Debt Collection Disclosure Testing: Consumer Bill of Rights

Privacy Act Statement
5 U.S.C. 552(a)(e)(3)
The information you provide through your responses to Fors Marsh will assist the study sponsor, the
Consumer Financial Protection Bureau (“CFPB”), in determining your eligibility in evaluating prototype
forms about debt collection.
The CFPB will not obtain or access any directly identifying information from Fors Marsh about study
participants. The agency will only obtain, and access, de-identified results and aggregated analyses of
those results.
Information collected on behalf of the Bureau by Fors Marsh will be treated in accordance with the
System of Records Notice (“SORN”), CFPB.022,
https://www.federalregister.gov/articles/2012/11/14/2012-27582/privacy-act-of-1974-as-amended.
This information will not be disclosed as outlined in the Routine Uses for the SORN. Direct identifying
information will only be used by Fors Marsh to facilitate the study and will be kept private except as
required by law.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022,
codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this exercise is voluntary, you are not required to participate or share any identifying
information with Fors March, including name, email address, mobile number, alternate number, age,
race, ethnic origin, gender, city, state, level of education, current employment status, occupation,
income range, type of debt. You may withdraw participation at any time. However, if you do not include
the requested information, you may not participate in the study.