Attachment C - SIPP-105(L3)2016 - Advance Letter with $40 Incentive

Attachment C

SIPP-105(L3)(2016)(CA)
(3-2016)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
Thank you for helping the U.S. Census Bureau collect data for the Survey of Income and Program
Participation last year. The Census Bureau is again conducting this vitally important survey, and we need
your help to ensure accurate data collection. Within a few days, a Census Bureau Field Representative
will contact your household regarding this survey. I want you to know that your household’s participation in
this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each
unanswered question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Sections 141 and 182. Section
9 of Title 13 requires that we hold all information about you and your household in strictest confidence.
Every Census Bureau employee, from the Director to every Field Representative, has taken an oath to
uphold this confidentiality. If an employee discloses any information that identifies you or your household,
he or she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
15350 SHERMAN WAY STE 400
VAN NUYS CA 91406-4203

census.gov

SIPP-105(L3)(2016)(CO)
(3-2016)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
Thank you for helping the U.S. Census Bureau collect data for the Survey of Income and Program
Participation last year. The Census Bureau is again conducting this vitally important survey, and we need
your help to ensure accurate data collection. Within a few days, a Census Bureau Field Representative
will contact your household regarding this survey. I want you to know that your household’s participation
in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people
in the United States. For example, policymakers use the survey’s results to evaluate the future needs of
the Social Security system, changes to and the effectiveness of programs like the Supplemental
Nutrition Assistance Program, and the impact of changes to health insurance and the cost of medical
care. In order to provide accurate information to your elected representatives and support improving
such significant programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each
unanswered question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Sections 141 and 182.
Section 9 of Title 13 requires that we hold all information about you and your household in strictest
confidence. Every Census Bureau employee, from the Director to every Field Representative, has taken
an oath to uphold this confidentiality. If an employee discloses any information that identifies you or your
household, he or she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
6950 W JEFFERSON AVE STE 250
DENVER CO 80235-2377

census.gov

SIPP-105(L3)(2016)(GA)
(3-2016)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU

Dear Resident:
Thank you for helping the U.S. Census Bureau collect data for the Survey of Income and Program
Participation last year. The Census Bureau is again conducting this vitally important survey, and we need
your help to ensure accurate data collection. Within a few days, a Census Bureau Field Representative
will contact your household regarding this survey. I want you to know that your household’s participation in
this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each
unanswered question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Sections 141 and 182. Section
9 of Title 13 requires that we hold all information about you and your household in strictest confidence.
Every Census Bureau employee, from the Director to every Field Representative, has taken an oath to
uphold this confidentiality. If an employee discloses any information that identifies you or your household,
he or she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
101 MARIETTA ST NW STE 3200
ATLANTA GA 30303–2711

census.gov

SIPP-105(L3)(2016)(IL)
(3-2016)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
Thank you for helping the U.S. Census Bureau collect data for the Survey of Income and Program
Participation last year. The Census Bureau is again conducting this vitally important survey, and we need
your help to ensure accurate data collection. Within a few days, a Census Bureau Field Representative
will contact your household regarding this survey. I want you to know that your household’s participation in
this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each
unanswered question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Sections 141 and 182. Section
9 of Title 13 requires that we hold all information about you and your household in strictest confidence.
Every Census Bureau employee, from the Director to every Field Representative, has taken an oath to
uphold this confidentiality. If an employee discloses any information that identifies you or your household,
he or she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
1111 W 22ND ST STE 400
OAK BROOK IL 60523–1918

census.gov

SIPP-105(L3)(2016)(NY)
(3-2016)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
Thank you for helping the U.S. Census Bureau collect data for the Survey of Income and Program
Participation last year. The Census Bureau is again conducting this vitally important survey, and we need
your help to ensure accurate data collection. Within a few days, a Census Bureau Field Representative
will contact your household regarding this survey. I want you to know that your household’s participation in
this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each
unanswered question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Sections 141 and 182. Section
9 of Title 13 requires that we hold all information about you and your household in strictest confidence.
Every Census Bureau employee, from the Director to every Field Representative, has taken an oath to
uphold this confidentiality. If an employee discloses any information that identifies you or your household,
he or she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
32 OLD SLIP 9TH FLOOR
NEW YORK NY 10005–3500

census.gov

SIPP-105(L3)(2016)(PA)
(3-2016)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
Thank you for helping the U.S. Census Bureau collect data for the Survey of Income and Program
Participation last year. The Census Bureau is again conducting this vitally important survey, and we need
your help to ensure accurate data collection. Within a few days, a Census Bureau Field Representative
will contact your household regarding this survey. I want you to know that your household’s participation in
this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each
unanswered question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Sections 141 and 182. Section
9 of Title 13 requires that we hold all information about you and your household in strictest confidence.
Every Census Bureau employee, from the Director to every Field Representative, has taken an oath to
uphold this confidentiality. If an employee discloses any information that identifies you or your household,
he or she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
100 S INDEPENDENCE MALL W #410
PHILADELPHIA PA 19106–2320

census.gov

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 law authorizes the Census Bureau to collect information for this survey (Title 13, United States
Code (U.S.C.), Sections 141 and 182). Section 9 of this law requires us to keep all information about
you and your household strictly confidential. The Census Bureau will use this information only for
statistical purposes. Everyone who has access to your responses is subject to a prison term, a fine up
to $250,000, or both, if any information is revealed that identifies you or your household.
How will the Census Bureau use the information that I provide?
Because Title 13 guarantees the confidentiality of your information, 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 same confidentiality laws that protect your
survey answers also protect any additional information we collect (Title 13, U.S.C., Section 9). If you
wish to request that your information not be combined with information from other agencies, we ask that
you notify the field representative at the time of the interview.
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 8H590, Washington, DC 20233. You may also e-mail comments to
DEMO.Paperwork@census.gov; use “Demo Survey Comments 0607-0977” as the subject.
The U.S. Office of Management and Budget (OMB) approved this survey and gave it OMB approval
number 0607-0977; the expiration date is 12/31/2016. Displaying this number shows that the Census
Bureau is authorized to conduct this survey. If this number were not displayed, we could not request
your participation. Please use this number in any correspondence concerning this survey.

SIPP-105(L3)(2016)(3-2016)