Confidentiality Agreement and affidavit of non-disclosure

Appendix E

PIAAC Confidentiality Agreement

and Affidavit of Non-Disclosure

PIAAC Confidentiality Agreement

ETS and its partners will develop and implement The Program for the International Assessment of Adult Competencies (PIAAC) for the Organization for Economic Co-operation and Development (OECD). PIAAC is an international, multi-cycle program that is open to participation from both OECD and non-OECD countries. In addition to testing fundamental cognitive skills associated with successful participation in the 21st century, PIAAC will seek to capture information about a range of other generic skills required in the workplace, as well as collect information on individual labor market and social outcomes and other background characteristics. ETS is the prime contractor on this project and will work closely with several sub-contractors both here in the United States and in Europe to meet the project goals.

Under the PIAAC contract, ETS and its partners agree not to disclose information or data to third parties and to protect the raw and aggregate data files, frameworks, items, responses, and all documents and related reports. By extension, I, __________________ _____________________, as a member of a PIAAC National Center, agree to the above terms and also agree not to distribute, publish, or present any information or results relating to PIAAC prior to the OECD’s release of the international report without first obtaining written permission from either the OECD or ETS.

Signature: ____________________________________

Name, Title: __________________________________

Country: _____________________________________

Date: ________________________________________

AFFIDAVIT OF NONDISCLOSURE

Staff

The Program for the International Assessment of Adult Competencies (PIAAC)

Name: _________________________ Position: _________________________

Organization: _________________________

Address:

Telephone Number: _________________ Email: ___________________________

I, _______________________________________________, do solemnly swear (or affirm) that in the process of reviewing materials prepared for the Program for the International Assessment of Adult Competencies (PIAAC), I will not:

1. Reveal the content of any items developed for use on the Program for the International Assessment of Adult Competencies (PIAAC) or related studies.

2. Reveal bibliographic information or content of any passages considered for use on the Program for the International Assessment of Adult Competencies (PIAAC)or related studies.

3. Reveal the content of any secure material, including items and passages, from the Program for the International Assessment of Adult Competencies (PIAAC).

4. Make any improper disclosure whereby an examinee or survey respondent, or their related data (including individuals) could be identified, which includes, but is not limited to information collected from the PIAAC or related studies cognitive labs.

5. Permit anyone other than the individuals authorized by the National Center for Education Statistics, or other official designees, to have access to PIAAC or related studies items, passages, cognitive lab materials, data, or reports.

6. Use or reveal any individually identifiable information furnished, acquired, retrieved, or assembled by me or others, under the provisions of Section 9573 of the Education Sciences Reform Act of 2002 (P.L. 107-279) and Title V, subtitle A of the E-Government Act of 2002 (P.L. 107-347) for any purpose other than statistical or reporting purposes specified in the PIAAC project or related studies.

______________________________

Signature

(The penalty for unlawful disclosure is a fine of not more than $250,000 (under 18 U.S.C. 3571) or imprisonment for no more than five years (under 18 U.S. C. 3559), or both. The word “swear” should be stricken out when a person elects to affirm the affidavit rather than to swear it.)

City/County of _______________________ , Commonwealth/State of_____________________

Sworn to and subscribed before me this ____day of______________, 20___, Witness my hand and official Seal.

(Notary Public/Seal)

My Commission Expires: ______________________