DUE FEBRUARY 4, 2013 
OMB No. 0535-0226: Approval Expires 10/31/2014 
UNITED STATES 2012 CENSUS OF AGRICULTURE 
Form Number: 12-A106 
(12/13/2011) 
USDA 
National Agricultural 
Statistics Service 
Return your 
completed report to: 
Census of Agriculture 
1201 East 10th Street 
Jeffersonville, IN 47132 
OFFICE USE ONLY 
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□011 
0012 
0014 
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0016 
0021 
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0023 
12-A106 
Make corrections to name, address, and ZIP code if necessary. 
Complete your report by mail or via the internet at www.agcensus.usda,gov 
* Your report is due by February 4, 2013. 
* To fill out the paper form, use a black or blue ballpoint pen. 
* Duplicate forms? If you received extra Census report forms for the SAME farming operation, 
return all report forms in the same envelope with this completed report. 
Print the information below for the person completing this form: 
1092 
1093 
1095 
Name 
Area Code and Phone Number Date Completed (MM-DD-YYYY) 
- 
- 
1094 
- 
- 
E-mail 
THANK YOU FOR YOUR COOPERATION. 
Questions? Call us toll free at 1-888-424-7828 
i,Preguntas? Llamenos libre de cargos al 1-888-424-7328 
NOTICE: Response to this inquiry is required by law (Title 7, U.S. Code). By the same law and the Confidential Information Profection and Statistical Efficiency Act 
of 2002 (Public Law 107-347), YOUR REPORT IS CONFIDENTIAL and will only be used 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. (Title 7, U.S. Code) 
http://www.agcensus.usda.gov/About_the_Census/Regulations_Guiding_NASS/index.asp 
12106019 
2012 Census of Agriculture APPENDIX B B - 27 
USDA, National Agricultural Statistics Service 
