Appendix C- Staff Confidentiality Pledge

Appendix C: Staff Confidentiality Pledge

STAFF CONFIDENTIALITY PLEDGE

Understanding the Rates, Causes, and Costs of Churning

in the Supplemental Nutrition Assistance Program (SNAP)

Assurance of Confidentiality

The Urban Institute and MEF Associates assure all respondents and participating organizations that the information they release to this study is considered private by the contracting organizations and that no information obtained in the course of this study will be disclosed in such a way that individuals or organizations are identifiable. Access to the data in this study is by consent of the respondents who have been notified of privacy except when the intent to commit a crime or harm themselves is revealed to the researcher. Their right to privacy is protected under law.

I have carefully read and understand this assurance that pertains to the secure nature of all information and records to be handled in this study. I have read a copy of the “Confidential Data at the Urban Institute – Guidelines for Data Security.” I understand that I must comply with all of data security requirements adapted from those Guidelines for this project as approved by the Urban Institute Institutional Review Board. As an employee of The Urban Institute or MEF Associates, I understand that I am prohibited from disclosing any such private information which has been obtained under the terms of this contract to anyone other than authorized contractor staff and agree to follow the procedures outlined to me during training. I understand that any willful and knowing disclosure of information released to this study may subject an employee of the Urban Institute or MEF Associates to disciplinary action, up to and including termination of employment.

_____________________________________________________

(Print Your Name) (Signature)

_____________________________________

(Date)

_____________________________________

(Witness signature)

______________________________________

(Date)