Form 1 Privacy Act Test Language and FAQ Context

Privacy Act Testing Language

Privacy Act Statement Commerce

Disclosure of the information provided to us is permitted under the Privacy Act of 1974 (U.S. Code 5, Section 552a) and may be shared with other Census Bureau staff and Special Sworn Status individuals for work-related purposes. Disclosure of this information is also subject to all of the published routine uses as identified in the Privacy Act System of Records Notice COMMERCE/Census-5, Decennial Census Programs.

Privacy Act Statement CSM

In accordance with the Privacy Act of 1974 (U.S. Code 5, Section 552a), access to the data is limited to those identified in the Privacy Act System of Record Notice titled COMMERCE/Census-5, Decennial Census Programs.

Privacy Act Statement SIPP

The Census Bureau will combine the information you provide with that of others to produce statistics. To be efficient, the Census Bureau attempts to obtain information you may have given to other agencies if you have participated in other government programs. We do so because it helps to ensure your data are complete, and it reduces the number of questions you are asked on this survey. These and other routine uses are identified in the Systems of Records Notice COMMERCE/Census 3, Demographic Survey Collection (Census Bureau Sampling Frame).

Privacy Act Statement EJ

The information provided to us may be shared as permitted under the Privacy Act of 1974 (U.S. Code 5, Section 552a) for work-related purposes and as identified in the Privacy Act System of Records Notice COMMERCE/Census 3, Demographic Survey Collection (Census Bureau Sampling Frame).

Privacy Act Language in FAQ Context

FREQUENTLY ASKED QUESTIONS

How do I respond?

Go online at survey.census.gov to complete the Census Test online. You will need the 12-digit

User ID on the other side.

Are my answers confidential?

Yes. The Census Bureau is required by U.S. law to keep your answers confidential (Title 13, United

States Code, Sections 9 and 214). This means that the Census Bureau cannot give out information that

identifies you or your household. The Census Bureau chose your address, not you personally, as part of

a randomly selected sample. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.

For more information about how we protect your information, please visit our website at www.census.gov

and click on “Data Protection and Privacy Policy” at the bottom of the home page.

Am I required to fill out this survey?

Yes. We are conducting this survey under the authority of Title 13, United States Code, Sections 141

and 193. This survey has been approved by the Office of Management and Budget (OMB). For this

survey, the OMB approval number is 0607-0996.

What is the Census Test?

The Census Test is a survey that the U.S. Census Bureau is conducting in preparation for the

2020 Census. The goal of this survey is to develop new methods that will make the next census easier,

more convenient, and less costly for taxpayers.

How will the Census Bureau use the information I provide?

Your information will be combined with the information provided by other sampled households to help

determine the content and design of the 2020 Census. Disclosure of the information provided to us is permitted under the Privacy Act of 1974 (U.S. Code 5, Section 552a) and may be shared with other Census Bureau staff and Special Sworn Status individuals for work-related purposes. Disclosure of this information is also subject to all of the published routine uses as identified in the Privacy Act System of Records Notice COMMERCE/Census-5, Decennial Census Programs.

How long will this survey take?

The U.S. Census Bureau estimates that, for the average household, this survey will take about 10

minutes to complete, including the time for reviewing the instructions and answers.

Send comments regarding this burden estimate or any other aspect of this burden to: Paperwork

Reduction Project 0607-0996, U.S. Census Bureau, DCMD-2H174, 4600 Silver Hill Road,

Washington, DC 20233. You may e-mail comments to <2020.census.paperwork@census.gov>; use

"Paperwork Reduction Project 0607-0996" as the subject.

You are not required to respond to this collection of information if it does not display a valid approval

number from the Office of Management and Budget (OMB). The eight-digit OMB number is 0607-0996.

FREQUENTLY ASKED QUESTIONS

How do I respond?

Go online at survey.census.gov to complete the 2017 Census Test online. You will need the 12-digit

User ID on the other side.

Are my answers confidential?

Yes. The Census Bureau is required by U.S. law to keep your answers confidential (Title 13, United

States Code, Sections 9 and 214). This means that the Census Bureau cannot give out information that

identifies you or your household. The Census Bureau chose your address, not you personally, as part of

a randomly selected sample. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.

For more information about how we protect your information, please visit our website at www.census.gov

and click on “Data Protection and Privacy Policy” at the bottom of the home page.

Am I required to fill out this survey?

Yes. We are conducting this survey under the authority of Title 13, United States Code, Sections 141

and 193. This survey has been approved by the Office of Management and Budget (OMB). For this

survey, the OMB approval number is 0607-0996.

What is the 2017 Census Test?

The 2017 Census Test is a survey that the U.S. Census Bureau is conducting in preparation for the

2020 Census. The goal of this survey is to develop new methods that will make the next census easier,

more convenient, and less costly for taxpayers.

How will the Census Bureau use the information I provide?

Your information will be combined with the information provided by other sampled households to help

determine the content and design of the 2020 Census. In accordance with the Privacy Act of 1974 (U.S. Code 5, Section 552a), access to the data is limited to those identified in the Privacy Act System of Record Notice titled COMMERCE/Census-5, Decennial Census Programs.

