Fingerprint Directional Symbols - Demographic Questionnaire

National Institute of Standards and Technology (NIST)

Information Technology Laboratory (ITL), Information Access Division (IAD)

Fingerprint Directional Symbols Study Task Evaluation

Demographic Questionnaire

Participant #: _________________ Date: ___________

1. Age: ____________

2. Gender: ___ Female ___ Male

3. Handedness: ___ Right handed ___ Left handed ___ Ambidextrous

4. Ethnicity: Do you consider yourself to be Hispanic or Latino?  Please check one only.

Yes

No

What is your race?  Please check one or more.

___ American Indian or Alaska Native

___ Asian

___ Black or African American

___ Native Hawaiian or Other Pacific Islander

___ White

5. Profession: ______________________________________________

Have you ever had your biometrics captured before? ___ Yes ___ No

If “Yes” check all that apply:

___ Fingerprinted with ink/paper

___ Fingerprinted electronically

___ Eye (Iris) Scan

___ Others, please describe: _______________________

NOTE:  This collection of information contains Paperwork Reduction Act (PRA) requirements approved by the Office of Management and Budget (OMB).  Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to penalty for failure to comply with, a collection of information subject to the requirements of the PRA unless that collection of information displays a currently valid OMB control number. Public reporting burden for this collection is estimated to be 3 minutes per response, including the response time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing this burden, to the National Institute of Standards and Technology, Attn., Mary Theofanos, at [email protected] .

OMB Control No.0693-0043

Expiration Date: 10/31/2012