APPENDIX D. 

 Report Form and Information Sheet 



DUE BY FEBRUARY I. 1988 



OMB No. 0S07-0S34: ApofOval Esplrea Septrmbttr 30. T 989 



F0Rv87-A0203 



(8 13-e- 



UNITED STATES 



CENSUS 

 OF AGRICULTURE 



BUREAU OF THE CENSUS 

 1 201 East Tenth Street 

 Jeffsrsonvills, IN 47133 



Note — If your records are not available, reasonable BSTimates mav be 

 used, tf you cannot file by February 1 , a time e}ctensJon request may be 

 sent to the above address. Include your 12 -character Census File 

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



us. 



IF you received more than one 

 report form, enter eictra 

 Census File Number(s) here 

 and return extra copies with 

 ytMjr complated report. 



CENSUS 



USE 



ONLY 



036 



NOTICE — Response to this inquiry Is required bylaw (title 13. U.S. Code) By the same law YOUR REPORT TO 

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

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

 The law also provides that copies retained in your files ere Immuno from legal process. 



t € M >rrc » ponft encq pertaining to ttila report, pleaas r«fer to your Certaus FHa Number |CFN| 



87-A0203 



JiiiaiiiiW^ttH ACngAfigHU 1QR7 R^r^^rt lar.H »»^r.oH ,o»>oH r.,..o»^ 



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. 



If tfta MCrm you opmrmtttd in 1987 cft^ngod during tho year, 

 rmfow to tho INFORMATION SHEET, mmcHon 1. 1 



Please correct errors in ryame, address, and ZIP Code. ENTER street and number if not shoMfn. 



1 . All land owned Q 



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 □ 



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

 shares by others and land subleased. Also complete item 6 below. □ 



4. Acres in "THIS PLACE" — add acres owned (item 1 ) 

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



TO OTHERS (Item 3). and enter the result In this space ^ 



Number of acres 



.^ 



For this census report these are the acres in "THIS PLACE* " J 



tf the entry is zero pfease refer to the INFORMATION SHEET, section 1. 



5. If you rented land FROM OTHERS (hem 21. enter the following information for each landlord. 



Name of landlord | Mailir>g address (Inctude ZIP Codet Number of acres 



Usr additional landlords on a saparote sheet of papar. 



6. If you rented land TO OTHERS (item 3), enter the following information for each renter. 



Name of renter 



Mailing address (Include ZIP Code} Number of acres 



Usr additional ranters on a separatB sheet of paper. 



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

 acres did you own? 



7. Did you have any grazing permits on a per-head ba^s? 



064 



1 LJ Yes — Maii( fXf all boxes which apply . 



2 LJ No — Go fo item 8 



3 I I Forest Service 



' 4 Taylor Grazing Sec. 3 (BLM) 

 , s LJ Indian Land 

 i 6 CD Other 



Specifvi 



8. LOCATION OF AGRICULTURAL ACTIVITY FOR "THIS PLACE" 

 a . In what county was the 



largest valuft of your 

 agricultural products 

 laised or produced? . . 



b.H you also had agrlcultura) 

 operations In any other 

 countydes), enter the 

 county name(sj, etc 



Principal 

 county^ 



Other J 

 counties , 



County name 



Number of acres 



INSTRUCTIONS — Please 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 grown on land rented to others. 



!&jia»*ii»h'i'i3 w«r« »nv «# tt»« i«n«ittna rnnpg h«rw»««i>rf >>«»■ "Tmis pi arg" 

 In 19877 



1 . Com (fieldj for grain or 



seed (Report quantity on a 

 dry shelled- weight ttasis. ) . . 



2. Corn (field) for silage 



or green chop D 



n 



3. Wheat for grain 

 (including durum) 



n 



4. Oats for grain CJ 



5. Barley for grain HU 



6. Rye for grain CH 



7. Soybeans for beans . . ED 



8. Beans, dry edible .... D 



9. Sunflower seed D 



10. Flaxseed D 



1 1 . Sugar beets for sugar LH 



12. Tobacco — all types . . EI] 



13. Potatoes, Irish D 



Acres 

 harvested 



Quantity harvested 



Tons, 

 green 



Acres 

 irrigated 



oso 



yMj*^i(»V!lteii WiM miv PHY HAY. BRASS SILAGE. HAYLAGE. or GREEN CHOP cut 

 or harvested from "THIS PLACE" in 19877 

 Include morghurrt-mudan crosses and hay cut from pastures. 



1 D YES — Connptoffo rMs section 2 LJ 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 ttie appropriate items urtder DRY 



HAY and also under GRASS Sit AGE, HAYLAGE, and GREEN CHOP. 



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

 hay were made from the same acres, report 

 acres only once, but report total tons from all 

 cuttings.) 



B. Alfalfa and alfalfa mixtures for 



hay or dehydrating 



b. Small grain hay — oats, wheat, 

 barley, rye, etc 



c. Other lame dry hay — clover, lespedeza, 

 timothy, bromegrass, Sudangrass, 

 millet, etc 



d. Wild hay 



2. GRASS SILAGE, HAYLAGE, AND 



GREEN CHOP (If two or more cuttings 

 were made from the same acres, report 

 acres only once, but report total tons from 

 all cuttirjgs.J 



3. HAY SOLD — Did you sell any Hay 

 or grass silage in 1 987?fRepofr value 

 of hay sold in section 9, item 31 



Acres 

 harvested 



Quantity 

 harvested 



(Report either dry 



Of grwn mreight as 



indtcatadi 



Tons, 

 dry 



Acres 

 irrigated 



.LJ Yes 



1 LJ No 



PENALTY FOR FAILURE TO REPORT 



1987 CENSUS OF AGRICULTURE 



APPENDIX D 0-1 



