Appendix B (control group): 12-Month Survey Advance Letter

Appendix B (control).doc.pdf

Accelerated Benefits Demonstration Project

Appendix B (control group): 12-Month Survey Advance Letter

OMB: 0960-0747

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12-MONTH ADVANCE LETTER—CONTROLS

Date

Dear ____________:
In {FILL RA MONTH YEAR}, you completed an interview as part of the Accelerated
Benefits (AB) Demonstration, a study sponsored by the Social Security Administration (SSA).
Thank you for your contribution to this important study.
We are now conducting the final interview for this study. An interviewer from Mathematica
Policy Research will call in a few days to interview you. The interview will take about 45
minutes to complete. To thank you for completing the interview, we will send you $25.
As before, the information we collect is completely confidential. The information will be
used for research purposes only. Only members of the study team—MDRC, Mathematica, and
the Office of Policy Development and Research at SSA—will have access to this information.
Your name will never be used in any reports.
Your opinions and experiences are very valuable to us. Your answers will help SSA learn
more about the needs of people with disabilities. Your answers will also help SSA improve their
services. You are critical to the study’s success.
Thank you in advance for completing this important final survey. If you have any questions
about the survey, or if you have a new phone number, please call Mathematica toll-free at
xxx-xxx-xxxx and ask for Terry Mann. We look forward to speaking with you soon.
Best Wishes,

David Butler, Project Director
Accelerated Benefits Demonstration

Appendix B. Advance Letters

ON REVERSE SIDE OF THIS LETTER
Privacy Act Statement -- The person(s) completing the interview will remain confidential as
provided in the Privacy Act (5 U.S.C. 552a). You do not have to provide the information
requested. However, the information you provide will allow the Social Security Administration
(SSA) to better foster independence and community participation among persons with
disabilities. The Privacy Act says that SSA will keep personally identifying information
confidential unless disclosing that information is required by law or is necessary for purposes of
litigation or other legal proceedings. The Privacy Act also allows SSA to share personally
identifiable information with other agencies or researchers under specified circumstances. If you
want information about the circumstances under which your information can be shared, please
call MDRC toll free at 1-866-907-1936.
Paperwork Reduction Act Statement - This information collection meets the requirements of
44 U.S.C. § 3507, as amended by Section 2 of the Paperwork Reduction Act of 1995. You do
not need to answer these questions unless we display a valid Office of Management and Budget
control number. The OMB control number for this study is 0960-0747. We estimate that it will
take about 30 minutes to participate in this activity. Send only comments on our time estimate
above to: SSA, 6401 Security Blvd., Baltimore, MD 21235-6401.


File Typeapplication/pdf
File TitleMEMORANDUM
AuthorRebecca Weiner
File Modified2009-01-27
File Created2009-01-27

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