FUELS MARCH 2018
	OMB No. 0535-0003 Approval Expires: 7/31/2019 Project Code: 171 QID: 050801 SMetaKey: 1991
		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 E-mail: nass@nass.usda.gov

Please make corrections to name, address and ZIP Code, if necessary.

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 provisions of Title V, Subtitle A, Public Law 107-347 and other applicable Federal laws. For more information on how we protect your information please visit: https://www.nass.usda.gov/confidentiality. Response to this survey is voluntary.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number is 0535-0003. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

1. Did this operation sell fuel to farmers/ranchers in the U.S. during 2017?

Yes - go to Question 2 No - go to Question 3

2. Report the total gallons of fuel sold in 2017, and either the total value of sales or the average price per gallon of fuel sold

to farmers/ranchers in the U.S. in 2017.

Fill in one column below:

FUELS

What were the Total Gallons Sold in 2017?

What was the Total Value of Sales in 2017?

OR

What was the Average Price per gallon in 2017?

GASOLINE, unleaded, pumped at service station (Include Federal, State and local taxes)

$

OR

$ __ __ __ ▪ __ __ __

GASOLINE, unleaded, bulk delivery (Include Federal, State and local taxes)

$

OR

$ __ __ __ ▪ __ __ __

DIESEL FUEL, bulk delivery (off-road, farm use) (Exclude all taxes)

$

OR

$ __ __ __ ▪ __ __ __

L.P. GAS, propane, etc., bulk delivery (farm use) (Exclude all taxes)

$

OR

$ __ __ __ ▪ __ __ __

3. Will this operation sell fuel to farmers/ranchers in the U.S. in the future? Yes No 4. SURVEY RESULTS: To receive the complete results of this survey on its release date, go to http://www.nass.usda.gov/Surveys/Guide_to_NASS_Surveys/ COMMENTS:

Respondent Name:	9911 Phone: ( )		9910 MM DD YY Date: __ __ __ __ __ __

Office Use Only

Response

Respondent

Mode

Enum.

Eval.

R. Unit

Change

Office Use for POID

1-Comp 2-R 3-Inac 4-Office Hold 5-R – Est 6-Inac – Est 7-Off Hold – Est

9901

1-Op/Mgr 2-Sp 3-Acct/Bkpr 4-Partner 9-Oth

9902

1-Mail 2-Tel 3-Face-to-Face 4-CATI 5-Web 6-e-mail 7-Fax 8-CAPI 19-Other

9903

9998

9900

9921

9985

9989 __ __ __ - __ __ __ - __ __ __

Optional Use

9907

9908

9906

9916

S/E Name