How long will this survey take?

The U.S. Census Bureau estimates that, for the average household, this survey will take about 10

minutes to complete, including the time for reviewing the instructions and answers.

Send comments regarding this burden estimate or any other aspect of this burden to: Paperwork

Reduction Project 0607-0996, U.S. Census Bureau, DCMD-2H174, 4600 Silver Hill Road,

Washington, DC 20233. You may e-mail comments to <2020.census.paperwork@census.gov>; use

"Paperwork Reduction Project 0607-0996" as the subject.

You are not required to respond to this collection of information if it does not display a valid approval

number from the Office of Management and Budget (OMB). The eight-digit OMB number is 0607-0996.

FREQUENTLY ASKED QUESTIONS

Why does the Census Bureau collect this information?

Although we conduct a census every ten years, some information needs to be updated more often. This survey provides current data about a variety of important issues, such as changes people have experienced in their jobs, health insurance coverage, medical expenditures, the well-being of children and adults, childcare and child support status, retirement and pension planning, participation in government programs, and other information. Since the country changes rapidly, up-to-date facts are necessary in order to create effective programs. Policymakers in government and private organizations need current economic information to make informed decisions about programs that will affect people of all income levels. Your voluntary participation is essential to ensure that this survey’s results are complete and accurate.

How do I know the Census Bureau will protect my information?

The U.S. Census Bureau is required by law to keep your information confidential. The Census Bureau is not permitted to publicly release your responses in a way that could identify you or your household. By law, the Census Bureau can only use your responses to produce statistics.

How will the Census Bureau use the information that I provide?

The Census Bureau will combine the information you provide with that of others to produce statistics. To be efficient, the Census Bureau attempts to obtain information you may have given to other agencies if you have participated in other government programs. We do so because it helps to ensure your data are complete, and it reduces the number of questions you are asked on this survey. These and other routine uses are identified in the Systems of Records Notice COMMERCE/Census 3, Demographic Survey Collection (Census Bureau Sampling Frame). The same confidentiality laws that protect your survey answers also protect any additional information we collect. For more information about how the Census Bureau combines these data with your survey responses, please visit our website: https://census.gov/about/what/admin-data.html.

How much time will the survey take?

We estimate that it will take about 60 minutes per person to collect the information. This includes time for reviewing the instructions and completing and reviewing your answers. You may send comments regarding time estimates or any other aspect of this data collection process, including suggestions for reducing this burden, to Paperwork Reduction Project 0607-0977, U.S. Census Bureau, 4600 Silver Hill Road, Room 3K138, Washington, DC 20233. You may also e-mail comments to <census.sipp@census.gov>; use “Paperwork Project 0607-0977” as the subject.

This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number that appears at the upper right of this form confirms this approval. If this number were not displayed, we could not conduct this survey.

FREQUENTLY ASKED QUESTIONS

Why does the Census Bureau collect this information?

Although we conduct a census every ten years, some information needs to be updated more often. This survey provides current data about a variety of important issues, such as changes people have experienced in their jobs, health insurance coverage, medical expenditures, the well-being of children and adults, childcare and child support status, retirement and pension planning, participation in government programs, and other information. Since the country changes rapidly, up-to-date facts are necessary in order to create effective programs. Policymakers in government and private organizations need current economic information to make informed decisions about programs that will affect people of all income levels. Your voluntary participation is essential to ensure that this survey’s results are complete and accurate.

How do I know the Census Bureau will protect my information?

The U.S. Census Bureau is required by law to keep your information confidential. The Census Bureau is not permitted to publicly release your responses in a way that could identify you or your household. By law, the Census Bureau can only use your responses to produce statistics.

How will the Census Bureau use the information that I provide?

The Census Bureau will combine the information you provide with that of others to produce statistics. To be efficient, the Census Bureau attempts to obtain information you may have given to other agencies if you have participated in other government programs. We do so because it helps to ensure your data are complete, and it reduces the number of questions you are asked on this survey.

The information provided to us may be shared as permitted under the Privacy Act of 1974 (U.S. Code 5, Section 552a) for work-related purposes and as identified in the Privacy Act System of Records Notice COMMERCE/Census 3, Demographic Survey Collection (Census Bureau Sampling Frame). The same confidentiality laws that protect your survey answers also protect any additional information we collect. For more information about how the Census Bureau combines these data with your survey responses, please visit our website: https://census.gov/about/what/admin-data.html.

How much time will the survey take?

We estimate that it will take about 60 minutes per person to collect the information. This includes time for reviewing the instructions and completing and reviewing your answers. You may send comments regarding time estimates or any other aspect of this data collection process, including suggestions for reducing this burden, to Paperwork Reduction Project 0607-0977, U.S. Census Bureau, 4600 Silver Hill Road, Room 3K138, Washington, DC 20233. You may also e-mail comments to <census.sipp@census.gov>; use “Paperwork Project 0607-0977” as the subject.

This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number that appears at the upper right of this form confirms this approval. If this number were not displayed, we could not conduct this survey.

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