APPENDIX D. 

 Report Form and Information Sheet 



DUE BY FEBRUARY 1, 1988 



OUB No 0B07-OS!M: Approval Eiipire* 5«pt«inl>m 30. 1 989 



UNITED STATES 



CENSUS 

 OF AGRICULTURE 



BUREAU OF THE CENSUS 

 1 201 East Tenth Street 

 J«ff arson villA, IN 47133 



Nots It your records are not available, reasonable estimates may be 

 used. If you cannot file by February 1 , a time extension request may be 

 sent to the above address. Include your 1 2-character Census File 

 Number (CFN) as shown In your address label in all correspondence to 



us. 



jHa»^foTi'itfa ACRgAGE IN -IQHT Rpnnrt lanH ownpH mntPH nr m^pH 



g, by you, your spouse, or by the partnership, corporation, or 



organization for which you are reporting. Include ALL LAND. 

 REGARDLESS OF LOCATION OR USE - cropland, 

 pastureland, rangeland, woodland, idle land, house lots. etc. 



H you received more than one 

 repOfl form, entsr extra 

 Census File Numberlst here 

 and return cxtre copies with 

 your completed repon. 



CENSUS 



USE 



ONLY 



03B 



NOTICE — Response to t^is lr>quirv Is required by law (title 1 3, U.S. Code). By the same law YOUR REPORT TO 

 THE CENSUS BUREAU IS CONFIDENTIAL. It may be seen only by sworn Census employees and may be used 

 only for statistical purposes. Your report CANNOT be used for purposes of taxation, investigation, or regulation. 

 The law also provides that copies retained in your files are Immune from legal process. 



In correspondence pertaining to tffils report, pleese refer to your Census File Number (CFN| 



r 



87-A0203 



Please correct errors in name, address, and ZIP Code. ENTER street and number if not shown. 



If tfte ecres roe opmr B tBd In 1987 changatt durirrg the i>eer, 

 rmfmr to ffte INFORMATION SHEET, maction 1. 



1 . All land owned 



None 

 . □ 



2. All land rented or leased FROM OTHERS, including land worked 

 by you on shares, used rent free, in exchange for services, 

 payment of taxes, etc. Include leased Federal, State, and railroad 

 land. {DO NOT include land used on a per-head basis under a 

 grazing permit.) Also complete item 5 below LH 



3 . All land rented or leased TO' OTHERS, including land worked on 

 shares by others and land subleased. Also complete Item 6 below. CH 



4. Acres in "THIS PLACE" — ADD acres owned mem 1 ) 

 and acres rented (item 2), then SUBTRACT acres rented 



TO OTHERS (item 3), and enter the result in this space ». 



Number of acres 



bb. 



For thH census report these are the acres in "THIS PLACE. " ' 



If the entry is zero please refer to the INFORMA TfON SHEET, section 1 . 



5 . If you rented land FROM OTHERS (item 2), enter the following information for each landlord. 



Name of landlord 



Mailir>g address (Include ZIP Code) Number of acres 



Usv addiXionaf londtorda on a separate sheet of paper. 



6. If you rented land TO OTHERS (item 3), enter tf>e followir>g information for each renter. 



Name of renter 



Mailing address (Include ZIP Code) 



Un addlrionat ranters Ofy s sepsrate sheet of paper. 



••Of the land you rented or leased to others, how many 



acres did you own? LJ 



7. Did vou have any grazing permits on a per-head basis? 



054 



1 U Yes — Mark (X) all boxes which apply . 



2 LJ No — Go to /rem 8 



Number of acres 



' 3 LU Forest Service 



4 n Taylor Grazing Sec. 3 (BLM) 



5 LJ Indian Land 

 ^ a Q Other — Spec'ifvi 



8. LOCATION OF AGRICULTURAL ACTIVITY FOR "THIS PLACE" 

 a . In what county was the 



largest value of your 

 agricultural products 

 raised or produced? . . 



b. If you also had agricultural 

 operations in any other 

 county(ies), enter the 

 county name(s), etc 



Principal 

 county—^ 



Other \ 

 counties , 



County name 



Number of acres 



INSTRUCTIONS — Pleaso report your crops in the appropriate section. 



Use section 7 to report ONLY those CROPS NOT listed in sections 2 through 6 



and section 8. DO NOT INCLUDE crops growm on land rented to others. 



^a^ijit W.^lBa Weri> xnv nf thu foHni^no gBOPS h»rvi><f orf frft». "THIS PI APF" 



in 19877 



1 . Com (field) for grain or 



seed (Report quantity on a 

 dry shelled- weight tresis.) . . 



2. Corn (field) for silage 



or green chop LJ 



n 



3. Wheat for grain 

 (including durum) 



n 



4. Oats for grain LJ 



5. Barley for grain LJ 



6. Rye for grain LJ 



7. Soybeans for beans . . LJ 



8. Beans, dry edible .... LJ 



9. Sunflower seed LJ 



10. Flaxseed LJ 



1 1 . Sugar beets for sugar LJ 



12. Tobacco — all types . . LJ 



13. Potatoes, Irish LJ 



Acres 

 harvested 



Quantity harvested 



Tont, 

 green 



Acres 

 irrigated 



an J»^ JtOJBeil W^ miv PBV HAY QRASS SILAGg. HAYLAGE. or GREEN CHOP cut 

 or harvested from "THIS PLACE" In 1 9877 

 Indudm morshum-sudmn crosses mnd hay cut from pasturas. 



1 I — ] YES — Completa thia aoctton 2 I — I NO — Go to section 4 



If cuttings were made for both dry hay and grass silage, haylage, or green chop 

 from the same fields, report the acreage in the appropriate items under DRY 

 HAY and also under GRASS SILAGE, HAYLAGE. and GREEN CHOP. 



1. DRY HAY (If two or more cuTTlngs of dry 

 hay were made from the same acres, report 

 acres only once, but report total tons from all 

 cuttings.) 



a. Alfalfa and alfalfa mixtures for 



hay or dehydrating 



b. Small grain hay — oats, wheat, 

 barley, rye, etc 



c. Other tame dry hay — clover, lespedeza. 

 timothy, bromegrass, Sudangrass. 

 millet, etc 



d. Wild hay 



2 . GRASS SILAGE, HAYLAGE, AND 

 GREEN CHOP (If two or more cuttfrygs 

 were made from the same acres, report 

 acres only once, but report total tons from 

 all cuttings.) 



3. HAY SOLD — Did you sell any hay 

 or grass silage in ^^&7? (Report value 



of hay sold in section 9, item 3} 



Acres 

 harvested 



Quantity 

 harvested 



(Report oitrter dry 



or groon weight as 



Indicated! 



Acres 

 irrigated 



I D Yes 



iLJ ^0 



PENALTY FOR FAILURE TO REPORT 



1987 CENSUS OF AGRICULTURE 



APPENDIX D 0-1 



