Post-election Voting Survey of State and Local Election Officials

Privacy Act & Informed Consent Statement

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2012 Post-Election Voting Survey of Local Election Officials
Agency Disclosure Notice
The public reporting burden for this collection of information is estimated to average 20 minutes per
response, including the time for reviewing the 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 aspect of this collection of information, including suggestions for
reducing the burden, to the Department of Defense, Executive Services Directorate (xxxx-xxxx). Respondents
should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for
failing to comply with a collection of information if it does not display a currently valid OMB control
number.

Privacy Notice
This survey does not collect or use personally identifiable information and is not retrieved by personal
identifier. Therefore, the information collected is not subject to the Privacy Act of 1974, as amended (5
U.S.C. § 552a).
This notice informs you of the purpose of the 2012 Post-Election Voting Surveys and how the findings
of these surveys will be used. Please read it carefully.
AUTHORITY: 42 United States Code, Section 1973ff.
PRINCIPAL PURPOSE: This survey is conducted by the Federal Voting Assistance Program (FVAP),
which informs and educates United States citizens covered by the Uniformed and Overseas Absentee Voting
Act (UOCAVA). The UOCAVA covers members of the Uniformed Services and Merchant Marines, their
family members, and citizens residing outside the United States. Reports will be provided to the President
and to Congress.
ROUTINE USES: None.
DISCLOSURE: Providing information on this survey is voluntary. Most people can complete the survey 20
minutes. There is no penalty to you or your office if you choose not to respond. However, maximum
participation is encouraged so that the data will be complete and representative. Your responses will be kept
private to the extent permitted by law. If you answer any items and indicate distress or being upset, etc., you
will not be contacted for follow-up purposes. However, if you indicate a direct threat to harm yourself or
others within responses or communications about the survey, because of concern for your welfare, The
Defense Manpower Data Center (DMDC) will notify an office in your area for appropriate action.
SURVEY ELIGIBILITY AND POTENTIAL BENEFITS: Local Election Official offices representing all
voting jurisdictions including the District of Columbia and the U.S. territories are included in the survey
population. There is no direct benefit for your individual participation, however your responses, when taken
together with the responses from all the other Local Election Officials, will make a difference by helping to
identify areas where the absentee voting process can be improved.
STATEMENT OF RISK: The data collection procedures are not expected to involve any risk or discomfort
to you. The only risk to you is accidental or unintentional disclosure of the data you provide. However, the

Wednesday, June 27, 2012

Privacy Act & Informed Consent Statement

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government and its contractors have a number of policies and procedures to ensure that survey data are safe
and protected. Government and contractor staff members have been trained to protect client identity and are
subject to civil penalties for violating your confidentiality.
If you experience any difficulties taking the survey, please contact the Survey Processing Center by
sending an e-mail to [email protected] or call, toll-free, 1-800-881-5307. If you have
concerns about your rights as a research participant, please contact the OUSD(P&R) Research
Regulatory Oversight Office at 703-575-2677/703-575-3536 or e-mail [email protected].
Once you start answering the survey, if you desire to withdraw your answers, please notify the Survey
Processing Center prior to {CLOSE_DATE}. Please include in the e-mail or phone message your name
and Ticket Number. Unless withdrawn, partially completed survey data may be used after that date.
Click Continue if you agree to do the survey.

Wednesday, June 27, 2012